|
Whole Skeleton X-ray Survey
|
$117.04 |
$462.00 |
$1,168.00 |
|
|
Who nontorsion jnts pre cst
|
$313.32 |
$820.47 |
$820.47 |
|
|
Who nontorsion jnts pre ots
|
$820.47 |
$820.47 |
$820.47 |
|
|
Wilate injection
|
$1.83 |
$1.83 |
$1.83 |
|
|
Wipe adh remover univ ostomy adh/barrier remover
|
$0.48 |
$0.48 |
$0.48 |
|
|
Wnd prep f/n/hf/g addl cm
|
$117.89 |
$117.89 |
$979.44 |
|
|
Woman's shoe oxford brace
|
$114.60 |
$114.60 |
$114.60 |
|
|
Wound Cleaning and Dead Tissue Removal (up to 20 sq cm)
|
$254.00 |
$276.00 |
$780.67 |
|
|
Wound closure by adhesive
|
$21.49 |
$21.49 |
$21.49 |
|
|
Woundfix biowound plus xplus
|
$171.12 |
$171.12 |
$171.12 |
|
|
Wound pouch each
|
$28.28 |
$28.28 |
$28.28 |
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$282.24 |
$500.00 |
$1,153.00 |
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$313.04 |
$1,142.00 |
$1,862.00 |
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$147.84 |
$452.00 |
$724.00 |
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$178.08 |
$534.00 |
$735.00 |
|
|
Wrist arthroscopy
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Wrist arthroscopy/surgery
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Wrist arthroscopy/surgery
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Wrist arthroscopy/surgery
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Wrist arthroscopy/surgery
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Wrist arthroscopy/surgery
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Wrist/elbow bowden cable mol
|
$3,430.74 |
$3,430.74 |
$3,430.74 |
|
|
Wrist/elbow bowden cbl dir f
|
$2,881.36 |
$2,881.36 |
$2,881.36 |
|
|
Wrist endoscopy/surgery
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
|
|
Wrist X-ray
|
$91.84 |
$378.00 |
$830.40 |
|
|
Wrist X-ray (2 views, both wrists)
|
$80.08 |
$300.00 |
$672.00 |
|
|
Wrst mld sck flx hng tri pad
|
$4,223.96 |
$4,223.96 |
$4,223.96 |
|
|
Xcapsl ctrc rmvl cplx w/ecp
|
$5,683.61 |
$5,683.61 |
$5,683.61 |
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$3,173.34 |
$3,173.34 |
$3,173.34 |
|
|
Xcapsl ctrc rmvl insj 1+
|
$7,316.99 |
$7,316.99 |
$7,316.99 |
|
|
Xcapsl ctrc rmvl w/ecp
|
$5,683.61 |
$5,683.61 |
$5,683.61 |
|
|
Xcpsl ctrc rmvl cplx insj 1+
|
$7,316.99 |
$7,316.99 |
$7,316.99 |
|
|
Xe133 xenon 10mci
|
$107.94 |
$339.48 |
$340.63 |
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,837.09 |
$3,256.00 |
$4,926.00 |
|
|
Xfer tis s/a/l 10 sq cm/<
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
|
|
X-linked intellectual dblt
|
$1,261.32 |
$1,261.32 |
$1,261.32 |
|
|
X-linked intellectual dblt
|
$1,261.32 |
$1,261.32 |
$1,261.32 |
|
|
Xm archive tissue molec anal
|
$25.76 |
$39.77 |
$168.00 |
|
|
Xpos opn axillary/sbclvn art w/cndt crtn
|
$519.39 |
$3,680.00 |
$3,680.00 |
|
|
Xpos opn fmrl eprst aor uni add-on
|
$287.48 |
$1,820.00 |
$3,613.00 |
|
|
X-ray abdomen >=3 views
|
$62.16 |
$398.00 |
$491.00 |
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$248.22 |
$479.72 |
$2,186.40 |
|
|
X-ray assay calculus
|
$17.28 |
$17.28 |
$26.46 |
|
|
X-ray bone length studies
|
$60.48 |
$169.00 |
$613.60 |
|
|
X-ray bone survey infant
|
$75.60 |
$361.00 |
$562.00 |
|
|
X-ray consultation
|
$27.73 |
$27.73 |
$27.73 |
|
|
Xray endovasc thor ao repr
|
$486.45 |
$486.45 |
$542.64 |
|
|
Xray endovasc thor ao repr
|
$364.25 |
$369.04 |
$522.00 |
|
|
