|
Warde vitamin a
|
$52.00 |
$52.00 |
$52.00 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$94.90 |
$94.90 |
$94.90 |
$83.99
|
|
Warde vitamin b6 (pyridoxine)
|
$126.10 |
$126.10 |
$126.10 |
$118.30
|
|
Warde vitamin c (ascorbic acid)
|
$44.20 |
$44.20 |
$44.20 |
$50.70
|
|
Warde vitamin d (1 25 dihydroxy)
|
$172.90 |
$172.90 |
$172.90 |
$140.32
|
|
Warde vitamin e (alpha-tocopherol)
|
$63.70 |
$63.70 |
$63.70 |
$61.15
|
|
Warde zinc
|
$51.35 |
$51.35 |
$51.35 |
$62.70
|
|
Wash harvest stem cells
|
$1,136.85 |
$1,136.85 |
$1,136.85 |
$1,263.60
|
|
Wbc automated
|
$11.70 |
$11.70 |
$11.70 |
$32.50
|
|
Wcd device interrogate
|
$139.10 |
$139.10 |
$250.90 |
$109.20
|
|
Wedge biopsy of liver 47100
|
$3,356.60 |
$3,356.60 |
$3,356.60 |
$1,584.00
|
|
Wedge rescj/bisctj ovary uni/bi 58920
|
$3,107.00 |
$3,107.00 |
$3,107.00 |
$8,185.02
|
|
Wedge resect of lung add-on 32506
|
$780.00 |
$780.00 |
$780.00 |
$381.60
|
|
Wedge resect of lung diag 32507
|
$780.00 |
$780.00 |
$780.00 |
$381.60
|
|
Wedge resect of lung initial 32505
|
$4,095.00 |
$4,095.00 |
$4,095.00 |
$2,868.00
|
|
Wedging of cast
|
$794.30 |
$794.30 |
$794.30 |
$314.28
|
|
Western blot test
|
$76.70 |
$76.70 |
$76.70 |
$144.00
|
|
Wet mounts/ w preparations
|
$99.45 |
$99.45 |
$99.45 |
$36.80
|
|
Whfo nontorsion joint prefab
|
$69.55 |
$69.55 |
$69.55 |
$224.01
|
|
Whfo w/joint(s) custom fab
|
$308.75 |
$308.75 |
$339.95 |
$465.88
|
|
Whole blood for transfusion
|
$1,009.45 |
$1,009.45 |
$1,009.45 |
$491.50
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$772.20 |
$772.20 |
$772.20 |
$491.04
|
|
Whole-Body Bone Scan (Nuclear Medicine)
|
$1,802.45 |
$1,802.45 |
$2,048.15 |
$1,570.65
|
|
Whole body photography
|
$114.40 |
$114.40 |
$114.40 |
$178.08
|
|
Whole mitochondrial genome
|
$4,197.70 |
$4,197.70 |
$4,197.70 |
$1,673.10
|
|
Whole Skeleton X-ray Survey
|
$477.10 |
$477.10 |
$634.40 |
$639.93
|
|
Wnd prep f/n/hf/g addl cm
|
$416.00 |
$416.00 |
$416.00 |
$811.00
|
|
Woman's shoe oxford brace
|
$51.69 |
$51.69 |
$51.69 |
$149.37
|
|
Wound Cleaning and Dead Tissue Removal (up to 20 sq cm)
|
$594.10 |
$594.10 |
$594.10 |
$351.60
|
|
Wound closure by adhesive
|
$88.40 |
$88.40 |
$88.40 |
$138.25
|
|
Wound pouch each
|
$28.46 |
$28.46 |
$28.46 |
$40.48
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$1,194.70 |
$1,194.70 |
$1,194.70 |
$574.80
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$1,194.70 |
$1,194.70 |
$1,194.70 |
$594.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$594.10 |
$594.10 |
$594.10 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$1,194.70 |
$1,194.70 |
$1,194.70 |
$438.91
|
|
Wrist arthroscopy
|
$1,476.80 |
$1,476.80 |
$1,476.80 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$1,599.00 |
$1,599.00 |
$1,599.00 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$1,692.60 |
$1,692.60 |
$1,692.60 |
$3,839.54
|
|
Wrist arthroscopy/surgery
|
$1,999.40 |
$1,999.40 |
$1,999.40 |
$4,022.93
|
|
Wrist arthroscopy/surgery
|
$1,791.40 |
$1,791.40 |
$1,791.40 |
$3,986.00
|
|
Wrist arthroscopy/surgery
|
$1,877.20 |
$1,877.20 |
$1,877.20 |
$8,412.89
|
|
Wrist endoscopy/surgery
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$3,452.80
|
|
Wrist X-ray
|
$395.20 |
$395.20 |
$443.95 |
$350.40
|
|
Wrist X-ray (2 views, both wrists)
|
$395.20 |
$395.20 |
$436.80 |
$290.40
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$2,931.50 |
$2,931.50 |
$2,931.50 |
$3,786.00
|
|
Xcapsl ctrc rmvl insj 1+
|
$15,427.75 |
$15,427.75 |
$15,427.75 |
$7,316.99
|
|
Xcpsl ctrc rmvl cplx insj 1+
|
$15,427.75 |
$15,427.75 |
$15,427.75 |
$8,652.80
|
|
Xe133 xenon 10mci
|
$299.00 |
$299.00 |
$299.00 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,830.00
|
|
Xfer tis s/a/l 10 sq cm/<
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,838.00
|
|
X-linked intellectual dblt
|
