|
Warde thyroid stimulating immunoglobulins
|
$96.20 |
$96.20 |
$96.20 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$66.95 |
$66.95 |
$66.95 |
$71.19
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$37.05 |
$37.05 |
$37.05 |
$127.20
|
|
Warde viscosity
|
$53.30 |
$53.30 |
$53.30 |
$52.65
|
|
Warde vitamin a
|
$27.95 |
$27.95 |
$27.95 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$57.85 |
$57.85 |
$57.85 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$50.70 |
$50.70 |
$50.70 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$66.30 |
$66.30 |
$66.30 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$86.45 |
$86.45 |
$86.45 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$27.95 |
$27.95 |
$27.95 |
$55.00
|
|
Warde zinc
|
$18.85 |
$18.85 |
$18.85 |
$62.50
|
|
Wash harvest stem cells
|
$1,783.60 |
$1,783.60 |
$1,783.60 |
$815.00
|
|
Wbc automated
|
$31.20 |
$31.20 |
$31.20 |
$32.80
|
|
Western blot test
|
$258.05 |
$258.05 |
$258.05 |
$153.18
|
|
Whole blood for transfusion
|
$1,626.95 |
$1,626.95 |
$1,626.95 |
$479.50
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$1,762.15 |
$1,762.15 |
$1,762.15 |
$740.15
|
|
Whole mitochondrial genome
|
$4,037.80 |
$4,037.80 |
$4,037.80 |
$1,776.06
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$826.15 |
$826.15 |
$826.15 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$826.15 |
$826.15 |
$826.15 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$1,223.95 |
$1,223.95 |
$1,223.95 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$2,454.40 |
$2,454.40 |
$2,454.40 |
$436.15
|
|
Wrist X-ray
|
$364.00 |
$364.00 |
$364.00 |
$343.70
|
|
Xpos opn axillary/sbclvn art w/cndt crtn
|
$892.45 |
$892.45 |
$892.45 |
$1,819.20
|
|
X-ray abdomen 1 view
|
$163.15 |
$163.15 |
$163.15 |
$255.00
|
|
X-ray abdomen 2 views
|
$252.20 |
$252.20 |
$252.20 |
$312.36
|
|
X-ray abdomen >=3 views
|
$263.90 |
$263.90 |
$263.90 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$359.45 |
$359.45 |
$359.45 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$215.15 |
$215.15 |
$215.15 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$436.80 |
$436.80 |
$436.80 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$768.30
|
|
X-ray bone age studies
|
$205.40 |
$205.40 |
$205.40 |
$246.75
|
|
X-ray bone length studies
|
$223.60 |
$223.60 |
$223.60 |
$287.25
|
|
X-ray bone survey complete
|
$515.45 |
$515.45 |
$515.45 |
$666.60
|
|
X-ray bone survey infant
|
$282.75 |
$282.75 |
$282.75 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$235.95 |
$235.95 |
$235.95 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$299.65 |
$299.65 |
$299.65 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$360.75 |
$360.75 |
$360.75 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$386.10 |
$386.10 |
$386.10 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$528.45 |
$528.45 |
$528.45 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$665.60 |
$665.60 |
$665.60 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$409.50 |
$409.50 |
$409.50 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$481.00 |
$481.00 |
$481.00 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$353.60 |
$353.60 |
$353.60 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$283.40 |
$283.40 |
$283.40 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$333.45 |
$333.45 |
$333.45 |
$575.76
|
|
X-ray exam of arm infant
|
$492.70 |
$492.70 |
$492.70 |
$248.82
|
|
X-ray exam of eye sockets
|
$278.20 |
$278.20 |
$278.20 |
$349.05
|
|
X-ray exam of femur 1
|
$249.60 |
$249.60 |
$249.60 |
$232.36
|
|
X-ray exam of jaw joint
|
$147.55 |
$147.55 |
$147.55 |
$192.39
|
|
X-ray exam of middle ear
|
$1,223.95 |
$1,223.95 |
$1,223.95 |
$341.25
|
|
X-ray exam of penis
|
$1,454.05 |
$1,454.05 |
$1,454.05 |
$565.20
|
|
X-ray exam of perineum
|
$1,122.55 |
$1,122.55 |
$1,122.55 |
$420.93
|
|
X-ray exam of sinuses
|
$144.30 |
$144.30 |
$144.30 |
$211.00
|
|
X-ray exam si joints
|
$173.55 |
$173.55 |
$173.55 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$321.10 |
$321.10 |
$321.10 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$357.50 |
$357.50 |
$357.50 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$252.20 |
$252.20 |
$252.20 |
$366.60
|
|
X-ray fallopian tube
|
$1,293.50 |
$1,293.50 |
$1,293.50 |
$501.00
|
|
X-ray femur >=2 views (both sides)
|
$305.50 |
$305.50 |
$305.50 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$330.20 |
$330.20 |
$330.20 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$369.20 |
$369.20 |
$369.20 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$431.60 |
$431.60 |
$431.60 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$319.80 |
$319.80 |
$319.80 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$416.00 |
$416.00 |
$416.00 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$263.90 |
$263.90 |
$263.90 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$215.15 |
$215.15 |
$215.15 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$315.25 |
$315.25 |
$315.25 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$354.90 |
$354.90 |
$354.90 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$207.35 |
$207.35 |
$207.35 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$217.75 |
$217.75 |
$217.75 |
$304.15
|
|
X-ray joint survey 1 view
|
$215.80 |
$215.80 |
$215.80 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$408.20 |
$408.20 |
$408.20 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$490.10 |
$490.10 |
$490.10 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$209.30 |
$209.30 |
$209.30 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$378.30 |
$378.30 |
$378.30 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$206.70 |
$206.70 |
$206.70 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$286.65 |
$286.65 |
$286.65 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$366.60 |
$366.60 |
$366.60 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$235.95 |
$235.95 |
$235.95 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$138.45 |
$138.45 |
$138.45 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$154.70 |
$154.70 |
$154.70 |
$277.70
|
|
X-ray neck soft tissue
|
$202.80 |
$202.80 |
$202.80 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$618.80 |
$618.80 |
$618.80 |
$225.96
|
|
X-ray of mammary ducts
|
$336.05 |
$336.05 |
$336.05 |
$473.55
|
|
X-ray optic foramina
|
$492.70 |
$492.70 |
$492.70 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$234.65 |
$234.65 |
$234.65 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$300.95 |
$300.95 |
$300.95 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$831.35 |
$831.35 |
$831.35 |
$742.00
|
|
X-ray ribs 2 views left
|
$209.30 |
$209.30 |
$209.30 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$354.25 |
$354.25 |
$354.25 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$328.25 |
$328.25 |
$328.25 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$419.25 |
$419.25 |
$419.25 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$235.30 |
$235.30 |
$235.30 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$223.60 |
$223.60 |
$223.60 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$447.20 |
$447.20 |
$447.20 |
$292.50
|
|
X-ray sella turcica
|
$177.45 |
$177.45 |
$177.45 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$384.80 |
$384.80 |
$384.80 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$258.70 |
$258.70 |
$258.70 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$596.70 |
$596.70 |
$596.70 |
$601.30
|
|
X-ray skull < 4 views
|
$233.35 |
$233.35 |
$233.35 |
$291.78
|
