|
Venogram ext bil s&i
|
$1,761.90 |
$1,761.90 |
$1,761.90 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,761.90 |
$1,761.90 |
$1,761.90 |
$1,326.00
|
|
Venous mech thrombectomy
|
$12,648.65 |
$12,648.65 |
$12,648.65 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$12,648.65 |
$12,648.65 |
$12,648.65 |
$5,352.00
|
|
Ventilator each subsequent day
|
$2,254.70 |
$2,254.70 |
$2,254.70 |
$1,305.92
|
|
Ventilator initial day
|
$2,254.70 |
$2,254.70 |
$2,254.70 |
$1,540.80
|
|
Version cephalic external
|
$3,213.35 |
$3,213.35 |
$3,213.35 |
$2,598.57
|
|
Vest large holster
|
$731.62 |
$731.62 |
$731.62 |
$1,012.50
|
|
Vinblastine 1 mg/ml intravenous solution
|
$230.69 |
$230.69 |
$230.69 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$99.81 |
$99.81 |
$99.81 |
$100.19
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$788.29 |
$788.29 |
$788.29 |
$226.75
|
|
Visit established high 40-54 minutes/level 5
|
$1,695.75 |
$1,695.75 |
$1,695.75 |
$287.73
|
|
Vital capacity test
|
$96.60 |
$96.60 |
$96.60 |
$173.33
|
|
Vitamin b-12
|
$124.60 |
$124.60 |
$124.60 |
$94.90
|
|
Vitamin D Test
|
$77.70 |
$77.70 |
$77.70 |
$132.00
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$215.60 |
$215.60 |
$215.60 |
$215.60
|
|
Warde 1015200 kappa light chain free
|
$45.33 |
$45.33 |
$45.33 |
$64.28
|
|
Warde 3008005 oligoclonal bands
|
$20.13 |
$20.13 |
$20.13 |
$102.60
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$268.45 |
$268.45 |
$268.45 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$294.00 |
$294.00 |
$294.00 |
$78.57
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$61.25 |
$61.25 |
$61.25 |
$381.50
|
|
Warde calculus (stone) infrared
|
$24.19 |
$24.19 |
$24.19 |
$61.73
|
|
Warde growth hormone (hgh)
|
$136.50 |
$136.50 |
$136.50 |
$81.24
|
|
Warde immunofixation electrophoresis urine
|
$483.70 |
$483.70 |
$483.70 |
$155.20
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$47.75 |
$47.75 |
$47.75 |
$127.20
|
|
Warde vitamin b-1 (thiamine)
|
$50.63 |
$50.63 |
$50.63 |
$78.65
|
|
Wbc automated
|
$108.85 |
$108.85 |
$108.85 |
$32.80
|
|
Wedging of cast
|
$140.00 |
$140.00 |
$140.00 |
$309.54
|
|
Wnd prep f/n/hf/g addl cm
|
$284.20 |
$284.20 |
$284.20 |
$865.80
|
|
Wound closure by adhesive
|
$43.75 |
$43.75 |
$43.75 |
$170.95
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$610.05 |
$610.05 |
$610.05 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$641.90 |
$641.90 |
$641.90 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$122.85 |
$122.85 |
$122.85 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$332.15 |
$332.15 |
$332.15 |
$436.15
|
|
Wrist X-ray
|
$343.70 |
$343.70 |
$343.70 |
$343.70
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$3,146.85 |
$3,146.85 |
$3,146.85 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$1,644.30 |
$1,644.30 |
$1,644.30 |
$2,623.24
|
|
X-ray abdomen 1 view
|
$304.15 |
$304.15 |
$304.15 |
$255.00
|
|
X-ray abdomen 2 views
|
$361.90 |
$361.90 |
$361.90 |
$312.36
|
|
X-ray abdomen >=3 views
|
$420.70 |
$420.70 |
$420.70 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$553.70 |
$553.70 |
$553.70 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$435.40 |
$435.40 |
$435.40 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$318.85 |
$318.85 |
$318.85 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$535.85 |
$535.85 |
$535.85 |
$768.30
|
|
X-ray bone age studies
|
$324.80 |
$324.80 |
$324.80 |
$246.75
|
|
X-ray bone length studies
|
$326.20 |
$326.20 |
$326.20 |
$287.25
|
|
X-ray bone survey complete
|
$860.30 |
$860.30 |
$860.30 |
$666.60
|
|
X-ray bone survey infant
|
$313.95 |
$313.95 |
$313.95 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$360.85 |
$360.85 |
$360.85 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$474.95 |
$474.95 |
$474.95 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$603.40 |
