Quotation Estimate Radiologist in United States New York City –Free Word Template Download with AI
450 Park Avenue, Suite 1200, New York, NY 10022
Telephone: (212) 555-0187 | Fax: (212) 555-0188
Email: [email protected]
NYC Department of Health License No. 44-2019-7834
Quotation EstimateQuotation Details
Quotation No.: QE-2025-04471
Date Issued: June 12, 2025
Valid Until: July 12, 2025
Prepared By: Dr. Margaret Chen, MD, FACR
Service Location: United States New York City
Client Information
Client Name: Manhattan Health Partners LLC
Address: 285 Madison Avenue, New York, NY 10017
Attn: Mr. David Rosen, Director of Operations
Phone: (212) 555-3341
Email: [email protected]
Dear Mr. Rosen,
Thank you for your inquiry regarding the engagement of a board-certified Radiologist to provide comprehensive diagnostic imaging interpretation services for Manhattan Health Partners LLC. This Quotation Estimate has been prepared in accordance with the prevailing medical billing standards and fee schedules applicable to the United States New York City metropolitan area. The following itemization reflects our professional assessment of the services, personnel, and resources required to deliver the requested radiological consulting arrangement.
| # | Service Description | Quantity / Duration | Unit Rate (USD) | Extended Cost (USD) | Notes |
|---|---|---|---|---|---|
| 1 | Board-Certified Radiologist – Full-Time Diagnostic Interpretation (CT, MRI, X-Ray, Ultrasound) | 12 months | $18,500.00 / mo | $222,000.00 | 40 hrs/week, Mon–Fri |
| 2 | Interventional Radiologist – On-Call Coverage (Weekends & Holidays) | 12 months | $4,200.00 / mo | $50,400.00 | 16 hrs/week coverage |
| 3 | Mammography & Breast Imaging Specialist – Dedicated Radiologist Consultation | 12 months | $3,800.00 / mo | $45,600.00 | ACR-accredited protocols |
| 4 | Pediatric Radiologist – Part-Time Interpretation Services | 12 months | $2,900.00 / mo | $34,800.00 | 20 hrs/week |
| 5 | Radiology Information System (RIS) & PACS Integration – Annual Licensing & Support | 12 months | $1,200.00 / mo | $14,400.00 | HIPAA-compliant platform |
| 6 | Continuing Medical Education (CME) & Board Recertification Allowance | Annual | $3,500.00 | $3,500.00 | Per Radiologist (x4) |
| 7 | Malpractice & Professional Liability Insurance – Radiologist Panel | 12 months | $2,100.00 / mo | $25,200.00 | $5M aggregate limit |
| 8 | Administrative & Billing Coordination – NYC Medical Fee Schedule Compliance | 12 months | $950.00 / mo | $11,400.00 | United States New York City rates |
| Subtotal | $407,300.00 |
| Applicable NYC Sales & Service Tax (8.875%) | $36,147.88 |
| NYC Occupational Tax (3.078%) | $12,536.68 |
| Grand Total (USD) | $455,984.56 |
Terms and Conditions of This Quotation Estimate
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issuance. All pricing is based on current fee schedules in the United States New York City region and is subject to adjustment should applicable state or municipal regulations change prior to contract execution.
- All Radiologist professionals engaged under this arrangement hold active New York State medical licenses, board certification through the American Board of Radiology (ABR), and maintain malpractice coverage meeting or exceeding the minimum requirements set forth by the New York State Department of Health.
- Payment terms: Net 30 days from the date of invoice. A 1.5% monthly late fee shall apply to any outstanding balance exceeding the stated payment window. Payment may be made via ACH transfer, certified check, or corporate wire to the account designated on each invoice.
- This Quotation Estimate does not constitute a binding contract. A formal Service Agreement must be executed by both parties prior to the commencement of any Radiologist services. All terms herein are subject to the final executed agreement.
- Should the client require additional Radiologist specialists beyond those itemized above, a supplemental Quotation Estimate will be issued within five (5) business days of the written request.
- All diagnostic imaging reports and patient data shall be handled in strict compliance with the Health Insurance Portability and Accountability Act (HIPAA), the New York State Public Health Law, and all applicable federal and United States New York City municipal privacy regulations.
- Early termination of this engagement may be initiated by either party with sixty (60) days written notice. In the event of early termination, the client shall be responsible for all services rendered through the termination date plus a pro-rated portion of the annual insurance and licensing fees.
- This Quotation Estimate reflects professional fees only. Costs associated with imaging equipment, contrast agents, facility overhead, and patient scheduling are excluded and shall be billed separately at the United States New York City prevailing rates.
Prepared and Authorized By:
Dr. Margaret Chen, MD, FACR
Chief of Radiology, Empire Diagnostic Imaging Center
Date: ______________________
Accepted and Approved By (Client):
David Rosen
Director of Operations, Manhattan Health Partners LLC
Date: ______________________
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