|
X-ray exam of sinuses
|
$257.04 |
$257.04 |
$257.04 |
$214.50
|
|
X-ray exam of tear duct
|
$2,161.60 |
$2,161.60 |
$2,161.60 |
$467.50
|
|
X-ray exam of teeth
|
$616.00 |
$616.00 |
$616.00 |
$119.66
|
|
X-ray exam of teeth
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$328.08
|
|
X-ray exam si joints
|
$347.20 |
$347.20 |
$347.20 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$677.60 |
$677.60 |
$677.60 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$257.04 |
$257.04 |
$257.04 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$492.80 |
$492.80 |
$492.80 |
$381.75
|
|
X-ray fallopian tube
|
$2,223.20 |
$2,223.20 |
$2,223.20 |
$532.38
|
|
X-ray femur >=2 views (both sides)
|
$492.80 |
$492.80 |
$492.80 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$492.80 |
$492.80 |
$492.80 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$470.40 |
$470.40 |
$470.40 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$588.00 |
$588.00 |
$588.00 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$431.20 |
$431.20 |
$431.20 |
$291.20
|
|
X-ray head for orthodontia
|
$554.40 |
$554.40 |
$554.40 |
$158.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$532.00 |
$532.00 |
$532.00 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$492.80 |
$492.80 |
$492.80 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$526.40 |
$526.40 |
$526.40 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$571.20 |
$571.20 |
$571.20 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$739.20 |
$739.20 |
$739.20 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$352.80 |
$352.80 |
$352.80 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$604.80 |
$604.80 |
$604.80 |
$309.31
|
|
X-ray joint survey 1 view
|
$375.20 |
$375.20 |
$375.20 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$403.20 |
$403.20 |
$403.20 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$459.20 |
$459.20 |
$459.20 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$238.56 |
$238.56 |
$238.56 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$604.80 |
$604.80 |
$604.80 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$996.80 |
$996.80 |
$996.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$588.00 |
$588.00 |
$588.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$677.60 |
$677.60 |
$677.60 |
$535.91
|
|
X-ray male genital tract
|
$2,083.20 |
$2,083.20 |
$2,083.20 |
$603.50
|
|
X-ray mandible complete > 4 views
|
$968.80 |
$968.80 |
$968.80 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$604.80 |
$604.80 |
$604.80 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$604.80 |
$604.80 |
$604.80 |
$274.65
|
|
X-ray neck soft tissue
|
$464.80 |
$464.80 |
$464.80 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$604.80 |
$604.80 |
$604.80 |
$225.60
|
|
X-ray of mammary ducts
|
$694.40 |
$694.40 |
$694.40 |
$568.26
|
|
X-ray optic foramina
|
$604.80 |
$604.80 |
$604.80 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$526.40 |
$526.40 |
$526.40 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$554.40 |
$554.40 |
$554.40 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,052.80 |
$1,052.80 |
$1,052.80 |
$755.50
|
|
X-ray ribs 2 views left
|
$431.20 |
$431.20 |
$431.20 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$616.00 |
$616.00 |
$616.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$616.00 |
$616.00 |
$616.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$739.20 |
$739.20 |
$739.20 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$728.00 |
$728.00 |
$728.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$515.20 |
$515.20 |
$515.20 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$879.20 |
$879.20 |
$879.20 |
$285.00
|
|
X-ray sella turcica
|
$604.80 |
$604.80 |
$604.80 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$599.20 |
$599.20 |
$599.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$308.00 |
$308.00 |
$308.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$606.89
|
|
X-ray skull < 4 views
|
$683.20 |
$683.20 |
$683.20 |
$292.50
|
|
X-ray skull > 4 views complete
|
$1,002.40 |
$1,002.40 |
$1,002.40 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$974.40 |
$974.40 |
$974.40 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$481.60 |
$481.60 |
$481.60 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,540.00 |
$1,540.00 |
$1,540.00 |
$499.50
|
|
X-ray spine single view
|
$498.40 |
$498.40 |
$498.40 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$644.00 |
$644.00 |
$644.00 |
$264.48
|
|
X-ray sternum > 2 views
|
$560.00 |
$560.00 |
$560.00 |
$274.65
|
|
X-ray surgical specimen
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,170.40 |
$1,170.40 |
$1,170.40 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$565.60 |
$565.60 |
$565.60 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$554.40 |
$554.40 |
$554.40 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$588.00 |
$588.00 |
$588.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$352.80 |
$352.80 |
$352.80 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$257.04 |
$257.04 |
$257.04 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$341.60 |
$341.60 |
$341.60 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$576.80 |
$576.80 |
$576.80 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$330.40 |
$330.40 |
$330.40 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$739.20 |
$739.20 |
$739.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$616.00 |
$616.00 |
$616.00 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$509.60 |
$509.60 |
$509.60 |
$290.40
|
|
X-ray xm phrnx&/crv esoph c+
|
$968.80 |
$968.80 |
$968.80 |
$354.00
|
|
Xtrnl ecg rec>48hr<7d
|
$789.60 |
$789.60 |
$789.60 |
$789.60
|
|
Xwrap 1 sq cm
|
$16.80 |
$16.80 |
$16.80 |
$16.80
|
|
Xylose absorption test blood &/or urine
|
$120.96 |
$120.96 |
$120.96 |
$99.89
|
|
Xyntha inj
|
$7.16 |
$7.16 |
$7.16 |
$6.65
|
|
Yersinia antibody
|
$33.60 |
$33.60 |
$33.60 |
$55.80
|
|
Yttrium y-90 ibritumomab ther
|
$109,383.86 |
$109,383.86 |
$109,383.86 |
$55,035.00
|
|
Ziconotide injection
|
$10,414.45 |
$10,414.45 |
$10,414.45 |
$7,216.02
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$69.48 |
$69.48 |
$69.48 |
$93.06
|
|
Zika virus dna/rna amp probe
|
$174.72 |
$174.72 |
$174.72 |
$185.00
|
|
Zika virus igm antibody
|
$45.92 |
$45.92 |
$45.92 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$132.69 |
$132.69 |
$132.69 |
$122.45
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$5,616.24 |
$5,616.24 |
$5,616.24 |
$5,215.08
|
|
Zolbetuximab-clzb 100 mg intravenous solution
|
$8,411.76 |
$8,411.76 |
$8,411.76 |
$7,810.92
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$2,290.03 |
$2,290.03 |
$2,290.03 |
$452.69
|
|
Zoster vaccine-live inj
|
$388.08 |
$388.08 |
$388.08 |
$361.50
|
|
Zrsr2 gene common variants
|
$324.80 |
$324.80 |
$324.80 |
$243.34
|
