|
Ultrasound breast unilateral limited (both sides)
|
$421.20 |
$421.20 |
$421.20 |
$455.26
|
|
Ultrasound chest
|
$904.80 |
$904.80 |
$904.80 |
$452.40
|
|
Ultrasound elastography parenchyma
|
$701.22 |
$701.22 |
$701.22 |
$284.25
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$821.34 |
$821.34 |
$821.34 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$3,362.58 |
$3,362.58 |
$3,362.58 |
$333.60
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,006.98 |
$1,006.98 |
$1,006.98 |
$673.19
|
|
Ultrasound joint complete left
|
$906.36 |
$906.36 |
$906.36 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$680.16 |
$680.16 |
$680.16 |
$454.74
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$240.24 |
$240.24 |
$240.24 |
$280.02
|
|
Ultrasound ob >=14wks ea addl gest
|
$827.58 |
$827.58 |
$827.58 |
$442.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,267.50 |
$1,267.50 |
$1,267.50 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$616.20 |
$616.20 |
$616.20 |
$447.30
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$904.80 |
$904.80 |
$904.80 |
$452.30
|
|
Ultrasound pregnant uterus transvaginal
|
$906.36 |
$906.36 |
$906.36 |
$481.65
|
|
Ultrasound retroperitoneal limited
|
$911.04 |
$911.04 |
$911.04 |
$483.99
|
|
Ultrasound scrotum and contents
|
$1,039.74 |
$1,039.74 |
$1,039.74 |
$615.00
|
|
Ultrasound transvaginal non obstetric
|
$906.36 |
$906.36 |
$906.36 |
$561.60
|
|
Unlisted procedure rectum
|
$1,864.20 |
$1,864.20 |
$1,864.20 |
$1,278.72
|
|
Unlisted px hands/fingers
|
$404.04 |
$404.04 |
$404.04 |
$547.20
|
|
Unlisted px salivry glnd/dux
|
$405.60 |
$405.60 |
$405.60 |
$619.50
|
|
Unlisted px small intestine
|
$1,851.72 |
$1,851.72 |
$1,851.72 |
$2,118.35
|
|
Unlisted ultrasound procedure
|
$616.20 |
$616.20 |
$616.20 |
$321.20
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,609.92 |
$1,609.92 |
$1,609.92 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,609.92 |
$1,609.92 |
$1,609.92 |
$1,675.80
|
|
Urea nitrogen
|
$60.06 |
$60.06 |
$60.06 |
$45.00
|
|
Urea nitrogen 24 hour urine
|
$12.48 |
$12.48 |
$12.48 |
$50.40
|
|
Uric acid blood
|
$61.62 |
$61.62 |
$61.62 |
$46.64
|
|
Uric acid urine
|
$20.28 |
$20.28 |
$20.28 |
$47.20
|
|
Urinalysis (with microscopy)
|
$145.08 |
$145.08 |
$145.08 |
$48.14
|
|
Urinalysis (without microscopy)
|
$173.94 |
$173.94 |
$173.94 |
$39.00
|
|
Urine Culture Test
|
$102.96 |
$102.96 |
$102.96 |
$84.60
|
|
Urine pregnancy test
|
$112.32 |
$112.32 |
$112.32 |
$66.87
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$227.64 |
$227.64 |
$227.64 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$227.64 |
$227.64 |
$227.64 |
$233.60
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$204.52 |
$204.52 |
$204.52 |
$240.91
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$136.94 |
$136.94 |
$136.94 |
$148.80
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$101.96 |
$101.96 |
$101.96 |
$98.04
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$25.12 |
$25.12 |
$25.12 |
$42.90
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$627.78 |
$627.78 |
$627.78 |
$273.66
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,128.52 |
$1,128.52 |
$1,128.52 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,204.06 |
$1,204.06 |
$1,204.06 |
$720.50
|
|
Vaccine tdap >=7 years im
|
$264.65 |
$264.65 |
$264.65 |
$148.06
|
|
Vaccine td preservative free >= 7 years im
|
$227.27 |
$227.27 |
$227.27 |
$131.77
|
|
Vaginal bx
|
$399.36 |
$399.36 |
$399.36 |
$576.55
|
|
Vaginal delivery after cesarean delivery 59612
|
$6,340.62 |
$6,340.62 |
$6,340.62 |
$4,075.20
|
|
Valproic acid total therapeutic drug level
|
$170.82 |
$170.82 |
$170.82 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$95.67 |
$95.67 |
$95.67 |
$170.87
|
|
Vancomycin peak therapeutic drug level
|
$170.82 |
$170.82 |
$170.82 |
$123.91
|
|
Varicella zoster antibody igg
|
$174.72 |
$174.72 |
$174.72 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$897.39 |
