|
Warde viscosity
|
$139.80 |
$139.80 |
$139.80 |
$49.00
|
|
Warde vitamin a
|
$165.30 |
$165.30 |
$165.30 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$348.90 |
$348.90 |
$348.90 |
$82.04
|
|
Warde vitamin b6 (pyridoxine)
|
$251.40 |
$251.40 |
$251.40 |
$115.92
|
|
Warde vitamin d (1 25 dihydroxy)
|
$152.70 |
$152.70 |
$152.70 |
$136.80
|
|
Warde zinc
|
$47.70 |
$47.70 |
$47.70 |
$62.50
|
|
Whfo electric custom fitted
|
$4,582.54 |
$4,582.54 |
$4,582.54 |
$5,209.82
|
|
Whfo nontorsion joint prefab
|
$283.07 |
$283.07 |
$283.07 |
$224.01
|
|
Whfo w/joint(s) custom fab
|
$616.68 |
$616.68 |
$616.68 |
$465.50
|
|
Who nontorsion jnts pre cst
|
$721.68 |
$721.68 |
$721.68 |
$706.80
|
|
Who nontorsion jnts pre ots
|
$721.68 |
$721.68 |
$721.68 |
$1,144.66
|
|
Woman's shoe oxford brace
|
$100.79 |
$100.79 |
$100.79 |
$149.37
|
|
Wrist X-ray
|
$225.90 |
$225.90 |
$225.90 |
$342.80
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$5,842.58 |
$5,842.58 |
$5,842.58 |
$3,724.80
|
|
Xcellistem, 1 mg
|
$3,332.16 |
$3,332.16 |
$3,332.16 |
$2,859.19
|
|
Xe133 xenon 10mci
|
$69.60 |
$69.60 |
$69.60 |
$198.79
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,198.80 |
$1,198.80 |
$1,198.80 |
$2,692.80
|
|
X-ray abdomen 1 view
|
$224.40 |
$224.40 |
$224.40 |
$258.00
|
|
X-ray abdomen 2 views
|
$396.90 |
$396.90 |
$396.90 |
$316.47
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$370.80 |
$370.80 |
$370.80 |
$417.30
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$90.60 |
$90.60 |
$90.60 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$218.10 |
$218.10 |
$218.10 |
$282.50
|
|
X-ray bone age studies
|
$219.60 |
$219.60 |
$219.60 |
$250.20
|
|
X-ray bone length studies
|
$217.80 |
$217.80 |
$217.80 |
$285.30
|
|
X-ray bone survey complete
|
$903.00 |
$903.00 |
$903.00 |
$660.00
|
|
X-ray bone survey infant
|
$202.80 |
$202.80 |
$202.80 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$225.30 |
$225.30 |
$225.30 |
$333.11
|
|
X-ray cervical spine 4-5 views
|
$395.10 |
$395.10 |
$395.10 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$448.80 |
$448.80 |
$448.80 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$237.00 |
$237.00 |
$237.00 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$435.60 |
$435.60 |
$435.60 |
$652.19
|
|
X-ray elbow 2 views (both sides)
|
$217.80 |
$217.80 |
$217.80 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$225.30 |
$225.30 |
$225.30 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$328.80 |
$328.80 |
$328.80 |
$483.50
|
|
X-ray exam of arm infant
|
$123.00 |
$123.00 |
$123.00 |
$248.44
|
|
X-ray exam of eye sockets
|
$318.90 |
$318.90 |
$318.90 |
$328.35
|
|
X-ray exam of femur 1
|
$171.60 |
$171.60 |
$171.60 |
$240.00
|
|
X-ray exam of sinuses
|
$183.00 |
$183.00 |
$183.00 |
$214.50
|
|
X-ray exam si joints
|
$278.10 |
$278.10 |
$278.10 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$387.60 |
$387.60 |
$387.60 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$219.00 |
$219.00 |
$219.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$251.10 |
$251.10 |
$251.10 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$226.20 |
$226.20 |
$226.20 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$217.50 |
$217.50 |
$217.50 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$217.80 |
$217.80 |
$217.80 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$222.90 |
$222.90 |
$222.90 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$225.00 |
$225.00 |
$225.00 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$218.40 |
$218.40 |
$218.40 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$121.80 |
$121.80 |
$121.80 |
$376.40
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$381.30 |
