|
Warde thyroid stimulating immunoglobulins
|
$220.80 |
$220.80 |
$220.80 |
$178.53
|
|
Warde topiramate therapeutic drug level
|
$166.80 |
$166.80 |
$166.80 |
$71.20
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$159.00 |
$159.00 |
$159.00 |
$129.54
|
|
Warde viscosity
|
$47.40 |
$47.40 |
$47.40 |
$49.47
|
|
Warde vitamin a
|
$42.00 |
$42.00 |
$42.00 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$120.00 |
$120.00 |
$120.00 |
$82.04
|
|
Warde vitamin b6 (pyridoxine)
|
$89.40 |
$89.40 |
$89.40 |
$116.20
|
|
Warde vitamin c (ascorbic acid)
|
$72.00 |
$72.00 |
$72.00 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$341.40 |
$341.40 |
$341.40 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$127.80 |
$127.80 |
$127.80 |
$59.25
|
|
Warde zinc
|
$114.00 |
$114.00 |
$114.00 |
$62.50
|
|
Wbc automated
|
$16.20 |
$16.20 |
$16.20 |
$32.35
|
|
Western blot test
|
$243.00 |
$243.00 |
$243.00 |
$150.00
|
|
Whfo electric custom fitted
|
$8,251.39 |
$8,251.39 |
$8,251.39 |
$5,209.82
|
|
Whfo nontorsion joint prefab
|
$509.70 |
$509.70 |
$509.70 |
$224.01
|
|
Whfo w/joint(s) custom fab
|
$1,110.41 |
$1,110.41 |
$1,110.41 |
$465.50
|
|
Whole mitochondrial genome
|
$1,689.00 |
$1,689.00 |
$1,689.00 |
$2,175.00
|
|
Whole mitochondrial genome
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$1,681.55
|
|
Who nontorsion jnts pre cst
|
$1,299.46 |
$1,299.46 |
$1,299.46 |
$706.80
|
|
Who nontorsion jnts pre ots
|
$1,299.46 |
$1,299.46 |
$1,299.46 |
$1,144.66
|
|
Wnd prep f/n/hf/g addl cm
|
$990.00 |
$990.00 |
$990.00 |
$811.00
|
|
Woman's shoe oxford brace
|
$181.49 |
$181.49 |
$181.49 |
$149.37
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$920.40 |
$920.40 |
$920.40 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$920.40 |
$920.40 |
$920.40 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$420.00 |
$420.00 |
$420.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$511.80 |
$511.80 |
$511.80 |
$438.75
|
|
Wrist X-ray
|
$510.60 |
$510.60 |
$510.60 |
$342.80
|
|
Xcellistem, 1 mg
|
$5,999.95 |
$5,999.95 |
$5,999.95 |
$2,859.19
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$7,835.46 |
$7,835.46 |
$7,835.46 |
$2,692.80
|
|
Xfer tis s/a/l 10 sq cm/<
|
$12,162.18 |
$12,162.18 |
$12,162.18 |
$2,837.09
|
|
X-linked intellectual dblt
|
$2,418.60 |
$2,418.60 |
$2,418.60 |
$1,258.40
|
|
X-linked intellectual dblt
|
$2,418.60 |
$2,418.60 |
$2,418.60 |
$1,173.00
|
|
X-ray abdomen 1 view
|
$393.00 |
$393.00 |
$393.00 |
$258.50
|
|
X-ray abdomen 2 views
|
$510.60 |
$510.60 |
$510.60 |
$316.47
|
|
X-ray abdomen >=3 views
|
$412.20 |
$412.20 |
$412.20 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$549.60 |
$549.60 |
$549.60 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$255.60 |
$255.60 |
$255.60 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$370.20 |
$370.20 |
$370.20 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,272.60 |
$1,272.60 |
$1,272.60 |
$773.40
|
|
X-ray bone age studies
|
$234.60 |
$234.60 |
$234.60 |
$251.40
|
|
X-ray bone length studies
|
$199.80 |
$199.80 |
$199.80 |
$285.30
|
|
X-ray bone survey complete
|
$577.80 |
$577.80 |
$577.80 |
$660.00
|
|
X-ray bone survey infant
|
$293.40 |
$293.40 |
$293.40 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$572.40 |
$572.40 |
$572.40 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$1,249.20 |
$1,249.20 |
$1,249.20 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$301.80 |
$301.80 |
$301.80 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$661.80 |
$661.80 |
$661.80 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$863.40 |
$863.40 |
$863.40 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$340.80 |
$340.80 |
$340.80 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$511.20 |
