|
Warde vitamin c (ascorbic acid)
|
$83.16 |
$83.16 |
$83.16 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$256.62 |
$256.62 |
$256.62 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$119.28 |
$119.28 |
$119.28 |
$59.25
|
|
Warde zinc
|
$31.50 |
$31.50 |
$31.50 |
$62.50
|
|
Wbc automated
|
$42.84 |
$42.84 |
$42.84 |
$32.35
|
|
Wcd device interrogate
|
$46.62 |
$46.62 |
$46.62 |
$109.20
|
|
Wedging of cast
|
$170.52 |
$170.52 |
$170.52 |
$314.28
|
|
Western blot test
|
$177.66 |
$177.66 |
$177.66 |
$150.00
|
|
Whfo nontorsion joint prefab
|
$7.96 |
$7.96 |
$7.96 |
$224.01
|
|
Whole blood for transfusion
|
$421.26 |
$421.26 |
$421.26 |
$497.00
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$591.36 |
$591.36 |
$591.36 |
$696.45
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$278.88 |
$278.88 |
$278.88 |
$491.04
|
|
Wilate injection
|
$41.79 |
$41.79 |
$41.79 |
$4.58
|
|
Wnd prep f/n/hf/g addl cm
|
$360.36 |
$360.36 |
$360.36 |
$811.00
|
|
Wound closure by adhesive
|
$97.02 |
$97.02 |
$97.02 |
$149.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$273.00 |
$273.00 |
$273.00 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$189.42 |
$189.42 |
$189.42 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$178.92 |
$178.92 |
$178.92 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$284.34 |
$284.34 |
$284.34 |
$438.75
|
|
Wrist X-ray
|
$217.14 |
$217.14 |
$217.14 |
$342.80
|
|
Xe133 xenon 10mci
|
$181.02 |
$181.02 |
$181.02 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,254.54 |
$1,254.54 |
$1,254.54 |
$2,692.80
|
|
Xm archive tissue molec anal
|
$85.26 |
$85.26 |
$85.26 |
$49.84
|
|
Xpos opn fmrl eprst aor uni add-on
|
$1,170.96 |
$1,170.96 |
$1,170.96 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$205.38 |
$205.38 |
$205.38 |
$258.50
|
|
X-ray abdomen 2 views
|
$254.52 |
$254.52 |
$254.52 |
$316.47
|
|
X-ray abdomen >=3 views
|
$71.82 |
$71.82 |
$71.82 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$348.60 |
$348.60 |
$348.60 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$204.54 |
$204.54 |
$204.54 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$167.58 |
$167.58 |
$167.58 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$504.42 |
$504.42 |
$504.42 |
$773.40
|
|
X-ray assay calculus
|
$119.28 |
$119.28 |
$119.28 |
$33.60
|
|
X-ray bone age studies
|
$90.30 |
$90.30 |
$90.30 |
$251.40
|
|
X-ray bone length studies
|
$153.30 |
$153.30 |
$153.30 |
$285.30
|
|
X-ray bone survey complete
|
$522.48 |
$522.48 |
$522.48 |
$660.00
|
|
X-ray bone survey infant
|
$245.70 |
$245.70 |
$245.70 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$211.68 |
$211.68 |
$211.68 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$338.52 |
$338.52 |
$338.52 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$472.08 |
$472.08 |
$472.08 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$166.32 |
$166.32 |
$166.32 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$417.48 |
$417.48 |
$417.48 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$564.06 |
$564.06 |
$564.06 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$164.64 |
$164.64 |
$164.64 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$205.80 |
$205.80 |
$205.80 |
$364.12
|
|
Xray endovasc thor ao repr
|
$543.06 |
$543.06 |
$543.06 |
$1,734.00
|
|
Xray endovasc thor ao repr
|
$1,392.30 |
$1,392.30 |
$1,392.30 |
$1,622.18
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$358.68 |
$358.68 |
$358.68 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$178.50 |
$178.50 |
$178.50 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$178.50 |
$178.50 |
$178.50 |
$517.80
|
|
X-ray exam of arm infant
|
$81.06 |
$81.06 |
$81.06 |
$248.44
|
|
X-ray exam of eye sockets
|
$247.38 |
$247.38 |
$247.38 |
$328.35
|
|
X-ray exam of femur 1
|
$65.52 |
$65.52 |
$65.52 |
$240.00
|
|
X-ray exam of sinuses
|
$207.48 |
$207.48 |
$207.48 |
$214.50
|
|
X-ray exam si joints
|
$205.38 |
$205.38 |
$205.38 |
$246.16
|
|
X-ray eye detection foreign body (both sides)
|
$86.94 |
$86.94 |
$86.94 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$259.56 |
$259.56 |
$259.56 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$65.52 |
$65.52 |
$65.52 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$141.54 |
$141.54 |
$141.54 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$157.08 |
$157.08 |
$157.08 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$194.46 |
$194.46 |
$194.46 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$171.78 |
$171.78 |
$171.78 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$145.32 |
$145.32 |
$145.32 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$108.78 |
$108.78 |
$108.78 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$108.78 |
$108.78 |
$108.78 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$108.78 |
$108.78 |
$108.78 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$207.48 |
$207.48 |
$207.48 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$79.80 |
$79.80 |
$79.80 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$204.12 |
$204.12 |
$204.12 |
$309.31
|
|
X-ray joint survey 1 view
|
$88.20 |
$88.20 |
$88.20 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$231.84 |
$231.84 |
$231.84 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$264.18 |
$264.18 |
$264.18 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$120.54 |
$120.54 |
$120.54 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$105.84 |
$105.84 |
$105.84 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$519.54 |
$519.54 |
$519.54 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$351.54 |
$351.54 |
$351.54 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$429.24 |
$429.24 |
$429.24 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$218.40 |
$218.40 |
$218.40 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$87.36 |
$87.36 |
$87.36 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$204.96 |
$204.96 |
$204.96 |
$274.65
|
|
X-ray neck soft tissue
|
$186.48 |
$186.48 |
$186.48 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$186.06 |
$186.06 |
$186.06 |
$225.60
|
|
X-ray of mammary ducts
|
$537.18 |
$537.18 |
$537.18 |
$568.26
|
|
X-ray pelvis 1-2 views
|
$168.42 |
$168.42 |
$168.42 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$261.24 |
$261.24 |
$261.24 |
$348.19
|
|
Xray place dist ext thor ao
|
$543.06 |
$543.06 |
$543.06 |
$1,194.70
|
|
Xray place prox ext thor ao
|
$570.36 |
$570.36 |
$570.36 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$476.70 |
$476.70 |
$476.70 |
$755.50
|
|
X-ray ribs 2 views left
|
$169.26 |
$169.26 |
$169.26 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$235.62 |
$235.62 |
$235.62 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$228.90 |
$228.90 |
$228.90 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$322.56 |
$322.56 |
$322.56 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$236.88 |
$236.88 |
$236.88 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$102.06 |
$102.06 |
$102.06 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$203.70 |
$203.70 |
$203.70 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$163.38 |
$163.38 |
$163.38 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$242.76 |
$242.76 |
$242.76 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$636.30 |
$636.30 |
$636.30 |
$606.89
|
|
X-ray skull < 4 views
|
$143.64 |
$143.64 |
$143.64 |
$292.50
|
|
X-ray skull > 4 views complete
|
$243.18 |
$243.18 |
$243.18 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$119.28 |
$119.28 |
$119.28 |
$399.82
|
