|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$87.00 |
$87.00 |
$87.00 |
$32.50
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$596.00 |
$596.00 |
$596.00 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$640.00 |
$640.00 |
$640.00 |
$349.15
|
|
Vaccine mmr live subcutaneous
|
$951.00 |
$951.00 |
$951.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$580.00 |
$580.00 |
$580.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$857.00 |
$857.00 |
$857.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$19.00 |
$19.00 |
$19.00 |
$385.45
|
|
Vaccine rabies im
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$348.00 |
$348.00 |
$348.00 |
$150.76
|
|
Vaccine varicella live subcutaneous
|
$518.00 |
$518.00 |
$518.00 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$1,127.30 |
$1,127.30 |
$1,127.30 |
$115.00
|
|
Varicella-zoster immue globin im
|
$3,213.00 |
$3,213.00 |
$3,213.00 |
$2,372.84
|
|
Venous sampling s&i
|
$10,291.30 |
$10,291.30 |
$10,291.30 |
$4,416.78
|
|
Ventilator each subsequent day
|
$5,737.80 |
$5,737.80 |
$5,737.80 |
$1,305.92
|
|
Ventilator initial day
|
$7,207.85 |
$7,207.85 |
$7,207.85 |
$1,540.80
|
|
Vincristine 1 mg/ml intravenous solution
|
$416.00 |
$416.00 |
$416.00 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$4,889.00 |
$4,889.00 |
$4,889.00 |
$245.36
|
|
Virus isolation addl studies ea
|
$82.85 |
$82.85 |
$82.85 |
$90.35
|
|
Vital capacity test
|
$148.60 |
$148.60 |
$148.60 |
$173.33
|
|
Vitamin b-12
|
$399.20 |
$399.20 |
$399.20 |
$94.90
|
|
Volume measurement urine timed
|
$11.80 |
$11.80 |
$11.80 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$1,358.00 |
$1,358.00 |
$1,358.00 |
$224.40
|
|
Warde 1005020 citrate 24 hour urine
|
$19.05 |
$19.05 |
$19.05 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$9.95 |
$9.95 |
$9.95 |
$72.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$1,675.15 |
$1,675.15 |
$1,675.15 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$58.25 |
$58.25 |
$58.25 |
$78.57
|
|
Warde acetylcholine receptor blocking antibody
|
$59.60 |
$59.60 |
$59.60 |
$68.90
|
|
Warde adrenocorticotropic hormone (acth)
|
$12.85 |
$12.85 |
$12.85 |
$129.75
|
|
Warde aldolase
|
$14.55 |
$14.55 |
$14.55 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$54.65 |
$54.65 |
$54.65 |
$176.20
|
|
Warde amiodarone therapeutic drug level
|
$12.15 |
$12.15 |
$12.15 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$485.25 |
$485.25 |
$485.25 |
$260.94
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$245.55 |
$245.55 |
$245.55 |
$381.50
|
|
Warde anti-mullerian hormone
|
$125.15 |
$125.15 |
$125.15 |
$93.28
|
|
Warde bile acids
|
$4.85 |
$4.85 |
$4.85 |
$64.28
|
|
Warde calcitonin
|
$40.10 |
$40.10 |
$40.10 |
$89.40
|
|
Warde calculus (stone) infrared
|
$13.40 |
$13.40 |
$13.40 |
$61.73
|
|
Warde clozapine therapeutic drug level
|
$24.25 |
$24.25 |
$24.25 |
$63.00
|
|
Warde cobalt heavy metal quantitative each nes
|
$71.15 |
$71.15 |
$71.15 |
$122.50
|
|
Warde collagen cross links c-telopeptide
|
$83.43 |
$83.43 |
$83.43 |
$90.40
|
|
Warde complement total hemolytic
|
$3.95 |
$3.95 |
$3.95 |
$105.00
|
|
Warde cryoglobulin
|
$9.65 |
$9.65 |
$9.65 |
$43.45
|
|
Warde erythropoietin
|
$194.15 |
$194.15 |
$194.15 |
$90.35
|
|
Warde folic acid rbc
|
$7.55 |
$7.55 |
$7.55 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$4.45 |
$4.45 |
$4.45 |
$43.55
|
|
Warde gastrin
|
$26.40 |
$26.40 |
$26.40 |
$75.25
|
|
Warde growth hormone (hgh)
|
$172.25 |
$172.25 |
$172.25 |
$81.24
|
|
Warde haloperidol therapeutic drug level
|
$19.45 |
$19.45 |
$19.45 |
$68.16
|
|
