Teleradiology cost per study: what each study type buys

Budgeting an imaging operation means knowing what a study costs before it is ordered, and teleradiology quotes answer that question unevenly: a rate for CT, a rate for MRI, and silence about what happens when the order is a CT of the chest, abdomen, and pelvis with contrast and three priors. Teleradiology cost per study has an anatomy, and buyers who understand it read quotes differently.

This page walks that anatomy by study type: what drives each modality's price, which figures are published, and the invoice-definition questions that move real costs more than the rates do. The market price table across all twelve study types is on teleradiology cost per read, and the vendor-side economics of the rate itself are on teleradiology pricing per read; this page is the study-level view between them.

What does teleradiology cost per study in 2026?

Published figures, which exist for about seven of the twelve common study types, run from $12 to $99. NDX Imaging, the most complete public US price card, publishes starting rates of $12 for X-ray, $28 for ultrasound, $32 for mammography, $40 for CT, $60 for MRI, $45 for echocardiogram, $38 for nuclear medicine, $40 for NIOSH B reads, and $99 for PET-CT, checked September 3, 2026. Wider market bands, assembled from vendor rate sheets and buyer-reported terms, put X-ray at $10 to $15, single-region CT at $30 to $50, and single-part MRI at $45 to $75.

None of those figures is an AstraRad price. AstraRad prices each of its twelve study types as one figure per signed final report, on a written rate card that reaches you within one business day of a request; the numbers on this page are market context for reading any card, including ours.

The spread from $12 to $99 is not arbitrary. It tracks interpretation work, reader scarcity, and regulatory overhead, and each study class carries a different mix of the three.

The cost anatomy, study type by study type

Study class	Published range	What the rate is mostly paying for
Plain film X-ray	$10 to $15	Volume throughput; fixed delivery overhead is the price floor
Ultrasound	around $28	Cine and Doppler review time; operator-dependent image quality
Mammography	$25 to $40	MQSA-qualified readers and standing audit obligations
NIOSH B read	around $40	A federally certified reader classification, small reader pool
CT, single region	$30 to $50	Cross-sectional volume review; contrast and protocol variety
CT, multi-region	rarely published	Two or more regions in one sitting; the definition question below
MRI, single part	$45 to $75	Sequence count; neuro and MSK subspecialty demand
MRI, advanced and cardiac	rarely published	The scarcest reader supply on any card
Nuclear medicine, gamma	around $38	Functional imaging interpretation; smaller reader pool
PET-CT	up to $99	Two co-registered volumes, oncologic context, prior comparison

Sources: NDX Imaging published rates as above; bands from the vendor rate sheets and buyer-reported contract terms compiled on teleradiology cost per read.

Plain film is priced by throughput. The interpretation is fast for an experienced reader, so the rate's floor is set less by physician time and more by everything that wraps it: routing, QA sampling, report delivery, archiving. This is why X-ray rates cluster tightly across vendors while MRI rates spread.

Mammography costs more than its image count suggests because federal law restricts who may read it. Under the FDA's Mammography Quality Standards Act, interpreting physicians must meet initial and continuing qualification requirements, and every reader's outcomes feed an annual medical audit tracking cancer detection and recall rates. A vendor quoting mammography is quoting a compliance program with a physician inside it; screening workflow specifics are on the telemammography service page.

B reads are the clearest example of certification pricing. A B read is a chest radiograph classification for pneumoconiosis surveillance performed by a physician certified through the NIOSH B Reader program, a competency examination administered by CDC's occupational safety institute. The image is a plain film; the $40 published rate, more than three times NDX's ordinary X-ray figure, prices the credential and the small pool that holds it. Occupational medicine clients should confirm a vendor actually staffs B Readers before contracting for the line.

CT and MRI price on interpretation time and subspecialty pull. The Medicare work RVU files, the public measure of valued physician work per CPT code, put a two-view chest X-ray at 0.22 work RVUs against 1.48 for a brain MRI, a nearly sevenfold spread that vendor rates compress but follow. Advanced MRI and cardiac MRI sit atop the card because their reader supply is thinnest; almost no vendor publishes a figure for either, which makes those two lines the first thing to demand in any written quote. Modality-specific coverage detail is on MRI teleradiology.

Nuclear medicine and PET-CT combine functional interpretation with oncologic context. A PET-CT read is two co-registered volumes, usually with priors, usually feeding a treatment decision, and the published $99 top of the market reflects all three; the workflow is described on PET-CT and nuclear medicine reads.

What counts as one study, and why it moves invoices more than rates do

Two vendors can quote identical rates and invoice 30 percent apart, because "per study" hides a definition. Four cases decide most of the money.

Multi-region CT. A chest-abdomen-pelvis order can be one combined study, two lines (chest; abdomen and pelvis), or three regions. Coding practice recognizes the ambiguity: Medicare prices a combined abdomen-pelvis CT under a single CPT code precisely because the paired acquisition is standard, per the CMS Physician Fee Schedule relative value files. Ask each bidder how that exact order bills, in writing.

