|
Warde mitochondrial antibody each
|
$88.80 |
$88.80 |
$88.80 |
$59.28
|
|
Warde neutralization rabies
|
$53.40 |
$53.40 |
$53.40 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$73.20 |
$73.20 |
$73.20 |
$64.35
|
|
Warde pancreatic elastase fecal quantitative
|
$79.80 |
$79.80 |
$79.80 |
$94.25
|
|
Warde protein c antigen
|
$156.00 |
$156.00 |
$156.00 |
$93.43
|
|
Warde sex hormone binding globulin
|
$123.00 |
$123.00 |
$123.00 |
$82.08
|
|
Warde somatomedin
|
$142.20 |
$142.20 |
$142.20 |
$113.58
|
|
Warde t3 (triiodothyronine) reverse
|
$115.80 |
$115.80 |
$115.80 |
$69.50
|
|
Warde thyroid stimulating immunoglobulins
|
$211.20 |
$211.20 |
$211.20 |
$178.53
|
|
Warde topiramate therapeutic drug level
|
$123.00 |
$123.00 |
$123.00 |
$71.20
|
|
Warde virus isolation tissue culture innoculation presumptive id herpes simplex
|
$200.40 |
$200.40 |
$200.40 |
$129.54
|
|
Warde viscosity
|
$70.20 |
$70.20 |
$70.20 |
$49.47
|
|
Warde vitamin a
|
$82.80 |
$82.80 |
$82.80 |
$58.80
|
|
Warde vitamin b-1 (thiamine)
|
$216.60 |
$216.60 |
$216.60 |
$82.04
|
|
Warde vitamin b6 (pyridoxine)
|
$171.00 |
$171.00 |
$171.00 |
$116.20
|
|
Warde vitamin c (ascorbic acid)
|
$83.40 |
$83.40 |
$83.40 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$218.40 |
$218.40 |
$218.40 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$114.60 |
$114.60 |
$114.60 |
$59.25
|
|
Warde zinc
|
$96.60 |
$96.60 |
$96.60 |
$62.50
|
|
Wbc automated
|
$30.00 |
$30.00 |
$30.00 |
$32.35
|
|
Western blot test
|
$174.00 |
$174.00 |
$174.00 |
$150.00
|
|
Whfo electric custom fitted
|
$11,956.97 |
$11,956.97 |
$11,956.97 |
$5,209.82
|
|
Whfo nontorsion joint prefab
|
$738.59 |
$738.59 |
$738.59 |
$224.01
|
|
Whfo w/joint(s) custom fab
|
$1,609.07 |
$1,609.07 |
$1,609.07 |
$465.50
|
|
Whole blood or red blood cells frozen/deglycerolized/washed leukocytes reduced each unit
|
$442.20 |
$442.20 |
$442.20 |
$696.45
|
|
Who nontorsion jnts pre cst
|
$1,883.03 |
$1,883.03 |
$1,883.03 |
$706.80
|
|
Who nontorsion jnts pre ots
|
$1,883.03 |
$1,883.03 |
$1,883.03 |
$1,144.66
|
|
Wilate injection
|
$6,562.50 |
$6,562.50 |
$6,562.50 |
$4.58
|
|
Woman's shoe oxford brace
|
$262.99 |
$262.99 |
$262.99 |
$149.37
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$372.60 |
$372.60 |
$372.60 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$384.60 |
$384.60 |
$384.60 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$1,095.60 |
$1,095.60 |
$1,095.60 |
$438.75
|
|
Wrist arthroscopy/surgery
|
$20,607.44 |
$20,607.44 |
$20,607.44 |
$3,839.54
|
|
Wrist X-ray
|
$447.60 |
$447.60 |
$447.60 |
$342.80
|
|
Xcellistem, 1 mg
|
$8,694.44 |
$8,694.44 |
$8,694.44 |
$2,859.19
|
|
Xe133 xenon 10mci
|
$69.60 |
$69.60 |
$69.60 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$22,509.06 |
$22,509.06 |
$22,509.06 |
$2,692.80
|
|
Xm archive tissue molec anal
|
$60.60 |
$60.60 |
$60.60 |
$49.84
|
|
X-ray abdomen 1 view
|
$388.20 |
$388.20 |
$388.20 |
$258.50
|
|
X-ray abdomen 2 views
|
$327.60 |
$327.60 |
$327.60 |
$316.47
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$708.60 |
$708.60 |
$708.60 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$181.20 |
$181.20 |
$181.20 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$422.40 |
$422.40 |
$422.40 |
$282.50
|
|
X-ray bone age studies
|
$250.20 |
$250.20 |
$250.20 |
$251.40
|
|
X-ray bone length studies
|
$584.40 |
$584.40 |
$584.40 |
$285.30
|
|
X-ray bone survey complete
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$660.00
|
|
X-ray bone survey infant
|
$405.60 |
$405.60 |
$405.60 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$803.40 |
$803.40 |
$803.40 |
$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
|
$1,330.20 |
$1,330.20 |
$1,330.20 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$558.00 |
$558.00 |
