Referring Veterinarian/Clinic Information:

Client Information:

Patient Information:

Patient Case History:

Is there metal in this patient?
Previous Anesthesia or Surgery?

IMPORTANT: Minimum Required Diagnostic Screening Prior to CT

ASA <6 months old 6 months - 5 years 6 6 years or Older
1-2 Blood Glucose BUN, CREA CBC, Chem10 CBC, Chem17, Lytes Urinalysis
3 CBC, chem 10, lytes CBC, Chem 10, Lytes Thoracic Radiographs CBC, Chem17, Lytes, Urinalysis Thoracic Radiographs
4-5 CBC, chem17, lytes Urinalysis CBC, Chem17, Lytes Urinalysis Thoracic Radiographs CBC, Chem17, Lytes Urinalysis Thoracic Radiographs

CT Scan Requested:

CT Price List:

1.) CT Scan by Region:

a.) Abdomen $450

b.) Thorax $450

c.) Head $255

d.) Extremity $255

e.) Whole Body $1,400

2.) CT Contrast Iohexol 300mg/mL (Dose is typically 1mL/lb):

a.) Up to 26mL $95

b.) 26.1 - 53mL $194

c.) 53.1 - 79mL $256

d.) 79.1 - 106mL $343

3.) CT Consultation:

a.) Normal $108

b.) Additional Areas $108/additional region

c.) STAT (1 hour, weekday) $186

4.) Sedation:

a.) Ranges from $35-$100 depending on size

5.) Anesthesia (Required for Chest/Abdomen):

a.) $130/hour *

*ALL costs increase on procedures performed on Saturday/Sunday or after 8PM. Please call and discuss the case for exact pricing if this must be performed on a weekend or between the hours of 8PM-8AM.**

**The referring veterinarian is responsible for relaying these results to the client.**