|
Warde vitamin e (alpha-tocopherol)
|
$129.00 |
$129.00 |
$130.64 |
$59.25
|
|
Warde zinc
|
$34.50 |
$34.50 |
$35.50 |
$62.50
|
|
Wbc automated
|
$20.24 |
$20.24 |
$35.00 |
$32.35
|
|
Western blot test
|
$98.00 |
$98.00 |
$126.50 |
$150.00
|
|
Whole blood for transfusion
|
$305.00 |
$305.00 |
$305.00 |
$497.00
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$452.00 |
$452.00 |
$452.00 |
$696.45
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$238.50 |
$238.50 |
$278.76 |
$491.04
|
|
Wilate injection
|
$0.46 |
$0.46 |
$0.50 |
$4.58
|
|
Wnd prep f/n/hf/g addl cm
|
$194.12 |
$194.12 |
$236.00 |
$811.00
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$245.00 |
$245.00 |
$245.00 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$227.50 |
$227.50 |
$227.50 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$121.90 |
$121.90 |
$150.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$226.78 |
$226.78 |
$279.00 |
$438.75
|
|
Wrist X-ray
|
$251.16 |
$251.16 |
$270.50 |
$342.80
|
|
Xe133 xenon 10mci
|
$153.50 |
$153.50 |
$358.34 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,854.00 |
$2,854.00 |
$2,854.00 |
$2,692.80
|
|
Xpos opn fmrl eprst aor uni add-on
|
$566.26 |
$566.26 |
$766.50 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$205.62 |
$205.62 |
$294.00 |
$258.50
|
|
X-ray abdomen 2 views
|
$255.30 |
$255.30 |
$294.00 |
$316.47
|
|
X-ray abdomen >=3 views
|
$281.98 |
$281.98 |
$281.98 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$385.00 |
$385.00 |
$401.12 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$245.50 |
$245.50 |
$245.50 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$89.24 |
$89.24 |
$192.50 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$622.00 |
$622.00 |
$622.00 |
$773.40
|
|
X-ray bone age studies
|
$111.50 |
$111.50 |
$111.50 |
$251.40
|
|
X-ray bone length studies
|
$200.00 |
$200.00 |
$200.00 |
$285.30
|
|
X-ray bone survey complete
|
$599.84 |
$599.84 |
$640.00 |
$660.00
|
|
X-ray bone survey infant
|
$249.50 |
$249.50 |
$249.50 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$207.92 |
$207.92 |
$270.50 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$328.90 |
$328.90 |
$373.00 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$508.50 |
$508.50 |
$529.46 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$102.58 |
$102.58 |
$220.50 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$741.00 |
$741.00 |
$741.00 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$941.00 |
$941.00 |
$941.00 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$188.14 |
$188.14 |
$212.50 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$205.62 |
$205.62 |
$270.00 |
$364.12
|
|
Xray endovasc thor ao repr
|
$600.30 |
$600.30 |
$600.30 |
$1,734.00
|
|
Xray endovasc thor ao repr
|
$1,050.18 |
$1,050.18 |
$1,050.18 |
$1,622.18
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$479.00 |
$479.00 |
$479.00 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$205.00 |
$205.00 |
$205.00 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$212.50 |
$212.50 |
$212.50 |
$517.80
|
|
X-ray exam of arm infant
|
$102.50 |
$102.50 |
$102.50 |
$248.44
|
|
X-ray exam of eye sockets
|
$333.50 |
$333.50 |
$333.50 |
$328.35
|
|
X-ray exam of femur 1
|
$105.80 |
$105.80 |
$107.50 |
$240.00
|
|
X-ray exam of jaw joint
|
$3,595.00 |
$3,595.00 |
$3,595.00 |
$452.00
|
|
X-ray exam of salivary gland
|
$136.50 |
$136.50 |
$136.50 |
$162.60
|
|
X-ray exam of sinuses
|
$214.50 |
$214.50 |
$214.50 |
$214.50
|
|
X-ray exam of teeth
|
$1,203.00 |
$1,203.00 |
$1,203.00 |
$328.08
|
|
X-ray exam si joints
|
$177.00 |
$177.00 |
$177.00 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$245.00 |
$245.00 |
$245.00 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$176.50 |
$176.50 |
$176.50 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$346.50 |
$346.50 |
$346.50 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$125.12 |
$125.12 |
$168.50 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$84.18 |
$84.18 |
$171.50 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$126.50 |
$126.50 |
$194.50 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$120.98 |
$120.98 |
$210.50 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$184.92 |
$184.92 |
$216.50 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$121.00 |
$121.00 |
$121.00 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$82.34 |
$82.34 |
$144.00 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$151.80 |
$151.80 |
$344.50 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$170.20 |
$170.20 |
$344.50 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$189.52 |
$189.52 |
$313.50 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$43.70 |
$43.70 |
$116.00 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$191.36 |
$191.36 |
$217.00 |
$309.31
|
|
X-ray joint survey 1 view
|
$111.50 |
$111.50 |
$111.50 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$126.50 |
$126.50 |
$288.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$138.92 |
$138.92 |
$309.50 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$127.42 |
$127.42 |
$155.00 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$113.50 |
$113.50 |
$113.50 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$152.72 |
$152.72 |
$167.50 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$234.14 |
$234.14 |
$423.50 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$201.48 |
$201.48 |
$458.00 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$315.50 |
$315.50 |
$315.50 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$151.50 |
$151.50 |
$151.50 |
$235.30
|
|
X-ray measurement of pelvis
|
$441.00 |
$441.00 |
$441.00 |
$157.39
|
|
X-ray nasal bones complete > 3 views
|
$115.00 |
$115.00 |
$233.00 |
$274.65
|
|
X-ray neck soft tissue
|
$107.18 |
$107.18 |
$234.50 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$208.00 |
$208.00 |
$208.00 |
$225.60
|
|
X-ray of mammary ducts
|
$466.50 |
$466.50 |
$466.50 |
$568.26
|
|
X-ray pelvis 1-2 views
|
$199.64 |
$199.64 |
$215.50 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$241.00 |
$241.00 |
$359.72 |
$348.19
|
|
Xray place prox ext thor ao
|
$651.82 |
$651.82 |
$651.82 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$529.50 |
$529.50 |
$529.50 |
$755.50
|
|
X-ray ribs 2 views left
|
$182.16 |
$182.16 |
$205.50 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$177.10 |
$177.10 |
$314.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$236.44 |
$236.44 |
$277.50 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$322.46 |
$322.46 |
$366.50 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$146.28 |
$146.28 |
$299.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$179.00 |
$179.00 |
$179.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$244.00 |
$244.00 |
$244.00 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$147.66 |
$147.66 |
$167.50 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$282.00 |
$282.00 |
$282.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$557.06 |
$557.06 |
$654.00 |
$606.89
|
|
X-ray skull < 4 views
|
$139.00 |
$139.00 |
$139.00 |
$292.50
|
|
X-ray skull > 4 views complete
|
$343.00 |
$343.00 |
$343.00 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$463.00 |
$463.00 |
$463.00 |
$557.70
|
|
X-ray small intestine follow-through study
|
$571.78 |
$571.78 |
$586.50 |
$499.50
|
|
X-ray spine single view
|
$175.72 |
$175.72 |
$216.00 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$175.50 |
$175.50 |
$175.50 |
$264.48
|
|
X-ray sternum > 2 views
|
$96.50 |
$96.50 |
$96.50 |
$274.65
|
