|
Warde vitamin e (alpha-tocopherol)
|
$24.38 |
$24.38 |
$24.38 |
$56.95
|
|
Warde zinc
|
$19.55 |
$19.55 |
$19.55 |
$64.00
|
|
Wbc automated
|
$4.37 |
$4.37 |
$4.37 |
$33.00
|
|
Western blot test
|
$29.21 |
$29.21 |
$29.21 |
$146.90
|
|
Whole blood for transfusion
|
$106.26 |
$106.26 |
$106.26 |
$487.92
|
|
Whole mitochondrial genome
|
$1,621.04 |
$1,621.04 |
$1,621.04 |
$2,175.00
|
|
Whole mitochondrial genome
|
$1,178.52 |
$1,178.52 |
$1,178.52 |
$1,658.80
|
|
Wnd prep f/n/hf/g addl cm
|
$82.57 |
$82.57 |
$82.57 |
$811.00
|
|
Wound closure by adhesive
|
$17.25 |
$17.25 |
$17.25 |
$149.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$74.06 |
$74.06 |
$74.06 |
$574.80
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$74.06 |
$74.06 |
$74.06 |
$596.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$60.03 |
$60.03 |
$60.03 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$53.59 |
$53.59 |
$53.59 |
$436.15
|
|
Wrist X-ray
|
$75.21 |
$75.21 |
$75.21 |
$350.40
|
|
Xe133 xenon 10mci
|
$67.62 |
$67.62 |
$67.62 |
$189.50
|
|
X-ray abdomen 1 view
|
$64.63 |
$64.63 |
$64.63 |
$258.00
|
|
X-ray abdomen 2 views
|
$67.85 |
$67.85 |
$67.85 |
$316.30
|
|
X-ray abdomen >=3 views
|
$71.53 |
$71.53 |
$71.53 |
$338.25
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$67.85 |
$67.85 |
$67.85 |
$406.90
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$67.85 |
$67.85 |
$67.85 |
$268.80
|
|
X-ray ankle 2 views (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$282.96
|
|
X-ray bone age studies
|
$67.85 |
$67.85 |
$67.85 |
$252.75
|
|
X-ray bone survey complete
|
$71.53 |
$71.53 |
$71.53 |
$660.00
|
|
X-ray bone survey infant
|
$67.85 |
$67.85 |
$67.85 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$67.85 |
$67.85 |
$67.85 |
$333.00
|
|
X-ray cervical spine 4-5 views
|
$71.53 |
$71.53 |
$71.53 |
$455.49
|
|
X-ray cervical spine >= 6 views
|
$75.21 |
$75.21 |
$75.21 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$304.15
|
|
X-ray elbow 2 views (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$75.21 |
$75.21 |
$75.21 |
$364.20
|
|
X-ray exam entire spi 4/5 vw
|
$71.53 |
$71.53 |
$71.53 |
$434.40
|
|
X-ray exam entire spi 6/> vw
|
$83.72 |
$83.72 |
$83.72 |
$512.05
|
|
X-ray exam of arm infant
|
$94.53 |
$94.53 |
$94.53 |
$246.75
|
|
X-ray exam of eye sockets
|
$67.85 |
$67.85 |
$67.85 |
$328.35
|
|
X-ray exam of femur 1
|
$64.63 |
$64.63 |
$64.63 |
$237.60
|
|
X-ray exam of jaw joint
|
$64.63 |
$64.63 |
$64.63 |
$194.36
|
|
X-ray exam of sinuses
|
$34.04 |
$34.04 |
$34.04 |
$211.90
|
|
X-ray exam si joints
|
$64.63 |
$64.63 |
$64.63 |
$246.98
|
|
X-ray eye detection foreign body (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$237.78
|
|
X-ray facial bones complete > 3 views
|
$67.85 |
$67.85 |
$67.85 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$314.50
|
|
X-ray finger(s) >= 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$241.50
|
|
X-ray foot 2 views (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$290.40
|
|
X-ray forearm 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$321.00
|
|
X-ray hand 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$294.90
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$276.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$71.53 |
$71.53 |
$71.53 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$64.63 |
$64.63 |
$64.63 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$67.85 |
$67.85 |
$67.85 |
$421.20