$558.00 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$1,151.40 |
$1,151.40 |
$1,151.40 |
$657.03
|
|
X-ray elbow 2 views (both sides)
|
$411.00 |
$411.00 |
$411.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$633.60 |
$633.60 |
$633.60 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$820.20 |
$820.20 |
$820.20 |
$483.50
|
|
X-ray exam of arm infant
|
$246.00 |
$246.00 |
$246.00 |
$248.44
|
|
X-ray exam of eye sockets
|
$517.80 |
$517.80 |
$517.80 |
$328.35
|
|
X-ray exam of femur 1
|
$519.00 |
$519.00 |
$519.00 |
$240.00
|
|
X-ray exam of jaw joint
|
$186.60 |
$186.60 |
$186.60 |
$188.40
|
|
X-ray exam of sinuses
|
$500.40 |
$500.40 |
$500.40 |
$214.50
|
|
X-ray exam si joints
|
$583.80 |
$583.80 |
$583.80 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$814.20 |
$814.20 |
$814.20 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$546.60 |
$546.60 |
$546.60 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$790.20 |
$790.20 |
$790.20 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$519.00 |
$519.00 |
$519.00 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$410.40 |
$410.40 |
$410.40 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$384.60 |
$384.60 |
$384.60 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$509.40 |
$509.40 |
$509.40 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$414.60 |
$414.60 |
$414.60 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$480.00 |
$480.00 |
$480.00 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$267.60 |
$267.60 |
$267.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$615.60 |
$615.60 |
$615.60 |
$374.40
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$206.40 |
$206.40 |
$206.40 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$476.40 |
$476.40 |
$476.40 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$461.40 |
$461.40 |
$461.40 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$467.40 |
$467.40 |
$467.40 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$413.40 |
$413.40 |
$413.40 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$304.20 |
$304.20 |
$304.20 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$436.20 |
$436.20 |
$436.20 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$1,325.40 |
$1,325.40 |
$1,325.40 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$1,333.80 |
$1,333.80 |
$1,333.80 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$553.20 |
$553.20 |
$553.20 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$267.00 |
$267.00 |
$267.00 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$369.60 |
$369.60 |
$369.60 |
$274.65
|
|
X-ray neck soft tissue
|
$440.40 |
$440.40 |
$440.40 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$181.20 |
$181.20 |
$181.20 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$462.60 |
$462.60 |
$462.60 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$428.40 |
$428.40 |
$428.40 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$743.40 |
$743.40 |
$743.40 |
$755.50
|
|
X-ray ribs 2 views left
|
$330.00 |
$330.00 |
$330.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$624.60 |
$624.60 |
$624.60 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$523.80 |
$523.80 |
$523.80 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$784.80 |
$784.80 |
$784.80 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$841.80 |
$841.80 |
$841.80 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$519.00 |
$519.00 |
$519.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$519.60 |
$519.60 |
$519.60 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$388.20 |
$388.20 |
$388.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$599.40 |
$599.40 |
$599.40 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$977.40 |
$977.40 |
$977.40 |
$606.89
|
|
X-ray skull < 4 views
|
$405.60 |
$405.60 |
$405.60 |
$292.50
|