X-ray exam entire spi 4/5 vw
|
$143.75 |
$684.00 |
$787.00 |
|
|
X-ray exam entire spi 6/> vw
|
$143.75 |
$684.00 |
$787.00 |
|
|
X-ray exam of arm infant
|
$45.36 |
$359.00 |
$704.00 |
|
|
X-ray exam of femur 1
|
$61.60 |
$279.00 |
$925.60 |
|
|
X-ray exam of jaw joint
|
$108.10 |
$272.00 |
$412.00 |
|
|
X-ray exam of jaw joint
|
$328.08 |
$328.08 |
$328.08 |
|
|
X-ray exam of mastoids
|
$100.38 |
$143.75 |
$896.80 |
|
|
X-ray exam of middle ear
|
$78.49 |
$751.34 |
$751.34 |
|
|
X-ray exam of penis
|
$143.75 |
$143.75 |
$908.80 |
|
|
X-ray exam of perineum
|
$298.00 |
$298.00 |
$436.00 |
|
|
X-ray exam of salivary gland
|
$119.66 |
$119.66 |
$119.66 |
|
|
X-ray exam of tear duct
|
$328.08 |
$805.00 |
$805.00 |
|
|
X-ray exam of teeth
|
$119.66 |
$119.66 |
$119.66 |
|
|
X-ray exam of teeth
|
$328.08 |
$328.08 |
$328.08 |
|
|
X-ray exam si joints
|
$62.72 |
$302.00 |
$394.40 |
|
|
X-ray exam thorac spine4/>vw
|
$96.32 |
$153.44 |
$569.60 |
|
|
X-ray eye detection foreign body (both sides)
|
$119.66 |
$202.00 |
$440.00 |
|
|
X-ray fallopian tube
|
$39.32 |
$39.32 |
$1,147.20 |
|
|
X-ray head for orthodontia
|
$119.66 |
$119.66 |
$119.66 |
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$81.31 |
$381.00 |
$588.80 |
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$143.75 |
$726.00 |
$1,076.00 |
|
|
X-ray joint survey 1 view
|
$93.53 |
$174.72 |
$502.40 |
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$79.52 |
$380.00 |
$704.00 |
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$75.60 |
$544.00 |
$637.00 |
|
|
X-ray male genital tract
|
$328.08 |
$328.08 |
$328.08 |
|
|
X-ray mandible ltd <4 views
|
$76.61 |
$137.00 |
$429.60 |
|
|
X-ray nose to rectum for foreign body child
|
$32.48 |
$201.00 |
$477.60 |
|
|
X-ray of mammary ducts
|
$189.84 |
$328.08 |
$1,012.00 |
|
|
X-ray optic foramina
|
$84.00 |
$171.00 |
$317.00 |
|
|
Xray place dist ext thor ao
|
$350.56 |
$350.56 |
$418.30 |
|
|
Xray place prox ext thor ao
|
$350.56 |
$350.56 |
$350.56 |
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$202.57 |
$479.72 |
$1,319.00 |
|
|
X-ray ribs 2 views left
|
$54.88 |
$302.00 |
$448.80 |
|
|
X-ray sella turcica
|
$46.06 |
$119.66 |
$119.66 |
|
|
X-ray sinus tract/fistula/abscess
|
$124.32 |
$860.00 |
$1,663.00 |
|
|
X-ray slg plne bdy sect without urogr
|
$143.75 |
$143.75 |
$2,114.40 |
|
|
X-ray small intestine follow-through study
|
$63.49 |
$526.00 |
$920.00 |
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$64.96 |
$314.00 |
$569.60 |
|
|
X-ray surgical specimen
|
$42.77 |
$751.34 |
$1,623.00 |
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$119.66 |
$279.00 |
$313.00 |
|
|
X-ray xm phrnx&/crv esoph c+
|
$150.40 |
$354.00 |
$903.00 |
|
|
Xtrnl ecg rec>48hr<7d
|
$373.97 |
$373.97 |
$373.97 |
|
|
Xtrnl ecg rec up to 48 hrs
|
$95.47 |
$95.47 |
$95.47 |
|
|
Xwrap 1 sq cm
|
$171.12 |
$171.12 |
$171.12 |
|
|
Xylose absorption test blood &/or urine
|
$17.82 |
$38.01 |
$343.20 |
|
|
Xyntha inj
|
$2.19 |
$2.19 |
$2.19 |
|
|
Yersinia antibody
|
$16.80 |
$42.58 |
$42.58 |
|
|
Yttrium y-90 ibritumomab ther
|
$50,918.56 |
$78,417.88 |
$78,417.88 |
|
|
Zenith amniotic membrane psc
|
$171.12 |
$171.12 |
$171.12 |
|
|
Ziconotide injection
|
$14.58 |
$14.58 |
$14.58 |
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$2.09 |
$2.09 |
$2.09 |
|
|
Zika virus dna/rna amp probe
|
$26.80 |
$70.81 |
$919.20 |
|
