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Pricing Transparency Updated: September 30, 2025
Shoppable Services
Pricing Transparency Updated: September 20, 2025
A shoppable service means a service that can be scheduled by a healthcare consumer in advance. Procedures such as joint replacements and services such as physical therapy are examples of shoppable services or hospital-based outpatient services.
Disclaimer: Users must review and accept the following terms and conditions to use this site. You acknowledge that you are accessing this information for the purposes of estimating your out of pocket costs for healthcare services at this selected hospital.
The services available in this website do not represent a comprehensive list but rather a selected list of the most common inpatient and outpatient procedures. For estimates on additional services, please contact the hospital directly.
The information provide through this website is ONLY AN ESTIMATE and is not a guarantee of what you will be billed. In many cases it is impossible to predict the final charges that will result from services you will receive. There are a number of things involved that may increase or decrease your final charges, including but not limited to: specific equipment used; supplies and medications required by physicians(s); and/or an unusual special care or unexpected conditions or complications.
Also, please note, this estimate DOES NOT INCLUDE any other service provider charges (for example, your physician(s), any office visit, surgeon, anesthesiologist, emergency room physician, radiologist, pathologist, consulting physicians, lab work, etc.) which are billed separately by those service providers.
If you have insurance, the patient’s benefits (including deductibles, co-pay, co-insurance, and out-of-pocket maximums) will ultimately determine the amount you owe. Please make sure your insurance premiums are paid timely. Under the terms of some plans offered under the Affordable Care Act (“ACA”), nonpayment of premiums could lead to cancellations of your coverage, even if your coverage appears to be in effect today, and such cancellation will impact your financial responsibility.
This information is provided in compliance with 45 C.F.R. Part 180 (CMS Hospital Price Transparency Rule) and Texas Health & Safety Code §327. The actual amount due will be determined after services are rendered and your insurance has processed claims.
Shoppable Services files can be downloaded by clicking the links below:
STAT Specialty Hospital – Del Rio
Pricing Transparency Revised: September 30, 2025
STAT Specialty Hospital – Eagle Pass
Pricing Transparency Revised: September 30, 2025
STAT Emergency Center – Laredo South
Pricing Transparency Revised: September 30, 2025
STAT Specialty Hospital – Laredo North
Pricing Transparency Revised: September 30, 2025
Top 300 Shoppable Services by Location (Alphabetical)
STAT Specialty Hospital – Del Rio
| Description | Price | Base Cost |
|---|---|---|
| RADEX EYE DETCJ FB | $2,190 | $657 |
| RADEX MNDBL PRTL LESS THAN < 4 VIEWS | $379 | $114 |
| RADEX MNDBL COMPL MINIMUM 4 VIEWS | $2,538 | $761 |
| RADEX FACIAL B1S < 3 VIEWS | $2,394 | $718 |
| RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS | $2,394 | $718 |
| RADEX NSL B1S COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX ORBITS COMPLETE MINIMUM 4 VIEWS | $3,024 | $907 |
| Radiologic examination, sinuses, paranasal, less than 3 views | $3,024 | $907 |
| RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX SKL < 4 VIEWS | $2,724 | $817 |
| RADEX SKL COMPL MINIMUM 4 VIEWS | $2,724 | $817 |
| RADEX TMPRMAND JT OPN&CLSD MOUTH UNI | $607 | $182 |
| RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT | $3,024 | $907 |
| CEPHALOGRAM ORTHODONTIC | $710 | $213 |
| RADEX OF NECK SOFT TISSUE | $3,024 | $907 |
| CT HEAD/BRN C-MATRL | $7,429 | $2,229 |
| CT HEAD/BRN C+ MATRL | $6,804 | $2,041 |
| CT HEAD/BRN C-/C+ | $7,507 | $2,252 |
| CT ORBIT SELLA/POST FOSSA/EAR C-MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C-/C+ | $6,804 | $2,041 |
| CT SCAN MAXLFCL AREA C-MATRL – SINUS AREA | $6,804 | $2,041 |
| CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT MAXLFCL AREA C+ MATRL | $6,804 | $2,041 |
| CT MAXLFCL AREA C-/C+ | $6,250 | $1,875 |
| CT SOFT TISS NCK C-MATRL | $6,048 | $1,814 |
| CT SOFT TISS NCK C+ MATRL | $6,804 | $2,041 |
| CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL | $6,650 | $1,995 |
| CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $7,000 | $2,100 |
| Computed tomographic angiography, neck, with contrast materi… | $7,010 | $2,103 |
| MRI ORBIT FACE &/NECK W/O CONTRAST | $5,860 | $1,758 |
| MRI ORBIT/FACE/NECK C+ | $6,074 | $1,822 |
| MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL | $7,174 | $2,152 |
| MRA HEAD C-MATRL | $6,383 | $1,915 |
| MRA NCK C-MATRL | $6,367 | $1,910 |
| MRA NECK W/O &W/CONTRAST MATERIAL | $7,971 | $2,391 |
| MRI BRN BRN STEM C-MATRL | $6,086 | $1,826 |
| MRI BRN BRN STEM C-/C+ | $10,265 | $3,080 |
| RADEX CH 1 VIEW FRNT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ | $2,019 | $606 |
| RADEX CH COMPL MINIMUM 4 VIEWS | $2,019 | $606 |
| RADEX CHEST 1 VIEW | $2,370 | $711 |
| RADEX CHEST 2 VIEWS | $3,024 | $907 |
| RADEX CHEST 3 VIEWS | $3,024 | $907 |
| RADEX CHEST 4+ VIEWS | $3,024 | $907 |
| RADEX RIBS UNI 2 VIEWS | $2,274 | $682 |
| RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS | $2,634 | $790 |
| RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS | $2,634 | $790 |
| RADEX RIBS BI 3 VIEWS | $3,024 | $907 |
| RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS | $3,024 | $907 |
| RADEX STERNUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS | $2,270 | $681 |
| CT THORAX W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT THORAX C+ MATRL | $6,804 | $2,041 |
| CT THORAX C-/C+ | $6,804 | $2,041 |
| CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $10,046 | $3,014 |
| MRI CH C-MATRL | $6,086 | $1,826 |
| RADEX SPI 1 VIEW SPEC LVL | $3,024 | $907 |
| RADEX SPI CRV 2/3 VIEWS | $3,024 | $907 |
| RADEX SPI CRV MINIMUM 4 VIEWS | $3,025 | $908 |
| RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | $3,025 | $908 |
| RADEX SPI THRC 2 VIEWS | $3,024 | $907 |
| RADEX SPI THRC 3 VIEWS | $3,024 | $907 |
| RADEX SPI THRC MINIMUM 4 VIEWS | $3,024 | $907 |
| X RAY EXAM TRUNK SPINE 2VWS | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW | $406 | $122 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW | $886 | $266 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW | $1,032 | $310 |
| RADEX SPI LUMBOSAC 2/3 VIEWS | $3,258 | $977 |
| LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | $3,571 | $1,071 |
| RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | $3,024 | $907 |
| RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | $13,053 | $3,916 |
| CT CRV SPI C-MATRL | $8,000 | $2,400 |
| CT CRV SPI C+ MATRL | $6,048 | $1,814 |
| CT CRV SPI C-/C+ | $8,305 | $2,492 |
| CT THRC SPI C-MATRL | $6,804 | $2,041 |
| CT THRC SPI C+ MATRL | $6,573 | $1,972 |
| CT LUMBAR SPINE W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LMBR SPI C+ MATRL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL | $7,366 | $2,210 |
| MRI SPI CANAL&CNTS CRV C-MATRL | $8,786 | $2,636 |
| MRI SPI CANAL&CNTS THRC C-MATRL | $4,859 | $1,458 |
| MRI SPI CANAL&CNTS LMBR C-MATRL | $8,385 | $2,516 |
| MRI SPI CANAL&CNTS C-/C+ CRV | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ LMBR | $12,204 | $3,661 |
| RADEX PELVIS 1/2 VIEWS | $2,111 | $633 |
| RADEX PELVIS COMPL MINIMUM 3 VIEWS | $2,214 | $664 |
| CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST | $5,991 | $1,797 |
| CT PELVIS C-MATRL | $7,687 | $2,306 |
| CT PELVIS C+ MATRL | $6,827 | $2,048 |
| CT PELVIS C-/C+ | $7,507 | $2,252 |
| MRI PELVIS C-MATRL | $8,080 | $2,424 |
| MRI PELVIS C+ MATRL | $9,075 | $2,723 |
| MRI PELVIS W/O & W/CONTRAST MATERIAL | $7,341 | $2,202 |
| RADEX SACROILIAC JNTS <3 VIEWS | $2,940 | $882 |
| RADEX SACRUM&COCCYX MINIMUM 2 VIEWS | $3,024 | $907 |
| MYELOGRAPY THRC RS&I | $3,903 | $1,171 |
| MYELOGRAPY LUMBOSAC RS&I | $7,196 | $2,159 |
| RADEX CLAV COMPL | $3,024 | $907 |
| RADEX SCAPULA COMPL | $3,024 | $907 |
| RADEX SHO 1 VIEW | $2,279 | $684 |
