|
Warde viscosity
|
$202.00 |
$202.00 |
$202.00 |
$50.10
|
|
Warde vitamin a
|
$267.00 |
$267.00 |
$267.00 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$470.00 |
$470.00 |
$470.00 |
$83.99
|
|
Warde vitamin b6 (pyridoxine)
|
$620.00 |
$620.00 |
$620.00 |
$118.30
|
|
Warde vitamin c (ascorbic acid)
|
$205.00 |
$205.00 |
$205.00 |
$50.70
|
|
Warde vitamin d (1 25 dihydroxy)
|
$840.00 |
$840.00 |
$840.00 |
$140.32
|
|
Warde vitamin e (alpha-tocopherol)
|
$315.00 |
$315.00 |
$315.00 |
$61.15
|
|
Warde zinc
|
$259.00 |
$259.00 |
$259.00 |
$62.70
|
|
Wbc automated
|
$60.00 |
$60.00 |
$60.00 |
$32.50
|
|
Wcd device interrogate
|
$223.00 |
$223.00 |
$223.00 |
$109.20
|
|
Whole blood for transfusion
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$504.00
|
|
Whole-Body Bone Scan (Nuclear Medicine)
|
$2,117.00 |
$2,117.00 |
$2,117.00 |
$1,570.65
|
|
Whole Skeleton X-ray Survey
|
$506.00 |
$506.00 |
$506.00 |
$639.93
|
|
Wilate injection
|
$3.75 |
$3.75 |
$3.75 |
$4.58
|
|
Wound Cleaning and Dead Tissue Removal (up to 20 sq cm)
|
$802.00 |
$802.00 |
$802.00 |
$354.00
|
|
Wound closure by adhesive
|
$39.62 |
$39.62 |
$39.62 |
$138.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$574.80
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$594.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$1,228.00 |
$1,228.00 |
$1,228.00 |
$442.58
|
|
Wrist arthroscopy
|
$8,264.00 |
$8,264.00 |
$8,264.00 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$8,264.00 |
$8,264.00 |
$8,264.00 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
$4,022.93
|
|
Wrist arthroscopy/surgery
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
$3,986.00
|
|
Wrist arthroscopy/surgery
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
$8,412.89
|
|
Wrist endoscopy/surgery
|
$13,882.00 |
$13,882.00 |
$13,882.00 |
$3,452.80
|
|
Wrist X-ray
|
$378.00 |
$378.00 |
$378.00 |
$351.00
|
|
Wrist X-ray (2 views, both wrists)
|
$351.00 |
$351.00 |
$351.00 |
$291.20
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$10,558.00 |
$10,558.00 |
$10,558.00 |
$3,786.00
|
|
Xcapsl ctrc rmvl insj 1+
|
$13,057.00 |
$13,057.00 |
$13,057.00 |
$7,316.99
|
|
Xcpsl ctrc rmvl cplx insj 1+
|
$13,057.00 |
$13,057.00 |
$13,057.00 |
$8,652.80
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$2,838.00
|
|
Xm archive tissue molec anal
|
$46.00 |
$46.00 |
$46.00 |
$48.38
|
|
Xpos opn fmrl eprst aor uni add-on
|
$1,774.00 |
$1,774.00 |
$1,774.00 |
$2,087.40
|
|
X-ray abdomen >=3 views
|
$645.00 |
$645.00 |
$645.00 |
$344.12
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$794.00
|
|
X-ray bone length studies
|
$267.00 |
$267.00 |
$267.00 |
$285.30
|
|
X-ray bone survey infant
|
$402.00 |
$402.00 |
$402.00 |
$396.50
|
|
Xray endovasc thor ao repr
|
$2,857.00 |
$2,857.00 |
$2,857.00 |
$1,734.00
|
|
Xray endovasc thor ao repr
|
$2,447.00 |
$2,447.00 |
$2,447.00 |
$1,622.18
|
|
X-ray exam entire spi 4/5 vw
|
$738.00 |
$738.00 |
$738.00 |
$457.98
|
|
X-ray exam entire spi 6/> vw
|
$738.00 |
$738.00 |
$738.00 |
$519.00
|
|
X-ray exam of arm infant
|
$388.00 |
$388.00 |
$388.00 |
$248.82
|
|
X-ray exam of femur 1
|
$235.00 |
$235.00 |
$235.00 |
$237.78
|
|
X-ray exam of jaw joint
|
$373.00 |
$373.00 |
$373.00 |
$201.75
|
|
X-ray exam of perineum
|
$769.00 |
$769.00 |
$769.00 |
$588.00
|
|
X-ray exam of teeth
|
$204.00 |
$204.00 |
$204.00 |
$138.40
|
|
X-ray exam of teeth
|
$738.00 |
$738.00 |
$738.00 |
$385.39
|
|
X-ray exam si joints
|
$388.00 |
$388.00 |
$388.00 |
$246.98
|
|
X-ray exam thorac spine4/>vw
|
$569.00 |
$569.00 |
$569.00 |
$395.00
|
|
X-ray eye detection foreign body (both sides)
|
$438.00 |
$438.00 |
$438.00 |
$238.29
|
|
X-ray fallopian tube
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$565.40
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$388.00 |
$388.00 |
$388.00 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$527.00 |
$527.00 |
$527.00 |
$513.60
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$235.00 |
$235.00 |
$235.00 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$331.00 |
$331.00 |
$331.00 |
$364.75
|
|
X-ray mandible ltd <4 views
|
$382.00 |
$382.00 |
$382.00 |
$238.00
|
|
X-ray nose to rectum for foreign body child
|
$976.00 |
$976.00 |
$976.00 |
$229.00
|
|
Xray place dist ext thor ao
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
$1,203.95
|
|
Xray place prox ext thor ao
|
$1,633.00 |
$1,633.00 |
$1,633.00 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$4,377.00 |
$4,377.00 |
$4,377.00 |
$769.50
|
|
X-ray ribs 2 views left
|
$434.00 |
$434.00 |
$434.00 |
$296.32
|
|
X-ray sinus tract/fistula/abscess
|
$1,784.00 |
$1,784.00 |
$1,784.00 |
$636.30
|
|
X-ray small intestine follow-through study
|
$1,518.00 |
$1,518.00 |
$1,518.00 |
$504.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$485.00 |
$485.00 |
$485.00 |
$267.50
|
|
X-ray surgical specimen
|
$1,018.00 |
$1,018.00 |
$1,018.00 |
$521.28
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$235.00 |
$235.00 |
$235.00 |
$257.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$1,061.00 |
$1,061.00 |
$1,061.00 |
$362.98
|
|
Yttrium y-90 ibritumomab ther
|
$111,451.00 |
$111,451.00 |
$111,451.00 |
$56,824.55
|
|
Ziconotide injection
|
$27.39 |
$27.39 |
$27.39 |
$7,216.02
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$7.52 |
$7.52 |
$7.52 |
$83.25
|
|
Zidovudine, oral, 100 mg
|
$11.67 |
$11.67 |
$11.67 |
$11.67
|
|
Zika virus dna/rna amp probe
|
$129.00 |
$129.00 |
$129.00 |
$181.08
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$145.14 |
$145.14 |
$145.14 |
$123.21
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$374.59 |
$374.59 |
$374.59 |
$423.96
|
