|
Whfo w/joint(s) custom fab
|
$295.00 |
$295.00 |
$295.00 |
$442.81
|
|
Whole blood for transfusion
|
$585.00 |
$585.00 |
$585.00 |
$487.92
|
|
Whole blood/red blood cells leukocytes reduced cmv negative each unit
|
$432.50 |
$432.50 |
$432.50 |
$495.00
|
|
Who nontorsion jnts pre cst
|
$347.50 |
$347.50 |
$347.50 |
$711.46
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$585.00 |
$585.00 |
$585.00 |
$567.84
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$885.00 |
$885.00 |
$885.00 |
$594.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$220.00 |
$220.00 |
$220.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$330.00 |
$330.00 |
$330.00 |
$435.60
|
|
Wrist X-ray
|
$480.00 |
$480.00 |
$480.00 |
$355.00
|
|
Xe133 xenon 10mci
|
$65.00 |
$65.00 |
$65.00 |
$198.79
|
|
Xpos opn axillary/sbclvn art w/cndt crtn
|
$3,025.00 |
$3,025.00 |
$3,025.00 |
$3,025.00
|
|
Xpos opn fmrl eprst aor uni add-on
|
$3,295.00 |
$3,295.00 |
$3,295.00 |
$1,814.88
|
|
X-ray abdomen 1 view
|
$125.00 |
$125.00 |
$125.00 |
$258.00
|
|
X-ray abdomen 2 views
|
$160.00 |
$160.00 |
$160.00 |
$316.30
|
|
X-ray abdomen >=3 views
|
$185.00 |
$185.00 |
$185.00 |
$339.00
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$222.50 |
$222.50 |
$222.50 |
$416.40
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$295.00 |
$295.00 |
$295.00 |
$270.69
|
|
X-ray ankle 2 views (both sides)
|
$530.00 |
$530.00 |
$530.00 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$965.00 |
$965.00 |
$965.00 |
$781.55
|
|
X-ray bone age studies
|
$292.50 |
$292.50 |
$292.50 |
$250.20
|
|
X-ray bone length studies
|
$350.00 |
$350.00 |
$350.00 |
$285.30
|
|
X-ray bone survey complete
|
$885.00 |
$885.00 |
$885.00 |
$660.00
|
|
X-ray bone survey infant
|
$525.00 |
$525.00 |
$525.00 |
$394.80
|
|
X-ray cervical spine 2-3 views
|
$235.00 |
$235.00 |
$235.00 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$342.50 |
$342.50 |
$342.50 |
$464.55
|
|
X-ray cervical spine >= 6 views
|
$390.00 |
$390.00 |
$390.00 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$575.00 |
$575.00 |
$575.00 |
$306.00
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$472.50 |
$472.50 |
$472.50 |
$667.61
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$615.00 |
$615.00 |
$615.00 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$475.00 |
$475.00 |
$475.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$595.00 |
$595.00 |
$595.00 |
$368.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$505.00 |
$505.00 |
$505.00 |
$484.80
|
|
X-ray exam entire spi 4/5 vw
|
$565.00 |
$565.00 |
$565.00 |
$436.80
|
|
X-ray exam entire spi 6/> vw
|
$845.00 |
$845.00 |
$845.00 |
$517.80
|
|
X-ray exam of arm infant
|
$220.00 |
$220.00 |
$220.00 |
$246.75
|
|
X-ray exam of eye sockets
|
$327.50 |
$327.50 |
$327.50 |
$328.35
|
|
X-ray exam of femur 1
|
$470.00 |
$470.00 |
$470.00 |
$237.42
|
|
X-ray exam of jaw joint
|
$260.00 |
$260.00 |
$260.00 |
$188.40
|
|
X-ray exam of sinuses
|
$282.50 |
$282.50 |
$282.50 |
$211.00
|
|
X-ray exam si joints
|
$252.50 |
$252.50 |
$252.50 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$307.50 |
$307.50 |
$307.50 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$275.00 |
$275.00 |
$275.00 |
$236.00
|
|
X-ray facial bones complete > 3 views
|
$402.50 |
$402.50 |
$402.50 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$695.00 |
$695.00 |
$695.00 |
$319.00
|
|
X-ray finger(s) >= 2 views (both sides)
|
$545.00 |
$545.00 |
$545.00 |
$243.60
|
|
X-ray foot 2 views (both sides)
|
$360.00 |
$360.00 |
$360.00 |
$292.83
|
|
X-ray forearm 2 views (both sides)
|
$560.00 |
$560.00 |
$560.00 |
$329.50
|
|
X-ray hand 2 views (both sides)
|
$355.00 |
$355.00 |
$355.00 |
$294.90
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$510.00 |
$510.00 |
$510.00 |
$280.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$432.50 |
$432.50 |
$432.50 |
$376.40
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$432.50 |
