|
Warde vitamin c (ascorbic acid)
|
$3.93 |
$3.93 |
$5.19 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$7.33 |
$7.33 |
$9.68 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$2.62 |
$2.62 |
$3.46 |
$55.00
|
|
Warde zinc
|
$15.70 |
$15.70 |
$20.74 |
$62.50
|
|
Wbc automated
|
$47.75 |
$47.75 |
$63.08 |
$32.80
|
|
Wet mounts/ w preparations
|
$29.43 |
$29.43 |
$38.88 |
$36.80
|
|
Whfo nontorsion joint prefab
|
$65.40 |
$65.40 |
$86.40 |
$188.80
|
|
Whfo w/joint(s) custom fab
|
$163.50 |
$163.50 |
$216.00 |
$436.49
|
|
Whole blood for transfusion
|
$123.17 |
$123.17 |
$162.72 |
$479.50
|
|
Who nontorsion jnts pre cst
|
$16.57 |
$16.57 |
$21.89 |
$711.46
|
|
Wilate injection
|
$872.00 |
$872.00 |
$872.00 |
$2.94
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$300.19 |
$300.19 |
$396.58 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$300.19 |
$300.19 |
$396.58 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$297.79 |
$297.79 |
$393.41 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$340.30 |
$340.30 |
$449.57 |
$436.15
|
|
Xcellistem, 1 mg
|
$2,274.83 |
$2,274.83 |
$3,005.28 |
$1,356.81
|
|
Xfer tis s/a/l 10 sq cm/<
|
$1,426.60 |
$1,426.60 |
$1,884.68 |
$2,623.24
|
|
X-ray abdomen 1 view
|
$229.78 |
$229.78 |
$303.56 |
$255.00
|
|
X-ray abdomen 2 views
|
$255.06 |
$255.06 |
$336.96 |
$312.36
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$255.06 |
$255.06 |
$336.96 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$241.33 |
$241.33 |
$318.82 |
$271.44
|
|
X-ray bone length studies
|
$269.02 |
$269.02 |
$355.40 |
$287.25
|
|
X-ray bone survey complete
|
$294.52 |
$294.52 |
$389.09 |
$666.60
|
|
X-ray bone survey infant
|
$294.52 |
$294.52 |
$389.09 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$229.78 |
$229.78 |
$303.56 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$255.06 |
$255.06 |
$336.96 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$255.06 |
$255.06 |
$336.96 |
$515.35
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$368.21 |
$368.21 |
$486.44 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$368.21 |
$368.21 |
$486.44 |
$820.15
|
|
Xray endovasc thor ao repr
|
$2,256.96 |
$2,256.96 |
$2,981.67 |
$1,963.50
|
|
Xray endovasc thor ao repr
|
$2,527.71 |
$2,527.71 |
$3,339.36 |
$2,269.47
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$379.76 |
$379.76 |
$501.70 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$255.50 |
$255.50 |
$337.54 |
$486.01
|
|
X-ray exam of eye sockets
|
$282.53 |
$282.53 |
$373.25 |
$349.05
|
|
X-ray exam of sinuses
|
$241.33 |
$241.33 |
$318.82 |
$211.00
|
|
X-ray exam thorac spine4/>vw
|
$256.15 |
$256.15 |
$338.40 |
$395.59
|
|
X-ray facial bones complete > 3 views
|
$231.96 |
$231.96 |
$306.44 |
$366.60
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$255.06 |
$255.06 |
$336.96 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$255.06 |
$255.06 |
$336.96 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$255.06 |
$255.06 |
$336.96 |
$508.00
|
|
X-ray knee ap standing bilateral
|
$243.51 |
$243.51 |
$321.70 |
$276.25
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$256.15 |
$256.15 |
$338.40 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$256.15 |
$256.15 |
$338.40 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$256.15 |
$256.15 |
$338.40 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$280.57 |
$280.57 |
$370.66 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$252.45 |
$252.45 |
$333.51 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$252.67 |
$252.67 |
$333.80 |
$277.70
|
|
X-ray neck soft tissue
|
$229.78 |
$229.78 |
$303.56 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$229.78 |
$229.78 |
$303.56 |
$225.96
|
|
X-ray pelvis 1-2 views
|
$256.15 |
$256.15 |
$338.40 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$256.15 |
$256.15 |
$338.40 |
$342.30
|
|
Xray place dist ext thor ao
|
$717.66 |
$717.66 |
$948.10 |
$1,339.40
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$606.70 |
$606.70 |
$801.51 |
$742.00
|
|
X-ray ribs 3 views bilateral
|
$256.15 |
$256.15 |
$338.40 |
$394.34
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$256.15 |
$256.15 |
$338.40 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$255.06 |
$255.06 |
$336.96 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$229.78 |
$229.78 |
$303.56 |
$285.60
|
|
X-ray sinuses paranasal complete > 3 views
|
$241.33 |
$241.33 |
$318.82 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$515.14 |
$515.14 |
$680.55 |
$601.30
|
|
X-ray skull < 4 views
|
$256.15 |
$256.15 |
$338.40 |
$291.78
|
|
X-ray skull > 4 views complete
|
$256.15 |
$256.15 |
$338.40 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$417.69 |
$417.69 |
$551.81 |
$557.70
|
|
X-ray small intestine follow-through study
|
$501.19 |
$501.19 |
$662.12 |
$504.14
|
|
X-ray spine single view
|
$229.78 |
$229.78 |
$303.56 |
$252.60
|
|
X-ray sternum > 2 views
|
$229.78 |
$229.78 |
$303.56 |
$269.75
|
|
X-ray surgical specimen
|
$383.68 |
$383.68 |
$506.88 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$379.76 |
$379.76 |
$501.70 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$241.33 |
$241.33 |
$318.82 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$256.15 |
$256.15 |
$338.40 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$256.15 |
$256.15 |
$338.40 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$229.78 |
$229.78 |
$303.56 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$229.99 |
$229.99 |
$303.84 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$255.50 |
$255.50 |
$337.54 |
$385.80
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$342.70 |
$342.70 |
$452.74 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$379.76 |
$379.76 |
$501.70 |
$555.04
|
|
Xylose absorption test blood &/or urine
|
$2.82 |
$2.82 |
$3.72 |
$64.28
|
|
Yttrium y-90 ibritumomab ther
|
$37,136.74 |
$37,136.74 |
$49,061.38 |
$55,035.00
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$30.74 |
$30.74 |
$40.61 |
$106.94
|
|
Zika virus dna/rna amp probe
|
$28.78 |
$28.78 |
$38.02 |
$175.00
|
|
Zika virus igm antibody
|
$16.31 |
$16.31 |
$21.55 |
$75.40
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$57.34 |
$57.34 |
$75.75 |
$121.56
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$2,456.64 |
$2,456.64 |
$4,534.40 |
$405.10
|
|
Zoster vaccine-live inj
|
$294.05 |
$294.05 |
$294.05 |
$235.20
|