|
Whole mitochondrial genome
|
$54.60 |
$54.60 |
$54.60 |
$2,175.00
|
|
Wnd prep f/n/hf/g addl cm
|
$89.10 |
$89.10 |
$89.10 |
$811.00
|
|
Wound closure by adhesive
|
$10.20 |
$10.20 |
$10.20 |
$149.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$15.30 |
$15.30 |
$15.30 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$17.40 |
$17.40 |
$17.40 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$246.00 |
$246.00 |
$246.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$498.30 |
$498.30 |
$498.30 |
$438.75
|
|
Wrist arthroscopy
|
$486.30 |
$486.30 |
$486.30 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$533.70 |
$533.70 |
$533.70 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$556.20 |
$556.20 |
$556.20 |
$3,839.54
|
|
Wrist endoscopy/surgery
|
$824.10 |
$824.10 |
$824.10 |
$3,452.80
|
|
Wrist X-ray
|
$414.60 |
$414.60 |
$414.60 |
$342.80
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$778.20 |
$778.20 |
$778.20 |
$3,724.80
|
|
Xcapsl ctrc rmvl insj 1+
|
$716.10 |
$716.10 |
$716.10 |
$6,311.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$811.50 |
$811.50 |
$811.50 |
$2,692.80
|
|
Xfer tis s/a/l 10 sq cm/<
|
$752.70 |
$752.70 |
$752.70 |
$2,837.09
|
|
Xpos opn fmrl eprst aor uni add-on
|
$193.50 |
$193.50 |
$193.50 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$191.70 |
$191.70 |
$191.70 |
$258.50
|
|
X-ray abdomen 2 views
|
$269.70 |
$269.70 |
$269.70 |
$316.47
|
|
X-ray abdomen >=3 views
|
$344.40 |
$344.40 |
$344.40 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$370.20 |
$370.20 |
$370.20 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$244.80 |
$244.80 |
$244.80 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$310.50 |
$310.50 |
$310.50 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$725.40 |
$725.40 |
$725.40 |
$773.40
|
|
X-ray bone age studies
|
$143.70 |
$143.70 |
$143.70 |
$251.40
|
|
X-ray bone length studies
|
$252.00 |
$252.00 |
$252.00 |
$285.30
|
|
X-ray bone survey complete
|
$399.60 |
$399.60 |
$399.60 |
$660.00
|
|
X-ray bone survey infant
|
$179.70 |
$179.70 |
$179.70 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$269.10 |
$269.10 |
$269.10 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$345.30 |
$345.30 |
$345.30 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$406.50 |
$406.50 |
$406.50 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$320.40 |
$320.40 |
$320.40 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$504.00 |
$504.00 |
$504.00 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$479.40 |
$479.40 |
$479.40 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$333.60 |
$333.60 |
$333.60 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$449.70 |
$449.70 |
$449.70 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$266.70 |
$266.70 |
$266.70 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$211.20 |
$211.20 |
$211.20 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$263.40 |
$263.40 |
$263.40 |
$517.80
|
|
X-ray exam of arm infant
|
$120.60 |
$120.60 |
$120.60 |
$248.44
|
|
X-ray exam of eye sockets
|
$314.40 |
$314.40 |
$314.40 |
$328.35
|
|
X-ray exam of femur 1
|
$235.50 |
$235.50 |
$235.50 |
$240.00
|
|
X-ray exam of jaw joint
|
$183.90 |
$183.90 |
$183.90 |
$188.40
|
|
X-ray exam of mastoids
|
$132.30 |
$132.30 |
$132.30 |
$193.41
|
|
X-ray exam of salivary gland
|
$9.60 |
$9.60 |
$9.60 |
$162.60
|
|
X-ray exam of sinuses
|
$203.10 |
$203.10 |
$203.10 |
$214.50
|
|
X-ray exam si joints
|
$172.20 |
$172.20 |
$172.20 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$308.10 |
$308.10 |
$308.10 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$84.00 |
$84.00 |
$84.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$300.00 |
$300.00 |
$300.00 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$403.80 |
$403.80 |
$403.80 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$276.30 |
$276.30 |
$276.30 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$272.70 |
$272.70 |
$272.70 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$388.80 |
$388.80 |
$388.80 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$320.40 |
$320.40 |
$320.40 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$316.50 |
$316.50 |
$316.50 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$307.20 |
$307.20 |
$307.20 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$305.10 |
$305.10 |
$305.10 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$337.50 |
$337.50 |
$337.50 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$373.20 |
$373.20 |
$373.20 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$220.20 |
$220.20 |
$220.20 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$337.20 |
$337.20 |
$337.20 |
$309.31
|
|
X-ray joint survey 1 view
|
$19.50 |
$19.50 |
$19.50 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$294.30 |
$294.30 |
$294.30 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$404.70 |
$404.70 |
$404.70 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$194.40 |
$194.40 |
$194.40 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$134.70 |
$134.70 |
$134.70 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$391.20 |
$391.20 |
$391.20 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$440.10 |
$440.10 |
$440.10 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$391.20 |
$391.20 |
$391.20 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$300.30 |
$300.30 |
$300.30 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$174.60 |
$174.60 |
$174.60 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$207.30 |
$207.30 |
$207.30 |
$274.65
|
|
X-ray neck soft tissue
|
$191.40 |
$191.40 |
$191.40 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$130.50 |
$130.50 |
$130.50 |
$225.60
|
|
X-ray of mammary ducts
|
$24.90 |
$24.90 |
$24.90 |
$568.26
|
|
X-ray optic foramina
|
$262.50 |
$262.50 |
$262.50 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$218.40 |
$218.40 |
$218.40 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$273.60 |
$273.60 |
$273.60 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$610.20 |
$610.20 |
$610.20 |
$755.50
|
|
X-ray ribs 2 views left
|
$220.50 |
$220.50 |
$220.50 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$297.90 |
$297.90 |
$297.90 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$295.80 |
$295.80 |
$295.80 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$397.50 |
$397.50 |
$397.50 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$273.60 |
$273.60 |
$273.60 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$255.00 |
$255.00 |
$255.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$373.20 |
$373.20 |
$373.20 |
$285.00
|
|
X-ray sella turcica
|
$10.80 |
$10.80 |
$10.80 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$274.20 |
$274.20 |
$274.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$298.50 |
$298.50 |
$298.50 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$28.80 |
$28.80 |
$28.80 |
$606.89
|
|
X-ray skull < 4 views
|
$270.60 |
$270.60 |
$270.60 |
$292.50
|
|
X-ray skull > 4 views complete
|
$303.30 |
$303.30 |
$303.30 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$32.40 |
$32.40 |
$32.40 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$513.00 |
$513.00 |
$513.00 |
$557.70
|
|
X-ray small intestine follow-through study
|
$69.00 |
$69.00 |
$69.00 |
$499.50
|
|
X-ray spine single view
|
$196.20 |
$196.20 |
$196.20 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$156.30 |
$156.30 |
$156.30 |
$264.48
|
|
X-ray sternum > 2 views
|
$233.40 |
$233.40 |
$233.40 |
$274.65
|
|
X-ray surgical specimen
|
$472.20 |
$472.20 |
$472.20 |
$504.00
|
