|
Western blot test
|
$334.65 |
$334.65 |
$334.65 |
$153.18
|
|
Wilate injection
|
$3,669.19 |
$3,669.19 |
$3,669.19 |
$2.94
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$629.96 |
$629.96 |
$629.96 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$919.34 |
$919.34 |
$919.34 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$546.86 |
$546.86 |
$546.86 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$863.69 |
$863.69 |
$863.69 |
$436.15
|
|
Wrist X-ray
|
$1,092.97 |
$1,092.97 |
$1,092.97 |
$343.70
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$997.25 |
$997.25 |
$997.25 |
$2,830.00
|
|
Xm archive tissue molec anal
|
$66.78 |
$66.78 |
$66.78 |
$47.85
|
|
Xpos opn fmrl eprst aor uni add-on
|
$6,021.33 |
$6,021.33 |
$6,021.33 |
$2,160.89
|
|
X-ray abdomen 1 view
|
$357.65 |
$357.65 |
$357.65 |
$255.00
|
|
X-ray abdomen 2 views
|
$418.49 |
$418.49 |
$418.49 |
$312.36
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$718.26 |
$718.26 |
$718.26 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$418.49 |
$418.49 |
$418.49 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$843.66 |
$843.66 |
$843.66 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,466.20 |
$1,466.20 |
$1,466.20 |
$768.30
|
|
X-ray bone age studies
|
$411.07 |
$411.07 |
$411.07 |
$246.75
|
|
X-ray bone length studies
|
$638.87 |
$638.87 |
$638.87 |
$287.25
|
|
X-ray bone survey complete
|
$739.78 |
$739.78 |
$739.78 |
$666.60
|
|
X-ray bone survey infant
|
$290.13 |
$290.13 |
$290.13 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$629.22 |
$629.22 |
$629.22 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$835.50 |
$835.50 |
$835.50 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$911.18 |
$911.18 |
$911.18 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$855.53 |
$855.53 |
$855.53 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$954.96 |
$954.96 |
$954.96 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,203.53 |
$1,203.53 |
$1,203.53 |
$820.15
|
|
X-ray consultation
|
$48.98 |
$48.98 |
$48.98 |
$36.00
|
|
X-ray elbow 2 views (both sides)
|
$586.93 |
$586.93 |
$586.93 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$1,108.55 |
$1,108.55 |
$1,108.55 |
$342.00
|
|
Xray endovasc thor ao repr
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$1,889.01
|
|
Xray endovasc thor ao repr
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$2,266.32
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,026.93 |
$1,026.93 |
$1,026.93 |
$486.24
|
|
X-ray exam of arm infant
|
$519.40 |
$519.40 |
$519.40 |
$248.82
|
|
X-ray exam of eye sockets
|
$647.03 |
$647.03 |
$647.03 |
$349.05
|
|
X-ray exam of middle ear
|
$899.31 |
$899.31 |
$899.31 |
$341.25
|
|
X-ray exam of sinuses
|
$409.59 |
$409.59 |
$409.59 |
$211.00
|
|
X-ray exam thorac spine4/>vw
|
$641.83 |
$641.83 |
$641.83 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$205.54 |
$205.54 |
$205.54 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$797.65 |
$797.65 |
$797.65 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$788.75 |
$788.75 |
$788.75 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$655.93 |
$655.93 |
$655.93 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$743.49 |
$743.49 |
$743.49 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$1,075.16 |
$1,075.16 |
$1,075.16 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$728.65 |
$728.65 |
$728.65 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$801.36 |
$801.36 |
$801.36 |
$270.00
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$623.28 |
$623.28 |
$623.28 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$83.11 |
$83.11 |
$83.11 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$648.51 |
$648.51 |
$648.51 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$323.52 |
$323.52 |
$323.52 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$938.63 |
$938.63 |
$938.63 |
$304.15
|
|
X-ray knee 1-2 views (both sides)
|
$808.78 |
$808.78 |
$808.78 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$1,226.53 |
$1,226.53 |
$1,226.53 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$434.82 |
$434.82 |
$434.82 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$421.46 |
$421.46 |
$421.46 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$589.89 |
$589.89 |
$589.89 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$816.20 |
$816.20 |
$816.20 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$822.88 |
$822.88 |
$822.88 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$756.84 |
$756.84 |
$756.84 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$189.96 |
$189.96 |
$189.96 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$584.70 |
$584.70 |
$584.70 |
$277.70
|
|
X-ray neck soft tissue
|
$527.57 |
$527.57 |
$527.57 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$448.91 |
$448.91 |
$448.91 |
$225.96
|
|
X-ray of mammary ducts
|
$1,028.42 |
$1,028.42 |
$1,028.42 |
$473.55
|
|
X-ray optic foramina
|
$327.97 |
$327.97 |
$327.97 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$467.46 |
$467.46 |
$467.46 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$584.70 |
$584.70 |
$584.70 |
$342.30
|
|
Xray place prox ext thor ao
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$832.53 |
$832.53 |
$832.53 |
$742.00
|
|
X-ray ribs 2 views left
|
$291.61 |
$291.61 |
$291.61 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$535.73 |
$535.73 |
$535.73 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$695.26 |
$695.26 |
$695.26 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$822.88 |
$822.88 |
$822.88 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$618.09 |
$618.09 |
$618.09 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$464.50 |
$464.50 |
$464.50 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$954.96 |
$954.96 |
$954.96 |
$292.50
|
|
X-ray sella turcica
|
$250.06 |
$250.06 |
$250.06 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$968.31 |
$968.31 |
$968.31 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$966.09 |
$966.09 |
$966.09 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$876.31 |
$876.31 |
$876.31 |
$601.30
|
|
X-ray skull < 4 views
|
$410.33 |
$410.33 |
$410.33 |
$291.78
|
|
X-ray skull > 4 views complete
|
$1,147.14 |
$1,147.14 |
$1,147.14 |
$414.60
|
|
X-ray slg plne bdy sect without urogr
|
$1,197.59 |
$1,197.59 |
$1,197.59 |
$387.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$859.98 |
$859.98 |
$859.98 |
$557.70
|
|
X-ray small intestine follow-through study
|
$265.64 |
$265.64 |
$265.64 |
$504.14
|
|
X-ray spine single view
|
$175.86 |
$175.86 |
$175.86 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$490.47 |
$490.47 |
$490.47 |
$263.49
|
|
X-ray sternum > 2 views
|
$563.18 |
$563.18 |
$563.18 |
$269.75
|
|
X-ray surgical specimen
|
$920.08 |
$920.08 |
$920.08 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$834.01 |
$834.01 |
$834.01 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$630.70 |
$630.70 |
$630.70 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$370.26 |
$370.26 |
$370.26 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$655.19 |
$655.19 |
$655.19 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$315.35 |
$315.35 |
$315.35 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$1,290.34 |
$1,290.34 |
$1,290.34 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$1,065.52 |
$1,065.52 |
$1,065.52 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$795.43 |
$795.43 |
$795.43 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$839.95 |
$839.95 |
$839.95 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$882.98 |
$882.98 |
$882.98 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$863.69 |
$863.69 |
$863.69 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$130.60 |
$130.60 |
$130.60 |
$64.28
|