$4,099.55 |
$4,099.55 |
$4,099.55 |
$1,258.40
|
|
Xm archive tissue molec anal
|
$105.95 |
$105.95 |
$105.95 |
$48.38
|
|
Xpos opn axillary/sbclvn art w/cndt crtn
|
$1,869.40 |
$1,869.40 |
$1,869.40 |
$3,143.58
|
|
Xpos opn fmrl eprst aor uni add-on
|
$12,129.00 |
$12,129.00 |
$12,129.00 |
$1,825.60
|
|
X-ray abdomen >=3 views
|
$477.10 |
$477.10 |
$554.45 |
$341.90
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,601.60 |
$1,601.60 |
$1,756.30 |
$789.36
|
|
X-ray bone length studies
|
$477.10 |
$477.10 |
$544.70 |
$285.30
|
|
X-ray bone survey infant
|
$477.10 |
$477.10 |
$659.10 |
$391.38
|
|
X-ray consultation
|
$1,217.45 |
$1,217.45 |
$1,217.45 |
$40.88
|
|
X-ray exam entire spi 4/5 vw
|
$477.10 |
$477.10 |
$577.20 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$477.10 |
$477.10 |
$594.10 |
$517.80
|
|
X-ray exam of arm infant
|
$477.10 |
$477.10 |
$518.70 |
$248.50
|
|
X-ray exam of femur 1
|
$395.20 |
$395.20 |
$436.80 |
$236.40
|
|
X-ray exam of jaw joint
|
$442.00 |
$442.00 |
$442.00 |
$201.75
|
|
X-ray exam of jaw joint
|
$1,224.60 |
$1,224.60 |
$1,224.60 |
$452.00
|
|
X-ray exam of mastoids
|
$523.90 |
$523.90 |
$523.90 |
$193.41
|
|
X-ray exam of penis
|
$803.40 |
$803.40 |
$803.40 |
$593.46
|
|
X-ray exam of perineum
|
$1,084.20 |
$1,084.20 |
$1,261.65 |
$588.00
|
|
X-ray exam of salivary gland
|
$439.40 |
$439.40 |
$439.40 |
$162.60
|
|
X-ray exam of teeth
|
$395.20 |
$395.20 |
$421.20 |
$138.40
|
|
X-ray exam of teeth
|
$1,084.20 |
$1,084.20 |
$1,129.70 |
$385.39
|
|
X-ray exam si joints
|
$477.10 |
$477.10 |
$525.85 |
$247.80
|
|
X-ray exam thorac spine4/>vw
|
$477.10 |
$477.10 |
$548.60 |
$395.00
|
|
X-ray eye detection foreign body (both sides)
|
$395.20 |
$395.20 |
$446.55 |
$237.78
|
|
X-ray fallopian tube
|
$430.95 |
$430.95 |
$430.95 |
$565.40
|
|
X-ray head for orthodontia
|
$439.40 |
$439.40 |
$439.40 |
$158.50
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$477.10 |
$477.10 |
$554.45 |
$372.64
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$477.10 |
$477.10 |
$557.70 |
$500.28
|
|
X-ray joint survey 1 view
|
$477.10 |
$477.10 |
$562.90 |
$232.00
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$395.20 |
$395.20 |
$440.70 |
$251.74
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$477.10 |
$477.10 |
$540.15 |
$364.75
|
|
X-ray male genital tract
|
$1,084.20 |
$1,084.20 |
$1,192.75 |
$603.50
|
|
X-ray mandible ltd <4 views
|
$395.20 |
$395.20 |
$442.00 |
$238.00
|
|
X-ray nose to rectum for foreign body child
|
$395.20 |
$395.20 |
$442.00 |
$229.00
|
|
X-ray of mammary ducts
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$568.26
|
|
X-ray optic foramina
|
$449.80 |
$449.80 |
$449.80 |
$188.40
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,601.60 |
$1,601.60 |
$1,736.80 |
$769.50
|
|
X-ray ribs 2 views left
|
$395.20 |
$395.20 |
$452.40 |
$291.61
|
|
X-ray sella turcica
|
$444.60 |
$444.60 |
$444.60 |
$162.50
|
|
X-ray sinus tract/fistula/abscess
|
$2,458.95 |
$2,458.95 |
$2,599.35 |
$636.30
|
|
X-ray slg plne bdy sect without urogr
|
$627.90 |
$627.90 |
$627.90 |
$398.75
|
|
X-ray small intestine follow-through study
|
$516.75 |
$516.75 |
$698.75 |
$504.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$395.20 |
$395.20 |
$458.25 |
$267.50
|
|
X-ray surgical specimen
|
$2,458.95 |
$2,458.95 |
$2,539.55 |
$521.28
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$395.20 |
$395.20 |
$469.30 |
$257.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$951.60 |
$951.60 |
$951.60 |
$362.98
|
|
Xtrnl ecg rec up to 48 hrs
|
$111.80 |
$111.80 |
$111.80 |
$232.98
|
|
Xylose absorption test blood &/or urine
|
$57.85 |
$57.85 |
$57.85 |
$99.89
|
|
Yttrium y-90 ibritumomab ther
|
$96,361.76 |
$96,361.76 |
$96,361.76 |
$55,035.00
|
|
Ziconotide injection
|
$440.69 |
$2,938.53 |
$2,938.53 |
$7,216.02
|
