|
Warde vitamin e (alpha-tocopherol)
|
$36.12 |
$36.12 |
$36.12 |
$55.00
|
|
Warde zinc
|
$20.43 |
$20.43 |
$20.43 |
$62.50
|
|
Wbc automated
|
$5.63 |
$5.63 |
$5.63 |
$32.80
|
|
Western blot test
|
$29.90 |
$29.90 |
$29.90 |
$153.18
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$323.24 |
$323.24 |
$323.24 |
$740.15
|
|
Whole mitochondrial genome
|
$1,570.28 |
$1,570.28 |
$1,570.28 |
$1,776.06
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$370.30 |
$370.30 |
$370.30 |
$558.97
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$202.17 |
$202.17 |
$202.17 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$388.06 |
$388.06 |
$388.06 |
$436.15
|
|
Wrist X-ray
|
$320.57 |
$320.57 |
$320.57 |
$343.70
|
|
Xpos opn fmrl eprst aor uni add-on
|
$3,313.72 |
$3,313.72 |
$3,313.72 |
$2,160.89
|
|
X-ray abdomen 1 view
|
$225.26 |
$225.26 |
$225.26 |
$255.00
|
|
X-ray abdomen 2 views
|
$256.64 |
$256.64 |
$256.64 |
$312.36
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$267.88 |
$267.88 |
$267.88 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$171.09 |
$171.09 |
$171.09 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$180.27 |
$180.27 |
$180.27 |
$283.00
|
|
X-ray bone age studies
|
$50.03 |
$50.03 |
$50.03 |
$246.75
|
|
X-ray bone length studies
|
$146.23 |
$146.23 |
$146.23 |
$287.25
|
|
X-ray bone survey complete
|
$547.01 |
$547.01 |
$547.01 |
$666.60
|
|
X-ray cervical spine 2-3 views
|
$101.53 |
$101.53 |
$101.53 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$338.33 |
$338.33 |
$338.33 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$429.80 |
$429.80 |
$429.80 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$247.16 |
$247.16 |
$247.16 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$338.92 |
$338.92 |
$338.92 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$338.92 |
$338.92 |
$338.92 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$103.01 |
$103.01 |
$103.01 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$291.27 |
$291.27 |
$291.27 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$390.13 |
$390.13 |
$390.13 |
$486.24
|
|
X-ray exam of arm infant
|
$54.76 |
$54.76 |
$54.76 |
$248.82
|
|
X-ray exam of eye sockets
|
$76.96 |
$76.96 |
$76.96 |
$349.05
|
|
X-ray exam of sinuses
|
$139.42 |
$139.42 |
$139.42 |
$211.00
|
|
X-ray exam thorac spine4/>vw
|
$134.98 |
$134.98 |
$134.98 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$115.74 |
$115.74 |
$115.74 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$304.00 |
$304.00 |
$304.00 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$99.46 |
$99.46 |
$99.46 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$205.43 |
$205.43 |
$205.43 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$181.45 |
$181.45 |
$181.45 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$234.73 |
$234.73 |
$234.73 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$55.36 |
$55.36 |
$55.36 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$153.92 |
$153.92 |
$153.92 |
$270.00
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$108.93 |
$108.93 |
$108.93 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$325.90 |
$325.90 |
$325.90 |
$409.24
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$65.42 |
$65.42 |
$65.42 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$199.80 |
$199.80 |
$199.80 |
$304.15
|
|
X-ray knee 1-2 views (both sides)
|
$265.52 |
$265.52 |
$265.52 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$122.25 |
$122.25 |
$122.25 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$282.98 |
$282.98 |
$282.98 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$118.11 |
$118.11 |
$118.11 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$186.48 |
$186.48 |
$186.48 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$548.79 |
$548.79 |
$548.79 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$365.27 |
$365.27 |
$365.27 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$182.04 |
$182.04 |
$182.04 |
$352.83
|
|
X-ray nasal bones complete > 3 views
|
$216.97 |
$216.97 |
$216.97 |
$277.70
|
|
X-ray neck soft tissue
|
$165.17 |
$165.17 |
$165.17 |
$237.43
|
|
X-ray pelvis 1-2 views
|
$80.81 |
$80.81 |
$80.81 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$188.26 |
$188.26 |
$188.26 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$429.20 |
$429.20 |
$429.20 |
$742.00
|
|
X-ray ribs 2 views left
|
$241.54 |
$241.54 |
$241.54 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$422.40 |
$422.40 |
$422.40 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$354.91 |
$354.91 |
$354.91 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$472.12 |
$472.12 |
$472.12 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$160.73 |
$160.73 |
$160.73 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$220.23 |
$220.23 |
$220.23 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$147.71 |
$147.71 |
$147.71 |
$292.50
|
|
X-ray shoulder 1 view (both sides)
|
$206.91 |
$206.91 |
$206.91 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$297.19 |
$297.19 |
$297.19 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$234.44 |
$234.44 |
$234.44 |
$601.30
|
|
X-ray skull < 4 views
|
$148.00 |
$148.00 |
$148.00 |
$291.78
|
|
X-ray skull > 4 views complete
|
$315.24 |
$315.24 |
$315.24 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$307.55 |
$307.55 |
$307.55 |
$557.70
|
|
X-ray small intestine follow-through study
|
$236.80 |
$236.80 |
$236.80 |
$504.14
|
|
X-ray spine single view
|
$95.32 |
$95.32 |
$95.32 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$137.94 |
$137.94 |
$137.94 |
$263.49
|
|
X-ray sternum > 2 views
|
$212.24 |
$212.24 |
$212.24 |
$269.75
|
|
X-ray surgical specimen
|
$565.36 |
$565.36 |
$565.36 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$485.15 |
$485.15 |
$485.15 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$128.47 |
$128.47 |
$128.47 |
$317.70
|
|
X-ray thoracic spine 3 views
|
$139.12 |
$139.12 |
$139.12 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$152.74 |
$152.74 |
$152.74 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$123.44 |
$123.44 |
$123.44 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$227.04 |
$227.04 |
$227.04 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$156.88 |
$156.88 |
$156.88 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$412.92 |
$412.92 |
$412.92 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$273.51 |
$273.51 |
$273.51 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$105.97 |
$105.97 |
$105.97 |
$290.40
|
|
Zika virus dna/rna amp probe
|
$89.99 |
$89.99 |
$89.99 |
$175.00
|
|
Zika virus igm antibody
|
$30.49 |
$30.49 |
$30.49 |
$75.40
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$89.64 |
$89.64 |
$89.64 |
$121.56
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$358.24 |
$358.24 |
$358.24 |
$405.10
|