|
Warde vitamin d (1 25 dihydroxy)
|
$23.00 |
$23.00 |
$23.00 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$8.00 |
$8.00 |
$8.00 |
$55.00
|
|
Warde zinc
|
$17.00 |
$17.00 |
$17.00 |
$62.50
|
|
Wbc automated
|
$78.00 |
$78.00 |
$78.00 |
$32.80
|
|
Western blot test
|
$356.00 |
$356.00 |
$356.00 |
$153.18
|
|
Whole mitochondrial genome
|
$2,428.00 |
$2,428.00 |
$2,428.00 |
$1,776.06
|
|
Whole mitochondrial genome
|
$2,428.00 |
$2,428.00 |
$2,428.00 |
$1,524.90
|
|
Wilate injection
|
$3.44 |
$3.44 |
$3.44 |
$2.94
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$468.00 |
$468.00 |
$468.00 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$468.00 |
$468.00 |
$468.00 |
$436.15
|
|
Wrist X-ray
|
$2,623.00 |
$2,623.00 |
$2,623.00 |
$343.70
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$4,406.57 |
$4,406.57 |
$4,406.57 |
$3,724.80
|
|
Xe133 xenon 10mci
|
$346.50 |
$346.50 |
$346.50 |
$299.00
|
|
X-ray abdomen 1 view
|
$731.00 |
$731.00 |
$731.00 |
$255.00
|
|
X-ray abdomen 2 views
|
$1,454.00 |
$1,454.00 |
$1,454.00 |
$312.36
|
|
X-ray abdomen >=3 views
|
$2,217.00 |
$2,217.00 |
$2,217.00 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$2,217.00 |
$2,217.00 |
$2,217.00 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$819.00 |
$819.00 |
$819.00 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$2,274.00 |
$2,274.00 |
$2,274.00 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$3,573.00 |
$3,573.00 |
$3,573.00 |
$768.30
|
|
X-ray bone age studies
|
$812.00 |
$812.00 |
$812.00 |
$246.75
|
|
X-ray bone length studies
|
$421.00 |
$421.00 |
$421.00 |
$287.25
|
|
X-ray bone survey complete
|
$4,952.00 |
$4,952.00 |
$4,952.00 |
$666.60
|
|
X-ray bone survey infant
|
$3,386.00 |
$3,386.00 |
$3,386.00 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$389.00 |
$389.00 |
$389.00 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$415.00 |
$415.00 |
$415.00 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$415.00 |
$415.00 |
$415.00 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$2,093.00 |
$2,093.00 |
$2,093.00 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$919.00 |
$919.00 |
$919.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$891.00 |
$891.00 |
$891.00 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,614.00 |
$1,614.00 |
$1,614.00 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$1,778.00 |
$1,778.00 |
$1,778.00 |
$486.01
|
|
X-ray exam of arm infant
|
$895.00 |
$895.00 |
$895.00 |
$248.82
|
|
X-ray exam of eye sockets
|
$2,147.00 |
$2,147.00 |
$2,147.00 |
$349.05
|
|
X-ray exam of jaw joint
|
$778.00 |
$778.00 |
$778.00 |
$192.39
|
|
X-ray exam thorac spine4/>vw
|
$1,856.00 |
$1,856.00 |
$1,856.00 |
$395.59
|
|
X-ray facial bones complete > 3 views
|
$1,550.00 |
$1,550.00 |
$1,550.00 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$612.00 |
$612.00 |
$612.00 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$1,861.00 |
$1,861.00 |
$1,861.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$1,812.00 |
$1,812.00 |
$1,812.00 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$1,812.00 |
$1,812.00 |
$1,812.00 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$2,665.00 |
$2,665.00 |
$2,665.00 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$2,665.00 |
$2,665.00 |
$2,665.00 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$2,665.00 |
$2,665.00 |
$2,665.00 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$464.00 |
$464.00 |
$464.00 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$304.15
|
|
X-ray knee 1-2 views (both sides)
|
$1,874.00 |
$1,874.00 |
$1,874.00 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$2,804.00 |
$2,804.00 |
$2,804.00 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$1,874.00 |
$1,874.00 |
$1,874.00 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$1,769.00 |
$1,769.00 |
$1,769.00 |
$249.13
|
|
X-ray lumbosacral spine >= 4 views
|
$2,323.00 |
$2,323.00 |
$2,323.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$2,323.00 |
$2,323.00 |
$2,323.00 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$906.00 |
$906.00 |
$906.00 |
$352.83
|
|
X-ray nasal bones complete > 3 views
|
$998.00 |
$998.00 |
$998.00 |
$277.70
|
|
X-ray neck soft tissue
|
$1,006.00 |
$1,006.00 |
$1,006.00 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$669.00 |
$669.00 |
$669.00 |
$225.96
|
|
X-ray of mammary ducts
|
$2,109.00 |
$2,109.00 |
$2,109.00 |
$473.55
|
|
X-ray pelvis 1-2 views
|
$586.00 |
$586.00 |
$586.00 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$602.00 |
$602.00 |
$602.00 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,934.00 |
$1,934.00 |
$1,934.00 |
$742.00
|
|
X-ray ribs 2 views left
|
$818.00 |
$818.00 |
$818.00 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$2,608.00 |
$2,608.00 |
$2,608.00 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$818.00 |
$818.00 |
$818.00 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$3,144.00 |
$3,144.00 |
$3,144.00 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$907.00 |
$907.00 |
$907.00 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$565.00 |
$565.00 |
$565.00 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$292.50
|
|
X-ray shoulder 1 view (both sides)
|
$854.00 |
$854.00 |
$854.00 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$339.00
|
|
X-ray skull < 4 views
|
$778.00 |
$778.00 |
$778.00 |
$291.78
|
|
X-ray skull > 4 views complete
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$1,621.00 |
$1,621.00 |
$1,621.00 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,882.00 |
$1,882.00 |
$1,882.00 |
$504.14
|
|
X-ray spine single view
|
$1,696.00 |
$1,696.00 |
$1,696.00 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$924.00 |
$924.00 |
$924.00 |
$263.49
|
|
X-ray sternum > 2 views
|
$680.00 |
$680.00 |
$680.00 |
$269.75
|
|
X-ray surgical specimen
|
$1,540.00 |
$1,540.00 |
$1,540.00 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,960.00 |
$1,960.00 |
$1,960.00 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$1,672.00 |
$1,672.00 |
$1,672.00 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$1,778.00 |
$1,778.00 |
$1,778.00 |
$387.60
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$1,778.00 |
$1,778.00 |
$1,778.00 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$1,778.00 |
$1,778.00 |
$1,778.00 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$2,271.00 |
$2,271.00 |
$2,271.00 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$612.00 |
$612.00 |
$612.00 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$2,340.00 |
$2,340.00 |
$2,340.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$1,960.00 |
$1,960.00 |
$1,960.00 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$1,499.00 |
$1,499.00 |
$1,499.00 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$111.00 |
$111.00 |
$111.00 |
$64.28
|
|
Xyntha inj
|
$2.95 |
$2.95 |
$2.95 |
$6.03
|
|
Yersinia antibody
|
$53.00 |
$53.00 |
$53.00 |
$66.95
|
|
Yttrium y-90 ibritumomab ther
|
$0.04 |
$0.04 |
$0.04 |
$55,035.00
|
|
Ziconotide injection
|
$924.57 |
$924.57 |
$924.57 |
$2,938.53
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$4.98 |
$4.98 |
$4.98 |
$106.94
|
|
Zika virus dna/rna amp probe
|
$109.00 |
$109.00 |
$109.00 |
$175.00
|