|
Vaccine hepatitis a (hepa) adult im
|
$166.00 |
$166.00 |
$166.00 |
$178.07
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$81.00 |
$81.00 |
$81.00 |
$61.50
|
|
Vaccine influenza nos 0.5ml dose im
|
$99.00 |
$99.00 |
$99.00 |
$36.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$33.00 |
$33.00 |
$33.00 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$805.00 |
$805.00 |
$805.00 |
$499.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$253.00 |
$253.00 |
$253.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$429.00 |
$429.00 |
$429.00 |
$397.18
|
|
Vaccine rabies im
|
$1,177.50 |
$1,177.50 |
$1,177.50 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$175.75 |
$175.75 |
$175.75 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$117.00 |
$117.00 |
$117.00 |
$131.77
|
|
Vasopressin 20 unit/ml intravenous solution
|
$406.00 |
$406.00 |
$406.00 |
$394.13
|
|
Venogram ext bil s&i
|
$2,648.00 |
$2,648.00 |
$2,648.00 |
$1,838.28
|
|
Ventilator each subsequent day
|
$2,449.75 |
$2,449.75 |
$2,449.75 |
$1,305.92
|
|
Ventilator initial day
|
$2,674.25 |
$2,674.25 |
$2,674.25 |
$1,540.80
|
|
Viper venom prothrombin time
|
$26.75 |
$26.75 |
$26.75 |
$35.20
|
|
Virus isolation addl studies ea
|
$93.25 |
$93.25 |
$93.25 |
$90.35
|
|
Vital capacity test
|
$172.00 |
$172.00 |
$172.00 |
$173.33
|
|
Volume measurement urine timed
|
$16.25 |
$16.25 |
$16.25 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$662.00 |
$662.00 |
$662.00 |
$224.40
|
|
Warde 1005020 citrate 24 hour urine
|
$22.25 |
$22.25 |
$22.25 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$11.50 |
$11.50 |
$11.50 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$8.00 |
$8.00 |
$8.00 |
$69.55
|
|
Warde 3008005 oligoclonal bands
|
$42.50 |
$42.50 |
$42.50 |
$102.60
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$83.25 |
$83.25 |
$83.25 |
$78.57
|
|
Warde 3400852 arsenic
|
$87.75 |
$87.75 |
$87.75 |
$105.12
|
|
Warde 3708165 mercury urine
|
$42.50 |
$42.50 |
$42.50 |
$72.80
|
|
Warde acetylcholine receptor blocking antibody
|
$85.00 |
$85.00 |
$85.00 |
$68.90
|
|
Warde adrenocorticotropic hormone (acth)
|
$15.00 |
$15.00 |
$15.00 |
$129.75
|
|
Warde aldolase
|
$2.75 |
$2.75 |
$2.75 |
$49.20
|
|
Warde amiodarone therapeutic drug level
|
$11.50 |
$11.50 |
$11.50 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$302.75 |
$302.75 |
$302.75 |
$260.94
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$759.25 |
$759.25 |
$759.25 |
$381.50
|
|
Warde anti-mullerian hormone
|
$248.00 |
$248.00 |
$248.00 |
$93.28
|
|
Warde bile acids
|
$79.25 |
$79.25 |
$79.25 |
$64.28
|
|
Warde calcitonin
|
$17.25 |
$17.25 |
$17.25 |
$89.40
|
|
Warde calculus (stone) infrared
|
$59.75 |
$59.75 |
$59.75 |
$61.73
|
|
Warde clozapine therapeutic drug level
|
$93.50 |
$93.50 |
$93.50 |
$63.00
|
|
Warde collagen cross links c-telopeptide
|
$64.50 |
$64.50 |
$64.50 |
$90.40
|
|
Warde complement total hemolytic
|
$4.50 |
$4.50 |
$4.50 |
$105.00
|
|
Warde cryoglobulin
|
$5.75 |
$5.75 |
$5.75 |
$43.45
|
|
Warde erythropoietin
|
$152.75 |
$152.75 |
$152.75 |
$90.35
|
|
Warde folic acid rbc
|
$97.25 |
$97.25 |
$97.25 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$14.50 |
$14.50 |
$14.50 |
$43.55
|
|
Warde gastrin
|
$6.75 |
$6.75 |
$6.75 |
$75.25
|
|
Warde growth hormone (hgh)
|
$135.50 |
$135.50 |
$135.50 |
$81.24
|
|
Warde haloperidol therapeutic drug level
|
$73.00 |
$73.00 |
$73.00 |
$68.16
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$114.25 |