$432.50 |
$432.50 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$515.00 |
$515.00 |
$515.00 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$655.00 |
$655.00 |
$655.00 |
$512.80
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$287.50 |
$287.50 |
$287.50 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$590.00 |
$590.00 |
$590.00 |
$310.00
|
|
X-ray knee 1-2 views (both sides)
|
$410.00 |
$410.00 |
$410.00 |
$298.85
|
|
X-ray knee 3 views (both sides)
|
$480.00 |
$480.00 |
$480.00 |
$369.95
|
|
X-ray knee ap standing bilateral
|
$252.50 |
$252.50 |
$252.50 |
$255.23
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$445.00 |
$445.00 |
$445.00 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$395.00 |
$395.00 |
$395.00 |
$373.10
|
|
X-ray lumbosacral spine >= 4 views
|
$352.50 |
$352.50 |
$352.50 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$550.00 |
$550.00 |
$550.00 |
$540.60
|
|
X-ray mandible complete > 4 views
|
$392.50 |
$392.50 |
$392.50 |
$365.66
|
|
X-ray mandible ltd <4 views
|
$292.50 |
$292.50 |
$292.50 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$332.50 |
$332.50 |
$332.50 |
$274.65
|
|
X-ray neck soft tissue
|
$280.00 |
$280.00 |
$280.00 |
$237.76
|
|
X-ray nose to rectum for foreign body child
|
$147.50 |
$147.50 |
$147.50 |
$226.20
|
|
X-ray of mammary ducts
|
$342.50 |
$342.50 |
$342.50 |
$621.00
|
|
X-ray pelvis 1-2 views
|
$270.00 |
$270.00 |
$270.00 |
$280.50
|
|
X-ray pelvis complete > 3 views
|
$360.00 |
$360.00 |
$360.00 |
$350.26
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$925.00 |
$925.00 |
$925.00 |
$762.24
|
|
X-ray ribs 2 views left
|
$280.00 |
$280.00 |
$280.00 |
$291.61
|
|
X-ray ribs 3 views bilateral
|
$417.50 |
$417.50 |
$417.50 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$417.50 |
$417.50 |
$417.50 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$485.00 |
$485.00 |
$485.00 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$322.50 |
$322.50 |
$322.50 |
$311.35
|
|
X-ray sacrum/coccyx >= 2 views
|
$332.50 |
$332.50 |
$332.50 |
$289.20
|
|
X-ray scapula complete (both sides)
|
$285.00 |
$285.00 |
$285.00 |
$286.00
|
|
X-ray shoulder 1 view (both sides)
|
$175.00 |
$175.00 |
$175.00 |
$261.60
|
|
X-ray sinuses paranasal complete > 3 views
|
$425.00 |
$425.00 |
$425.00 |
$346.45
|
|
X-ray sinus tract/fistula/abscess
|
$417.50 |
$417.50 |
$417.50 |
$599.23
|
|
X-ray skull < 4 views
|
$280.00 |
$280.00 |
$280.00 |
$291.78
|
|
X-ray skull > 4 views complete
|
$417.50 |
$417.50 |
$417.50 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$530.00 |
$530.00 |
$530.00 |
$551.81
|
|
X-ray small intestine follow-through study
|
$352.50 |
$352.50 |
$352.50 |
$490.20
|
|
X-ray spine single view
|
$195.00 |
$195.00 |
$195.00 |
$254.25
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$267.50 |
$267.50 |
$267.50 |
$267.50
|
|
X-ray sternum > 2 views
|
$290.00 |
$290.00 |
$290.00 |
$274.65
|
|
X-ray surgical specimen
|
$375.00 |
$375.00 |
$375.00 |
$488.66
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$437.50 |
$437.50 |
$437.50 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$390.00 |
$390.00 |
$390.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$235.00 |
$235.00 |
$235.00 |
$321.60
|
|
X-ray thoracic spine 3 views
|
$270.00 |
$270.00 |
$270.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$252.50 |
$252.50 |
$252.50 |
$288.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$247.50 |
$247.50 |
$247.50 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$375.00 |
$375.00 |
$375.00 |
$342.40
|
|
X-ray tibia/fibula 2 views (both sides)
|
$590.00 |
$590.00 |
$590.00 |
$333.45
|
|
X-ray toe(s) > 2 views (both sides)
|
$265.00 |
$265.00 |
$265.00 |
$259.60
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$705.00 |
$705.00 |
$705.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$655.00 |
$655.00 |
$655.00 |
$603.20
|