| RADEX SHO COMPL MINIMUM 2 VIEWS | $3,235 | $971 |
| RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ | $3,024 | $907 |
| RADEX HUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ELBW 2 VIEWS | $3,024 | $907 |
| RADEX ELBW COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX F/ARM 2 VIEWS | $3,024 | $907 |
| RADEX UXTR INFT MINIMUM 2 VIEWS | $2,019 | $606 |
| RADEX WRST 2 VIEWS | $3,024 | $907 |
| RADEX WRST COMPL MINIMUM 3 VIEWS | $3,164 | $949 |
| RADEX HAND 2 VIEWS | $2,584 | $775 |
| RADEX HAND MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX Fingers MINIMUM 2 VIEWS | $2,274 | $682 |
| CT UXTR C-MATRL | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT UPPER EXT W/DYE | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY | $7,115 | $2,135 |
| MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL | $5,060 | $1,518 |
| MRI UXTR OTH/THN JT C-/C+ | $10,265 | $3,080 |
| MRI ANY JT UXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT UXTR C-/C+ | $10,265 | $3,080 |
| (*DELETED 1/1/16*) RADEX HIP UNI 1 VIEW | 357 | $107 |
| RADEX HIP UNILATERAL WITH PELVIS 1 VIEW | $2,572 | $772 |
| RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $3,024 | $907 |
| RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS | $3,024 | $907 |
| (DELETED 1/1/16) RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS | $878 | $263 |
| RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS | $3,024 | $907 |
| X-RAY EXAM HIPS BI 5/> VIEWS | $582 | $175 |
| Radiologic examination, pelvis and hips, infant or child, mi… | $583 | $175 |
| RADEX FEMUR 2 VIEWS (DELETED CODE) | $861 | $258 |
| X-RAY EXAM OF FEMUR 1V | $1,320 | $396 |
| RADEX, Femur; 2V | $2,382 | $715 |
| RADEX KNE 1/2 VIEWS | $2,019 | $606 |
| RADEX KNE 3 VIEWS | $3,300 | $990 |
| RADEX KNE COMPL 4/MORE VIEWS | $3,024 | $907 |
| RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST | $7,196 | $2,159 |
| RADEX TIBFIB 2 VIEWS | $3,024 | $907 |
| RADEX LXTR INFT MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX FOOT 2 VIEWS | $2,538 | $761 |
| RADEX FOOT COMPL MINIMUM 3 VIEWS | $2,700 | $810 |
| RADEX CALCANEUS MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX TOE MINIMUM 2 VIEWS | $1,760 | $528 |
| CT LXTR C-MATRL | $8,004 | $2,401 |
| CT LXTR C+ MATRL | $7,770 | $2,331 |
| CT LOWER EXTREMITY C-/C+ | $6,408 | $1,922 |
| CT ANGIOGRAPHY LOWER EXTREMITY | $5,992 | $1,798 |
| MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL | $7,814 | $2,344 |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+ | $10,265 | $3,080 |
| MRI ANY JT LXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT LXTR C+ MATRL | $9,075 | $2,723 |
| MRI ANY JT LXTR C-/C+ | $10,265 | $3,080 |
| MRA LXTR C+-MATRL | $6,457 | $1,937 |
| RADEX ABD 1 ANTEROPOST VIEW | $3,024 | $907 |
| RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS | $5,637 | $1,691 |
| RADEX ABD 1 VIEW | $2,142 | $643 |
| RADEX ABD 2 VIEWS | $2,058 | $617 |
| RADEX ABD COMPL W/DCBTS&/ERC VIEWS | $8,389 | $2,517 |
| RADEX ABD 3+ VIEWS | $2,389 | $717 |
| RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH | $2,275 | $683 |
| CT ABD C-MATRL | $7,177 | $2,153 |
| CT ABD C+ MATRL | $7,177 | $2,153 |
| CT ABD C-/C+ | $7,262 | $2,179 |
| CT ANGIO ABD&PELV W/ O&W / DYE | $10,369 | $3,111 |
| CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST | $7,170 | $2,151 |
| Ct Abd & pelvis W/o Contrast | $12,476 | $3,743 |
| Ct Abdomen&pelvis W/contrast | $14,401 | $4,320 |
| CT ABDOEN & PELVIS W/CONTRAST MATERIAL | $14,401 | $4,320 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,767 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,767 |
| MRI ABD C-MATRL | $6,668 | $2,000 |
| MRI ABD C-/C+ | $10,265 | $3,080 |
| MRA ABDOMEN W/WO CONTRAST MATERIAL | $6,107 | $1,832 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS | $2,161 | $648 |
| RADEX GI TRC UPR +-DLYD FLMS W/KUB | $3,024 | $907 |
| RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB | $7,069 | $2,121 |
| Urography (pyelography), intravenous, with or without KUB, w… | $7,069 | $2,121 |
| URETHROCYSTOGRAPHY RETROGRADE RS&I | $5,637 | $1,691 |
| CT ANGIO ABDOMINAL ARTERIES | $7,069 | $2,121 |
| RADEX FROM NOSE RECTUM FB 1 VIEW CHLD | $2,520 | $756 |
| 3D RNDR I&R CT MRI US/OTH X REQ POSTPCX | $1,855 | $557 |
| CT LIMITED/LOCALIZED FOLLOW UP STUDY | $6,804 | $2,041 |
| OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN | $3,141 | $942 |
| US SOFT TISS HEAD&NCK R-T IMG | $3,024 | $907 |
| US CHEST REAL TIME W/IMAGE DOCUMENTATION | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE LIMITED | $1,941 | $582 |
| US ABDOMINAL R-T W/IMAGE DOCUMENTATION | $3,224 | $967 |
| ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED | $4,003 | $1,201 |
| US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA | $893 | $268 |
| US RETROPERITONEAL R-T W/IMAGE COMPL | $2,866 | $860 |
| US RPR B-SCAN&/R-T IMG LMTD | $3,024 | $907 |
| ULTRASOUND 14 WK TABDL 1/1ST GESTATION | $2,866 | $860 |
| US PREG UTERUS 14 WK TRANSABDL EACH ADDL GESTATION | $1,170 | $351 |
| ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION | $3,024 | $907 |
| US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO | $3,024 | $907 |
| US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION | $1,497 | $449 |
| Ultrasound, pregnant uterus, real time with image documentat… | $431 | $129 |
| US PREGNANT UTERUS LIMITED 1/> FETUSES | $2,300 | $690 |
| Ultrasound, pregnant uterus, real time with image documentat… | $1,854 | $556 |
| US PG UTER R-T IMG TRVG | $3,024 | $907 |
| DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE; Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete | $1,948 | $584 |
| US TRVG | $3,208 | $962 |
| US PELVIC NONOB REAL-TIME IMG COMPLETE | $3,024 | $907 |
| US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97 | $2,724 | $817 |
| US SCROTUM&CNTS | $3,654 | $1,096 |
| US EXTREMITY NON-VASC REAL-TIME IMG COMPL | $3,024 | $907 |
| US EXTREMITY NON-VASC REAL-TIME IMG LMTD | $1,521 | $456 |
| US GUIDE VASCULAR ACCESS | $2,671 | $801 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | 2613 | $784 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| UNLISTED US PROCEDURE | $1,155 | $347 |
| Radiologic examination, osseous survey; limited (eg, for metastases) | $895 | $269 |
| RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT | $2,272 | $682 |
| JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS | $2,251 | $675 |
| CT BONE MINERAL DENSITY STUDY 1+ SITS APPND | $706 | $212 |
| THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT | $913 | $274 |
| ADRNL IMG CORTEX&/MEDULLA | $5,004 | $1,501 |
| HIDA SCAN – HEPATBL DUX SYS IMG GLBLDR | $3,470 | $1,041 |
| B1&/JT IMG WHBDY | $3,235 | $971 |
| B1&/JT IMG 3 PHASE STD | $3,940 | $1,182 |
| B1&/JT IMG TOMOG SPECT | $3,940 | $1,182 |
| CARD BPI GTD =BRM PLNR 1 STD REST/STRS | $3,032 | $910 |
| NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS | $2,906 | $872 |
| BASIC METABOLIC PANEL CALCIUM IONIZED | $1,554 | $466 |
| BASIC METABOLIC PANEL CALCIUM TOTAL | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | 1430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| GENERAL HLTH PANEL | $1,473 | $442 |
| ELECTROLYTE PANEL | $540 | $162 |
| COMPRE METAB PANEL | $1,794 | $538 |
| PIC PANEL COMPREHENS METABOLBX | 1794 | $538 |
| LIPID PANEL | $1,512 | $454 |
| RENAL FUNCTION PANEL | $410 | $123 |
| AQT HEP PANEL | $1,440 | $432 |
| HEPATC FUNCJ PANEL | $1,458 | $437 |
| OBSTETRIC PANEL | $485 | $146 |
| DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX | $342 | $103 |
| DRUG ASSAY ACETAMINOPHEN | $1,020 | $306 |
| Carbamazepine; total | $327 | $98 |
| DRUG ASSAY CLOZAPINE | $169 | $51 |
| ASSAY OF DIGOXIN | $780 | $234 |
| Valproic acid (dipropylacetic acid); total | $960 | $288 |
| DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE | $1,140 | $342 |
| DRUG SCREEN QUANTITATIVE GENTAMICIN | $495 | $149 |
| DRUG SCREEN QUANTITATIVE LAMOTRIGINE | $95 | $29 |
| DRUG SCREEN QUANTITATIVE LEVETIRACETAM | $95 | $29 |
| LITHIUM | $114 | $34 |
| DRUG ASSAY SALICYLATE | $1,020 | $306 |
| DRUG SCREEN QUANTITATIVE OXCARBAZEPINE | $86 | $26 |
| DRUG SCREEN QUANTITATIVE PHENOBARBITAL | $197 | $59 |
| ASSAY OF PHENYTOIN TOTAL | $243 | $73 |