$897.39 |
$897.39 |
$427.07
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$7,192.38 |
$7,192.38 |
$7,192.38 |
$2,248.88
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$2,901.60 |
$2,901.60 |
$2,901.60 |
$188.65
|
|
Venipuncture <3 yrs other vein
|
$2,901.60 |
$2,901.60 |
$2,901.60 |
$67.00
|
|
Ventilator initial day
|
$1,282.32 |
$1,282.32 |
$1,282.32 |
$1,501.44
|
|
Ventricular puncture prev burr hole without inj 61020
|
$1,693.38 |
$1,693.38 |
$1,693.38 |
$1,081.00
|
|
Version cephalic external
|
$6,340.62 |
$6,340.62 |
$6,340.62 |
$2,507.22
|
|
Visit established high 40-54 minutes/level 5
|
$725.40 |
$725.40 |
$725.40 |
$173.25
|
|
Vitamin b-12
|
$187.98 |
$187.98 |
$187.98 |
$92.50
|
|
Vitamin D Test
|
$185.64 |
$185.64 |
$185.64 |
$132.00
|
|
Volume measurement urine timed
|
$56.94 |
$56.94 |
$56.94 |
$21.45
|
|
Warde 1003990 aldosterone
|
$276.12 |
$276.12 |
$276.12 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$23.40 |
$23.40 |
$23.40 |
$95.55
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$28.08 |
$28.08 |
$28.08 |
$68.25
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$21.06 |
$21.06 |
$21.06 |
$111.60
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$17.94 |
$17.94 |
$17.94 |
$68.80
|
|
Warde 1015200 kappa light chain free
|
$46.02 |
$46.02 |
$46.02 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$97.50 |
$97.50 |
$97.50 |
$41.40
|
|
Warde 3008005 oligoclonal bands
|
$59.28 |
$59.28 |
$59.28 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$46.80 |
$46.80 |
$46.80 |
$62.40
|
|
Warde 3016000 west nile virus antibody igg
|
$46.80 |
$46.80 |
$46.80 |
$65.65
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$32.76 |
$32.76 |
$32.76 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$94.38 |
$94.38 |
$94.38 |
$62.70
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$31.98 |
$31.98 |
$31.98 |
$78.00
|
|
Warde 3400852 arsenic
|
$17.16 |
$17.16 |
$17.16 |
$102.00
|
|
Warde 3708165 mercury urine
|
$71.76 |
$71.76 |
$71.76 |
$71.94
|
|
Warde actin (smooth muscle) antibody each
|
$210.60 |
$210.60 |
$210.60 |
$45.58
|
|
Warde adenosine deaminase pleural fluid
|
$183.30 |
$183.30 |
$183.30 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$312.00 |
$312.00 |
$312.00 |
$126.45
|
|
Warde aldolase
|
$104.52 |
$104.52 |
$104.52 |
$48.21
|
|
Warde amiodarone therapeutic drug level
|
$80.34 |
$80.34 |
$80.34 |
$53.95
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$141.96 |
$141.96 |
$141.96 |
$369.99
|
|
Warde bile acids
|
$95.16 |
$95.16 |
$95.16 |
$64.28
|
|
Warde cadmium blood
|
$39.00 |
$39.00 |
$39.00 |
$76.70
|
|
Warde calculus (stone) infrared
|
$55.38 |
$55.38 |
$55.38 |
$61.73
|
|
Warde cobalt heavy metal quantitative each nes
|
$583.44 |
$583.44 |
$583.44 |
$123.00
|
|
Warde collagen cross links c-telopeptide
|
$98.28 |
$98.28 |
$98.28 |
$90.40
|
|
Warde complement total hemolytic
|
$17.94 |
$17.94 |
$17.94 |
$100.86
|
|
Warde copper
|
$67.86 |
$67.86 |
$67.86 |
$79.20
|
|
Warde cryoglobulin
|
$15.60 |
$15.60 |
$15.60 |
$41.90
|
|
Warde fluorescent antibody screen endomysial iga
|
$81.90 |
$81.90 |
$81.90 |
$48.57
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$16.38 |
$16.38 |
$16.38 |
$43.55
|
|
Warde gastrin
|
$19.50 |
$19.50 |
$19.50 |
$70.88
|
|
Warde haloperidol therapeutic drug level
|
$19.50 |
$19.50 |
$19.50 |
$68.16
|
|
Warde helminth antibody strongyloides igg
|
$219.96 |
$219.96 |
$219.96 |
$96.88
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$70.98 |
$70.98 |
$70.98 |
$68.08
|
|
Warde hepatitis a antibody
|
$182.52 |
$182.52 |
$182.52 |
$83.20
|
|
Warde hepatitis delta agent antibody
|
$84.24 |
$84.24 |
$84.24 |
$93.60
|
|
Warde immunofixation electrophoresis urine
|
$211.38 |
$211.38 |
$211.38 |
$154.34
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$421.98 |
$421.98 |
$421.98 |
$636.09
|
|
Warde islet cell antibody zinc transporter 8
|
$255.06 |
$255.06 |
$255.06 |
$137.55
|
