|
Warde vitamin e (alpha-tocopherol)
|
$4.32 |
$4.32 |
$4.32 |
$59.25
|
|
Warde zinc
|
$23.04 |
$23.04 |
$23.04 |
$62.50
|
|
Wbc automated
|
$13.32 |
$13.32 |
$13.32 |
$32.35
|
|
Whole mitochondrial genome
|
$65.52 |
$65.52 |
$65.52 |
$2,175.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$315.72 |
$315.72 |
$315.72 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$420.84 |
$420.84 |
$420.84 |
$438.75
|
|
Wrist X-ray
|
$493.20 |
$493.20 |
$493.20 |
$342.80
|
|
Xe133 xenon 10mci
|
$227.52 |
$227.52 |
$227.52 |
$207.00
|
|
X-ray abdomen 1 view
|
$246.96 |
$246.96 |
$246.96 |
$258.50
|
|
X-ray abdomen 2 views
|
$302.04 |
$302.04 |
$302.04 |
$316.47
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$604.08 |
$604.08 |
$604.08 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$255.96 |
$255.96 |
$255.96 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$380.88 |
$380.88 |
$380.88 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$943.56 |
$943.56 |
$943.56 |
$773.40
|
|
X-ray bone age studies
|
$152.28 |
$152.28 |
$152.28 |
$251.40
|
|
X-ray bone length studies
|
$202.68 |
$202.68 |
$202.68 |
$285.30
|
|
X-ray bone survey complete
|
$494.28 |
$494.28 |
$494.28 |
$660.00
|
|
X-ray bone survey infant
|
$249.84 |
$249.84 |
$249.84 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$333.00 |
$333.00 |
$333.00 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$468.00 |
$468.00 |
$468.00 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$545.40 |
$545.40 |
$545.40 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$342.36 |
$342.36 |
$342.36 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$493.56 |
$493.56 |
$493.56 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$508.32 |
$508.32 |
$508.32 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$339.84 |
$339.84 |
$339.84 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$555.84 |
$555.84 |
$555.84 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$272.52 |
$272.52 |
$272.52 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$295.20 |
$295.20 |
$295.20 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$368.64 |
$368.64 |
$368.64 |
$517.80
|
|
X-ray exam of arm infant
|
$173.88 |
$173.88 |
$173.88 |
$248.44
|
|
X-ray exam of eye sockets
|
$131.76 |
$131.76 |
$131.76 |
$328.35
|
|
X-ray exam of femur 1
|
$164.16 |
$164.16 |
$164.16 |
$240.00
|
|
X-ray exam of mastoids
|
$152.28 |
$152.28 |
$152.28 |
$193.41
|
|
X-ray exam of sinuses
|
$210.96 |
$210.96 |
$210.96 |
$214.50
|
|
X-ray exam si joints
|
$131.76 |
$131.76 |
$131.76 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$121.68 |
$121.68 |
$121.68 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$270.00 |
$270.00 |
$270.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$474.48 |
$474.48 |
$474.48 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$354.96 |
$354.96 |
$354.96 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$295.56 |
$295.56 |
$295.56 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$337.68 |
$337.68 |
$337.68 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$402.48 |
$402.48 |
$402.48 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$422.28 |
$422.28 |
$422.28 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$336.96 |
$336.96 |
$336.96 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$326.16 |
$326.16 |
$326.16 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$402.12 |
$402.12 |
$402.12 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$376.20 |
$376.20 |
$376.20 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$413.28 |
$413.28 |
$413.28 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$268.56 |
$268.56 |
$268.56 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$359.64 |
$359.64 |
$359.64 |
$309.31
|
|
X-ray joint survey 1 view
|
$290.88 |
$290.88 |
$290.88 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$344.16 |
$344.16 |
$344.16 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$489.24 |
$489.24 |
$489.24 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$244.08 |
$244.08 |
$244.08 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$187.92 |
$187.92 |
$187.92 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$272.16 |
$272.16 |
$272.16 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$555.12 |
$555.12 |
$555.12 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$399.24 |
$399.24 |
$399.24 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$381.60 |
$381.60 |
$381.60 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$345.60 |
$345.60 |
$345.60 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$335.16 |
$335.16 |
$335.16 |
$274.65
|
|
X-ray neck soft tissue
|
$240.12 |
$240.12 |
$240.12 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$179.64 |
$179.64 |
$179.64 |
$225.60
|
|
X-ray optic foramina
|
$148.68 |
$148.68 |
$148.68 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$335.52 |
$335.52 |
$335.52 |
$280.80
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$628.92 |
$628.92 |
$628.92 |
$755.50
|
|
X-ray ribs 2 views left
|
$282.60 |
$282.60 |
$282.60 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$373.32 |
$373.32 |
$373.32 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$451.80 |
$451.80 |
$451.80 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$480.60 |
$480.60 |
$480.60 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$294.48 |
$294.48 |
$294.48 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$335.52 |
$335.52 |
$335.52 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$455.40 |
$455.40 |
$455.40 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$277.56 |
$277.56 |
$277.56 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$338.04 |
$338.04 |
$338.04 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$654.12 |
$654.12 |
$654.12 |
$606.89
|
|
X-ray skull < 4 views
|
$324.00 |
$324.00 |
$324.00 |
$292.50
|
|
X-ray skull > 4 views complete
|
$324.00 |
$324.00 |
$324.00 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$596.16 |
$596.16 |
$596.16 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$776.88 |
$776.88 |
$776.88 |
$557.70
|
|
X-ray small intestine follow-through study
|
$179.64 |
$179.64 |
$179.64 |
$499.50
|
|
X-ray spine single view
|
$198.36 |
$198.36 |
$198.36 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$171.72 |
$171.72 |
$171.72 |
$264.48
|
|
X-ray sternum > 2 views
|
$249.84 |
$249.84 |
$249.84 |
$274.65
|
|
X-ray surgical specimen
|
$612.00 |
$612.00 |
$612.00 |
$504.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$226.80 |
$226.80 |
$226.80 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$375.12 |
$375.12 |
$375.12 |
$320.45
|
|
X-ray thoracolumbar spine >=2 views
|
$304.56 |
$304.56 |
$304.56 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$207.72 |
$207.72 |
$207.72 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$273.24 |
$273.24 |
$273.24 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$381.24 |
$381.24 |
$381.24 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$261.36 |
$261.36 |
$261.36 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$574.20 |
$574.20 |
$574.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$559.08 |
$559.08 |
$559.08 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$305.28 |
$305.28 |
$305.28 |
$290.40
|
|
Yersinia antibody
|
$4.22 |
$4.22 |
$4.22 |
$55.80
|
|
Zika virus dna/rna amp probe
|
$16.42 |
$16.42 |
$16.42 |
$185.00
|
|
Zika virus igm antibody
|
$5.39 |
$5.39 |
$5.39 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$109.94 |
$109.94 |
$109.94 |
$122.45
|
|
Zoster vaccine-live inj
|
$243.00 |
$243.00 |
$243.00 |
$361.50
|