| SALICYLATE | $167 | $50 |
| TACROLIMUS | $521 | $156 |
| DRUG SCREEN QUANTITATIVE THEOPHYLLINE | $459 | $138 |
| Topiramate | $90 | $27 |
| DRUG SCREEN QUANT VANCOMYCIN | $1,765 | $530 |
| Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) | $342 | $103 |
| DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY | $493 | $148 |
| DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS | $756 | $227 |
| DRUG SCREEN QUANTITATIVE ALCOHOLS | $684 | $205 |
| Analgesics, non-opioid; 1 or 2 | $684 | $205 |
| DRUG SCREEN ANALGESICS NON-OPIOID 3-5 | $182 | $55 |
| ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2 | $310 | $93 |
| Antiepileptics, not otherwise specified; 1-3 | $155 | $47 |
| DRUG SCREENING BENZODIAZEPINES 1-12 | $1,260 | $378 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO MIC | $510 | $153 |
| URINALYSIS – URNLS DIP STICK/TABLET RGNT AUTO MIC | $690 | $207 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC | $300 | $90 |
| URNLS DIP STICK/TABLET RGNT AUTO W/O MIC | $545 | $164 |
| Urinalysis, microscopic only | $124 | $37 |
| URINE PREGNANCY TST VIS COLOR CMPRSN METHS | $684 | $205 |
| CYP2C19 GENE ANALYSIS COMMON VARIANTS | $2,447 | $734 |
| AK2 GENE ANALYSIS P.VAL617PHE VARIANT | $770 | $231 |
| ACETALDEHYDE BLD | $41 | $12 |
| KETONE BODIES SERUM QUALITATIVE | $196 | $59 |
| ACETONE/OTH KETONE BODIES SERUM QUAN | $382 | $115 |
| Adrenocorticotropic hormone (ACTH) | $664 | $199 |
| ALBUMIN SERUM PLASMA/WHOLE BLOOD | $204 | $61 |
| URINE ALBUMIN QUANTITATIVE | $96 | $29 |
| ALCOHOL BRTH | $600 | $180 |
| Alpha-fetoprotein (AFP); serum | $288 | $86 |
| AMINOLEVULINIC ACID DELTA | $118 | $35 |
| Ammonia | $1,020 | $306 |
| AMYLASE | $572 | $172 |
| ASSAY OF ARSENIC | $199 | $60 |
| Ascorbic acid (Vitamin C), blood | $104 | $31 |
| ATOMIC ABSRPJ SPECTROSCOPY EA ANAL | $85 | $26 |
| BILIRUBIN TOT | $366 | $110 |
| Bilirubin; direct | $450 | $135 |
| BLD OCLT PROXIDASE ACTV QUAL FECES 1 DETER | $1,512 | $454 |
| Blood, occult, by peroxidase activity (eg, guaiac), qualitat… | $349 | $105 |
STAT Specialty Hospital – Eagle Pass
| Description | Price | Cash Rate |
|---|---|---|
| RADEX EYE DETCJ FB | $2,190 | $657 |
| RADEX MNDBL PRTL LESS THAN < 4 VIEWS | $379 | $114 |
| RADEX MNDBL COMPL MINIMUM 4 VIEWS | $2,538 | $761 |
| RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE | $404 | $121 |
| RADEX FACIAL B1S < 3 VIEWS | $2,394 | $718 |
| RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS | $2,394 | $718 |
| RADEX NSL B1S COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX ORBITS COMPLETE MINIMUM 4 VIEWS | $3,024 | $907 |
| Radiologic examination, sinuses, paranasal, less than 3 views | $3,024 | $907 |
| RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX SKL < 4 VIEWS | $2,724 | $817 |
| RADEX SKL COMPL MINIMUM 4 VIEWS | $2,724 | $817 |
| RADEX TMPRMAND JT OPN&CLSD MOUTH UNI | $607 | $182 |
| RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT | $3,024 | $907 |
| MRI TEMPOROMANDIBULAR JOINT | $1,986 | $596 |
| CEPHALOGRAM ORTHODONTIC | $710 | $213 |
| RADEX OF NECK SOFT TISSUE | $3,024 | $907 |
| CT HEAD/BRN C-MATRL | $7,429 | $2,229 |
| CT HEAD/BRN C+ MATRL | $6,804 | $2,041 |
| CT HEAD/BRN C-/C+ | $7,507 | $2,252 |
| CT ORBIT SELLA/POST FOSSA/EAR C-MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C-/C+ | $6,804 | $2,041 |
| CT SCAN MAXLFCL AREA C-MATRL – SINUS AREA | $6,804 | $2,041 |
| CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT MAXLFCL AREA C+ MATRL | $6,804 | $2,041 |
| CT MAXLFCL AREA C-/C+ | $6,250 | $1,875 |
| CT SOFT TISS NCK C-MATRL | $6,048 | $1,814 |
| CT SOFT TISS NCK C+ MATRL | $6,804 | $2,041 |
| CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL | $6,650 | $1,995 |
| CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $7,000 | $2,100 |
| Computed tomographic angiography, neck, with contrast materi… | $7,010 | $2,103 |
| MRI ORBIT FACE &/NECK W/O CONTRAST | $5,860 | $1,758 |
| MRI ORBIT/FACE/NECK C+ | $6,074 | $1,822 |
| MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL | $7,174 | $2,152 |
| MRA HEAD C-MATRL | $6,383 | $1,915 |
| MRA NCK C-MATRL | $6,367 | $1,910 |
| MRA NECK W/O &W/CONTRAST MATERIAL | $7,971 | $2,391 |
| MRI BRN BRN STEM C-MATRL | $6,086 | $1,826 |
| MRI BRN BRN STEM C-/C+ | $10,265 | $3,080 |
| RADEX CH 1 VIEW FRNT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ | $2,019 | $606 |
| RADEX CH COMPL MINIMUM 4 VIEWS | $2,019 | $606 |
| RADEX CHEST 1 VIEW | $2,370 | $711 |
| RADEX CHEST 2 VIEWS | $3,024 | $907 |
| RADEX CHEST 3 VIEWS | $3,024 | $907 |
| RADEX CHEST 4+ VIEWS | $3,024 | $907 |
| RADEX RIBS UNI 2 VIEWS | $2,274 | $682 |
| RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS | $2,634 | $790 |
| RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS | $2,634 | $790 |
| RADEX RIBS BI 3 VIEWS | $3,024 | $907 |
| RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS | $3,024 | $907 |
| RADEX STERNUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS | $2,270 | $681 |
| CT THORAX W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT THORAX C+ MATRL | $6,804 | $2,041 |
| CT THORAX C-/C+ | $6,804 | $2,041 |
| CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $10,046 | $3,014 |
| MRI CH C-MATRL | $6,086 | $1,826 |
| RADEX SPI 1 VIEW SPEC LVL | $3,024 | $907 |
| RADEX SPI CRV 2/3 VIEWS | $3,024 | $907 |
| RADEX SPI CRV MINIMUM 4 VIEWS | $3,025 | $908 |
| RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | $3,025 | $908 |
| RADEX SPI THRC 2 VIEWS | $3,024 | $907 |
| RADEX SPI THRC 3 VIEWS | $3,024 | $907 |
| RADEX SPI THRC MINIMUM 4 VIEWS | $3,024 | $907 |
| X RAY EXAM TRUNK SPINE 2VWS | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW | $406 | $122 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW | $886 | $266 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW | $1,032 | $310 |
| RADEX SPI LUMBOSAC 2/3 VIEWS | $3,258 | $977 |
| LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | $3,571 | $1,071 |
| RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | $3,024 | $907 |
| RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | $13,053 | $3,916 |
| CT CRV SPI C-MATRL | $8,000 | $2,400 |
| CT CRV SPI C+ MATRL | $6,048 | $1,814 |
| CT CRV SPI C-/C+ | $8,305 | $2,491 |
| CT THRC SPI C-MATRL | $6,804 | $2,041 |
| CT THRC SPI C+ MATRL | $6,573 | $1,972 |
| CT THORACIC SPINE W/O & W/CONTRAST MATERIAL | $2,307 | $692 |
| CT LUMBAR SPINE W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LMBR SPI C+ MATRL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL | $7,366 | $2,210 |
| MRI SPI CANAL&CNTS CRV C-MATRL | $8,786 | $2,636 |
| MRI SPI CANAL&CNTS THRC C-MATRL | $4,859 | $1,458 |
| MRI SPI CANAL&CNTS LMBR C-MATRL | $8,385 | $2,516 |
| MRI SPI CANAL&CNTS C-/C+ CRV | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ LMBR | $12,204 | $3,661 |
| RADEX PELVIS 1/2 VIEWS | $2,111 | $633 |
| RADEX PELVIS COMPL MINIMUM 3 VIEWS | $2,214 | $664 |
| CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST | $5,991 | $1,797 |
| CT PELVIS C-MATRL | $7,687 | $2,306 |
| CT PELVIS C+ MATRL | $6,827 | $2,048 |
| CT PELVIS C-/C+ | $7,507 | $2,252 |
| MRI PELVIS C-MATRL | $8,080 | $2,424 |
| MRI PELVIS C+ MATRL | $9,075 | $2,722 |
| MRI PELVIS W/O & W/CONTRAST MATERIAL | $7,341 | $2,202 |
| RADEX SACROILIAC JNTS <3 VIEWS | $2,940 | $882 |
| RADEX SACRUM&COCCYX MINIMUM 2 VIEWS | $3,024 | $907 |
| MYELOGRAPY THRC RS&I | $3,903 | $1,171 |
| MYELOGRAPY LUMBOSAC RS&I | $7,196 | $2,159 |
| RADEX CLAV COMPL | $3,024 | $907 |
| RADEX SCAPULA COMPL | $3,024 | $907 |
| RADEX SHO 1 VIEW | $2,279 | $684 |
| RADEX SHO COMPL MINIMUM 2 VIEWS | $3,235 | $971 |
| RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ | $3,024 | $907 |
| RADEX HUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ELBW 2 VIEWS | $3,024 | $907 |
| RADEX ELBW COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX F/ARM 2 VIEWS | $3,024 | $907 |
| RADEX UXTR INFT MINIMUM 2 VIEWS | $2,019 | $606 |
| RADEX WRST 2 VIEWS | $3,024 | $907 |
| RADEX WRST COMPL MINIMUM 3 VIEWS | $3,164 | $949 |
| RADEX HAND 2 VIEWS | $2,584 | $775 |
| RADEX HAND MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX Fingers MINIMUM 2 VIEWS | $2,274 | $682 |
