|
Warde neutralization rabies
|
$44.80 |
$44.80 |
$44.80 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$34.56 |
$34.56 |
$34.56 |
$64.35
|
|
Warde pancreatic elastase fecal quantitative
|
$28.80 |
$28.80 |
$28.80 |
$94.25
|
|
Warde protein c antigen
|
$206.08 |
$206.08 |
$206.08 |
$93.43
|
|
Warde sex hormone binding globulin
|
$76.80 |
$76.80 |
$76.80 |
$82.08
|
|
Warde somatomedin
|
$184.83 |
$184.83 |
$184.83 |
$113.58
|
|
Warde t3 (triiodothyronine) reverse
|
$41.28 |
$41.28 |
$41.28 |
$69.50
|
|
Warde thyroid stimulating immunoglobulins
|
$211.20 |
$211.20 |
$211.20 |
$178.53
|
|
Warde topiramate therapeutic drug level
|
$126.72 |
$126.72 |
$126.72 |
$71.20
|
|
Warde vitamin a
|
$33.28 |
$33.28 |
$33.28 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$98.56 |
$98.56 |
$98.56 |
$82.04
|
|
Warde vitamin b6 (pyridoxine)
|
$28.80 |
$28.80 |
$28.80 |
$116.20
|
|
Warde vitamin c (ascorbic acid)
|
$40.32 |
$40.32 |
$40.32 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$201.60 |
$201.60 |
$201.60 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$28.80 |
$28.80 |
$28.80 |
$59.25
|
|
Warde zinc
|
$26.88 |
$26.88 |
$26.88 |
$62.50
|
|
Wbc automated
|
$33.60 |
$33.60 |
$33.60 |
$32.35
|
|
Wedging of cast
|
$394.24 |
$394.24 |
$394.24 |
$314.28
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$279.04 |
$279.04 |
$279.04 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$279.04 |
$279.04 |
$279.04 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$188.16 |
$188.16 |
$188.16 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$279.04 |
$279.04 |
$279.04 |
$438.75
|
|
Wrist endoscopy/surgery
|
$750.40 |
$750.40 |
$750.40 |
$3,452.80
|
|
Wrist X-ray
|
$105.60 |
$105.60 |
$105.60 |
$342.80
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,593.92 |
$2,593.92 |
$2,593.92 |
$2,692.80
|
|
X-ray abdomen 1 view
|
$134.40 |
$134.40 |
$134.40 |
$258.50
|
|
X-ray abdomen 2 views
|
$105.60 |
$105.60 |
$105.60 |
$316.47
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$182.40 |
$182.40 |
$182.40 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$86.08 |
$86.08 |
$86.08 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$282.50
|
|
X-ray bone age studies
|
$86.08 |
$86.08 |
$86.08 |
$251.40
|
|
X-ray bone length studies
|
$86.08 |
$86.08 |
$86.08 |
$285.30
|
|
X-ray bone survey complete
|
$196.48 |
$196.48 |
$196.48 |
$660.00
|
|
X-ray bone survey infant
|
$144.96 |
$144.96 |
$144.96 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$195.20 |
$195.20 |
$195.20 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$144.96 |
$144.96 |
$144.96 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$149.12 |
$149.12 |
$149.12 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$175.04 |
$175.04 |
$175.04 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$269.12 |
$269.12 |
$269.12 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$175.04 |
$175.04 |
$175.04 |
$483.50
|
|
X-ray exam of arm infant
|
$86.08 |
$86.08 |
$86.08 |
$248.44
|
|
X-ray exam of eye sockets
|
$81.73 |
$81.73 |
$81.73 |
$328.35
|
|
X-ray exam of femur 1
|
$96.00 |
$96.00 |
$96.00 |
$240.00
|
|
X-ray exam of middle ear
|
$138.05 |
$138.05 |
$138.05 |
$345.66
|
|
X-ray exam of penis
|
$266.24 |
$266.24 |
$266.24 |
$593.46
|
|
X-ray exam of sinuses
|
$86.08 |
$86.08 |
$86.08 |
$214.50
|
|
X-ray facial bones complete > 3 views
|
$86.08 |
$86.08 |
$86.08 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$153.60 |
$153.60 |
$153.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$152.32 |
$152.32 |
$152.32 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$217.60 |
$217.60 |
$217.60 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$305.28 |
$305.28 |
$305.28 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$86.08 |
$86.08 |
$86.08 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$88.64 |
$88.64 |
$88.64 |
$309.31
|
|
X-ray joint survey 1 view
|
$81.73 |
$81.73 |
$81.73 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$89.28 |
$89.28 |
$89.28 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$86.08 |
$86.08 |
$86.08 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$82.91 |
$82.91 |
$82.91 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$144.96 |
$144.96 |
$144.96 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$176.00 |
$176.00 |
$176.00 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$86.08 |
$86.08 |
$86.08 |
$361.61
|
|
X-ray nasal bones complete > 3 views
|
$86.08 |
$86.08 |
$86.08 |
$274.65
|
|
X-ray neck soft tissue
|
$86.08 |
$86.08 |
$86.08 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$81.73 |
$81.73 |
$81.73 |
$225.60
|
|
X-ray optic foramina
|
$81.73 |
$81.73 |
$81.73 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$174.72 |
$174.72 |
$174.72 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$92.48 |
$92.48 |
$92.48 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$297.28 |
$297.28 |
$297.28 |
$755.50
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$174.72 |
$174.72 |
$174.72 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$86.72 |
$86.72 |
$86.72 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$105.60 |
$105.60 |
$105.60 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$285.00
|
|
X-ray sella turcica
|
$81.73 |
$81.73 |
$81.73 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$128.00 |
$128.00 |
$128.00 |
$345.60
|
|
X-ray skull < 4 views
|
$174.72 |
$174.72 |
$174.72 |
$292.50
|
|
X-ray skull > 4 views complete
|
$144.96 |
$144.96 |
$144.96 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$175.04 |
$175.04 |
$175.04 |
$557.70
|
|
X-ray small intestine follow-through study
|
$144.00 |
$144.00 |
$144.00 |
$499.50
|
|
X-ray spine single view
|
$195.20 |
$195.20 |
$195.20 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$86.08 |
$86.08 |
$86.08 |
$264.48
|
|
X-ray sternum > 2 views
|
$86.08 |
$86.08 |
$86.08 |
$274.65
|
|
X-ray surgical specimen
|
$86.08 |
$86.08 |
$86.08 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$184.00 |
$184.00 |
$184.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$81.73 |
$81.73 |
$81.73 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$144.00 |
$144.00 |
$144.00 |
$320.45
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$86.08 |
$86.08 |
$86.08 |
$257.04
|
|
X-ray tibia/fibula 2 views (both sides)
|
$105.60 |
$105.60 |
$105.60 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$86.08 |
$86.08 |
$86.08 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$184.00 |
$184.00 |
$184.00 |
$657.77
|