|
Warde zinc
|
$30.64 |
$30.64 |
$30.64 |
$62.50
|
|
Wbc automated
|
$24.65 |
$24.65 |
$24.65 |
$32.80
|
|
Wet mounts/ w preparations
|
$13.32 |
$13.32 |
$13.32 |
$36.80
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$34.64 |
$34.64 |
$34.64 |
$558.97
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$109.23 |
$109.23 |
$109.23 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$61.94 |
$61.94 |
$61.94 |
$436.15
|
|
Xe133 xenon 10mci
|
$299.04 |
$299.04 |
$299.04 |
$299.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,214.79 |
$1,214.79 |
$1,214.79 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$1,009.66 |
$1,009.66 |
$1,009.66 |
$2,623.24
|
|
X-ray abdomen 1 view
|
$316.35 |
$316.35 |
$316.35 |
$255.00
|
|
X-ray abdomen 2 views
|
$564.77 |
$564.77 |
$564.77 |
$312.36
|
|
X-ray abdomen >=3 views
|
$672.66 |
$672.66 |
$672.66 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$672.66 |
$672.66 |
$672.66 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$552.12 |
$552.12 |
$552.12 |
$271.44
|
|
X-ray bone age studies
|
$263.07 |
$263.07 |
$263.07 |
$246.75
|
|
X-ray bone length studies
|
$458.21 |
$458.21 |
$458.21 |
$287.25
|
|
X-ray bone survey complete
|
$1,453.22 |
$1,453.22 |
$1,453.22 |
$666.60
|
|
X-ray bone survey infant
|
$1,336.67 |
$1,336.67 |
$1,336.67 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$622.71 |
$622.71 |
$622.71 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$813.19 |
$813.19 |
$813.19 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$1,088.25 |
$1,088.25 |
$1,088.25 |
$515.35
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$2,340.99 |
$2,340.99 |
$2,340.99 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$3,230.77 |
$3,230.77 |
$3,230.77 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,284.72 |
$1,284.72 |
$1,284.72 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$769.90 |
$769.90 |
$769.90 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$243.76 |
$243.76 |
$243.76 |
$575.76
|
|
X-ray exam of eye sockets
|
$564.77 |
$564.77 |
$564.77 |
$349.05
|
|
X-ray exam of salivary gland
|
$513.49 |
$513.49 |
$513.49 |
$124.24
|
|
X-ray exam of sinuses
|
$471.53 |
$471.53 |
$471.53 |
$211.00
|
|
X-ray exam si joints
|
$403.60 |
$403.60 |
$403.60 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$674.00 |
$674.00 |
$674.00 |
$395.59
|
|
X-ray facial bones complete > 3 views
|
$621.38 |
$621.38 |
$621.38 |
$366.60
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$662.67 |
$662.67 |
$662.67 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$692.64 |
$692.64 |
$692.64 |
$409.24
|
|
X-ray joint survey 1 view
|
$388.28 |
$388.28 |
$388.28 |
$211.00
|
|
X-ray knee ap standing bilateral
|
$555.45 |
$555.45 |
$555.45 |
$276.25
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$919.08 |
$919.08 |
$919.08 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$879.12 |
$879.12 |
$879.12 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$1,256.08 |
$1,256.08 |
$1,256.08 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$511.49 |
$511.49 |
$511.49 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$490.85 |
$490.85 |
$490.85 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$423.58 |
$423.58 |
$423.58 |
$277.70
|
|
X-ray neck soft tissue
|
$399.60 |
$399.60 |
$399.60 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$336.33 |
$336.33 |
$336.33 |
$225.96
|
|
X-ray optic foramina
|
$484.85 |
$484.85 |
$484.85 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$388.95 |
$388.95 |
$388.95 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$699.30 |
$699.30 |
$699.30 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$774.56 |
$774.56 |
$774.56 |
$742.00
|
|
X-ray ribs 3 views bilateral
|
$570.10 |
$570.10 |
$570.10 |
$394.34
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$777.89 |
$777.89 |
$777.89 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$477.53 |
$477.53 |
$477.53 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$388.28 |
$388.28 |
$388.28 |
$285.60
|
|
X-ray sinuses paranasal complete > 3 views
|
$555.45 |
$555.45 |
$555.45 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$646.69 |
$646.69 |
$646.69 |
$601.30
|
|
X-ray skull < 4 views
|
$552.78 |
$552.78 |
$552.78 |
$291.78
|
|
X-ray skull > 4 views complete
|
$658.01 |
$658.01 |
$658.01 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$1,465.87 |
$1,465.87 |
$1,465.87 |
$557.70
|
|
X-ray small intestine follow-through study
|
$424.91 |
$424.91 |
$424.91 |
$504.14
|
|
X-ray spine single view
|
$350.32 |
$350.32 |
$350.32 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$492.18 |
$492.18 |
$492.18 |
$263.49
|
|
X-ray sternum > 2 views
|
$403.60 |
$403.60 |
$403.60 |
$269.75
|
|
X-ray surgical specimen
|
$422.25 |
$422.25 |
$422.25 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,367.30 |
$1,367.30 |
$1,367.30 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$685.98 |
$685.98 |
$685.98 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$458.88 |
$458.88 |
$458.88 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$541.46 |
$541.46 |
$541.46 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$496.84 |
$496.84 |
$496.84 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$877.79 |
$877.79 |
$877.79 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$1,349.99 |
$1,349.99 |
$1,349.99 |
$385.80
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$1,788.88 |
$1,788.88 |
$1,788.88 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$1,581.09 |
$1,581.09 |
$1,581.09 |
$555.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$981.02 |
$981.02 |
$981.02 |
$324.20
|
|
Yersinia antibody
|
$24.47 |
$24.47 |
$24.47 |
$66.95
|
|
Yttrium y-90 ibritumomab ther
|
$29,979.99 |
$29,979.99 |
$29,979.99 |
$55,035.00
|
|
Zika virus dna/rna amp probe
|
$87.92 |
$87.92 |
$87.92 |
$175.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$210.27 |
$210.27 |
$210.27 |
$121.56
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$4,271.96 |
$4,271.96 |
$4,271.96 |
$405.10
|
|
Zoster vaccine-live inj
|
$728.14 |
$728.14 |
$728.14 |
$235.20
|