|
Warde vitamin b6 (pyridoxine)
|
$112.32 |
$112.32 |
$112.32 |
$116.20
|
|
Warde vitamin c (ascorbic acid)
|
$56.16 |
$56.16 |
$56.16 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$42.48 |
$42.48 |
$42.48 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$37.44 |
$37.44 |
$37.44 |
$59.25
|
|
Warde zinc
|
$45.36 |
$45.36 |
$45.36 |
$62.50
|
|
Wbc automated
|
$30.24 |
$30.24 |
$30.24 |
$32.35
|
|
Western blot test
|
$205.92 |
$205.92 |
$205.92 |
$150.00
|
|
Whfo nontorsion joint prefab
|
$92.16 |
$92.16 |
$92.16 |
$224.01
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$1,514.88 |
$1,514.88 |
$1,514.88 |
$696.45
|
|
Whole mitochondrial genome
|
$2,478.96 |
$2,478.96 |
$2,478.96 |
$2,175.00
|
|
Whole mitochondrial genome
|
$2,194.56 |
$2,194.56 |
$2,194.56 |
$1,681.55
|
|
Wound pouch each
|
$313.92 |
$313.92 |
$313.92 |
$57.00
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$863.28 |
$863.28 |
$863.28 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$865.44 |
$865.44 |
$865.44 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$840.96 |
$840.96 |
$840.96 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$865.44 |
$865.44 |
$865.44 |
$438.75
|
|
Wrist X-ray
|
$502.56 |
$502.56 |
$502.56 |
$342.80
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$3,951.36 |
$3,951.36 |
$3,951.36 |
$2,692.80
|
|
Xm archive tissue molec anal
|
$30.96 |
$30.96 |
$30.96 |
$49.84
|
|
Xpos opn fmrl eprst aor uni add-on
|
$11,381.76 |
$11,381.76 |
$11,381.76 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$426.24 |
$426.24 |
$426.24 |
$258.50
|
|
X-ray abdomen 2 views
|
$527.04 |
$527.04 |
$527.04 |
$316.47
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$507.60 |
$507.60 |
$507.60 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$722.16 |
$722.16 |
$722.16 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$526.32 |
$526.32 |
$526.32 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$773.40
|
|
X-ray bone age studies
|
$497.52 |
$497.52 |
$497.52 |
$251.40
|
|
X-ray bone length studies
|
$586.80 |
$586.80 |
$586.80 |
$285.30
|
|
X-ray bone survey complete
|
$1,035.36 |
$1,035.36 |
$1,035.36 |
$660.00
|
|
X-ray bone survey infant
|
$546.48 |
$546.48 |
$546.48 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$667.44 |
$667.44 |
$667.44 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$748.08 |
$748.08 |
$748.08 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$995.76 |
$995.76 |
$995.76 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$429.84 |
$429.84 |
$429.84 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$968.40 |
$968.40 |
$968.40 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,107.36 |
$1,107.36 |
$1,107.36 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$488.16 |
$488.16 |
$488.16 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$503.28 |
$503.28 |
$503.28 |
$364.12
|
|
Xray endovasc thor ao repr
|
$1,537.92 |
$1,537.92 |
$1,537.92 |
$1,734.00
|
|
Xray endovasc thor ao repr
|
$1,945.44 |
$1,945.44 |
$1,945.44 |
$1,622.18
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$781.92 |
$781.92 |
$781.92 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$649.44 |
$649.44 |
$649.44 |
$441.48
|
|
X-ray exam of arm infant
|
$230.40 |
$230.40 |
$230.40 |
$248.44
|
|
X-ray exam of eye sockets
|
$485.28 |
$485.28 |
$485.28 |
$328.35
|
|
X-ray exam of femur 1
|
$190.08 |
$190.08 |
$190.08 |
$240.00
|
|
X-ray exam of sinuses
|
$303.12 |
$303.12 |
$303.12 |
$214.50
|
|
X-ray exam of teeth
|
$292.32 |
$292.32 |
$292.32 |
$119.66
|
|
X-ray exam si joints
|
$312.48 |
$312.48 |
$312.48 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$690.48 |
$690.48 |
$690.48 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$203.76 |
$203.76 |
$203.76 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$663.84 |
$663.84 |
$663.84 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$463.68 |
$463.68 |
$463.68 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$443.52 |
$443.52 |
$443.52 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$511.92 |
$511.92 |
$511.92 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$458.64 |
$458.64 |
$458.64 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$468.72 |
$468.72 |
$468.72 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$347.76 |
$347.76 |
$347.76 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$628.56 |
$628.56 |
$628.56 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$571.68 |
$571.68 |
$571.68 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$638.64 |
$638.64 |
$638.64 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$832.32 |
$832.32 |
$832.32 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$269.28 |
$269.28 |
$269.28 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$509.04 |
$509.04 |
$509.04 |
$309.31
|
|
X-ray joint survey 1 view
|
$263.52 |
$263.52 |
$263.52 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$457.92 |
$457.92 |
$457.92 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$794.16 |
$794.16 |
$794.16 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$528.48 |
$528.48 |
$528.48 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$262.08 |
$262.08 |
$262.08 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$550.80 |
$550.80 |
$550.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$867.60 |
$867.60 |
$867.60 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$936.00 |
$936.00 |
$936.00 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$729.36 |
$729.36 |
$729.36 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$270.72 |
$270.72 |
$270.72 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$211.68 |
$211.68 |
$211.68 |
$274.65
|
|
X-ray neck soft tissue
|
$423.36 |
$423.36 |
$423.36 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$394.56 |
$394.56 |
$394.56 |
$225.60
|
|
X-ray of mammary ducts
|
$572.40 |
$572.40 |
$572.40 |
$568.26
|
|
X-ray pelvis 1-2 views
|
$482.40 |
$482.40 |
$482.40 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$766.08 |
$766.08 |
$766.08 |
$348.19
|
|
Xray place dist ext thor ao
|
$1,674.00 |
$1,674.00 |
$1,674.00 |
$1,194.70
|
|
Xray place prox ext thor ao
|
$1,521.36 |
$1,521.36 |
$1,521.36 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$945.36 |
$945.36 |
$945.36 |
$755.50
|
|
X-ray ribs 2 views left
|
$510.48 |
$510.48 |
$510.48 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$619.92 |
$619.92 |
$619.92 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$594.00 |
$594.00 |
$594.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$732.24 |
$732.24 |
$732.24 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$451.44 |
$451.44 |
$451.44 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$555.84 |
$555.84 |
$555.84 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$487.44 |
$487.44 |
$487.44 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$423.36 |
$423.36 |
$423.36 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$751.68 |
$751.68 |
$751.68 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$1,073.52 |
$1,073.52 |
$1,073.52 |
$606.89
|
|
X-ray skull < 4 views
|
$580.32 |
$580.32 |
$580.32 |
$292.50
|
|
X-ray skull > 4 views complete
|
$706.32 |
$706.32 |
$706.32 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$829.44 |
$829.44 |
$829.44 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,005.84 |
$1,005.84 |
$1,005.84 |
$499.50
|
|
X-ray spine single view
|
$565.92 |
$565.92 |
$565.92 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$338.40 |
$338.40 |
$338.40 |
$264.48
|
|
X-ray sternum > 2 views
|
$402.48 |
$402.48 |
$402.48 |
$274.65
|
|
X-ray surgical specimen
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$504.00
|