| CT UXTR C-MATRL | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT UPPER EXT W/DYE | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY | $7,115 | $2,134 |
| MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL | $5,060 | $1,518 |
| MRI UXTR OTH/THN JT C-/C+ | $10,265 | $3,080 |
| MRI ANY JT UXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT UXTR C-/C+ | $10,265 | $3,080 |
| (*DELETED 1/1/16*) RADEX HIP UNI 1 VIEW | $357 | $107 |
| RADEX HIP UNILATERAL WITH PELVIS 1 VIEW | $2,572 | $772 |
| RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $3,024 | $907 |
| RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS | $3,024 | $907 |
| (DELETED 1/1/16) RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS | $878 | $263 |
| RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS | $582 | $175 |
| Radiologic examination, pelvis and hips, infant or child, mi… | $583 | $175 |
| RADEX FEMUR 2 VIEWS (DELETED CODE) | $861 | $258 |
| X-RAY EXAM OF FEMUR 1V | $1,320 | $396 |
| RADEX, Femur; 2V | $2,382 | $715 |
| RADEX KNE 1/2 VIEWS | $2,019 | $606 |
| RADEX KNE 3 VIEWS | $3,300 | $990 |
| RADEX KNE COMPL 4/MORE VIEWS | $3,024 | $907 |
| RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST | $7,196 | $2,159 |
| RADEX TIBFIB 2 VIEWS | $3,024 | $907 |
| RADEX LXTR INFT MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX FOOT 2 VIEWS | $2,538 | $761 |
| RADEX FOOT COMPL MINIMUM 3 VIEWS | $2,700 | $810 |
| RADEX CALCANEUS MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX TOE MINIMUM 2 VIEWS | $1,760 | $528 |
| CT LXTR C-MATRL | $8,004 | $2,401 |
| CT LXTR C+ MATRL | $7,770 | $2,331 |
| CT LOWER EXTREMITY C-/C+ | $6,408 | $1,922 |
| CT ANGIOGRAPHY LOWER EXTREMITY | $5,992 | $1,798 |
| MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL | $7,814 | $2,344 |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+ | $10,265 | $3,080 |
| MRI ANY JT LXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT LXTR C+ MATRL | $9,075 | $2,722 |
| MRI ANY JT LXTR C-/C+ | $10,265 | $3,080 |
| MRA LXTR C+-MATRL | $6,457 | $1,937 |
| RADEX ABD 1 ANTEROPOST VIEW | $3,024 | $907 |
| RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS | $5,637 | $1,691 |
| RADEX ABD 1 VIEW | $2,142 | $643 |
| RADEX ABD 2 VIEWS | $2,058 | $617 |
| RADEX ABD COMPL W/DCBTS&/ERC VIEWS | $8,389 | $2,517 |
| RADEX ABD 3+ VIEWS | $2,389 | $717 |
| RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH | $2,275 | $683 |
| CT ABD C-MATRL | $7,177 | $2,153 |
| CT ABD C+ MATRL | $7,177 | $2,153 |
| CT ABD C-/C+ | $7,262 | $2,179 |
| CT ANGIO ABD&PELV W/ O&W / DYE | $10,369 | $3,111 |
| CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST | $7,170 | $2,151 |
| Ct Abd & pelvis W/o Contrast | $12,476 | $3,743 |
| Ct Abdomen&pelvis W/contrast | $14,401 | $4,320 |
| CT ABDOEN & PELVIS W/CONTRAST MATERIAL | $14,401 | $4,320 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| MRI ABD C-MATRL | $6,668 | $2,000 |
| MRI ABD C-/C+ | $10,265 | $3,080 |
| MRA ABDOMEN W/WO CONTRAST MATERIAL | $6,107 | $1,832 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS | $2,161 | $648 |
| RADEX GI TRC UPR +-DLYD FLMS W/KUB | $3,024 | $907 |
| RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB | $7,069 | $2,121 |
| Urography (pyelography), intravenous, with or without KUB, w… | $7,069 | $2,121 |
| URETHROCYSTOGRAPHY RETROGRADE RS&I | $5,637 | $1,691 |
| CT ANGIO ABDOMINAL ARTERIES | $7,069 | $2,121 |
| RADEX FROM NOSE RECTUM FB 1 VIEW CHLD | $2,520 | $756 |
| 3D RNDR I&R CT MRI US/OTH X REQ POSTPCX | $1,855 | $557 |
| CT LIMITED/LOCALIZED FOLLOW UP STUDY | $6,804 | $2,041 |
| OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN | $3,141 | $942 |
| US SOFT TISS HEAD&NCK R-T IMG | $3,024 | $907 |
| US CHEST REAL TIME W/IMAGE DOCUMENTATION | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE LIMITED | $1,941 | $582 |
| US ABDOMINAL R-T W/IMAGE DOCUMENTATION | $3,224 | $967 |
| ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED | $4,003 | $1,201 |
| US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA | $893 | $268 |
| US RETROPERITONEAL R-T W/IMAGE COMPL | $2,866 | $860 |
| US RPR B-SCAN&/R-T IMG LMTD | $3,024 | $907 |
| ULTRASOUND 14 WK TABDL 1/1ST GESTATION | $2,866 | $860 |
| US PREG UTERUS 14 WK TRANSABDL EACH ADDL GESTATION | $1,170 | $351 |
| ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION | $3,024 | $907 |
| US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO | $3,024 | $907 |
| US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION | $1,497 | $449 |
| Ultrasound, pregnant uterus, real time with image documentat… | $431 | $129 |
| US PREGNANT UTERUS LIMITED 1/> FETUSES | $2,300 | $690 |
| Ultrasound, pregnant uterus, real time with image documentat… | $1,854 | $556 |
| US PG UTER R-T IMG TRVG | $3,024 | $907 |
| DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE; Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete | $1,948 | $585 |
| US TRVG | $3,208 | $962 |
| US PELVIC NONOB REAL-TIME IMG COMPLETE | $3,024 | $907 |
| US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97 | $2,724 | $817 |
| US SCROTUM&CNTS | $3,654 | $1,096 |
| US EXTREMITY NON-VASC REAL-TIME IMG COMPL | $3,024 | $907 |
| US EXTREMITY NON-VASC REAL-TIME IMG LMTD | $1,521 | $456 |
| US GUIDE VASCULAR ACCESS | $2,671 | $801 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| UNLISTED US PROCEDURE | $1,155 | $347 |
| Radiologic examination, osseous survey; limited (eg, for metastases) | $895 | $268 |
| RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT | $2,272 | $682 |
| JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS | $2,251 | $675 |
| CT BONE MINERAL DENSITY STUDY 1+ SITS APPND | $706 | $212 |
| ADRNL IMG CORTEX&/MEDULLA | $5,004 | $1,501 |
| HIDA SCAN – HEPATBL DUX SYS IMG GLBLDR | $3,470 | $1,041 |
| B1&/JT IMG WHBDY | $3,235 | $970 |
| B1&/JT IMG 3 PHASE STD | $3,940 | $1,182 |
| B1&/JT IMG TOMOG SPECT | $3,940 | $1,182 |
| CARD BPI GTD =BRM PLNR 1 STD REST/STRS | $3,032 | $910 |
| NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS | $2,906 | $872 |
| BASIC METABOLIC PANEL CALCIUM IONIZED | $1,554 | $466 |
| BASIC METABOLIC PANEL CALCIUM TOTAL | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| GENERAL HLTH PANEL | $1,473 | $442 |
| ELECTROLYTE PANEL | $540 | $162 |
| COMPRE METAB PANEL | $1,794 | $538 |
| PIC PANEL COMPREHENS METABOLBX | $1,794 | $538 |
| LIPID PANEL | $1,512 | $454 |
| RENAL FUNCTION PANEL | $410 | $123 |
| AQT HEP PANEL | $1,440 | $432 |
| HEPATC FUNCJ PANEL | $1,458 | $437 |
| OBSTETRIC PANEL | $485 | $146 |
| DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX | $342 | $103 |
| DRUG ASSAY ACETAMINOPHEN | $1,020 | $306 |
| Carbamazepine; total | $327 | $98 |
| DRUG ASSAY CLOZAPINE | $169 | $51 |
| ASSAY OF DIGOXIN | $780 | $234 |
| Valproic acid (dipropylacetic acid); total | $960 | $288 |
| DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE | $1,140 | $342 |
| DRUG SCREEN QUANTITATIVE GENTAMICIN | $495 | $148 |
| DRUG SCREEN QUANTITATIVE LAMOTRIGINE | $95 | $28 |
| DRUG SCREEN QUANTITATIVE LEVETIRACETAM | $95 | $29 |
| LITHIUM | $114 | $34 |
| DRUG ASSAY SALICYLATE | $1,020 | $306 |
| DRUG SCREEN QUANTITATIVE OXCARBAZEPINE | $86 | $26 |
| DRUG SCREEN QUANTITATIVE PHENOBARBITAL | $197 | $59 |
| ASSAY OF PHENYTOIN TOTAL | $243 | $73 |
| SALICYLATE | $167 | $50 |
| TACROLIMUS | $521 | $156 |
| DRUG SCREEN QUANTITATIVE THEOPHYLLINE | $459 | $138 |
| Topiramate | $90 | $27 |
| DRUG SCREEN QUANT VANCOMYCIN | $1,765 | $529 |
| Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) | $342 | $103 |
| DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY | $493 | $148 |
| DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS | $756 | $227 |
| DRUG SCREEN QUANTITATIVE ALCOHOLS | $684 | $205 |
| Analgesics, non-opioid; 1 or 2 | $684 | $205 |
| DRUG SCREEN ANALGESICS NON-OPIOID 3-5 | $182 | $55 |
| ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2 | $310 | $93 |
| Antiepileptics, not otherwise specified; 1-3 | $155 | $47 |
| DRUG SCREENING BENZODIAZEPINES 1-12 | $1,260 | $378 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO MIC | $510 | $153 |
| URINALYSIS – URNLS DIP STICK/TABLET RGNT AUTO MIC | $690 | $207 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC | $300 | $90 |
