|
Warde sex hormone binding globulin
|
$76.70 |
$76.70 |
$76.70 |
$86.59
|
|
Warde somatomedin
|
$158.60 |
$158.60 |
$158.60 |
$111.80
|
|
Warde sugars single qualitative each specimen stool
|
$69.55 |
$69.55 |
$69.55 |
$35.75
|
|
Warde t3 (triiodothyronine) reverse
|
$51.35 |
$51.35 |
$51.35 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$102.05 |
$102.05 |
$102.05 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$65.65 |
$65.65 |
$65.65 |
$71.19
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$37.05 |
$37.05 |
$37.05 |
$127.20
|
|
Warde viscosity
|
$48.75 |
$48.75 |
$48.75 |
$52.65
|
|
Warde vitamin a
|
$29.90 |
$29.90 |
$29.90 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$61.75 |
$61.75 |
$61.75 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$53.95 |
$53.95 |
$53.95 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$70.20 |
$70.20 |
$70.20 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$70.85 |
$70.85 |
$70.85 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$29.90 |
$29.90 |
$29.90 |
$55.00
|
|
Warde zinc
|
$19.50 |
$19.50 |
$19.50 |
$62.50
|
|
Wbc automated
|
$25.35 |
$25.35 |
$25.35 |
$32.80
|
|
Western blot test
|
$250.90 |
$250.90 |
$250.90 |
$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
|
$4,260.75 |
$4,260.75 |
$4,260.75 |
$1,776.06
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$538.85 |
$538.85 |
$538.85 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$815.10 |
$815.10 |
$815.10 |
$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
|
$689.00 |
$689.00 |
$689.00 |
$343.70
|
|
X-ray abdomen 1 view
|
$268.45 |
$268.45 |
$268.45 |
$255.00
|
|
X-ray abdomen 2 views
|
$325.65 |
$325.65 |
$325.65 |
$312.36
|
|
X-ray abdomen >=3 views
|
$367.90 |
$367.90 |
$367.90 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$404.30 |
$404.30 |
$404.30 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$447.85 |
$447.85 |
$447.85 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$412.10 |
$412.10 |
$412.10 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$2,445.30 |
$2,445.30 |
$2,445.30 |
$768.30
|
|
X-ray bone age studies
|
$284.05 |
$284.05 |
$284.05 |
$246.75
|
|
X-ray bone length studies
|
$236.60 |
$236.60 |
$236.60 |
$287.25
|
|
X-ray bone survey complete
|
$574.60 |
$574.60 |
$574.60 |
$666.60
|
|
X-ray bone survey infant
|
$449.15 |
$449.15 |
$449.15 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$376.35 |
$376.35 |
$376.35 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$449.15 |
$449.15 |
$449.15 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$516.10 |
$516.10 |
$516.10 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$637.00 |
$637.00 |
$637.00 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$566.80 |
$566.80 |
$566.80 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$715.00 |
$715.00 |
$715.00 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$468.00 |
$468.00 |
$468.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$626.60 |
$626.60 |
$626.60 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$464.75 |
$464.75 |
$464.75 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$640.90 |
$640.90 |
$640.90 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$672.10 |
$672.10 |
$672.10 |
$575.76
|
|
X-ray exam of arm infant
|
$419.90 |
$419.90 |
$419.90 |
$248.82
|
|
X-ray exam of eye sockets
|
$377.00 |
$377.00 |
$377.00 |
$349.05
|
|
X-ray exam of femur 1
|
$432.90 |
$432.90 |
$432.90 |
$232.36
|
|
X-ray exam of jaw joint
|
$297.05 |
$297.05 |
$297.05 |
$192.39
|
|
X-ray exam of middle ear
|
$326.95 |
$326.95 |
$326.95 |
$341.25
|
|
X-ray exam of penis
|
$971.75 |
$971.75 |
$971.75 |
$565.20
|
|
X-ray exam of perineum
|
$1,391.65 |
$1,391.65 |
$1,391.65 |
$420.93
|
|
X-ray exam of sinuses
|
$193.70 |
$193.70 |
$193.70 |
$211.00
|
|
X-ray exam si joints
|
$287.30 |
$287.30 |
$287.30 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$387.40 |
$387.40 |
$387.40 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$687.70 |
$687.70 |
$687.70 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$449.15 |
$449.15 |
$449.15 |
$366.60
|
|
X-ray fallopian tube
|
$3,923.40 |
$3,923.40 |
$3,923.40 |
$501.00
|
|
X-ray femur >=2 views (both sides)
|
$542.10 |
$542.10 |
$542.10 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$387.40 |
$387.40 |
$387.40 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$447.20 |
$447.20 |
$447.20 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$419.90 |
$419.90 |
$419.90 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$403.00 |
$403.00 |
$403.00 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$555.10 |
$555.10 |
$555.10 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$455.65 |
$455.65 |
$455.65 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$423.15 |
$423.15 |
$423.15 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$466.05 |
$466.05 |
$466.05 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$528.45 |
$528.45 |
$528.45 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$338.65 |
$338.65 |
$338.65 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$455.00 |
$455.00 |
$455.00 |
$304.15
|
|
X-ray joint survey 1 view
|
$222.95 |
$222.95 |
$222.95 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$468.00 |
$468.00 |
$468.00 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$644.80 |
$644.80 |
$644.80 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$278.85 |
$278.85 |
$278.85 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$457.60 |
$457.60 |
$457.60 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$357.50 |
$357.50 |
$357.50 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$471.25 |
$471.25 |
$471.25 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$568.10 |
$568.10 |
$568.10 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$416.00 |
$416.00 |
$416.00 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$258.05 |
$258.05 |
$258.05 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$323.05 |
$323.05 |
$323.05 |
$277.70
|
|
X-ray neck soft tissue
|
$280.15 |
$280.15 |
$280.15 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$456.30 |
$456.30 |
$456.30 |
$225.96
|
|
X-ray of mammary ducts
|
$1,133.60 |
$1,133.60 |
$1,133.60 |
$473.55
|
|
X-ray optic foramina
|
$280.80 |
$280.80 |
$280.80 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$174.20 |
$174.20 |
$174.20 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$269.10 |
$269.10 |
$269.10 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$975.00 |
$975.00 |
$975.00 |
$742.00
|
|
X-ray ribs 2 views left
|
$301.60 |
$301.60 |
$301.60 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$382.85 |
$382.85 |
$382.85 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$357.50 |
$357.50 |
$357.50 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$440.05 |
$440.05 |
$440.05 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$380.90 |
$380.90 |
$380.90 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$322.40 |
$322.40 |
$322.40 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$655.20 |
$655.20 |
$655.20 |
$292.50
|
|
X-ray sella turcica
|
$200.20 |
$200.20 |
$200.20 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$361.40 |
$361.40 |
$361.40 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$346.45 |
$346.45 |
$346.45 |
$339.00
|
