|
Warde vitamin b-1 (thiamine)
|
$12.00 |
$12.00 |
$12.00 |
$82.04
|
|
Warde vitamin b6 (pyridoxine)
|
$11.00 |
$11.00 |
$11.00 |
$116.20
|
|
Warde vitamin c (ascorbic acid)
|
$7.00 |
$7.00 |
$7.00 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$14.00 |
$14.00 |
$14.00 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$14.50 |
$14.50 |
$14.50 |
$59.25
|
|
Warde zinc
|
$6.00 |
$6.00 |
$6.00 |
$62.50
|
|
Wbc automated
|
$24.00 |
$24.00 |
$24.00 |
$32.35
|
|
Wedge biopsy of liver 47100
|
$906.50 |
$906.50 |
$906.50 |
$1,584.00
|
|
Wnd prep f/n/hf/g addl cm
|
$100.00 |
$100.00 |
$100.00 |
$811.00
|
|
Wound closure by adhesive
|
$15.50 |
$15.50 |
$15.50 |
$149.25
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$751.00 |
$751.00 |
$751.00 |
$554.01
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$28.00 |
$28.00 |
$28.00 |
$579.70
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$206.00 |
$206.00 |
$206.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$306.50 |
$306.50 |
$306.50 |
$438.75
|
|
Wrist endoscopy/surgery
|
$541.00 |
$541.00 |
$541.00 |
$3,452.80
|
|
Wrist X-ray
|
$318.00 |
$318.00 |
$318.00 |
$342.80
|
|
Xcapsl ctrc rmvl cplx wo ecp
|
$1,495.50 |
$1,495.50 |
$1,495.50 |
$3,724.80
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,209.50 |
$1,209.50 |
$1,209.50 |
$2,692.80
|
|
Xfer tis s/a/l 10 sq cm/<
|
$1,421.50 |
$1,421.50 |
$1,421.50 |
$2,837.09
|
|
Xm archive tissue molec anal
|
$19.00 |
$19.00 |
$19.00 |
$49.84
|
|
Xpos opn axillary/sbclvn art w/cndt crtn
|
$398.00 |
$398.00 |
$398.00 |
$3,025.00
|
|
Xpos opn fmrl eprst aor uni add-on
|
$221.00 |
$221.00 |
$221.00 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$134.00 |
$134.00 |
$134.00 |
$258.50
|
|
X-ray abdomen 2 views
|
$215.50 |
$215.50 |
$215.50 |
$316.47
|
|
X-ray abdomen >=3 views
|
$218.50 |
$218.50 |
$218.50 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$229.50 |
$229.50 |
$229.50 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$171.00 |
$171.00 |
$171.00 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$133.50 |
$133.50 |
$133.50 |
$282.50
|
|
X-ray bone age studies
|
$145.00 |
$145.00 |
$145.00 |
$251.40
|
|
X-ray bone length studies
|
$174.50 |
$174.50 |
$174.50 |
$285.30
|
|
X-ray bone survey complete
|
$207.00 |
$207.00 |
$207.00 |
$660.00
|
|
X-ray bone survey infant
|
$117.00 |
$117.00 |
$117.00 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$145.50 |
$145.50 |
$145.50 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$264.50 |
$264.50 |
$264.50 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$170.50 |
$170.50 |
$170.50 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$296.00 |
$296.00 |
$296.00 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$416.00 |
$416.00 |
$416.00 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$533.00 |
$533.00 |
$533.00 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$234.00 |
$234.00 |
$234.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$145.50 |
$145.50 |
$145.50 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$221.00 |
$221.00 |
$221.00 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$212.00 |
$212.00 |
$212.00 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$242.50 |
$242.50 |
$242.50 |
$517.80
|
|
X-ray exam of eye sockets
|
$133.00 |
$133.00 |
$133.00 |
$328.35
|
|
X-ray exam of femur 1
|
$117.50 |
$117.50 |
$117.50 |
$240.00
|
|
X-ray exam of sinuses
|
$59.50 |
$59.50 |
$59.50 |
$214.50
|
|
X-ray exam thorac spine4/>vw
|
$291.50 |
$291.50 |
$291.50 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$87.00 |
$87.00 |
$87.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$208.50 |
$208.50 |
$208.50 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$154.50 |
$154.50 |
$154.50 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$201.00 |
$201.00 |
$201.00 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$133.50 |
$133.50 |
$133.50 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$134.00 |
$134.00 |
$134.00 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$246.00 |
$246.00 |
$246.00 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$162.50 |
$162.50 |
$162.50 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$164.50 |
$164.50 |
$164.50 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$195.00 |
$195.00 |
$195.00 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$173.00 |
$173.00 |
$173.00 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$164.50 |
$164.50 |
$164.50 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$91.50 |
$91.50 |
$91.50 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$145.50 |
$145.50 |
$145.50 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$223.00 |
$223.00 |
$223.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$336.00 |
$336.00 |
$336.00 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$208.50 |
$208.50 |
$208.50 |
$252.50
|
|
X-ray lumbosacral spine >= 4 views
|
$271.00 |
$271.00 |
$271.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$351.00 |
$351.00 |
$351.00 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$152.50 |
$152.50 |
$152.50 |
$361.61
|
|
X-ray nasal bones complete > 3 views
|
$130.00 |
$130.00 |
$130.00 |
$274.65
|
|
X-ray neck soft tissue
|
$148.50 |
$148.50 |
$148.50 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$198.00 |
$198.00 |
$198.00 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$118.50 |
$118.50 |
$118.50 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$165.00 |
$165.00 |
$165.00 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$446.00 |
$446.00 |
$446.00 |
$755.50
|
|
X-ray ribs 2 views left
|
$162.00 |
$162.00 |
$162.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$156.50 |
$156.50 |
$156.50 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$218.00 |
$218.00 |
$218.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$232.00 |
$232.00 |
$232.00 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$165.00 |
$165.00 |
$165.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$148.00 |
$148.00 |
$148.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$90.00 |
$90.00 |
$90.00 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$123.00 |
$123.00 |
$123.00 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$216.50 |
$216.50 |
$216.50 |
$345.60
|
|
X-ray skull < 4 views
|
$91.50 |
$91.50 |
$91.50 |
$292.50
|
|
X-ray skull > 4 views complete
|
$154.50 |
$154.50 |
$154.50 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$237.00 |
$237.00 |
$237.00 |
$557.70
|
|
X-ray small intestine follow-through study
|
$156.00 |
$156.00 |
$156.00 |
$499.50
|
|
X-ray spine single view
|
$78.00 |
$78.00 |
$78.00 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$132.50 |
$132.50 |
$132.50 |
$264.48
|
|
X-ray sternum > 2 views
|
$165.00 |
$165.00 |
$165.00 |
$274.65
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$320.00 |
$320.00 |
$320.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$208.50 |
$208.50 |
$208.50 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$154.50 |
$154.50 |
$154.50 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$190.50 |
$190.50 |
$190.50 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$220.50 |
$220.50 |
$220.50 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$235.50 |
$235.50 |
$235.50 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$164.50 |
$164.50 |
$164.50 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$307.00 |
$307.00 |
$307.00 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$94.00 |
$94.00 |
$94.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$416.00 |
$416.00 |
$416.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$308.50 |
$308.50 |
$308.50 |
$603.20
|