| URNLS DIP STICK/TABLET RGNT AUTO W/O MIC | $545 | $164 |
| Urinalysis, microscopic only | $124 | $37 |
| URINE PREGNANCY TST VIS COLOR CMPRSN METHS | $684 | $205 |
| BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE | $820 | $246 |
| CYP2C19 GENE ANALYSIS COMMON VARIANTS | $2,447 | $734 |
| AK2 GENE ANALYSIS P.VAL617PHE VARIANT | $770 | $231 |
| NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR | $722 | $217 |
| ACETALDEHYDE BLD | $41 | $12 |
| KETONE BODIES SERUM QUALITATIVE | $196 | $59 |
| ACETONE/OTH KETONE BODIES SERUM QUAN | $382 | $115 |
| Adrenocorticotropic hormone (ACTH) | $664 | $199 |
| ALBUMIN SERUM PLASMA/WHOLE BLOOD | $204 | $61 |
| URINE ALBUMIN QUANTITATIVE | $96 | $29 |
| ALCOHOL BRTH | $600 | $180 |
| ASSAY OF ALDOLASE | $97 | $29 |
| ALPHA-1-ANTITRYPSIN TOTAL | $134 | $40 |
| ALPHA-FETOPROTEIN SERUM | $288 | $86 |
| AMINOLEVULINIC ACID DELTA | $118 | $36 |
| Ammonia | $1,020 | $306 |
| AMYLASE | $572 | $172 |
| ASSAY OF ARSENIC | $199 | $60 |
STAT Specialty Hospital – Laredo North
| Description | Price | Cash Rate |
|---|---|---|
| RADEX EYE DETCJ FB | $2,190 | $657 |
| RADEX MNDBL PRTL LESS THAN < 4 VIEWS | $485 | $146 |
| RADEX MNDBL COMPL MINIMUM 4 VIEWS | $2,538 | $761 |
| RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE | $464 | $139 |
| RADEX FACIAL B1S < 3 VIEWS | $2,394 | $718 |
| RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS | $2,394 | $718 |
| RADEX NSL B1S COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX ORBITS COMPLETE MINIMUM 4 VIEWS | $3,024 | $907 |
| Radiologic examination, sinuses, paranasal, less than 3 views | $3,024 | $907 |
| RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX SKL < 4 VIEWS | $2,724 | $817 |
| RADEX SKL COMPL MINIMUM 4 VIEWS | $2,724 | $817 |
| RADEX TMPRMAND JT OPN&CLSD MOUTH UNI | $607 | $182 |
| RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT | $3,024 | $907 |
| MRI TEMPOROMANDIBULAR JOINT | $2,085 | $625 |
| CEPHALOGRAM ORTHODONTIC | $710 | $213 |
| RADEX OF NECK SOFT TISSUE | $3,024 | $907 |
| CT HEAD/BRN C-MATRL | $7,429 | $2,229 |
| CT HEAD/BRN C+ MATRL | $6,804 | $2,041 |
| CT HEAD/BRN C-/C+ | $7,507 | $2,252 |
| CT ORBIT SELLA/POST FOSSA/EAR C-MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C-/C+ | $6,804 | $2,041 |
| CT SCAN MAXLFCL AREA C-MATRL – SINUS AREA | $6,804 | $2,041 |
| CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT MAXLFCL AREA C+ MATRL | $6,804 | $2,041 |
| CT MAXLFCL AREA C-/C+ | $6,250 | $1,875 |
| CT SOFT TISS NCK C-MATRL | $6,048 | $1,814 |
| CT SOFT TISS NCK C+ MATRL | $6,804 | $2,041 |
| CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL | $6,650 | $1,995 |
| CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $7,000 | $2,100 |
| Computed tomographic angiography, neck, with contrast materi… | $7,010 | $2,103 |
| MRI ORBIT FACE &/NECK W/O CONTRAST | $5,860 | $1,758 |
| MRI ORBIT/FACE/NECK C+ | $6,074 | $1,822 |
| MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL | $7,174 | $2,152 |
| MRA HEAD C-MATRL | $6,383 | $1,915 |
| MRA NCK C-MATRL | $6,367 | $1,910 |
| MRA NECK W/O &W/CONTRAST MATERIAL | $7,971 | $2,391 |
| MRI BRN BRN STEM C-MATRL | $6,086 | $1,826 |
| MRI BRN BRN STEM C-/C+ | $10,265 | $3,080 |
| RADEX CH 1 VIEW FRNT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ | $2,019 | $606 |
| RADEX CH COMPL MINIMUM 4 VIEWS | $2,019 | $606 |
| RADEX CHEST 1 VIEW | $2,370 | $711 |
| RADEX CHEST 2 VIEWS | $3,024 | $907 |
| RADEX CHEST 3 VIEWS | $3,024 | $907 |
| RADEX CHEST 4+ VIEWS | $3,024 | $907 |
| RADEX RIBS UNI 2 VIEWS | $2,274 | $682 |
| RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS | $2,634 | $790 |
| RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS | $2,634 | $790 |
| RADEX RIBS BI 3 VIEWS | $3,024 | $907 |
| RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS | $3,024 | $907 |
| RADEX STERNUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS | $2,270 | $681 |
| CT THORAX W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT THORAX C+ MATRL | $6,804 | $2,041 |
| CT THORAX C-/C+ | $6,804 | $2,041 |
| CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $10,046 | $3,014 |
| MRI CH C-MATRL | $6,086 | $1,826 |
| RADEX SPI 1 VIEW SPEC LVL | $3,024 | $907 |
| RADEX SPI CRV 2/3 VIEWS | $3,024 | $907 |
| RADEX SPI CRV MINIMUM 4 VIEWS | $3,025 | $908 |
| RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | $3,025 | $908 |
| RADEX SPI THRC 2 VIEWS | $3,024 | $907 |
| RADEX SPI THRC 3 VIEWS | $3,024 | $907 |
| RADEX SPI THRC MINIMUM 4 VIEWS | $3,024 | $907 |
| X RAY EXAM TRUNK SPINE 2VWS | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW | $455 | $137 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW | $886 | $266 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW | $1,032 | $310 |
| RADEX SPI LUMBOSAC 2/3 VIEWS | $3,258 | $977 |
| LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | $3,571 | $1,071 |
| RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | $3,024 | $907 |
| RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | $13,053 | $3,916 |
| CT CRV SPI C-MATRL | $8,000 | $2,400 |
| CT CRV SPI C+ MATRL | $6,048 | $1,814 |
| CT CRV SPI C-/C+ | $8,305 | $2,491 |
| CT THRC SPI C-MATRL | $6,804 | $2,041 |
| CT THRC SPI C+ MATRL | $6,573 | $1,972 |
| CT THORACIC SPINE W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LMBR SPI C+ MATRL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL | $7,366 | $2,210 |
| MRI SPI CANAL&CNTS CRV C-MATRL | $8,786 | $2,636 |
| MRI SPI CANAL&CNTS THRC C-MATRL | $4,859 | $1,458 |
| MRI SPI CANAL&CNTS LMBR C-MATRL | $8,385 | $2,516 |
| MRI SPI CANAL&CNTS C-/C+ CRV | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ LMBR | $12,204 | $3,661 |
| RADEX PELVIS 1/2 VIEWS | $2,111 | $633 |
| RADEX PELVIS COMPL MINIMUM 3 VIEWS | $2,214 | $664 |
| CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST | $5,991 | $1,797 |
| CT PELVIS C-MATRL | $7,687 | $2,306 |
| CT PELVIS C+ MATRL | $6,827 | $2,048 |
| CT PELVIS C-/C+ | $7,507 | $2,252 |
| MRI PELVIS C-MATRL | $8,080 | $2,424 |
| MRI PELVIS C+ MATRL | $9,075 | $2,722 |
| MRI PELVIS W/O & W/CONTRAST MATERIAL | $7,341 | $2,202 |
| RADEX SACROILIAC JNTS <3 VIEWS | $2,940 | $882 |
| RADEX SACRUM&COCCYX MINIMUM 2 VIEWS | $3,024 | $907 |
| MYELOGRAPY THRC RS&I | $3,903 | $1,171 |
| MYELOGRAPY LUMBOSAC RS&I | $7,196 | $2,159 |
| RADEX CLAV COMPL | $3,024 | $907 |
| RADEX SCAPULA COMPL | $3,024 | $907 |
| RADEX SHO 1 VIEW | $2,279 | $684 |
| RADEX SHO COMPL MINIMUM 2 VIEWS | $3,235 | $971 |
| RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ | $3,024 | $907 |
| RADEX HUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ELBW 2 VIEWS | $3,024 | $907 |
| RADEX ELBW COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX F/ARM 2 VIEWS | $3,024 | $907 |
| RADEX UXTR INFT MINIMUM 2 VIEWS | $2,019 | $606 |
| RADEX WRST 2 VIEWS | $3,024 | $907 |
| RADEX WRST COMPL MINIMUM 3 VIEWS | $3,164 | $949 |
| RADEX HAND 2 VIEWS | $2,584 | $775 |
| RADEX HAND MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX Fingers MINIMUM 2 VIEWS | $2,274 | $682 |
| CT UXTR C-MATRL | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT UPPER EXT W/DYE | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY | $7,115 | $2,134 |
| MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL | $5,060 | $1,518 |
| MRI UXTR OTH/THN JT C-/C+ | $10,265 | $3,080 |
| MRI ANY JT UXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT UXTR C-/C+ | $10,265 | $3,080 |
| (*DELETED 1/1/16*) RADEX HIP UNI 1 VIEW | $448 | $135 |
| RADEX HIP UNILATERAL WITH PELVIS 1 VIEW | $2,572 | $772 |
| RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $3,024 | $907 |
| RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS | $3,024 | $907 |
| (DELETED 1/1/16) RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS | $878 | $263 |
| RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS | $582 | $175 |
| Radiologic examination, pelvis and hips, infant or child, mi… | $583 | $175 |
| RADEX FEMUR 2 VIEWS (DELETED CODE) | $861 | $258 |
| X-RAY EXAM OF FEMUR 1V | $1,320 | $396 |
| RADEX, Femur; 2V | $2,382 | $715 |
| RADEX KNE 1/2 VIEWS | $2,019 | $606 |
| RADEX KNE 3 VIEWS | $3,300 | $990 |
| RADEX KNE COMPL 4/MORE VIEWS | $3,024 | $907 |
| RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST | $7,196 | $2,159 |
| RADEX TIBFIB 2 VIEWS | $3,024 | $907 |
| RADEX LXTR INFT MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX FOOT 2 VIEWS | $2,538 | $761 |
| RADEX FOOT COMPL MINIMUM 3 VIEWS | $2,700 | $810 |
| RADEX CALCANEUS MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX TOE MINIMUM 2 VIEWS | $1,760 | $528 |
| CT LXTR C-MATRL | $8,004 | $2,401 |
| CT LXTR C+ MATRL | $7,770 | $2,331 |
| CT LOWER EXTREMITY C-/C+ | $6,408 | $1,922 |
| CT ANGIOGRAPHY LOWER EXTREMITY | $5,992 | $1,798 |
| MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL | $7,814 | $2,344 |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+ | $10,265 | $3,080 |
| MRI ANY JT LXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT LXTR C+ MATRL | $9,075 | $2,722 |
| MRI ANY JT LXTR C-/C+ | $10,265 | $3,080 |
| MRA LXTR C+-MATRL | $6,457 | $1,937 |
| RADEX ABD 1 ANTEROPOST VIEW | $3,024 | $907 |
| RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS | $5,637 | $1,691 |
| RADEX ABD 1 VIEW | $2,142 | $643 |
| RADEX ABD 2 VIEWS | $2,058 | $617 |
| RADEX ABD COMPL W/DCBTS&/ERC VIEWS | $8,389 | $2,517 |
| RADEX ABD 3+ VIEWS | $2,389 | $717 |
| RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH | $2,275 | $683 |
| CT ABD C-MATRL | $7,177 | $2,153 |
| CT ABD C+ MATRL | $7,177 | $2,153 |
| CT ABD C-/C+ | $7,262 | $2,179 |
| CT ANGIO ABD&PELV W/ O&W / DYE | $10,369 | $3,111 |
| CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST | $7,170 | $2,151 |
| Ct Abd & pelvis W/o Contrast | $12,476 | $3,743 |
| Ct Abdomen&pelvis W/contrast | $14,401 | $4,320 |
| CT ABDOEN & PELVIS W/CONTRAST MATERIAL | $14,401 | $4,320 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| MRI ABD C-MATRL | $6,668 | $2,000 |
| MRI ABD C-/C+ | $10,265 | $3,080 |
| MRA ABDOMEN W/WO CONTRAST MATERIAL | $6,107 | $1,832 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS | $2,161 | $648 |
| RADEX GI TRC UPR +-DLYD FLMS W/KUB | $3,024 | $907 |
| RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB | $7,069 | $2,121 |
| Urography (pyelography), intravenous, with or without KUB, w… | $7,069 | $2,121 |
| URETHROCYSTOGRAPHY RETROGRADE RS&I | $5,637 | $1,691 |
| CT ANGIO ABDOMINAL ARTERIES | $7,069 | $2,121 |
| RADEX FROM NOSE RECTUM FB 1 VIEW CHLD | $2,520 | $756 |
| 3D RNDR I&R CT MRI US/OTH X REQ POSTPCX | $1,855 | $557 |
| CT LIMITED/LOCALIZED FOLLOW UP STUDY | $6,804 | $2,041 |
| OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN | $3,141 | $942 |
| US SOFT TISS HEAD&NCK R-T IMG | $3,024 | $907 |
| US CHEST REAL TIME W/IMAGE DOCUMENTATION | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE LIMITED | $1,941 | $582 |
| US ABDOMINAL R-T W/IMAGE DOCUMENTATION | $3,224 | $967 |
| ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED | $4,003 | $1,201 |
| US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA | $893 | $268 |
| US RETROPERITONEAL R-T W/IMAGE COMPL | $2,866 | $860 |
| US RPR B-SCAN&/R-T IMG LMTD | $3,024 | $907 |
| ULTRASOUND 14 WK TABDL 1/1ST GESTATION | $2,866 | $860 |
| US PREG UTERUS 14 WK TRANSABDL EACH ADDL GESTATION | $1,170 | $351 |
| ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION | $3,024 | $907 |
| US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO | $3,024 | $907 |
| US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION | $1,497 | $449 |
| Ultrasound, pregnant uterus, real time with image documentat… | $431 | $129 |
| US PREGNANT UTERUS LIMITED 1/> FETUSES | $2,300 | $690 |
| Ultrasound, pregnant uterus, real time with image documentat… | $1,854 | $556 |
| US PG UTER R-T IMG TRVG | $3,024 | $907 |
| DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE; Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete | $1,948 | $585 |
| US TRVG | $3,208 | $962 |
| US PELVIC NONOB REAL-TIME IMG COMPLETE | $3,024 | $907 |
| US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97 | $2,724 | $817 |
| US SCROTUM&CNTS | $3,654 | $1,096 |
| US EXTREMITY NON-VASC REAL-TIME IMG COMPL | $3,024 | $907 |
| US EXTREMITY NON-VASC REAL-TIME IMG LMTD | $1,521 | $456 |
| US GUIDE VASCULAR ACCESS | $2,671 | $801 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| UNLISTED US PROCEDURE | $1,155 | $347 |
| Radiologic examination, osseous survey; limited (eg, for metastases) | $895 | $268 |
| RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT | $2,272 | $682 |
| JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS | $2,251 | $675 |
| CT BONE MINERAL DENSITY STUDY 1+ SITS APPND | $706 | $212 |
| ADRNL IMG CORTEX&/MEDULLA | $5,004 | $1,501 |
| HIDA SCAN – HEPATBL DUX SYS IMG GLBLDR | $3,470 | $1,041 |
| B1&/JT IMG WHBDY | $3,235 | $970 |
| B1&/JT IMG 3 PHASE STD | $3,940 | $1,182 |
| B1&/JT IMG TOMOG SPECT | $3,940 | $1,182 |
| CARD BPI GTD =BRM PLNR 1 STD REST/STRS | $3,032 | $910 |
| NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS | $2,906 | $872 |
| (DO NOT USE) PIC PANEL LIVER+ 10/BX | $808 | $242 |
| BASIC METABOLIC PANEL CALCIUM IONIZED | $1,554 | $466 |
| BASIC METABOLIC PANEL CALCIUM TOTAL | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| GENERAL HLTH PANEL | $1,473 | $442 |
| ELECTROLYTE PANEL | $540 | $162 |
| COMPRE METAB PANEL | $1,794 | $538 |
| PIC PANEL COMPREHENS METABOLBX | $1,794 | $538 |
| LIPID PANEL | $1,512 | $454 |
| RENAL FUNCTION PANEL | $410 | $123 |
| AQT HEP PANEL | $1,440 | $432 |
| HEPATC FUNCJ PANEL | $1,458 | $437 |
| OBSTETRIC PANEL | $970 | $291 |
| DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX | $342 | $103 |
| DRUG ASSAY ACETAMINOPHEN | $1,020 | $306 |
| Carbamazepine; total | $327 | $98 |
| DRUG ASSAY CLOZAPINE | $169 | $51 |
| ASSAY OF DIGOXIN | $780 | $234 |
| Valproic acid (dipropylacetic acid); total | $960 | $288 |
| DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE | $1,140 | $342 |
| DRUG SCREEN QUANTITATIVE GENTAMICIN | $495 | $148 |
| DRUG SCREEN QUANTITATIVE LAMOTRIGINE | $190 | $57 |
| DRUG SCREEN QUANTITATIVE LEVETIRACETAM | $191 | $57 |
| LITHIUM | $114 | $34 |
| DRUG ASSAY SALICYLATE | $1,020 | $306 |
| DRUG SCREEN QUANTITATIVE OXCARBAZEPINE | $172 | $52 |
| DRUG SCREEN QUANTITATIVE PHENOBARBITAL | $197 | $59 |
| ASSAY OF PHENYTOIN TOTAL | $243 | $73 |
| SALICYLATE | $167 | $50 |
| TACROLIMUS | $521 | $156 |
| DRUG SCREEN QUANTITATIVE THEOPHYLLINE | $459 | $138 |
| Topiramate | $179 | $54 |
| DRUG SCREEN QUANT VANCOMYCIN | $1,765 | $529 |
| Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) | $342 | $103 |
| DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY | $493 | $148 |
| DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS | $756 | $227 |
| DRUG SCREEN QUANTITATIVE ALCOHOLS | $684 | $205 |
| Analgesics, non-opioid; 1 or 2 | $684 | $205 |
| DRUG SCREEN ANALGESICS NON-OPIOID 3-5 | $364 | $109 |
| ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2 | $310 | $93 |
| Antiepileptics, not otherwise specified; 1-3 | $310 | $93 |
| DRUG SCREENING BENZODIAZEPINES 1-12 | $1,260 | $378 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO MIC | $510 | $153 |
| URINALYSIS – URNLS DIP STICK/TABLET RGNT AUTO MIC | $690 | $207 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC | $300 | $90 |
| URNLS DIP STICK/TABLET RGNT AUTO W/O MIC | $545 | $164 |
| Urinalysis, microscopic only | $124 | $37 |
| URINE PREGNANCY TST VIS COLOR CMPRSN METHS | $684 | $205 |
| BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE | $861 | $258 |
| CYP2C19 GENE ANALYSIS COMMON VARIANTS | $2,447 | $734 |
| AK2 GENE ANALYSIS P.VAL617PHE VARIANT | $770 | $231 |
| NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR | $758 | $227 |
| ACETALDEHYDE BLD | $82 | $25 |
| KETONE BODIES SERUM QUALITATIVE | $196 | $59 |
| ACETONE/OTH KETONE BODIES SERUM QUAN | $382 | $115 |
| Adrenocorticotropic hormone (ACTH) | $664 | $199 |
| ALBUMIN SERUM PLASMA/WHOLE BLOOD | $204 | $61 |
| URINE ALBUMIN QUANTITATIVE | $96 | $29 |
| ALCOHOL BRTH | $600 | $180 |
| ASSAY OF ALDOLASE | $167 | $50 |
| ALPHA-1-ANTITRYPSIN TOTAL | $141 | $42 |
| ALPHA-FETOPROTEIN SERUM | $288 | $86 |
| AMINOLEVULINIC ACID DELTA | $237 | $71 |
| Ammonia | $1,020 | $306 |
| AMYLASE | $572 | $172 |
STAT Emergency Center – Laredo South
| Description | Price | Cash Rate |
|---|---|---|
| RADEX EYE DETCJ FB | $2,190 | $657 |
