|
Test for urine cystines
|
$384.70 |
$384.70 |
$384.70 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$8,940.10 |
$8,940.10 |
$8,940.10 |
$780.48
|
|
Tetanus immune globulin inj
|
$52.50 |
$52.50 |
$52.50 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$1,028.45 |
$1,028.45 |
$1,028.45 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$79.35 |
$79.35 |
$79.35 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$79.35 |
$79.35 |
$79.35 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$54.00 |
$54.00 |
$54.00 |
$38.64
|
|
Thyroid imaging
|
$4,439.45 |
$4,439.45 |
$4,439.45 |
$670.80
|
|
Thyroid mets imag whole body
|
$13,377.45 |
$13,377.45 |
$13,377.45 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$2,084.40 |
$2,084.40 |
$2,084.40 |
$120.00
|
|
Thyroid uptake measurement
|
$3,927.40 |
$3,927.40 |
$3,927.40 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$13.25 |
$13.25 |
$13.25 |
$63.60
|
|
Tigecycline injection
|
$402.75 |
$402.75 |
$402.75 |
$308.75
|
|
Tissue culture placenta
|
$346.80 |
$346.80 |
$346.80 |
$520.91
|
|
Tissue culture skin/biopsy
|
$410.15 |
$410.15 |
$410.15 |
$558.87
|
|
Tissue culture tumor
|
$851.85 |
$851.85 |
$851.85 |
$529.23
|
|
Tl-201 thallium diag per mci
|
$870.40 |
$870.40 |
$870.40 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$288.85 |
$288.85 |
$288.85 |
$125.87
|
|
Trastuzumab 150 mg intravenous solution
|
$163.00 |
$163.00 |
$163.00 |
$3,401.26
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$196.50 |
$196.50 |
$196.50 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$147.15 |
$147.15 |
$147.15 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$407.25 |
$407.25 |
$407.25 |
$210.00
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$129.50 |
$129.50 |
$129.50 |
$48.22
|
|
Trimethobenzamide hcl inj
|
$86.75 |
$86.75 |
$86.75 |
$154.09
|
|
Ua w/micro/comp poc
|
$601.45 |
$601.45 |
$601.45 |
$24.45
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$21,802.95 |
$21,802.95 |
$21,802.95 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$17,890.50 |
$17,890.50 |
$17,890.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$13,081.60 |
$13,081.60 |
$13,081.60 |
$2,013.08
|
|
Urea nitrogen
|
$859.30 |
$859.30 |
$859.30 |
$45.10
|
|
Uric acid blood
|
$1,155.25 |
$1,155.25 |
$1,155.25 |
$46.64
|
|
Urinalysis microscopic only
|
$308.60 |
$308.60 |
$308.60 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$7.40 |
$7.40 |
$7.40 |
$25.72
|
|
Urine Culture Test
|
$918.50 |
$918.50 |
$918.50 |
$84.81
|
|
Vaccine hepatitis a (hepa) adult im
|
$75.00 |
$75.00 |
$75.00 |
$178.07
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$175.25 |
$175.25 |
$175.25 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$89.00 |
$89.00 |
$89.00 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$129.50 |
$129.50 |
$129.50 |
$40.01
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$631.25 |
$631.25 |
$631.25 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$104.25 |
$104.25 |
$104.25 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$840.25 |
$840.25 |
$840.25 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,718.70 |
$1,718.70 |
$1,718.70 |
$385.45
|
|
Vaccine rabies im
|
$1,641.50 |
$1,641.50 |
$1,641.50 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$144.50 |
$144.50 |
$144.50 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$30.75 |
$30.75 |
$30.75 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$60.00 |
$60.00 |
$60.00 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$1,217.85 |