$603.40 |
$603.40 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$560.35 |
$560.35 |
$560.35 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$451.50 |
$451.50 |
$451.50 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$696.15 |
$696.15 |
$696.15 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$324.80 |
$324.80 |
$324.80 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$383.95 |
$383.95 |
$383.95 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$305.20 |
$305.20 |
$305.20 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$363.65 |
$363.65 |
$363.65 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$482.65 |
$482.65 |
$482.65 |
$575.76
|
|
X-ray exam of arm infant
|
$166.25 |
$166.25 |
$166.25 |
$248.82
|
|
X-ray exam of eye sockets
|
$474.25 |
$474.25 |
$474.25 |
$349.05
|
|
X-ray exam of femur 1
|
$347.90 |
$347.90 |
$347.90 |
$232.36
|
|
X-ray exam of jaw joint
|
$172.20 |
$172.20 |
$172.20 |
$192.39
|
|
X-ray exam of mastoids
|
$326.90 |
$326.90 |
$326.90 |
$191.91
|
|
X-ray exam of salivary gland
|
$313.95 |
$313.95 |
$313.95 |
$124.24
|
|
X-ray exam of sinuses
|
$217.70 |
$217.70 |
$217.70 |
$211.00
|
|
X-ray exam si joints
|
$291.55 |
$291.55 |
$291.55 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$518.35 |
$518.35 |
$518.35 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$490.70 |
$490.70 |
$490.70 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$467.60 |
$467.60 |
$467.60 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$463.40 |
$463.40 |
$463.40 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$260.40 |
$260.40 |
$260.40 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$191.45 |
$191.45 |
$191.45 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$301.00 |
$301.00 |
$301.00 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$466.90 |
$466.90 |
$466.90 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$278.95 |
$278.95 |
$278.95 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$522.20 |
$522.20 |
$522.20 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$504.70 |
$504.70 |
$504.70 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$555.45 |
$555.45 |
$555.45 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$610.40 |
$610.40 |
$610.40 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$102.90 |
$102.90 |
$102.90 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$301.00 |
$301.00 |
$301.00 |
$304.15
|
|
X-ray joint survey 1 view
|
$211.40 |
$211.40 |
$211.40 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$191.45 |
$191.45 |
$191.45 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$369.95 |
$369.95 |
$369.95 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$191.45 |
$191.45 |
$191.45 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$166.25 |
$166.25 |
$166.25 |
$249.13
|
|
X-ray lumbosacral spine >= 4 views
|
$632.80 |
$632.80 |
$632.80 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$632.80 |
$632.80 |
$632.80 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$445.20 |
$445.20 |
$445.20 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$304.85 |
$304.85 |
$304.85 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$445.20 |
$445.20 |
$445.20 |
$277.70
|
|
X-ray neck soft tissue
|
$200.55 |
$200.55 |
$200.55 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$275.80 |
$275.80 |
$275.80 |
$225.96
|
|
X-ray of mammary ducts
|
$390.60 |
$390.60 |
$390.60 |
$473.55
|
|
X-ray optic foramina
|
$238.00 |
$238.00 |
$238.00 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$267.05 |
$267.05 |
$267.05 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$273.70 |
$273.70 |
$273.70 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$554.05 |
$554.05 |
$554.05 |
$742.00
|
|
X-ray ribs 2 views left
|
$343.70 |
$343.70 |
$343.70 |
$296.32
|