|
Warde protein c antigen
|
$697.75 |
$697.75 |
$697.75 |
$88.80
|
|
Warde sex hormone binding globulin
|
$288.00 |
$288.00 |
$288.00 |
$86.59
|
|
Warde thyroid stimulating immunoglobulins
|
$869.75 |
$869.75 |
$869.75 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$365.25 |
$365.25 |
$365.25 |
$71.19
|
|
Warde viscosity
|
$435.75 |
$435.75 |
$435.75 |
$52.65
|
|
Warde vitamin b-1 (thiamine)
|
$862.50 |
$862.50 |
$862.50 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$1,142.75 |
$1,142.75 |
$1,142.75 |
$116.00
|
|
Warde vitamin e (alpha-tocopherol)
|
$383.50 |
$383.50 |
$383.50 |
$55.00
|
|
Warde zinc
|
$213.25 |
$213.25 |
$213.25 |
$62.50
|
|
Wbc automated
|
$51.25 |
$51.25 |
$51.25 |
$32.80
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$999.50 |
$999.50 |
$999.50 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$1,049.50 |
$1,049.50 |
$1,049.50 |
$436.15
|
|
Xe133 xenon 10mci
|
$641.75 |
$641.75 |
$641.75 |
$299.00
|
|
X-ray abdomen 1 view
|
$2,083.50 |
$2,083.50 |
$2,083.50 |
$255.00
|
|
X-ray abdomen 2 views
|
$4,622.75 |
$4,622.75 |
$4,622.75 |
$312.36
|
|
X-ray abdomen >=3 views
|
$4,622.75 |
$4,622.75 |
$4,622.75 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$611.75 |
$611.75 |
$611.75 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$2,105.50 |
$2,105.50 |
$2,105.50 |
$271.44
|
|
X-ray bone age studies
|
$2,195.75 |
$2,195.75 |
$2,195.75 |
$246.75
|
|
X-ray bone length studies
|
$1,467.00 |
$1,467.00 |
$1,467.00 |
$287.25
|
|
X-ray bone survey complete
|
$5,397.50 |
$5,397.50 |
$5,397.50 |
$666.60
|
|
X-ray bone survey infant
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$1,921.25 |
$1,921.25 |
$1,921.25 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$3,876.50 |
$3,876.50 |
$3,876.50 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$3,996.75 |
$3,996.75 |
$3,996.75 |
$515.35
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$5,659.50 |
$5,659.50 |
$5,659.50 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$6,480.50 |
$6,480.50 |
$6,480.50 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$4,223.00 |
$4,223.00 |
$4,223.00 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$800.00 |
$800.00 |
$800.00 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$800.00 |
$800.00 |
$800.00 |
$575.76
|
|
X-ray exam of eye sockets
|
$4,265.25 |
$4,265.25 |
$4,265.25 |
$349.05
|
|
X-ray exam of femur 1
|
$317.25 |
$317.25 |
$317.25 |
$232.36
|
|
X-ray exam of middle ear
|
$2,323.75 |
$2,323.75 |
$2,323.75 |
$341.25
|
|
X-ray exam of salivary gland
|
$1,439.75 |
$1,439.75 |
$1,439.75 |
$124.24
|
|
X-ray exam of tear duct
|
$1,381.00 |
$1,381.00 |
$1,381.00 |
$340.70
|
|
X-ray eye detection foreign body (both sides)
|
$1,056.25 |
$1,056.25 |
$1,056.25 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$3,256.75 |
$3,256.75 |
$3,256.75 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$317.25 |
$317.25 |
$317.25 |
$304.15
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$523.25 |
$523.25 |
$523.25 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$419.50 |
$419.50 |
$419.50 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$419.50 |
$419.50 |
$419.50 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$800.00 |
$800.00 |
$800.00 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$317.25 |
$317.25 |
$317.25 |
$207.35
|
|
X-ray joint survey 1 view
|
$1,314.25 |
$1,314.25 |
$1,314.25 |
$211.00
|
|
X-ray knee ap standing bilateral
|
$651.25 |
$651.25 |
$651.25 |
$276.25
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$1,339.00 |
$1,339.00 |
$1,339.00 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$4,265.25 |
$4,265.25 |
$4,265.25 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$4,363.50 |
$4,363.50 |
$4,363.50 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$3,256.75 |
$3,256.75 |
$3,256.75 |
$352.83
|
|
X-ray nasal bones complete > 3 views
|
$2,430.00 |
$2,430.00 |
$2,430.00 |
$277.70
|
|
X-ray neck soft tissue
|
$1,963.75 |
$1,963.75 |
$1,963.75 |
$237.43
|
|
X-ray optic foramina
|
$1,302.25 |
$1,302.25 |
$1,302.25 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$3,208.00 |
$3,208.00 |
$3,208.00 |
$270.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$3,217.50 |
$3,217.50 |
$3,217.50 |
$742.00
|
|
X-ray ribs 3 views bilateral
|
$4,285.75 |
$4,285.75 |
$4,285.75 |
$394.34
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$611.75 |
$611.75 |
$611.75 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$793.00 |
$793.00 |
$793.00 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$285.60
|
|
X-ray sella turcica
|
$2,004.75 |
$2,004.75 |
$2,004.75 |
$162.50
|
|
X-ray sinuses paranasal complete > 3 views
|
$3,678.50 |
$3,678.50 |
$3,678.50 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$2,592.50 |
$2,592.50 |
$2,592.50 |
$601.30
|
|
X-ray skull < 4 views
|
$1,880.50 |
$1,880.50 |
$1,880.50 |
$291.78
|
|
X-ray skull > 4 views complete
|
$3,766.00 |
$3,766.00 |
$3,766.00 |
$414.60
|
|
X-ray slg plne bdy sect without urogr
|
$4,285.75 |
$4,285.75 |
$4,285.75 |
$387.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$4,265.25 |
$4,265.25 |
$4,265.25 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,067.50 |
$1,067.50 |
$1,067.50 |
$504.14
|
|
X-ray spine single view
|
$890.00 |
$890.00 |
$890.00 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$2,149.00 |
$2,149.00 |
$2,149.00 |
$263.49
|
|
X-ray sternum > 2 views
|
$2,612.75 |
$2,612.75 |
$2,612.75 |
$269.75
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,178.25 |
$1,178.25 |
$1,178.25 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$2,083.50 |
$2,083.50 |
$2,083.50 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$2,612.75 |
$2,612.75 |
$2,612.75 |
$318.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$317.25 |
$317.25 |
$317.25 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$523.25 |
$523.25 |
$523.25 |
$385.80
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$935.00 |
$935.00 |
$935.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$835.50 |
$835.50 |
$835.50 |
$555.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$4,223.00 |
$4,223.00 |
$4,223.00 |
$324.20
|
