Request Barnes Jewish Hospital Radiology Price Quote

To request a price quotation for Radiology research tests, please fill in all applicable fields. Click “Send” to submit your request.

Note: Quotes are based on CPT codes provided below and reflect the routine time and activities required when that clinical CPT code is billed. Please realize higher fees may apply if either the technical or professional research activities exceed those performed using that clinical CPT code.

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Date of Request:		PI:
Requester Name		PI Email:
Requester Email:		IRB #:
Phone:		Protocol #:

Campus:

Barnes Jewish Hospital Barnes Jewish West County Hospital

Funding:

Funding Source: Federal/PI Initiated/Department Industry Sponsor Name: Radiology: Procedure * (Nuc Med, US, IR, MRI and Breast require approval prior to receiving price estimate) CPT Code(s) (** required) Location where Service to be performed * For Radiology protocols outside the normal scope of the CPT Code, please check the Radiology area and submit with the Imaging Acquisition Guidelines (IAG) to contacts below. Price Estimates will not be provided until Compliance receives approval from the following contacts when protocol is outside the normal scope of the CPT code – this may impact turnaround of the price estimate. MRI: Tammie Benzinger/Pam Woodard benzingert@wustl.edu/woodardp@wustl.edu (314) 362-5950/(314) 362-2928 CT: Collin Woodside/Joshua Leyba/Lauren Hesterberg Collin.Woodside@bjc.org/Joshua.Leyba_bjc.org/lauren.hesterberg_bjc.org US: Jennifer Heitman/Charity Savary Jennifer.heitman@bjc.org/charity.savary@bjc.org Breast Health US Guided, Mam, etc: Stephanie White stephanie.white2@bjc.org (314) 454-7207 *Complete Attached Form General Dx (Ortho): Edward Brewer edward.brewer@bjc.org (314) 362-1958 Interventional Radiology: Lisa Gebhart lisa.gebhart@bjc.org (314) 362-1322 *Complete Attached Form Nuclear Medicine Requests Amera Javed / Greg Williams amera@wustl.edu / greg.wiliams@wustl.edu (314) 935-3806 / (314) 362-6213 WUMC Professional Services: Darcy R. Denner, PhD drdenner@wustl.edu (314) 362-2613     An email request will be sent to you and BJC Corporate Compliance when you click Submit.                         Copyright © 2016 Washington University.