$1,217.85 |
$1,217.85 |
$115.00
|
|
Vasopressin 20 unit/ml intravenous solution
|
$225.10 |
$225.10 |
$225.10 |
$394.13
|
|
Ventilator each subsequent day
|
$4,000.85 |
$4,000.85 |
$4,000.85 |
$1,305.92
|
|
Ventilator initial day
|
$3,982.85 |
$3,982.85 |
$3,982.85 |
$1,540.80
|
|
Vincristine 1 mg/ml intravenous solution
|
$48.00 |
$48.00 |
$48.00 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$629.25 |
$629.25 |
$629.25 |
$245.36
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$735.75 |
$735.75 |
$735.75 |
$224.40
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$11.55 |
$11.55 |
$11.55 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$8.05 |
$8.05 |
$8.05 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$14.90 |
$14.90 |
$14.90 |
$40.70
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$18.35 |
$18.35 |
$18.35 |
$78.57
|
|
Warde adenosine deaminase pleural fluid
|
$157.70 |
$157.70 |
$157.70 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$15.00 |
$15.00 |
$15.00 |
$129.75
|
|
Warde aldolase
|
$2.60 |
$2.60 |
$2.60 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$132.50 |
$132.50 |
$132.50 |
$176.20
|
|
Warde amiodarone therapeutic drug level
|
$11.55 |
$11.55 |
$11.55 |
$53.95
|
|
Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites
|
$100.45 |
$100.45 |
$100.45 |
$142.65
|
|
Warde bile acids
|
$13.25 |
$13.25 |
$13.25 |
$64.28
|
|
Warde cadmium blood
|
$99.75 |
$99.75 |
$99.75 |
$77.00
|
|
Warde calcitonin
|
$17.25 |
$17.25 |
$17.25 |
$89.40
|
|
Warde cobalt heavy metal quantitative each nes
|
$31.10 |
$31.10 |
$31.10 |
$122.50
|
|
Warde complement total hemolytic
|
$4.60 |
$4.60 |
$4.60 |
$105.00
|
|
Warde cryoglobulin
|
$6.65 |
$6.65 |
$6.65 |
$43.45
|
|
Warde fluorescent antibody screen endomysial iga
|
$23.05 |
$23.05 |
$23.05 |
$48.57
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$10.40 |
$10.40 |
$10.40 |
$43.55
|
|
Warde gastrin
|
$6.65 |
$6.65 |
$6.65 |
$75.25
|
|
Warde hepatitis be antibody
|
$4.00 |
$4.00 |
$4.00 |
$50.00
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$3.35 |
$3.35 |
$3.35 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$115.20 |
$115.20 |
$115.20 |
$636.09
|
|
Warde islet cell antibody zinc transporter 8
|
$25.35 |
$25.35 |
$25.35 |
$137.55
|
|
Warde oxcarbazepine therapeutic drug level
|
$4.10 |
$4.10 |
$4.10 |
$64.50
|
|
Warde t3 (triiodothyronine) reverse
|
$8.05 |
$8.05 |
$8.05 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$34.60 |
$34.60 |
$34.60 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$13.85 |
$13.85 |
$13.85 |
$71.19
|
|
Warde viscosity
|
$14.85 |
$14.85 |
$14.85 |
$52.65
|
|
Warde vitamin a
|
$13.55 |
$13.55 |
$13.55 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$17.15 |
$17.15 |
$17.15 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$20.75 |
$20.75 |
$20.75 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$15.90 |
$15.90 |
$15.90 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$13.85 |
$13.85 |
$13.85 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$12.25 |
$12.25 |
$12.25 |
$55.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$436.15
|
|
Xe133 xenon 10mci
|
$726.80 |
$726.80 |
$726.80 |
$299.00
|
|
Xylose absorption test blood &/or urine
|
$25.45 |
$25.45 |
$25.45 |
$64.28
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$211.00 |
$211.00 |
$211.00 |
$106.94
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$93.50 |
$93.50 |
$93.50 |
$128.10
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$56.00 |
$56.00 |
$56.00 |
$346.14
|