$114.25 |
$114.25 |
$68.64
|
|
Warde hepatitis a antibody
|
$103.00 |
$103.00 |
$103.00 |
$83.70
|
|
Warde hepatitis be antibody
|
$3.50 |
$3.50 |
$3.50 |
$50.00
|
|
Warde hepatitis delta agent antibody
|
$28.75 |
$28.75 |
$28.75 |
$92.30
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$3.00 |
$3.00 |
$3.00 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$115.75 |
$115.75 |
$115.75 |
$636.09
|
|
Warde neutralization rabies
|
$78.25 |
$78.25 |
$78.25 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$9.25 |
$9.25 |
$9.25 |
$64.50
|
|
Warde pancreatic elastase fecal quantitative
|
$106.25 |
$106.25 |
$106.25 |
$94.25
|
|
Warde protein c antigen
|
$55.75 |
$55.75 |
$55.75 |
$88.80
|
|
Warde sex hormone binding globulin
|
$100.75 |
$100.75 |
$100.75 |
$86.59
|
|
Warde somatomedin
|
$27.25 |
$27.25 |
$27.25 |
$111.80
|
|
Warde t3 (triiodothyronine) reverse
|
$8.00 |
$8.00 |
$8.00 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$235.50 |
$235.50 |
$235.50 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$51.25 |
$51.25 |
$51.25 |
$71.19
|
|
Warde viscosity
|
$54.00 |
$54.00 |
$54.00 |
$52.65
|
|
Warde vitamin a
|
$13.75 |
$13.75 |
$13.75 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$17.25 |
$17.25 |
$17.25 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$20.75 |
$20.75 |
$20.75 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$45.75 |
$45.75 |
$45.75 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$14.00 |
$14.00 |
$14.00 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$10.75 |
$10.75 |
$10.75 |
$55.00
|
|
Western blot test
|
$167.75 |
$167.75 |
$167.75 |
$153.18
|
|
Wet mounts/ w preparations
|
$82.00 |
$82.00 |
$82.00 |
$19.54
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$229.50 |
$229.50 |
$229.50 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$229.50 |
$229.50 |
$229.50 |
$436.15
|
|
Xe133 xenon 10mci
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$299.00
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$1,740.75 |
$1,740.75 |
$1,740.75 |
$271.44
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$4,542.00 |
$4,542.00 |
$4,542.00 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$4,490.75 |
$4,490.75 |
$4,490.75 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$2,939.75 |
$2,939.75 |
$2,939.75 |
$486.24
|
|
X-ray exam of mastoids
|
$193.50 |
$193.50 |
$193.50 |
$191.91
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$6,071.00 |
$6,071.00 |
$6,071.00 |
$508.00
|
|
X-ray sinus tract/fistula/abscess
|
$923.75 |
$923.75 |
$923.75 |
$601.30
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$3,287.75 |
$3,287.75 |
$3,287.75 |
$557.70
|
|
X-ray small intestine follow-through study
|
$3,287.75 |
$3,287.75 |
$3,287.75 |
$504.14
|
|
X-ray spine single view
|
$346.25 |
$346.25 |
$346.25 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$2,221.25 |
$2,221.25 |
$2,221.25 |
$263.49
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$2,467.75 |
$2,467.75 |
$2,467.75 |
$514.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$4,344.00 |
$4,344.00 |
$4,344.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$3,942.25 |
$3,942.25 |
$3,942.25 |
$555.04
|
|
Xylose absorption test blood &/or urine
|
$28.75 |
$28.75 |
$28.75 |
$64.28
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$255.00 |
$255.00 |
$255.00 |
$128.10
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$2,803.00 |
$2,803.00 |
$2,803.00 |
$346.14
|