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$71.53 |
$71.53 |
$71.53 |
$498.55
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$64.63 |
$64.63 |
$64.63 |
$226.00
|
|
X-ray humerus >= 2 views left
|
$71.53 |
$71.53 |
$71.53 |
$309.31
|
|
X-ray joint survey 1 view
|
$67.85 |
$67.85 |
$67.85 |
$236.80
|
|
X-ray knee 1-2 views (both sides)
|
$64.63 |
$64.63 |
$64.63 |
$291.20
|
|
X-ray knee 3 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$363.60
|
|
X-ray knee ap standing bilateral
|
$67.85 |
$67.85 |
$67.85 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$253.50
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$61.41 |
$61.41 |
$61.41 |
$370.15
|
|
X-ray lumbosacral spine >= 4 views
|
$67.85 |
$67.85 |
$67.85 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$71.53 |
$71.53 |
$71.53 |
$540.60
|
|
X-ray mandible complete > 4 views
|
$67.85 |
$67.85 |
$67.85 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$64.63 |
$64.63 |
$64.63 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$67.85 |
$67.85 |
$67.85 |
$274.65
|
|
X-ray neck soft tissue
|
$67.85 |
$67.85 |
$67.85 |
$237.76
|
|
X-ray nose to rectum for foreign body child
|
$67.85 |
$67.85 |
$67.85 |
$226.85
|
|
X-ray optic foramina
|
$67.85 |
$67.85 |
$67.85 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$64.63 |
$64.63 |
$64.63 |
$280.50
|
|
X-ray pelvis complete > 3 views
|
$67.85 |
$67.85 |
$67.85 |
$348.19
|
|
X-ray ribs 2 views left
|
$64.63 |
$64.63 |
$64.63 |
$287.50
|
|
X-ray ribs 3 views bilateral
|
$71.53 |
$71.53 |
$71.53 |
$393.75
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$67.85 |
$67.85 |
$67.85 |
$357.50
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$75.21 |
$75.21 |
$75.21 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$67.85 |
$67.85 |
$67.85 |
$309.11
|
|
X-ray sacrum/coccyx >= 2 views
|
$67.85 |
$67.85 |
$67.85 |
$287.04
|
|
X-ray scapula complete (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$285.20
|
|
X-ray shoulder 1 view (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$259.05
|
|
X-ray sinuses paranasal complete > 3 views
|
$67.85 |
$67.85 |
$67.85 |
$341.25
|
|
X-ray skull < 4 views
|
$64.63 |
$64.63 |
$64.63 |
$291.78
|
|
X-ray skull > 4 views complete
|
$67.85 |
$67.85 |
$67.85 |
$417.50
|
|
X-ray spine single view
|
$64.63 |
$64.63 |
$64.63 |
$251.40
|
|
X-ray sternum > 2 views
|
$64.63 |
$64.63 |
$64.63 |
$274.65
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$67.85 |
$67.85 |
$67.85 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$64.63 |
$64.63 |
$64.63 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$67.85 |
$67.85 |
$67.85 |
$380.82
|
|
X-ray thoracolumbar spine >=2 views
|
$75.21 |
$75.21 |
$75.21 |
$280.65
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$64.63 |
$64.63 |
$64.63 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$67.85 |
$67.85 |
$67.85 |
$346.40
|
|
X-ray tibia/fibula 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$330.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$71.53 |
$71.53 |
$71.53 |
$258.65
|
|
X-ray wrist 2 views (both sides)
|
$67.85 |
$67.85 |
$67.85 |
$290.40
|
|
Zika virus igm antibody
|
$17.94 |
$17.94 |
$17.94 |
$87.75
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$132.85 |
$132.85 |
$132.85 |
$121.03
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$2,040.02 |
$2,040.02 |
$2,040.02 |
$432.92
|
|
Zrsr2 gene common variants
|
$243.34 |
$243.34 |
$243.34 |
$243.34
|