Self Pay Patient Price List --(Updated 2-14-2012)

MRI Self-Pay

With & Without Contrast:  $550.00

Without Contrast:  $475.00

CT Scan Self-Pay

With Contrast:  $275.00

Without Contrast:  $225.00

(Price is for one scan only - if multiple – its PER SCAN)

CT Scan – “Screening”

Without Contrast:  $200.00

Dexa (Bone Density) Self-Pay

$125.00

Total Body Composition

$150.00

Ultrasound Self Pay
Abdomen Complete - $250.00

Renal Complete/Limited - $250.00

Renal Doppler - $250.00

Pelvic Complete - $250.00

Transvaginal - $150.00

Scrotal - $250.00

OB Complete- $300.00

Breast (single) - $200.00

Breast (bilateral) - $275.00

Thyroid - $175.00

Carotid - $325.00

Bilateral Arterial LE - $315.00

Single Arterial LE - $200.00

Bilateral Arterial UE - $325.00

Single Arterial UE - $200.00

Bilateral Venous Doppler - $325.00

Single Venous Doppler - $200.00

Non-Vascular Extremity - $200.00

Mammography

Screening Mammography - $175.00

Diagnostic Mammography (Unilateral) - $175.00

Diagnostic Mammography (Bilateral) - $225.00

X-RAY Self Pay
Abdomen (KUB) - $75.00

Abdomen (2 views) - $100.00

Ankle (2 views) - $50.00

Ankle (4 views) - $75.00

Bone Age - $65.00

Cervical (2 views) - $75.00

Cervical (with oblique’s) - $100.00

Chest (1 view) - $20.00

Chest (2 views) - $65.00

Clavicle - $50.00

Elbow Complete - $75.00

Femur - $80.00

Fingers - $50.00

Foot (2 views) - $50.00

Foot Complete - $70.00

Hand (2 views) - $25.00

Hand Complete - $75.00

Hip (1 view) - $65.00

Hip Complete - $100.00

Hip (bilateral/pelvis) - $175.00

Humerus - $75.00

Knee (2 views) - $45.00

Knee Complete - $65.00

Knee (bilateral) - $85.00

Lumbar Spine (2 views) - $80.00

Lumbar Spine Complete - $110.00

Lumbar Spine (bending) - $175.00

Nasal Bones - $110.00

Orbits - $95.00

Orbits (foreign body) - $110.00

Pelvis - $65.00

Ribs (bilateral) - $80.00

Ribs (unilateral) - $65.00

Scapula - $110.00

Scoliosis - $90.00

Shoulder Complete - $75.00

SI Joints - $75.00

Sinuses - $95.00

Skull - $95.00

Soft Tissue Neck - $45.00

Sternum (2 views) - $70.00

Thoracic Spine - $65.00

Tibia/Fibula - $90.00

TMJ (bilateral) - $175.00

Wrist (2 views) - $20.00

Wrist Complete - $75.00

Sacrum/Coccyx - $90.00