|
Warde vitamin b6 (pyridoxine)
|
$28.10 |
$28.10 |
$28.10 |
$118.30
|
|
Warde vitamin c (ascorbic acid)
|
$9.89 |
$9.89 |
$9.89 |
$50.70
|
|
Warde vitamin d (1 25 dihydroxy)
|
$38.50 |
$38.50 |
$38.50 |
$140.32
|
|
Warde vitamin e (alpha-tocopherol)
|
$14.18 |
$14.18 |
$14.18 |
$61.15
|
|
Warde zinc
|
$11.39 |
$11.39 |
$11.39 |
$62.70
|
|
Wash harvest stem cells
|
$517.34 |
$517.34 |
$517.34 |
$1,263.60
|
|
Wbc automated
|
$2.54 |
$2.54 |
$2.54 |
$32.50
|
|
Wcd device interrogate
|
$44.13 |
$44.13 |
$44.13 |
$109.20
|
|
Wedge rescj/bisctj ovary uni/bi 58920
|
$8,750.72 |
$8,750.72 |
$8,750.72 |
$8,185.02
|
|
Wedging of cast
|
$314.28 |
$314.28 |
$314.28 |
$314.28
|
|
Wedging of clubfoot cast
|
$314.28 |
$314.28 |
$314.28 |
$314.28
|
|
Western blot test
|
$17.03 |
$17.03 |
$17.03 |
$144.00
|
|
Wet mounts/ w preparations
|
$18.19 |
$18.19 |
$18.19 |
$36.80
|
|
Whole blood for transfusion
|
$266.40 |
$266.40 |
$266.40 |
$491.50
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$286.89 |
$286.89 |
$286.89 |
$696.45
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$203.77 |
$203.77 |
$203.77 |
$491.04
|
|
Whole-Body Bone Scan (Nuclear Medicine)
|
$475.51 |
$475.51 |
$475.51 |
$1,570.65
|
|
Whole mitochondrial genome
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$2,175.00
|
|
Whole mitochondrial genome
|
$936.00 |
$936.00 |
$936.00 |
$1,673.10
|
|
Whole Skeleton X-ray Survey
|
$125.84 |
$125.84 |
$125.84 |
$639.93
|
|
Wilate injection
|
$1.28 |
$1.28 |
$1.28 |
$4.58
|
|
Wound Cleaning and Dead Tissue Removal (up to 20 sq cm)
|
$235.13 |
$235.13 |
$235.13 |
$351.60
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$472.79 |
$472.79 |
$472.79 |
$574.80
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$472.79 |
$472.79 |
$472.79 |
$594.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$235.13 |
$235.13 |
$235.13 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$472.79 |
$472.79 |
$472.79 |
$438.91
|
|
Wrist arthroscopy
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,022.93
|
|
Wrist arthroscopy/surgery
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,986.00
|
|
Wrist arthroscopy/surgery
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,412.89
|
|
Wrist endoscopy/surgery
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$3,452.80
|
|
Wrist X-ray
|
$104.19 |
$104.19 |
$104.19 |
$350.40
|
|
Wrist X-ray (2 views, both wrists)
|
$104.19 |
$104.19 |
$104.19 |
$290.40
|
|
Xcapsl ctrc rmvl cplx w/ecp
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$4,760.49
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$3,786.00
|
|
Xcapsl ctrc rmvl insj 1+
|
$6,105.79 |
$6,105.79 |
$6,105.79 |
$7,316.99
|
|
Xcapsl ctrc rmvl w/ecp
|
$4,760.49 |
$4,760.49 |
$4,760.49 |
$4,760.49
|
|
Xcpsl ctrc rmvl cplx insj 1+
|
$6,105.79 |
$6,105.79 |
$6,105.79 |
$8,652.80
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,838.00
|
|
X-linked intellectual dblt
|
$914.00 |
$914.00 |
$914.00 |
$1,258.40
|
|
X-linked intellectual dblt
|
$914.00 |
$914.00 |
$914.00 |
$1,173.00
|
|
Xm archive tissue molec anal
|
$28.98 |
$28.98 |
$28.98 |
$48.38
|
|
X-ray abdomen >=3 views
|
$125.84 |
$125.84 |
$125.84 |
$341.90
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$422.61 |
$422.61 |
$422.61 |
$789.36
|
|
X-ray assay calculus
|
$12.52 |
$12.52 |
$12.52 |
$33.60
|
|
X-ray bone length studies
|
$125.84 |
$125.84 |
$125.84 |
$285.30
|
|
X-ray bone survey infant
|
