US
MRI
CT
VL
Random
100

US Right Axilla

US Right Breast

100

MRI Left Calf WO

MRI Tibia Fibula Left WO Contrast

100

CT Stone Protocol

CT Pyelogram

100

US Duplex RLE

Venous Duplex Lower Ext Right

100

Spot Compression

Mammogram Additional Views

200

US Lower Back

US Back Soft Tissue

200

MRI MRCP/Abdomen W+WO

MRI MRCP W+WO

200

CT Right Knee WO contrast

CT Lower Extremity Right WO

200

US Renal Doppler

Renal Artery Duplex

200

Metastatic Skeletal Survey

Bone Survey

300

32 week growth ultrasound

US OB Complete

300

MRA Renal W Contrast

MRI Abdomen Angio W+WO Contrast

300

LDCT, Chest, For Lung Cancer Screening

CT Lung Screening

300

Extracranial Arteries

Carotid Duplex

300

Pipida Scan

NM Biliary Scan

400

US Abdomen, Pelvis Transabdominal and Transvaginal

US Abdomen/Pevis

400

MRI Brain WO + MRA COW

MRI Brain WO/Head Angio WO Contrast

400

CTV Thorax

CT Angio Chest

400

US Femoral Artery LLE

Arterial Duplex Lower Left Extremity

400

Contrast XR Colon

Barium Enema

500

Liver Duplex Ultrasound

US Visceral Vascular

500

MRI Angio Thoracic Aorta

MRI Chest Angio W+WO Contrast

500

CT Sinus WO Landmarx

CT Surgical Planning

500

Visceral Artery Scan

Mesenteric Duplex

500

Uterosalpingography

Hysterosalpingogram

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