Board-certified radiologist final signed reports for a cash-pay functional medicine clinic, priced per report with no minimum and no platform fee.
Quinn Functional Health opens 31 August 2026 as a cash-pay, membership-model functional medicine clinic. You see the stage three and four oncology patients yourself; your PAs see everyone else. Patients move through advanced testing, nutrition, nurse coaching, IV and ozone therapy, hyperbarics and red light, then return three to four weeks later.
You bought a Butterfly IQ3 to scan at the point of care, and you are RVT and ARRT(S) credentialed, so the scanning is not the problem. You need the other half: an official report signed by a US board-certified radiologist that a patient's oncologist or rheumatologist will not question.
Not a STAT situation, you said — two to three weeks is fine, because the report only has to be in hand when the patient returns. We quote our routine tier of under 24 hours anyway, so a report never holds up a visit, and a scan that changes a plan reaches you the same day.
General and limited vascular ultrasound, signed as final reports:
| In scope | Typical exams |
|---|---|
| Abdominal | Complete and limited abdomen, liver, gallbladder and biliary, renal and retroperitoneal |
| Small parts | Thyroid, soft tissue neck, scrotal, superficial masses |
| Pelvic | Prostate and bladder, transabdominal |
| Vascular | Carotid duplex, lower extremity venous duplex for DVT |
Out of scope at your request: transvaginal, obstetric, musculoskeletal and echocardiography — same panel, same rate ladder, so adding them later is an email. Transrectal prostate imaging needs an endocavitary probe the IQ3 lacks, so prostate work here is transabdominal.
A membership clinic usually ends up wanting carotid screening in a wellness panel, so it is worth knowing the USPSTF recommends against it in asymptomatic adults with no history of stroke or TIA. Cash removes the coverage argument, not the standard-of-care one, and an incidental finding on a study you did not need creates a workup you own. For a symptomatic patient it is a different conversation, and we read those all day.
Every study returns structured — history, technique, comparison, findings and a numbered impression — electronically signed by the reading radiologist with name and credentials. There is no preliminary tier.
The value is not that a report exists. It is whose name is on it.
An ABR-certified signature is the version an oncologist puts in a chartButterfly IQ3 at the point of care. Studies land in Butterfly Cloud with demographics and your worksheet attached.
On a Butterfly organization plan, automatic DICOM forwarding to the AstraRad PACS: you upload nothing. On an individual plan, forwarding is not included, so we join your Butterfly Cloud organisation and read in place — no new software, no cost, working from day one.
Routed by body part to a board-certified radiologist licensed in Texas, read, and signed as a final report.
Delivered to your secure AstraRad portal as a clean printable PDF, ready to attach to a chart or hand to a referring specialist.
We checked rather than assumed. Cerbo publishes a documented API for pushing documents into a chart, and signed report PDFs go through it.
Cerbo is not ONC-certified and offers no FHIR, so the document API is the right path, not a shortcut. Portal PDF delivery works from the first study regardless. Confirmed against your tenant at onboarding.
The standard technologist worksheet: indication and history, measurements, laterality, and what you saw at the bedside that the images will not show. We send templates, or read yours.
Carotid duplex is worth agreeing first: the ACR parameter expects angle-corrected peak-systolic and end-diastolic velocities at multiple levels each side, the one place a handheld probe needs deliberate technique. Your IQ3's presets support angle correction, so it is a protocol conversation, not an equipment problem. You also get a small named reading group and a direct line for case discussion.
Turnaround is contractual, not an average we hope to hit. Miss a tier on a study and that study carries a per-report credit.
Urgent and STAT are available on any study at 1.25× and 1.75× the per-report price. 99.4% of reports landed inside their SLA tier over the trailing 12 months; median STAT turnaround is 28 minutes, measured monthly.
Per signed report, in USD. No minimum volume, no platform fee, no onboarding or per-seat charge. If we do not sign a report, you do not pay for it.
| Studies per month | Per signed report |
|---|---|
| Up to 100 Your tier | $44 |
| 101 – 200 | $39 |
| 201 – 500 | $33 |
| 500+ | $29 |
Cross a tier in a month and the lower rate applies to that month — no commitment, no renegotiation. At the 40 to 50 studies you quoted that is $1,760 to $2,200 a month, or $1,980 in your first month once the five free reports are deducted. You suspect you will scan more; at 120 studies it is $4,680, and the price follows you down.
You have friends quoting $25, and it is a fair question. The work inside one report does not get cheaper with volume: the read, the subspecialty routing, the peer-review sampling, the Texas licensure, the malpractice cover and the signature cost the same at 40 studies a month as at 400. Volume only spreads the fixed cost further.
So compare what is attached to the number. At $25, ask: final signed or preliminary; licensed in Texas; malpractice behind the read; turnaround credits in writing; and can you reach the radiologist. DocPanel publishes only $199 per study, for consumer second-opinion reads.
Exactly as Rafael offered on the call: five signed reports at no charge, on real studies. Full final reports, not samples — usable clinically. Billing starts at report six.
Texas treats the practice of medicine as happening where the patient is, so a radiologist reading a patient in Seguin needs a full Texas medical license. Since 2017 the Texas Medical Board no longer issues its out-of-state telemedicine license, and grandfathered ones converted on 1 September 2024. No shortcut exists.
A signed business associate agreement is in place before any patient data moves, with no pilot-data exception. Encryption in transit and at rest, a SHA-256 hash on every image, role-scoped access, an append-only audit log, documented breach notification. No patient data is ever used for marketing, resale or model training.
Professional liability cover, with per-state endorsements for every state we read into; certificate available before you sign. One report in twenty is double-read blind by a second subspecialist, major discrepancy under 0.3%, reported monthly alongside turnaround and SLA compliance.
Cash-pay means payer credentialing is not on your critical path. If you later bill insurance, our licensure position is unchanged.
The diagnostic study needs a licensed practitioner as ordering provider — most naturally your PAs under delegated authority — and that belongs in your protocol before the first scan. Texas also has a corporate-practice-of-medicine doctrine on how a business not owned by a physician handles a physician's professional fee, exactly the fact pattern of a cash-pay clinic charging a price that includes an interpretation. Well-trodden structures exist and nothing here changes; both are worth a conversation with your attorneys.
For scale: 600,000 reads a year, 240 subspecialists in ten subspecialties, 24/7/365, room for 25,000 more studies a month and no waitlist. A 40 to 50 study month is not a volume we need you to justify.
| Stage | What happens | Owner |
|---|---|---|
| Days 1–3 | BAA and service agreement signed; reading group assigned, portal accounts created. | AstraRad |
| Days 3–5 | Butterfly Cloud set up; DICOM forwarding and Doppler confirmed, route configured. | Joint |
| Days 5–10 | Test study end to end, worksheets agreed, then your first live signed reports. | Joint |
First signed report within 10 business days of countersignature; Cerbo delivery follows once the inbound path is confirmed. Sample reports, de-identified, follow separately as Abhijeet promised.
Signing starts onboarding, not a volume commitment. Pricing holds through 30 September 2026; the agreement is the signed MSA and BAA, by e-signature.
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