Teleradiology price list: how to read one line by line

A teleradiology price list finally arrived, four modalities and a footnote, and you are expected to sign a two-year agreement on it. The document deserves more scrutiny than it invites: a price list's structure predicts your invoices better than its numbers do, and the lines missing from it are where the second year's costs live.

This page reads the document the way a procurement reviewer should: what a complete teleradiology price list contains, what most lists omit, the red flags that show up in the formatting itself, and the worksheet that makes two differently shaped lists comparable. Market figures for what the numbers should roughly look like are on teleradiology cost per read; this page is about the document.

Why you rarely see a real teleradiology price list

Very few exist in public. Most US vendors price each contract privately, treating rates as negotiating leverage, so the buyer's first look at real numbers usually comes mid-sales-cycle, attached to an NDA or a proposal. The public exceptions are worth knowing as calibration: NDX Imaging publishes starting per-study figures, from $12 for X-ray to $99 for PET-CT, checked September 3, 2026, and European provider RADIEWCARE publishes a complete volume-tier table with per-region CT and MRI rates stepping down across six volume bands.

AstraRad sits in the middle of that spectrum deliberately: no public amounts, but a complete written rate card, all twelve study types and the priority multiplier on one page, sent within one business day of a request, before any call and without a signature. The reason this page can be specific about what a good list looks like is that producing one is the business model; the checklist below applies to any vendor's document, including ours.

Scarcity of public lists has a practical consequence: you cannot benchmark a quote by browsing. You benchmark it by collecting two or three written cards against the same order data and normalizing them, which the worksheet at the end of this page does in about an hour.

What should a teleradiology price list include?

Seven sections. Print this list and check the vendor's document against it; every missing section is a category of cost that will be decided later, by them.

1. A line for every study type, on one page. Not four headline modalities. A working diagnostic operation sends multi-region CTs, advanced MRI, cardiac studies, nuclear medicine, and screening mammography, and each needs its own printed figure. The market's public cards stop at seven to eleven lines; the studies past the end of the card are precisely the expensive ones, as unpacked in teleradiology cost per study.

2. The priority multiplier, as a printed factor. Market practice adds roughly 20 to 50 percent for STAT. The honest format is one number, for example a stated multiplier applied to the base rate for STAT and urgent tiers, visible per invoice line. "STAT pricing available on request" means your emergency volume is unpriced.

3. Timing surcharges, or their explicit absence. Nights, weekends, holidays. If they exist, exact hours and amounts; if they do not, the word "none" in writing. Silence is not absence, and a surcharge discovered on the third invoice is a surcharge you agreed to by not asking.

4. Every recurring fee, including the zeros. Platform access, PACS connection, portal seats, report storage, critical-results calls, addenda. The full catalog of quiet line items is in teleradiology hidden fees; the list should price each one, and a zero is a price.

5. The volume ladder. If committed volume moves the rate, the tiers and their thresholds belong on the document, plus the consequence of missing a tier in a slow month. A minimum commitment is a price term, and it belongs on the price list, not in clause 14 of the agreement; the contract-term side of minimums is treated in per-report versus subscription pricing.

6. Escalation terms. How and when the numbers change: annual on a stated date, capped at a stated percentage, or renegotiated at term. A list without escalation terms is a year-one document being sold as a term document.

7. Definitions. What counts as one study for multi-region orders and bilateral series, what the rate includes (final signed report, subspecialty routing, QA participation, connectivity), and what clock the turnaround tiers run on. Two vendors with identical numbers and different definitions can invoice 30 percent apart on the same worklist.

What is missing from most teleradiology price lists?

Four omissions recur across the market, and each has a specific fix you can request before signing.

The unpublished lines. Multi-region CT, CT coronary angiography, advanced MRI, and cardiac MRI almost never carry a printed figure anywhere in the market. They are also the studies where subspecialty reading time is longest and reader supply thinnest, which makes by-exception pricing most expensive exactly there. Fix: refuse to compare any two lists until both show all study types you actually send, priced.

The reader behind the rate. A price list prices the report and says nothing about who signs it: generalist or fellowship-trained subspecialist, and whether the answer changes by time of day. Two $40 CT lines are different products if one is a subspecialist final read and the other is a generalist read with morning overread; the quality difference by study type is mapped in subspecialty reads by study type. Fix: a written statement of reader qualifications per line, and whether subspecialty routing carries an upcharge.

The measurement behind the tiers. Lists quote STAT and routine prices; few state the clock the tier runs on. Last-image arrival to final signature is the auditable definition. Fix: the clock definition in writing, plus the vendor's measured compliance; how to audit both is in verifying teleradiology vendor claims.

The benchmark context. No list tells you whether its numbers are high. Build the context yourself: the professional component for each CPT code in the CMS Physician Fee Schedule search tool is the one public national study-level reference, and a per-read rate sits above it because it buys availability, turnaround commitments, and QA that the Medicare figure does not fund. The method is detailed in teleradiology pricing per read.