$125.84 |
$125.84 |
$125.84 |
$391.38
|
|
X-ray exam entire spi 4/5 vw
|
$125.84 |
$125.84 |
$125.84 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$125.84 |
$125.84 |
$125.84 |
$517.80
|
|
X-ray exam of arm infant
|
$125.84 |
$125.84 |
$125.84 |
$248.50
|
|
X-ray exam of femur 1
|
$104.19 |
$104.19 |
$104.19 |
$236.40
|
|
X-ray exam of jaw joint
|
$104.19 |
$104.19 |
$104.19 |
$201.75
|
|
X-ray exam of jaw joint
|
$286.04 |
$286.04 |
$286.04 |
$452.00
|
|
X-ray exam of mastoids
|
$125.84 |
$125.84 |
$125.84 |
$193.41
|
|
X-ray exam of middle ear
|
$648.84 |
$648.84 |
$648.84 |
$349.35
|
|
X-ray exam of penis
|
$125.84 |
$125.84 |
$125.84 |
$593.46
|
|
X-ray exam of perineum
|
$286.04 |
$286.04 |
$286.04 |
$588.00
|
|
X-ray exam of salivary gland
|
$104.19 |
$104.19 |
$104.19 |
$162.60
|
|
X-ray exam of tear duct
|
$286.04 |
$286.04 |
$286.04 |
$467.50
|
|
X-ray exam of teeth
|
$104.19 |
$104.19 |
$104.19 |
$138.40
|
|
X-ray exam of teeth
|
$286.04 |
$286.04 |
$286.04 |
$385.39
|
|
X-ray exam si joints
|
$125.84 |
$125.84 |
$125.84 |
$247.80
|
|
X-ray exam thorac spine4/>vw
|
$125.84 |
$125.84 |
$125.84 |
$395.00
|
|
X-ray eye detection foreign body (both sides)
|
$104.19 |
$104.19 |
$104.19 |
$237.78
|
|
X-ray head for orthodontia
|
$104.19 |
$104.19 |
$104.19 |
$158.50
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$125.84 |
$125.84 |
$125.84 |
$372.64
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$125.84 |
$125.84 |
$125.84 |
$500.28
|
|
X-ray joint survey 1 view
|
$125.84 |
$125.84 |
$125.84 |
$232.00
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$104.19 |
$104.19 |
$104.19 |
$251.74
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$125.84 |
$125.84 |
$125.84 |
$364.75
|
|
X-ray male genital tract
|
$286.04 |
$286.04 |
$286.04 |
$603.50
|
|
X-ray mandible ltd <4 views
|
$104.19 |
$104.19 |
$104.19 |
$238.00
|
|
X-ray nose to rectum for foreign body child
|
$104.19 |
$104.19 |
$104.19 |
$229.00
|
|
X-ray of mammary ducts
|
$286.04 |
$286.04 |
$286.04 |
$568.26
|
|
X-ray optic foramina
|
$104.19 |
$104.19 |
$104.19 |
$188.40
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$422.61 |
$422.61 |
$422.61 |
$769.50
|
|
X-ray ribs 2 views left
|
$104.19 |
$104.19 |
$104.19 |
$291.61
|
|
X-ray sella turcica
|
$104.19 |
$104.19 |
$104.19 |
$162.50
|
|
X-ray sinus tract/fistula/abscess
|
$648.84 |
$648.84 |
$648.84 |
$636.30
|
|
X-ray slg plne bdy sect without urogr
|
$125.84 |
$125.84 |
$125.84 |
$398.75
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$104.19 |
$104.19 |
$104.19 |
$267.50
|
|
X-ray surgical specimen
|
$648.84 |
$648.84 |
$648.84 |
$521.28
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$104.19 |
$104.19 |
$104.19 |
$257.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$210.66 |
$210.66 |
$210.66 |
$362.98
|
|
Xylose absorption test blood &/or urine
|
$12.91 |
$12.91 |
$12.91 |
$99.89
|
|
Xyntha inj
|
$1.48 |
$1.48 |
$1.48 |
$6.65
|
|
Yersinia antibody
|
$13.19 |
$13.19 |
$13.19 |
$55.80
|
|
Yttrium y-90 ibritumomab ther
|
$14,774.74 |
$14,774.74 |
$14,774.74 |
$55,035.00
|
|
Ziconotide injection
|
$9.65 |
$9.65 |
$9.65 |
$7,216.02
|
|
Zika virus dna/rna amp probe
|
$51.31 |
$51.31 |
$51.31 |
$181.08
|
|
Zika virus igm antibody
|
$16.85 |
$16.85 |
$16.85 |
$85.00
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$6.50 |
$6.50 |
$6.50 |
$5,215.08
|
|
Zrsr2 gene common variants
|
$193.25 |
$193.25 |
$193.25 |
$243.34
|