Warde helminth antibody strongyloides igg
|
$130.40 |
$130.40 |
$130.40 |
$96.80
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$132.45 |
$132.45 |
$132.45 |
$68.64
|
|
Warde hepatitis a antibody
|
$128.90 |
$128.90 |
$128.90 |
$83.70
|
|
Warde hepatitis be antibody
|
$3.45 |
$3.45 |
$3.45 |
$50.00
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$2.85 |
$2.85 |
$2.85 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$121.30 |
$121.30 |
$121.30 |
$636.09
|
|
Warde oxcarbazepine therapeutic drug level
|
$9.65 |
$9.65 |
$9.65 |
$64.50
|
|
Warde pancreatic elastase fecal quantitative
|
$83.60 |
$83.60 |
$83.60 |
$94.25
|
|
Warde protein c antigen
|
$12.15 |
$12.15 |
$12.15 |
$88.80
|
|
Warde sex hormone binding globulin
|
$19.75 |
$19.75 |
$19.75 |
$86.59
|
|
Warde t3 (triiodothyronine) reverse
|
$30.35 |
$30.35 |
$30.35 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$29.65 |
$29.65 |
$29.65 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$53.60 |
$53.60 |
$53.60 |
$71.19
|
|
Warde viscosity
|
$12.70 |
$12.70 |
$12.70 |
$52.65
|
|
Warde vitamin a
|
$17.40 |
$17.40 |
$17.40 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$31.80 |
$31.80 |
$31.80 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$42.10 |
$42.10 |
$42.10 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$32.05 |
$32.05 |
$32.05 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$11.85 |
$11.85 |
$11.85 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$21.20 |
$21.20 |
$21.20 |
$55.00
|
|
Xe133 xenon 10mci
|
$1,184.10 |
$1,184.10 |
$1,184.10 |
$299.00
|
|
Xm archive tissue molec anal
|
$123.45 |
$123.45 |
$123.45 |
$47.85
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$7,033.45 |
$7,033.45 |
$7,033.45 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$9,460.25 |
$9,460.25 |
$9,460.25 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$6,800.60 |
$6,800.60 |
$6,800.60 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$575.76
|
|
X-ray exam of sinuses
|
$2,374.25 |
$2,374.25 |
$2,374.25 |
$211.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$713.85 |
$713.85 |
$713.85 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$713.85 |
$713.85 |
$713.85 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$508.00
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$749.15 |
$749.15 |
$749.15 |
$364.75
|
|
X-ray nose to rectum for foreign body child
|
$468.95 |
$468.95 |
$468.95 |
$225.96
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$7,805.85 |
$7,805.85 |
$7,805.85 |
$742.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$7,023.25 |
$7,023.25 |
$7,023.25 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,141.05 |
$1,141.05 |
$1,141.05 |
$504.14
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$3,086.30 |
$3,086.30 |
$3,086.30 |
$263.49
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$4,185.75 |
$4,185.75 |
$4,185.75 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$369.75 |
$369.75 |
$369.75 |
$317.70
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$432.55 |
$432.55 |
$432.55 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$713.85 |
$713.85 |
$713.85 |
$385.80
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$8,854.10 |
$8,854.10 |
$8,854.10 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$899.00 |
$899.00 |
$899.00 |
$555.04
|
|
Xylose absorption test blood &/or urine
|
$17.05 |
$17.05 |
$17.05 |
$64.28
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$638.00 |
$638.00 |
$638.00 |
$106.94
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$591.00 |
$591.00 |
$591.00 |
$128.10
|