What a well-formed price list looks like on the page

The skeleton below is the shape to hold any vendor's document against. The rates column is deliberately blank; the structure is the point, and a vendor's card should fill every row with a committed figure or an explicit "none."

Section	Line	What a complete card shows
Study rates	CR X-ray	one printed figure
	Ultrasound, including vascular	one figure, Doppler definition stated
	Mammography, 2D and tomosynthesis	figures per type, reader qualification stated
	CT single region	one figure
	CT multi-region, abdomen and pelvis	own line, definition of regions stated
	CT special and coronary CTA	own lines
	MRI single part	one figure
	MRI advanced and cardiac	own lines
	Nuclear medicine, gamma	one figure
	PET-CT	one figure
Priority	STAT and urgent multiplier	one printed factor per tier, with the SLA hours
Timing	Nights, weekends, holidays	amounts and hours, or the word none
Fees	Platform, portal, storage, calls, addenda	each priced, zeros included
Volume	Discount ladder	thresholds, rates, and the missed-tier consequence
Term	Escalation	date, mechanism, cap
Definitions	Study counting and inclusions	one paragraph each, referenced by the contract

Two observations from holding real market documents against this skeleton. Public cards typically fill the first section only: NDX Imaging's page commits figures for nine study categories and is silent on multi-region definitions, timing surcharges, and escalation, which is normal for a marketing page and insufficient for a contract schedule. And the sections buyers skip, definitions and escalation, are the two that generate most first-year invoice disputes. The skeleton takes a vendor perhaps an hour to fill honestly. What it takes a buyer who skips it is a year of reconciliation.

Eight questions to send back with any price list

The list arrives; this is the reply. Each question closes a gap the document's format may have left open, and written answers become part of the record your counsel attaches to the agreement.

1. Which of these figures are committed rates for our contract, and which are indicative?
2. What does one study mean for a CT chest, abdomen, and pelvis order, a bilateral extremity series, and an ultrasound with Doppler? Invoice examples, please.
3. Who signs each line: generalist or fellowship-trained subspecialist, and does the answer change overnight?
4. Is every read a final signed report, or are any tiers preliminary with a later final? The difference is priced in STAT versus preliminary versus final reads.
5. What clock do the turnaround tiers run on, and what was measured compliance for the last 12 months?
6. Which fees exist beyond these rates? Please state each, including zeros, for platform, integration, critical-results calls, and addenda.
7. What were your actual rate changes for existing clients in each of the last two years?
8. What happens to our rate in a month we send 20 percent less than usual?

A vendor that answers all eight in writing within a week is operationally ready to be your reading partner. Slow, partial, or verbal-only answers are themselves the answer, and they arrive conveniently before signature instead of after.

Red flags you can spot in the formatting

The document's shape leaks information before you check a single number.

A list with four lines and "call for other studies" prices by exception. A range where a figure should be ("CT: $40 to $75") defers the real decision to invoice time; ranges are for market surveys, and a rate card should commit. Percentages without bases ("volume discounts up to 25 percent") advertise a ceiling while promising nothing. An expiration under 30 days manufactures urgency on a decision that deserves procurement time. And a list the vendor will present on screen but not leave behind is not a document at all; a vendor confident in its pricing puts it in writing and lets you shop it.

None of these is disqualifying alone. Two or more together tell you the list is a sales instrument, and the real price schedule will be discovered invoice by invoice.

The normalization worksheet: two lists to one number

Differently structured lists become comparable in five steps and about an hour.

1. Export last quarter's study counts by type from the RIS, with your STAT percentage and after-hours share.
2. Map each vendor's lines onto your counts, using their written definitions for multi-region and bilateral cases. Where a vendor has no line for a study you send, ask for one; do not estimate it.
3. Apply multipliers and surcharges to your real priority and timing profile.
4. Add every recurring fee and amortize any one-time charges over the expected term.
5. Divide each vendor's total by your study count: blended cost per signed study. Rerun at 80 percent volume to expose minimums.

Keep the worksheet; it becomes your invoice-reconciliation template after go-live, and the first invoice that disagrees with it is a conversation worth having in month one rather than a pattern discovered at renewal.

A complete list, honestly formatted, makes that worksheet trivial, and that is the real test of the document: a price list you can compute an invoice from is terms, and one you cannot is advertising. AstraRad's card is built to be computed from: one figure per study type across all twelve lines, one printed STAT and urgent multiplier, no timing surcharges, no minimums, no platform fees, final signed subspecialist reads inside SLA tiers of under 1 hour STAT, 4 hours urgent, and 24 hours routine, with measured compliance published on the SLA page. It reaches you within one business day of a request, in writing, shoppable.