|
Warde t3 (triiodothyronine) reverse
|
$33.00 |
$33.00 |
$33.00 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$85.32 |
$85.32 |
$85.32 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$61.26 |
$61.26 |
$61.26 |
$71.19
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$137.66 |
$137.66 |
$137.66 |
$127.20
|
|
Warde vitamin a
|
$20.86 |
$20.86 |
$20.86 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$73.72 |
$73.72 |
$73.72 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$81.32 |
$81.32 |
$81.32 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$37.34 |
$37.34 |
$37.34 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$111.42 |
$111.42 |
$111.42 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$21.72 |
$21.72 |
$21.72 |
$55.00
|
|
Warde zinc
|
$89.86 |
$89.86 |
$89.86 |
$62.50
|
|
Wbc automated
|
$151.31 |
$151.31 |
$151.31 |
$32.80
|
|
Wound closure by adhesive
|
$433.66 |
$433.66 |
$433.66 |
$153.40
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$392.81 |
$392.81 |
$392.81 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$678.54 |
$678.54 |
$678.54 |
$436.15
|
|
Wrist X-ray
|
$765.33 |
$765.33 |
$765.33 |
$343.70
|
|
Xm archive tissue molec anal
|
$116.93 |
$116.93 |
$116.93 |
$47.85
|
|
X-ray abdomen 1 view
|
$773.68 |
$773.68 |
$773.68 |
$255.00
|
|
X-ray abdomen 2 views
|
$962.76 |
$962.76 |
$962.76 |
$312.36
|
|
X-ray abdomen >=3 views
|
$1,014.35 |
$1,014.35 |
$1,014.35 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$1,446.06 |
$1,446.06 |
$1,446.06 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$873.56 |
$873.56 |
$873.56 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$596.61 |
$596.61 |
$596.61 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$3,579.19 |
$3,579.19 |
$3,579.19 |
$768.30
|
|
X-ray bone age studies
|
$547.64 |
$547.64 |
$547.64 |
$246.75
|
|
X-ray bone length studies
|
$507.14 |
$507.14 |
$507.14 |
$287.25
|
|
X-ray bone survey complete
|
$2,360.37 |
$2,360.37 |
$2,360.37 |
$666.60
|
|
X-ray bone survey infant
|
$719.29 |
$719.29 |
$719.29 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$796.43 |
$796.43 |
$796.43 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$1,560.08 |
$1,560.08 |
$1,560.08 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$1,795.32 |
$1,795.32 |
$1,795.32 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$796.43 |
$796.43 |
$796.43 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$1,184.35 |
$1,184.35 |
$1,184.35 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,933.20 |
$1,933.20 |
$1,933.20 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$796.43 |
$796.43 |
$796.43 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$898.60 |
$898.60 |
$898.60 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,090.75 |
$1,090.75 |
$1,090.75 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$590.09 |
$590.09 |
$590.09 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$1,334.45 |
$1,334.45 |
$1,334.45 |
$575.76
|
|
X-ray exam of arm infant
|
$781.00 |
$781.00 |
$781.00 |
$248.82
|
|
X-ray exam of eye sockets
|
$1,180.07 |
$1,180.07 |
$1,180.07 |
$349.05
|
|
X-ray exam of femur 1
|
$306.76 |
$306.76 |
$306.76 |
$232.36
|
|
X-ray exam of jaw joint
|
$330.18 |
$330.18 |
$330.18 |
$192.39
|
|
X-ray exam of sinuses
|
$387.60 |
$387.60 |
$387.60 |
$211.00
|
|
X-ray exam si joints
|
$383.76 |
$383.76 |
$383.76 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$977.70 |
$977.70 |
$977.70 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$330.47 |
$330.47 |
$330.47 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$1,261.16 |
$1,261.16 |
$1,261.16 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$840.79 |
$840.79 |
$840.79 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$620.93 |
$620.93 |
$620.93 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$796.43 |
$796.43 |
$796.43 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$796.43 |
$796.43 |
$796.43 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$688.44 |
$688.44 |
$688.44 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$698.07 |
$698.07 |
$698.07 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$2,093.19 |
$2,093.19 |
$2,093.19 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$1,118.41 |
$1,118.41 |
$1,118.41 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$270.12 |
$270.12 |
$270.12 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$1,095.58 |
$1,095.58 |
$1,095.58 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$752.05 |
$752.05 |
$752.05 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$796.43 |
$796.43 |
$796.43 |
$304.15
|
|
X-ray knee 1-2 views (both sides)
|
$796.43 |
$796.43 |
$796.43 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$873.56 |
$873.56 |
$873.56 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$286.89 |
$286.89 |
$286.89 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$804.12 |
$804.12 |
$804.12 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$592.00 |
$592.00 |
$592.00 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$1,461.71 |
$1,461.71 |
$1,461.71 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$1,934.17 |
$1,934.17 |
$1,934.17 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$1,303.61 |
$1,303.61 |
$1,303.61 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$669.18 |
$669.18 |
$669.18 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$796.43 |
$796.43 |
$796.43 |
$277.70
|
|
X-ray neck soft tissue
|
$649.49 |
$649.49 |
$649.49 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$106.96 |
$106.96 |
$106.96 |
$225.96
|
|
X-ray pelvis 1-2 views
|
$779.08 |
$779.08 |
$779.08 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$522.59 |
$522.59 |
$522.59 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,291.72 |
$1,291.72 |
$1,291.72 |
$742.00
|
|
X-ray ribs 2 views left
|
$929.48 |
$929.48 |
$929.48 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$1,168.59 |
$1,168.59 |
$1,168.59 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$1,151.26 |
$1,151.26 |
$1,151.26 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$1,349.88 |
$1,349.88 |
$1,349.88 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$898.60 |
$898.60 |
$898.60 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$898.60 |
$898.60 |
$898.60 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$898.60 |
$898.60 |
$898.60 |
$292.50
|
|
X-ray shoulder 1 view (both sides)
|
$315.77 |
$315.77 |
$315.77 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$1,023.98 |
$1,023.98 |
$1,023.98 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$781.96 |
$781.96 |
$781.96 |
$601.30
|
|
X-ray skull < 4 views
|
$678.79 |
$678.79 |
$678.79 |
$291.78
|
|
X-ray skull > 4 views complete
|
$1,091.46 |
$1,091.46 |
$1,091.46 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$1,388.76 |
$1,388.76 |
$1,388.76 |
$557.70
|
|
X-ray small intestine follow-through study
|
$686.93 |
$686.93 |
$686.93 |
$504.14
|
|
X-ray spine single view
|
$655.66 |
$655.66 |
$655.66 |
$252.60
|
|
X-ray sternum > 2 views
|
$898.60 |
$898.60 |
$898.60 |
$269.75
|
|
X-ray surgical specimen
|
$1,428.17 |
$1,428.17 |
$1,428.17 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,249.30 |
$1,249.30 |
$1,249.30 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$705.79 |
$705.79 |
$705.79 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$549.60 |
$549.60 |
$549.60 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$1,014.34 |
$1,014.34 |
$1,014.34 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$1,014.34 |
$1,014.34 |
$1,014.34 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$509.86 |
$509.86 |
$509.86 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$1,722.05 |
$1,722.05 |
$1,722.05 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$605.51 |
$605.51 |
$605.51 |
$328.00
|