<p>Agreement Period: May 1, 2017 through April 30, 2022 Suppliers must enter firm prices for all contracted years. </p><p>ESTIMATED UNIT QUANTITY PRICE TOTAL</p><p>Abdomen 1-View 1780 ea. $______$______</p><p>Abdomen 2-View 255 ea. $______$______</p><p>Abdomen 3-View 230 ea. $______$______</p><p>Ankle (AP & oblique, lateral) 330 ea. $______$______</p><p>Bone Density Study 340 ea. $______$______</p><p>Set-Up Fee for Bone Density 245 ea. $______$______</p><p>Calcaneus 120 ea. $______$______</p><p>Cervical Spine (AP & Lateral) 255 ea. $______$______</p><p>Chest (AP) 2230 ea. $______$______</p><p>Chest (AP & Lateral) 935 ea. $______$______</p><p>Clavicle (AP, AP Angle 15 degrees) 145 ea. $______$______</p><p>Dorsal Spine 135 ea. $______$______</p><p>Echo Cardiogram 515 ea. $______$______</p><p>EKG with Interpretation 3245 ea. $______$______</p><p>Set-Up Fee for EKG 435 ea. $______$______</p><p>Elbow (AP, external oblique, 300 ea. $______$______Lateral)</p><p>Elbow Complete 215 ea. $______$______</p><p>Facial Bones (water,lateral arches) 275 ea. $______$______</p><p>Femur (AP & Lateral) 225 ea. $______$______</p><p>Finger 200 ea. $______$______</p><p>Foot, complete, 3V 405 ea. $______$______</p><p>Foot (AP & Lateral) 395 ea. $______$______Forearm (AP & Lateral) 205 ea. $______$______</p><p>Hand (AP, oblique lateral) 385 ea. $______$______</p><p>Hand, 3 views 190 ea. $______$______</p><p>Hip, Unilateral 340 ea. $______$______</p><p>Hip, bilateral pelvis 220 ea. $______$______</p><p>Holter/Print out/ 165 ea. $______$______RPT interpretation</p><p>Humerus (AP & Lateral) 165 ea. $______$______</p><p>Knee (AP & Lateral 440 ea. $______$______</p><p>Knee, 3 view 187 ea. $______$______</p><p>Lower Leg (AP & Lateral) 125 ea. $______$______</p><p>Lumbar Spine (AP & Lateral) 325 ea. $______$______</p><p>Mammogram (bilateral) 960 ea. $______$______</p><p>Mammogram, (unilateral) 126 ea. $______$______</p><p>Set-Up fee/Site Visit, 240 ea. $______$______Mammogram</p><p>Mandible 125 ea. $______$______</p><p>Nasal Bones(waters, both laterals) 190 ea. $______$______</p><p>Orbit 145 ea. $______$______</p><p>Pelvis 240 ea. $______$______</p><p>Ribs (Bilateral) 180 ea. $______$______</p><p>Ribs (Unilateral) 205 ea. $______$______</p><p>Sacrum/Coccyx MIN 2V 155 ea. $______$______</p><p>Scapula Complete 120 ea. $______$______</p><p>Shoulder (Internal & external 275 ea. $______$______Rotation)</p><p>Sinuses (waters, PA lateral) 165 ea. $______$______Skull (AP, townes, both laterals) 250 ea. $______$______</p><p>Tibia/Fibula 217 ea. $______$______</p><p>Toe 180 ea. $______$______</p><p>Thoracic Spine AP & Lateral 340 ea. $______$______</p><p>ULTRASOUNDS Breast 210 ea. $______$______Abdomen Complete 690 ea. $______$______Renal-Retroperitone 440 ea. $______$______Pelvis Complete 285 ea. $______$______Pelvis Limited 145 ea. $______$______Extremity Ultrasound 195 ea. $______$______Thyroid 290 ea. $______$______Gall Bladder US 25 ea.</p><p>Vascular Studies 251 ea. $______$______</p><p>Wrist (AP, oblique, lateral) 200 ea. $______$______</p><p>Wrist (complete) 165 ea. $______$______</p><p>Set up Fees for X-Rays 1040 ea. $______$______</p><p>Arteries Doppler-Carotid 20 ea. $______$______</p><p>Bilateral Arterial 30 ea. $______$______</p><p>Ven Doppler Extrem/Lim 70 ea. $______$______</p><p>Ultrasound-Scrotum 20 ea. $______$______</p><p>Duplex Scan Arterial 10 ea. $______$______</p><p>Pulmonary Function Test 7 ea. $______$______</p><p>TOTAL FOR 5/1/17-4/30/22 $______</p>