| RADEX MNDBL PRTL LESS THAN < 4 VIEWS | $485 | $146 |
| RADEX MNDBL COMPL MINIMUM 4 VIEWS | $2,538 | $761 |
| RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE | $464 | $139 |
| RADEX FACIAL B1S < 3 VIEWS | $2,394 | $718 |
| RADEX FACIAL B1S COMPL MINIMUM 3 VIEWS | $2,394 | $718 |
| RADEX NSL B1S COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX ORBITS COMPLETE MINIMUM 4 VIEWS | $3,024 | $907 |
| Radiologic examination, sinuses, paranasal, less than 3 views | $3,024 | $907 |
| RADEX SINUSES PARANSL COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX SKL < 4 VIEWS | $2,724 | $817 |
| RADEX SKL COMPL MINIMUM 4 VIEWS | $2,724 | $817 |
| RADEX TMPRMAND JT OPN&CLSD MOUTH UNI | $607 | $182 |
| RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT | $3,024 | $907 |
| MRI TEMPOROMANDIBULAR JOINT | $2,085 | $625 |
| CEPHALOGRAM ORTHODONTIC | $710 | $213 |
| RADEX OF NECK SOFT TISSUE | $3,024 | $907 |
| CT HEAD/BRN C-MATRL | $7,429 | $2,229 |
| CT HEAD/BRN C+ MATRL | $6,804 | $2,041 |
| CT HEAD/BRN C-/C+ | $7,507 | $2,252 |
| CT ORBIT SELLA/POST FOSSA/EAR C-MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C+ MATRL | $6,804 | $2,041 |
| CT ORBIT SELLA/POST FOSSA/EAR C-/C+ | $6,804 | $2,041 |
| CT SCAN MAXLFCL AREA C-MATRL – SINUS AREA | $6,804 | $2,041 |
| CT MAXILLOFACIAL W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT MAXLFCL AREA C+ MATRL | $6,804 | $2,041 |
| CT MAXLFCL AREA C-/C+ | $6,250 | $1,875 |
| CT SOFT TISS NCK C-MATRL | $6,048 | $1,814 |
| CT SOFT TISS NCK C+ MATRL | $6,804 | $2,041 |
| CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL | $6,650 | $1,995 |
| CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST | $7,000 | $2,100 |
| Computed tomographic angiography, neck, with contrast materi… | $7,010 | $2,103 |
| MRI ORBIT FACE &/NECK W/O CONTRAST | $5,860 | $1,758 |
| MRI ORBIT/FACE/NECK C+ | $6,074 | $1,822 |
| MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL | $7,174 | $2,152 |
| MRA HEAD C-MATRL | $6,383 | $1,915 |
| MRA NCK C-MATRL | $6,367 | $1,910 |
| MRA NECK W/O &W/CONTRAST MATERIAL | $7,971 | $2,391 |
| MRI BRN BRN STEM C-MATRL | $6,086 | $1,826 |
| MRI BRN BRN STEM C-/C+ | $10,265 | $3,080 |
| RADEX CH 1 VIEW FRNT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT | $2,724 | $817 |
| RADEX CH 2 VIEWS FRNT&LAT OBLQ PRJCJ | $2,019 | $606 |
| RADEX CH COMPL MINIMUM 4 VIEWS | $2,019 | $606 |
| RADEX CHEST 1 VIEW | $2,370 | $711 |
| RADEX CHEST 2 VIEWS | $3,024 | $907 |
| RADEX CHEST 3 VIEWS | $3,024 | $907 |
| RADEX CHEST 4+ VIEWS | $3,024 | $907 |
| RADEX RIBS UNI 2 VIEWS | $2,274 | $682 |
| RADEX RIBS UNI W/POSTEROANT CH 3 VIEWS | $2,634 | $790 |
| RADEX RIBS UNI W/POSTEROANT CH 4 VIEWS | $2,634 | $790 |
| RADEX RIBS BI 3 VIEWS | $3,024 | $907 |
| RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS | $3,024 | $907 |
| RADEX STERNUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS | $2,270 | $681 |
| CT THORAX W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT THORAX C+ MATRL | $6,804 | $2,041 |
| CT THORAX C-/C+ | $6,804 | $2,041 |
| CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST | $10,046 | $3,014 |
| MRI CH C-MATRL | $6,086 | $1,826 |
| RADEX SPI 1 VIEW SPEC LVL | $3,024 | $907 |
| RADEX SPI CRV 2/3 VIEWS | $3,024 | $907 |
| RADEX SPI CRV MINIMUM 4 VIEWS | $3,025 | $908 |
| RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | $3,025 | $908 |
| RADEX SPI THRC 2 VIEWS | $3,024 | $907 |
| RADEX SPI THRC 3 VIEWS | $3,024 | $907 |
| RADEX SPI THRC MINIMUM 4 VIEWS | $3,024 | $907 |
| X RAY EXAM TRUNK SPINE 2VWS | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW | $455 | $137 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW | $3,024 | $907 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW | $886 | $266 |
| RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW | $1,032 | $310 |
| RADEX SPI LUMBOSAC 2/3 VIEWS | $3,258 | $977 |
| LUMBAR X-RAY 4 VIEWS RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | $3,571 | $1,071 |
| RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | $3,024 | $907 |
| RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | $13,053 | $3,916 |
| CT CRV SPI C-MATRL | $8,000 | $2,400 |
| CT CRV SPI C+ MATRL | $6,048 | $1,814 |
| CT CRV SPI C-/C+ | $8,305 | $2,491 |
| CT THRC SPI C-MATRL | $6,804 | $2,041 |
| CT THRC SPI C+ MATRL | $6,573 | $1,972 |
| CT THORACIC SPINE W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT LMBR SPI C+ MATRL | $6,804 | $2,041 |
| CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL | $7,366 | $2,210 |
| MRI SPI CANAL&CNTS CRV C-MATRL | $8,786 | $2,636 |
| MRI SPI CANAL&CNTS THRC C-MATRL | $4,859 | $1,458 |
| MRI SPI CANAL&CNTS LMBR C-MATRL | $8,385 | $2,516 |
| MRI SPI CANAL&CNTS C-/C+ CRV | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ | $10,265 | $3,080 |
| MRI SPI CANAL&CNTS C-/C+ LMBR | $12,204 | $3,661 |
| RADEX PELVIS 1/2 VIEWS | $2,111 | $633 |
| RADEX PELVIS COMPL MINIMUM 3 VIEWS | $2,214 | $664 |
| CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST | $5,991 | $1,797 |
| CT PELVIS C-MATRL | $7,687 | $2,306 |
| CT PELVIS C+ MATRL | $6,827 | $2,048 |
| CT PELVIS C-/C+ | $7,507 | $2,252 |
| MRI PELVIS C-MATRL | $8,080 | $2,424 |
| MRI PELVIS C+ MATRL | $9,075 | $2,722 |
| MRI PELVIS W/O & W/CONTRAST MATERIAL | $7,341 | $2,202 |
| RADEX SACROILIAC JNTS <3 VIEWS | $2,940 | $882 |
| RADEX SACRUM&COCCYX MINIMUM 2 VIEWS | $3,024 | $907 |
| MYELOGRAPY THRC RS&I | $3,903 | $1,171 |
| MYELOGRAPY LUMBOSAC RS&I | $7,196 | $2,159 |
| RADEX CLAV COMPL | $3,024 | $907 |
| RADEX SCAPULA COMPL | $3,024 | $907 |
| RADEX SHO 1 VIEW | $2,279 | $684 |
| RADEX SHO COMPL MINIMUM 2 VIEWS | $3,235 | $971 |
| RADEX ACROMCLAV JTS BI +-W8ED DISTRCJ | $3,024 | $907 |
| RADEX HUM MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ELBW 2 VIEWS | $3,024 | $907 |
| RADEX ELBW COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX F/ARM 2 VIEWS | $3,024 | $907 |
| RADEX UXTR INFT MINIMUM 2 VIEWS | $2,019 | $606 |
| RADEX WRST 2 VIEWS | $3,024 | $907 |
| RADEX WRST COMPL MINIMUM 3 VIEWS | $3,164 | $949 |
| RADEX HAND 2 VIEWS | $2,584 | $775 |
| RADEX HAND MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX Fingers MINIMUM 2 VIEWS | $2,274 | $682 |
| CT UXTR C-MATRL | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O CONTRAST MATERIAL | $6,804 | $2,041 |
| CT UPPER EXT W/DYE | $6,804 | $2,041 |
| CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL | $6,804 | $2,041 |
| CT ANGIOGRPHY W/WO CONTRAST UPPER EXTREMITY | $7,115 | $2,134 |
| MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL | $5,060 | $1,518 |
| MRI UXTR OTH/THN JT C-/C+ | $10,265 | $3,080 |
| MRI ANY JT UXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT UXTR C-/C+ | $10,265 | $3,080 |
| (*DELETED 1/1/16*) RADEX HIP UNI 1 VIEW | $448 | $135 |
| RADEX HIP UNILATERAL WITH PELVIS 1 VIEW | $2,572 | $772 |
| RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS | $3,024 | $907 |
| RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS | $3,024 | $907 |
| (DELETED 1/1/16) RADEX HIPS BI 2 VIEWS ANTEROPOST PELVIS | $878 | $263 |
| RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS | $3,024 | $907 |
| RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS | $582 | $175 |
| Radiologic examination, pelvis and hips, infant or child, mi… | $583 | $175 |
| RADEX FEMUR 2 VIEWS (DELETED CODE) | $861 | $258 |
| X-RAY EXAM OF FEMUR 1V | $1,320 | $396 |
| RADEX, Femur; 2V | $2,382 | $715 |
| RADEX KNE 1/2 VIEWS | $2,019 | $606 |
| RADEX KNE 3 VIEWS | $3,300 | $990 |
| RADEX KNE COMPL 4/MORE VIEWS | $3,024 | $907 |
| RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST | $7,196 | $2,159 |
| RADEX TIBFIB 2 VIEWS | $3,024 | $907 |
| RADEX LXTR INFT MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE 2 VIEWS | $3,024 | $907 |
| RADEX ANKLE COMPL MINIMUM 3 VIEWS | $3,024 | $907 |
| RADEX FOOT 2 VIEWS | $2,538 | $761 |
| RADEX FOOT COMPL MINIMUM 3 VIEWS | $2,700 | $810 |
| RADEX CALCANEUS MINIMUM 2 VIEWS | $3,024 | $907 |
| RADEX TOE MINIMUM 2 VIEWS | $1,760 | $528 |
| CT LXTR C-MATRL | $8,004 | $2,401 |
| CT LXTR C+ MATRL | $7,770 | $2,331 |
| CT LOWER EXTREMITY C-/C+ | $6,408 | $1,922 |
| CT ANGIOGRAPHY LOWER EXTREMITY | $5,992 | $1,798 |
| MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL | $7,814 | $2,344 |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; C-/C+ | $10,265 | $3,080 |
| MRI ANY JT LXTR C-MATRL | $6,086 | $1,826 |
| MRI ANY JT LXTR C+ MATRL | $9,075 | $2,722 |
| MRI ANY JT LXTR C-/C+ | $10,265 | $3,080 |
| MRA LXTR C+-MATRL | $6,457 | $1,937 |
| RADEX ABD 1 ANTEROPOST VIEW | $3,024 | $907 |
| RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS | $5,637 | $1,691 |
| RADEX ABD 1 VIEW | $2,142 | $643 |
| RADEX ABD 2 VIEWS | $2,058 | $617 |
| RADEX ABD COMPL W/DCBTS&/ERC VIEWS | $8,389 | $2,517 |
| RADEX ABD 3+ VIEWS | $2,389 | $717 |
| RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH | $2,275 | $683 |
| CT ABD C-MATRL | $7,177 | $2,153 |
| CT ABD C+ MATRL | $7,177 | $2,153 |
| CT ABD C-/C+ | $7,262 | $2,179 |
| CT ANGIO ABD&PELV W/ O&W / DYE | $10,369 | $3,111 |
| CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST | $7,170 | $2,151 |
| Ct Abd & pelvis W/o Contrast | $12,476 | $3,743 |
| Ct Abdomen&pelvis W/contrast | $14,401 | $4,320 |
| CT ABDOEN & PELVIS W/CONTRAST MATERIAL | $14,401 | $4,320 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE | $12,555 | $3,766 |
| MRI ABD C-MATRL | $6,668 | $2,000 |
| MRI ABD C-/C+ | $10,265 | $3,080 |
| MRA ABDOMEN W/WO CONTRAST MATERIAL | $6,107 | $1,832 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| Radiologic examination; pharynx a/o cervical esophagus | $2,170 | $651 |
| ESOPHOGRAM/ CONTRAST X-RAY ESOPHAGUS | $2,161 | $648 |
| RADEX GI TRC UPR +-DLYD FLMS W/KUB | $3,024 | $907 |
| RADEX GI UPR C+ +-GLUC +-DLYD FLMS W/KUB | $7,069 | $2,121 |
| Urography (pyelography), intravenous, with or without KUB, w… | $7,069 | $2,121 |
| URETHROCYSTOGRAPHY RETROGRADE RS&I | $5,637 | $1,691 |
| CT ANGIO ABDOMINAL ARTERIES | $7,069 | $2,121 |
| RADEX FROM NOSE RECTUM FB 1 VIEW CHLD | $2,520 | $756 |
| 3D RNDR I&R CT MRI US/OTH X REQ POSTPCX | $1,855 | $557 |
| CT LIMITED/LOCALIZED FOLLOW UP STUDY | $6,804 | $2,041 |
| OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN | $3,141 | $942 |
| US SOFT TISS HEAD&NCK R-T IMG | $3,024 | $907 |
| US CHEST REAL TIME W/IMAGE DOCUMENTATION | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE COMPLETE | $2,866 | $860 |
| US BREAST UNI REAL TIME WITH IMAGE LIMITED | $1,941 | $582 |
| US ABDOMINAL R-T W/IMAGE DOCUMENTATION | $3,224 | $967 |
| ULTRASOUND ABDOMINAL R-T W/IMAGE LIMITED | $4,003 | $1,201 |
| US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA | $893 | $268 |
| US RETROPERITONEAL R-T W/IMAGE COMPL | $2,866 | $860 |
| US RPR B-SCAN&/R-T IMG LMTD | $3,024 | $907 |
| ULTRASOUND 14 WK TABDL 1/1ST GESTATION | $2,866 | $860 |
| US PREG UTERUS 14 WK TRANSABDL EACH ADDL GESTATION | $1,170 | $351 |
| ULTRASOUND AFTER 1ST TRI 1/1ST GESTATION | $3,024 | $907 |
| US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO | $3,024 | $907 |
| US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION | $1,497 | $449 |
| Ultrasound, pregnant uterus, real time with image documentat… | $431 | $129 |
| US PREGNANT UTERUS LIMITED 1/> FETUSES | $2,300 | $690 |
| Ultrasound, pregnant uterus, real time with image documentat… | $1,854 | $556 |
| US PG UTER R-T IMG TRVG | $3,024 | $907 |
| DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE; Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete | $1,948 | $585 |
| US TRVG | $3,208 | $962 |
| US PELVIC NONOB REAL-TIME IMG COMPLETE | $3,024 | $907 |
| US PEL NONOB B-SCAN&/R-T IMG LMTD/F-UP+C97 | $2,724 | $817 |
| US SCROTUM&CNTS | $3,654 | $1,096 |
| US EXTREMITY NON-VASC REAL-TIME IMG COMPL | $3,024 | $907 |
| US EXTREMITY NON-VASC REAL-TIME IMG LMTD | $1,521 | $456 |
| US GUIDE VASCULAR ACCESS | $2,671 | $801 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| US GUIDANCE NEEDLE PLACEMENT IMG S&I | $2,613 | $784 |
| UNLISTED US PROCEDURE | $1,155 | $347 |
| Radiologic examination, osseous survey; limited (eg, for metastases) | $895 | $268 |
| RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT | $2,272 | $682 |
| JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS | $2,251 | $675 |
| CT BONE MINERAL DENSITY STUDY 1+ SITS APPND | $706 | $212 |
| ADRNL IMG CORTEX&/MEDULLA | $5,004 | $1,501 |
| HIDA SCAN – HEPATBL DUX SYS IMG GLBLDR | $3,470 | $1,041 |
| B1&/JT IMG WHBDY | $3,235 | $970 |
| B1&/JT IMG 3 PHASE STD | $3,940 | $1,182 |
| B1&/JT IMG TOMOG SPECT | $3,940 | $1,182 |
| CARD BPI GTD =BRM PLNR 1 STD REST/STRS | $3,032 | $910 |
| NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS | $2,906 | $872 |
| (DO NOT USE) PIC PANEL LIVER+ 10/BX | $808 | $242 |
| BASIC METABOLIC PANEL CALCIUM IONIZED | $1,554 | $466 |
| BASIC METABOLIC PANEL CALCIUM TOTAL | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| PIC PANEL BASIC METABOLIC | $1,430 | $429 |
| GENERAL HLTH PANEL | $1,473 | $442 |
| ELECTROLYTE PANEL | $540 | $162 |
| COMPRE METAB PANEL | $1,794 | $538 |
| PIC PANEL COMPREHENS METABOLBX | $1,794 | $538 |
| LIPID PANEL | $1,512 | $454 |
| RENAL FUNCTION PANEL | $410 | $123 |
| AQT HEP PANEL | $1,440 | $432 |
| HEPATC FUNCJ PANEL | $1,458 | $437 |
| OBSTETRIC PANEL | $970 | $291 |
| DRUG SCR QUAL MLT DRUG CLASSES CHROM EA PX | $342 | $103 |
| DRUG ASSAY ACETAMINOPHEN | $1,020 | $306 |
| Carbamazepine; total | $327 | $98 |
| DRUG ASSAY CLOZAPINE | $169 | $51 |
| ASSAY OF DIGOXIN | $780 | $234 |
| Valproic acid (dipropylacetic acid); total | $960 | $288 |
| DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE | $1,140 | $342 |
| DRUG SCREEN QUANTITATIVE GENTAMICIN | $495 | $148 |
| DRUG SCREEN QUANTITATIVE LAMOTRIGINE | $190 | $57 |
| DRUG SCREEN QUANTITATIVE LEVETIRACETAM | $191 | $57 |
| LITHIUM | $114 | $34 |
| DRUG ASSAY SALICYLATE | $1,020 | $306 |
| DRUG SCREEN QUANTITATIVE OXCARBAZEPINE | $172 | $52 |
| DRUG SCREEN QUANTITATIVE PHENOBARBITAL | $197 | $59 |
| ASSAY OF PHENYTOIN TOTAL | $243 | $73 |
| SALICYLATE | $167 | $50 |
| TACROLIMUS | $521 | $156 |
| DRUG SCREEN QUANTITATIVE THEOPHYLLINE | $459 | $138 |
| Topiramate | $179 | $54 |
| DRUG SCREEN QUANT VANCOMYCIN | $1,765 | $529 |
| Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) | $342 | $103 |
| DRUG TEST PRSMV QUAL DIR OPTICAL OBS PER DAY | $493 | $148 |
| DRUG TEST PRSMV INSTRMNT CHEMISTRY ANALYZERS | $756 | $227 |
| DRUG SCREEN QUANTITATIVE ALCOHOLS | $684 | $205 |
| Analgesics, non-opioid; 1 or 2 | $684 | $205 |
| DRUG SCREEN ANALGESICS NON-OPIOID 3-5 | $364 | $109 |
| ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2 | $310 | $93 |
| Antiepileptics, not otherwise specified; 1-3 | $310 | $93 |
| DRUG SCREENING BENZODIAZEPINES 1-12 | $1,260 | $378 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO MIC | $510 | $153 |
| URINALYSIS – URNLS DIP STICK/TABLET RGNT AUTO MIC | $690 | $207 |
| URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC | $300 | $90 |
| URNLS DIP STICK/TABLET RGNT AUTO W/O MIC | $545 | $164 |
| Urinalysis, microscopic only | $124 | $37 |
| URINE PREGNANCY TST VIS COLOR CMPRSN METHS | $684 | $205 |
| BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE | $861 | $258 |
| CYP2C19 GENE ANALYSIS COMMON VARIANTS | $2,447 | $734 |
| AK2 GENE ANALYSIS P.VAL617PHE VARIANT | $770 | $231 |
| NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR | $758 | $227 |
| ACETALDEHYDE BLD | $82 | $25 |
| KETONE BODIES SERUM QUALITATIVE | $196 | $59 |
| ACETONE/OTH KETONE BODIES SERUM QUAN | $382 | $115 |
| Adrenocorticotropic hormone (ACTH) | $664 | $199 |
| ALBUMIN SERUM PLASMA/WHOLE BLOOD | $204 | $61 |
| URINE ALBUMIN QUANTITATIVE | $96 | $29 |
| ALCOHOL BRTH | $600 | $180 |
| ASSAY OF ALDOLASE | $167 | $50 |
| ALPHA-1-ANTITRYPSIN TOTAL | $141 | $42 |
| ALPHA-FETOPROTEIN SERUM | $288 | $86 |
| AMINOLEVULINIC ACID DELTA | $237 | $71 |
| Ammonia | $1,020 | $306 |
| AMYLASE | $572 | $172 |
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STAT Specialty Hospital and STAT Emergency Center makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and STAT Specialty Hospital and STAT Emergency Center cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill for services rendered at STAT Specialty Hospital and STAT Emergency Center may differ substantially from the information provided by this website, and STAT Specialty Hospital and STAT Emergency Center shall not be liable for any inaccuracies.