$381.30 |
$381.30 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$293.10 |
$293.10 |
$293.10 |
$424.05
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$123.30 |
$123.30 |
$123.30 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$238.20 |
$238.20 |
$238.20 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$232.20 |
$232.20 |
$232.20 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$222.60 |
$222.60 |
$222.60 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$126.30 |
$126.30 |
$126.30 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$320.40 |
$320.40 |
$320.40 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$297.30 |
$297.30 |
$297.30 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$377.10 |
$377.10 |
$377.10 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$410.40 |
$410.40 |
$410.40 |
$535.91
|
|
X-ray mandible ltd <4 views
|
$127.20 |
$127.20 |
$127.20 |
$235.00
|
|
X-ray nasal bones complete > 3 views
|
$213.90 |
$213.90 |
$213.90 |
$274.65
|
|
X-ray neck soft tissue
|
$213.90 |
$213.90 |
$213.90 |
$237.43
|
|
X-ray pelvis 1-2 views
|
$210.60 |
$210.60 |
$210.60 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$214.20 |
$214.20 |
$214.20 |
$348.19
|
|
X-ray ribs 2 views left
|
$234.00 |
$234.00 |
$234.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$319.50 |
$319.50 |
$319.50 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$327.00 |
$327.00 |
$327.00 |
$354.91
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$358.80 |
$358.80 |
$358.80 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$223.80 |
$223.80 |
$223.80 |
$312.00
|
|
X-ray sacrum/coccyx >= 2 views
|
$223.80 |
$223.80 |
$223.80 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$260.40 |
$260.40 |
$260.40 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$169.50 |
$169.50 |
$169.50 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$225.30 |
$225.30 |
$225.30 |
$345.24
|
|
X-ray skull < 4 views
|
$287.40 |
$287.40 |
$287.40 |
$292.00
|
|
X-ray skull > 4 views complete
|
$396.90 |
$396.90 |
$396.90 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$284.10 |
$284.10 |
$284.10 |
$557.70
|
|
X-ray small intestine follow-through study
|
$140.40 |
$140.40 |
$140.40 |
$499.50
|
|
X-ray spine single view
|
$204.00 |
$204.00 |
$204.00 |
$250.56
|
|
X-ray sternum > 2 views
|
$192.90 |
$192.90 |
$192.90 |
$274.65
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$354.00 |
$354.00 |
$354.00 |
$522.22
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$176.70 |
$176.70 |
$176.70 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$279.00 |
$279.00 |
$279.00 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$306.90 |
$306.90 |
$306.90 |
$380.82
|
|
X-ray thoracolumbar spine >=2 views
|
$225.30 |
$225.30 |
$225.30 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$224.40 |
$224.40 |
$224.40 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$224.40 |
$224.40 |
$224.40 |
$352.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$225.90 |
$225.90 |
$225.90 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$207.00 |
$207.00 |
$207.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$634.20 |
$634.20 |
$634.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$544.50 |
$544.50 |
$544.50 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$231.60 |
$231.60 |
$231.60 |
$290.40
|
|
Yttrium y-90 ibritumomab ther
|
$2,194.80 |
$2,194.80 |
$2,194.80 |
$55,035.00
|
|
Zika virus dna/rna amp probe
|
$143.40 |
$143.40 |
$143.40 |
$185.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$310.20 |
$310.20 |
$310.20 |
$122.69
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$164.33 |
$164.33 |
$164.33 |
$452.69
|