$511.20 |
$511.20 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$726.60 |
$726.60 |
$726.60 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$382.80 |
$382.80 |
$382.80 |
$441.48
|
|
X-ray exam of arm infant
|
$158.40 |
$158.40 |
$158.40 |
$248.44
|
|
X-ray exam of eye sockets
|
$486.60 |
$486.60 |
$486.60 |
$328.35
|
|
X-ray exam of femur 1
|
$227.40 |
$227.40 |
$227.40 |
$240.00
|
|
X-ray exam of jaw joint
|
$189.60 |
$189.60 |
$189.60 |
$188.40
|
|
X-ray exam of jaw joint
|
$1,331.40 |
$1,331.40 |
$1,331.40 |
$452.00
|
|
X-ray exam of sinuses
|
$333.00 |
$333.00 |
$333.00 |
$214.50
|
|
X-ray exam of teeth
|
$188.40 |
$188.40 |
$188.40 |
$328.08
|
|
X-ray exam si joints
|
$203.40 |
$203.40 |
$203.40 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$541.20 |
$541.20 |
$541.20 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$288.60 |
$288.60 |
$288.60 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$502.20 |
$502.20 |
$502.20 |
$381.75
|
|
X-ray fallopian tube
|
$380.40 |
$380.40 |
$380.40 |
$532.38
|
|
X-ray femur >=2 views (both sides)
|
$430.80 |
$430.80 |
$430.80 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$462.60 |
$462.60 |
$462.60 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$367.20 |
$367.20 |
$367.20 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$352.80 |
$352.80 |
$352.80 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$334.20 |
$334.20 |
$334.20 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$280.80 |
$280.80 |
$280.80 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$527.40 |
$527.40 |
$527.40 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$678.60 |
$678.60 |
$678.60 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$712.80 |
$712.80 |
$712.80 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$537.00 |
$537.00 |
$537.00 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$405.00 |
$405.00 |
$405.00 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$436.80 |
$436.80 |
$436.80 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$405.00 |
$405.00 |
$405.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$660.60 |
$660.60 |
$660.60 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$282.60 |
$282.60 |
$282.60 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$171.60 |
$171.60 |
$171.60 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$250.80 |
$250.80 |
$250.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$969.00 |
$969.00 |
$969.00 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$404.40 |
$404.40 |
$404.40 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$136.80 |
$136.80 |
$136.80 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$490.80 |
$490.80 |
$490.80 |
$274.65
|
|
X-ray neck soft tissue
|
$330.00 |
$330.00 |
$330.00 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$246.00 |
$246.00 |
$246.00 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$424.80 |
$424.80 |
$424.80 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$353.40 |
$353.40 |
$353.40 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$703.80 |
$703.80 |
$703.80 |
$755.50
|
|
X-ray ribs 2 views left
|
$566.40 |
$566.40 |
$566.40 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$640.20 |
$640.20 |
$640.20 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$732.00 |
$732.00 |
$732.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$786.00 |
$786.00 |
$786.00 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$226.80 |
$226.80 |
$226.80 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$538.80 |
$538.80 |
$538.80 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$319.20 |
$319.20 |
$319.20 |
$285.00
|
|
X-ray sella turcica
|
$196.80 |
$196.80 |
$196.80 |
$162.50
|
