|
Warde sex hormone binding globulin
|
$98.40 |
$98.40 |
$98.40 |
$86.59
|
|
Warde somatomedin
|
$457.60 |
$457.60 |
$457.60 |
$111.80
|
|
Warde sugars single qualitative each specimen stool
|
$43.20 |
$43.20 |
$43.20 |
$35.75
|
|
Warde t3 (triiodothyronine) reverse
|
$108.00 |
$108.00 |
$108.00 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$251.20 |
$251.20 |
$251.20 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$108.80 |
$108.80 |
$108.80 |
$71.19
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$88.00 |
$88.00 |
$88.00 |
$127.20
|
|
Warde viscosity
|
$110.40 |
$110.40 |
$110.40 |
$52.65
|
|
Warde vitamin a
|
$96.00 |
$96.00 |
$96.00 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$120.80 |
$120.80 |
$120.80 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$144.80 |
$144.80 |
$144.80 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$132.80 |
$132.80 |
$132.80 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$249.60 |
$249.60 |
$249.60 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$145.60 |
$145.60 |
$145.60 |
$55.00
|
|
Warde zinc
|
$110.40 |
$110.40 |
$110.40 |
$62.50
|
|
Wbc automated
|
$10.40 |
$10.40 |
$10.40 |
$32.80
|
|
Wedging of cast
|
$152.00 |
$152.00 |
$152.00 |
$309.54
|
|
Western blot test
|
$71.20 |
$71.20 |
$71.20 |
$153.18
|
|
Whole blood for transfusion
|
$300.80 |
$300.80 |
$300.80 |
$479.50
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$227.20 |
$227.20 |
$227.20 |
$495.00
|
|
Wnd prep f/n/hf/g addl cm
|
$173.60 |
$173.60 |
$173.60 |
$865.80
|
|
Wound closure by adhesive
|
$264.00 |
$264.00 |
$264.00 |
$149.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$524.00 |
$524.00 |
$524.00 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$479.20 |
$479.20 |
$479.20 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$91.20 |
$91.20 |
$91.20 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$479.20 |
$479.20 |
$479.20 |
$436.15
|
|
Wrist endoscopy/surgery
|
$754.40 |
$754.40 |
$754.40 |
$2,512.00
|
|
Wrist X-ray
|
$239.20 |
$239.20 |
$239.20 |
$343.70
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,142.40 |
$1,142.40 |
$1,142.40 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$1,056.80 |
$1,056.80 |
$1,056.80 |
$2,623.24
|
|
X-ray abdomen 1 view
|
$180.00 |
$180.00 |
$180.00 |
$255.00
|
|
X-ray abdomen 2 views
|
$188.80 |
$188.80 |
$188.80 |
$312.36
|
|
X-ray abdomen >=3 views
|
$324.00 |
$324.00 |
$324.00 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$546.40 |
$546.40 |
$546.40 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$242.40 |
$242.40 |
$242.40 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$179.20 |
$179.20 |
$179.20 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$636.80 |
$636.80 |
$636.80 |
$768.30
|
|
X-ray bone age studies
|
$293.60 |
$293.60 |
$293.60 |
$246.75
|
|
X-ray bone length studies
|
$541.60 |
$541.60 |
$541.60 |
$287.25
|
|
X-ray bone survey complete
|
$902.40 |
$902.40 |
$902.40 |
$666.60
|
|
X-ray bone survey infant
|
$218.40 |
$218.40 |
$218.40 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$241.60 |
$241.60 |
$241.60 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$359.20 |
$359.20 |
$359.20 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$423.20 |
$423.20 |
$423.20 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$172.80 |
$172.80 |
$172.80 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$760.80 |
$760.80 |
$760.80 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,031.20 |
$1,031.20 |
$1,031.20 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$192.00 |
$192.00 |
$192.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$193.60 |
$193.60 |
$193.60 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$386.40 |
$386.40 |
$386.40 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$558.40 |
$558.40 |
$558.40 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$558.40 |
$558.40 |
$558.40 |
$575.76
|
|
X-ray exam of arm infant
|
$193.60 |
$193.60 |
$193.60 |
$248.82
|
|
X-ray exam of eye sockets
|
$181.60 |
$181.60 |
$181.60 |
$349.05
|
|
X-ray exam of femur 1
|
$178.40 |
$178.40 |
$178.40 |
$232.36
|
|
X-ray exam of jaw joint
|
$137.60 |
$137.60 |
$137.60 |
$192.39
|
|
X-ray exam of jaw joint
|
$619.20 |
$619.20 |
$619.20 |
$354.79
|
|
X-ray exam of sinuses
|
$196.00 |
$196.00 |
$196.00 |
$211.00
|
|
X-ray exam si joints
|
$204.80 |
$204.80 |
$204.80 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$304.80 |
$304.80 |
$304.80 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$371.20 |
$371.20 |
$371.20 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$455.20 |
$455.20 |
$455.20 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$178.40 |
$178.40 |
$178.40 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$236.00 |
$236.00 |
$236.00 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$172.80 |
$172.80 |
$172.80 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$203.20 |
$203.20 |
$203.20 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$169.60 |
$169.60 |
$169.60 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$179.20 |
$179.20 |
$179.20 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$294.40 |
$294.40 |
$294.40 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$294.40 |
$294.40 |
$294.40 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$294.40 |
$294.40 |
$294.40 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$558.40 |
$558.40 |
$558.40 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$160.80 |
$160.80 |
$160.80 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$193.60 |
$193.60 |
$193.60 |
$304.15
|
|
X-ray joint survey 1 view
|
$121.60 |
$121.60 |
$121.60 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$192.00 |
$192.00 |
$192.00 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$193.60 |
$193.60 |
$193.60 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$153.60 |
$153.60 |
$153.60 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$193.60 |
$193.60 |
$193.60 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$309.60 |
$309.60 |
$309.60 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$330.40 |
$330.40 |
$330.40 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$492.80 |
$492.80 |
$492.80 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$458.40 |
$458.40 |
$458.40 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$278.40 |
$278.40 |
$278.40 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$208.80 |
$208.80 |
$208.80 |
$277.70
|
|
X-ray neck soft tissue
|
$224.80 |
$224.80 |
$224.80 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$141.60 |
$141.60 |
$141.60 |
$225.96
|
|
X-ray pelvis 1-2 views
|
$198.40 |
$198.40 |
$198.40 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$223.20 |
$223.20 |
$223.20 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$621.60 |
$621.60 |
$621.60 |
$742.00
|
|
X-ray ribs 2 views left
|
$308.80 |
$308.80 |
$308.80 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$560.80 |
$560.80 |
$560.80 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$357.60 |
$357.60 |
$357.60 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$585.60 |
$585.60 |
$585.60 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$204.80 |
$204.80 |
$204.80 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$251.20 |
$251.20 |
$251.20 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$252.80 |
$252.80 |
$252.80 |
$292.50
|
|
X-ray shoulder 1 view (both sides)
|
$220.00 |
$220.00 |
$220.00 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$290.40 |
$290.40 |
$290.40 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$632.80 |
$632.80 |
$632.80 |
$601.30
|
