for uninsured services - Saskatchewan Medical Association

SECTION X:DIAGNOSTIC RADIOLOGYTechnicalTechnical Interpretation andComponent Component Interpretation174X Tarsus $50.60 $21.80 $72.40175X Forefoot $42.50 $18.00 $60.50176X Os calcis $42.50 $18.00 $60.50190X Single digit, same hand or foot $40.00 $17.50 $57.50191X Digits, same hand or foot $42.50 $17.50 $60.00192X Orthoroentgenograms $42.00 $22.00 $64.00Bone Survey193X Bone survey $116.00 $48.00 $164.00194X Joint survey $116.00 $48.00 $164.00195X Wrist -- four views $44.50 $23.50 $68.00196X Knee -- four views $62.30 $26.50 $88.80197X Skeletal survey -- infant $78.00 $35.00 $113.00Abdomen200X Single film of abdomen (K.U.B.) $36.00 $17.50 $53.50201X Acute abdomen survey with erect $52.00 $30.50 $82.50and/or lateral viewsGastro-Intestinal Tract210X Oesophagus $72.50 $31.50 $104.00211X G.I. Series $134.00 $65.00 $199.00212X Small bowel study $104.00 $40.00 $144.00213X Colon -- enema $163.50 $71.50 $235.00214X Colon -- double contrast enema $227.50 $88.50 $316.00215X Fluoroscopy for position of tube $29.00 $26.40 $55.40in abdomen216X Hypotonic duodenography $73.20 $42.80 $116.00217X Double contrast G.I. with $136.50 $40.00 $176.50glucagonBiliary System220X Cholecystogram $62.00 $28.00 $90.00Cholangiogram221X -- intravenous $161.80 $61.20 $223.00222X -- operative $112.40 $49.60 $162.00223X -- post-operative (T-tube) $100.00 $47.00 $147.00224X -- transhepatic, percutaneous $169.00 $71.00 $240.00Urinary System228X Percutaneous renal cystography $46.60 $16.40 $63.00229X Intravenous pyelogram $141.60 $38.40 $180.00(hypertensive survey)230X Cystogram $73.20 $26.80 $100.00Pyelogram231X -- intravenous $183.80 $47.20 $231.00SMA FEE GUIDE - X3 - April 1, 2012