Per-region pricing structures. Some vendors price regions explicitly: European provider RADIEWCARE publishes a per-region table where a one-region CT is 23 euros and a four-region CT is 52 euros at the smallest volume tier, checked September 3, 2026. Per-region pricing is not worse; it is more granular, and it forces the definition into the open, which is where you want it regardless of structure.

Bilateral and series studies. Bilateral extremity films, scoliosis series, and whole-spine MRI each either aggregate into one study or split into several depending on the contract. Urgent care and orthopedic operations, where bilateral orders are routine, should price this case specifically.

Recalls, addenda, and repeat sends. A study resent after a technical failure, an addendum after new clinical information, a comparison re-read: each is either free, included, or a fresh line item. Addenda in particular should never bill, and the contract should say so.

The test that resolves all four at once: pull five real, messy orders from last month's RIS, send the identical five to every bidder, and ask for the invoice each would generate. Ten minutes of vendor effort, and the answers are more informative than any rate card. Where the definitions hide fees rather than merely varying, the patterns are cataloged in teleradiology hidden fees.

How study mix moves your blended teleradiology cost per study

Two facilities can buy from the same vendor, on the same rate card, and pay wildly different average costs, because the blended number is mostly a property of the mix. Two worked examples, both computed on NDX Imaging's published starting rates from above, show the size of the effect. Every figure is a third party's published market rate used to illustrate the method, and none is an AstraRad price.

An urgent care mix, per 100 studies: 85 X-rays at $12, 10 ultrasounds at $28, 5 CTs at $40. Total $1,500, or a blended $15.00 per study. Plain film dominance keeps the average within a few dollars of the X-ray rate, which is why urgent care operators should negotiate the X-ray line hardest and mostly ignore the rest of the card.

An outpatient imaging center mix, per 100 studies: 30 X-rays at $12, 20 ultrasounds at $28, 15 mammograms at $32, 20 CTs at $40, 12 MRIs at $60, 3 PET-CTs at $99. Total $3,217, or a blended $32.17 per study. Same vendor, same card, and the average cost per study more than doubles on mix alone.

The drift matters as much as the snapshot. Shift the imaging center's mix by five points from X-ray to CT, the ordinary direction as cross-sectional referrals grow, and the blend rises about $1.40 per study, roughly $250 a month at 1,500 studies, with no rate change anywhere. Budget owners who track only the negotiated rates miss this entirely and then attribute the creeping invoice to the vendor. Put blended cost per study on the same monthly dashboard as turnaround, computed from the invoice, and mix drift becomes a number you see rather than a surprise you audit.

The mix lens also reorders negotiation priorities. The line worth a hard negotiation is the one that multiplies across your volume: the X-ray rate for an urgent care group, the CT and MRI lines for an imaging center, the PET-CT line for an oncology-heavy operation. A $2 concession on a line you send 800 times a month is worth more than a $15 concession on one you send twice.

Which modifiers sit on top of the study price?

Whatever the base anatomy, three modifiers apply at invoice time, and each one belongs on the rate card as a printed figure with its trigger conditions stated, never as a discretion exercised at billing.

Priority multiplies the rate: market practice adds roughly 20 to 50 percent for STAT tiers. Subspecialty routing is an upcharge at some vendors and the default at others. Timing surcharges for nights, weekends, and holidays stack at some vendors on top of the priority multiplier, charging twice for one scarcity. The full lever-by-lever treatment is on teleradiology cost per read, and the structural comparison against subscriptions and block fees is in per-report versus subscription pricing.

AstraRad's modifier structure, stated as fact for comparison: one printed multiplier for STAT reads under 1 hour and urgent under 4 hours; subspecialty routing as the default on every study, never an upcharge, so a pediatric abdominal CT goes to a pediatric radiologist at the base rate; no nights, weekend, or holiday surcharge; no surge premium at any volume. Every study returns as a final signed report from a board-certified, fellowship-trained subspecialist, and 99.4 percent of reports came back inside their SLA tier over the trailing 12 months, measured from last-image arrival to signature and published on the SLA page. Which studies benefit most from the subspecialty match is mapped in subspecialty reads by study type.

Pricing your own worklist: a 30-minute exercise

Take last month's order list and build the only number that matters, your blended cost per study, under each proposal.

1. Export study counts by type from the RIS. Collapse them into the ten study classes above.
2. Apply each vendor's rates, using their written answers to the five-order definition test for the ambiguous cases.
3. Add priority: apply the STAT multiplier to your actual STAT percentage, and any timing surcharges to your actual after-hours volume.
4. Add the fixed items: platform fees, minimum shortfalls at your slowest recent month, integration charges amortized over the term.
5. Divide by total studies. That is the real teleradiology cost per study for your operation, and it is the number to compare, one proposal against the next.

Run it twice, once at last month's volume and once at 80 percent of it, because fixed items and minimums behave differently in the slow case. A vendor whose real blended number rises sharply at 80 percent volume has priced your commitment; one whose number holds has priced your work. When you want a card to run this exercise against, AstraRad's complete written rate card, all twelve study types and the priority multiplier on one page, arrives within one business day of a request.