|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$999.29 |
$999.29 |
$999.29 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$833.84 |
$833.84 |
$833.84 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$833.84 |
$833.84 |
$833.84 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$251.19 |
$251.19 |
$251.19 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$767.00 |
$767.00 |
$767.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,089.69 |
$1,089.69 |
$1,089.69 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,309.10 |
$1,309.10 |
$1,309.10 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$1,032.16 |
$1,032.16 |
$1,032.16 |
$119.17
|
|
Vaccine rabies im
|
$1,818.06 |
$1,818.06 |
$1,818.06 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,169.00 |
$2,169.00 |
$2,169.00 |
$1,196.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$2,169.00 |
$2,169.00 |
$2,169.00 |
$1,159.00
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$452.44 |
$452.44 |
$452.44 |
$108.00
|
|
Vaccine tdap >=7 years im
|
$204.20 |
$204.20 |
$204.20 |
$150.76
|
|
Varicella-zoster immue globin im
|
$6,869.02 |
$6,869.02 |
$6,869.02 |
$2,372.84
|
|
Vein x-ray kidney
|
$11,290.55 |
$11,290.55 |
$11,290.55 |
$2,716.20
|
|
Vein x-ray liver w/hemodynam
|
$29,410.86 |
$29,410.86 |
$29,410.86 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$17,795.83 |
$17,795.83 |
$17,795.83 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$11,290.55 |
$11,290.55 |
$11,290.55 |
$2,489.25
|
|
Vein x-ray spleen/liver
|
$29,410.86 |
$29,410.86 |
$29,410.86 |
$3,450.30
|
|
Ventilator each subsequent day
|
$3,266.46 |
$3,266.46 |
$3,266.46 |
$1,305.92
|
|
Ventilator initial day
|
$3,653.06 |
$3,653.06 |
$3,653.06 |
$1,540.80
|
|
Vinblastine 1 mg/ml intravenous solution
|
$17.26 |
$17.26 |
$17.26 |
$186.71
|
|
Virus isolation addl studies ea
|
$247.77 |
$247.77 |
$247.77 |
$90.35
|
|
Vital capacity test
|
$638.69 |
$638.69 |
$638.69 |
$173.33
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$995.45 |
$995.45 |
$995.45 |
$224.40
|
|
Warde 1005020 citrate 24 hour urine
|
$18.53 |
$18.53 |
$18.53 |
$97.61
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$16.14 |
$16.14 |
$16.14 |
$63.05
|
|
Warde acetylcholine receptor blocking antibody
|
$86.64 |
$86.64 |
$86.64 |
$68.90
|
|
Warde adrenocorticotropic hormone (acth)
|
$15.30 |
$15.30 |
$15.30 |
$129.75
|
|
Warde aldolase
|
$2.65 |
$2.65 |
$2.65 |
$49.20
|
|
Warde amiodarone therapeutic drug level
|
$11.77 |
$11.77 |
$11.77 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$71.92 |
$71.92 |
$71.92 |
$260.94
|
|
Warde anti-mullerian hormone
|
$181.85 |
$181.85 |
$181.85 |
$93.28
|
|
Warde bile acids
|
$11.03 |
$11.03 |
$11.03 |
$64.28
|
|
Warde calcitonin
|
$17.66 |
$17.66 |
$17.66 |
$89.40
|
|
Warde calculus (stone) infrared
|
$60.74 |
$60.74 |
$60.74 |
$61.73
|
|
Warde clozapine therapeutic drug level
|
$23.54 |
$23.54 |
$23.54 |
$63.00
|
|
Warde cobalt heavy metal quantitative each nes
|
$18.84 |
$18.84 |
$18.84 |
$122.50
|
|
Warde collagen cross links c-telopeptide
|
$16.48 |
$16.48 |
$16.48 |
$90.40
|
|
Warde complement total hemolytic
|
$4.71 |
$4.71 |
$4.71 |
$105.00
|
|
Warde cryoglobulin
|
$5.89 |
$5.89 |
$5.89 |
$43.45
|
|
Warde erythropoietin
|
$10.59 |
$10.59 |
$10.59 |
$90.35
|
|
Warde folic acid rbc
|
$5.57 |
$5.57 |
$5.57 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$5.30 |
$5.30 |
$5.30 |
$43.55
|
|
Warde gastrin
|
$6.83 |
$6.83 |
$6.83 |
$75.25
|
|
Warde growth hormone (hgh)
|
$12.59 |
$12.59 |
$12.59 |
$81.24
|
|
Warde haloperidol therapeutic drug level
|
$74.30 |
$74.30 |
$74.30 |
$68.16
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$60.60 |
$60.60 |
$60.60 |
$68.64
|
|
Warde hepatitis a antibody
|
$3.53 |
$3.53 |
$3.53 |
$83.70
|
|
Warde hepatitis be antibody
|
$3.53 |
$3.53 |
$3.53 |
$50.00
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$2.95 |
$2.95 |
$2.95 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$117.72 |
$117.72 |
$117.72 |
$636.09
|
|
Warde lipoprotein (a)
|
$12.67 |
$12.67 |
$12.67 |
$69.96
|
|
Warde lipoprotein-associated phospholipase a2
|
$123.61 |
$123.61 |
$123.61 |
$97.00
|
|
Warde neutralization rabies
|
$79.63 |
$79.63 |
$79.63 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$7.68 |
$7.68 |
$7.68 |
$64.50
|
|
Warde pancreatic elastase fecal quantitative
|
$108.16 |
$108.16 |
$108.16 |
$94.25
|
|
Warde protein c antigen
|
$7.06 |
$7.06 |
$7.06 |
$88.80
|
|
Warde sex hormone binding globulin
|
$102.32 |
$102.32 |
$102.32 |
$86.59
|
|
Warde somatomedin
|
$8.83 |
$8.83 |
$8.83 |
$111.80
|
|
Warde t3 (triiodothyronine) reverse
|
$8.24 |
$8.24 |
$8.24 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$35.32 |
$35.32 |
$35.32 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$11.50 |
$11.50 |
$11.50 |
$71.19
|
|
Warde viscosity
|
$15.16 |
$15.16 |
$15.16 |
$52.65
|
|
Warde vitamin a
|
$15.01 |
$15.01 |
$15.01 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$17.54 |
$17.54 |
$17.54 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$17.26 |
$17.26 |
$17.26 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$16.24 |
$16.24 |
$16.24 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$14.13 |
$14.13 |
$14.13 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$10.83 |
$10.83 |
$10.83 |
$55.00
|
|
Xe133 xenon 10mci
|
$946.57 |
$946.57 |
$946.57 |
$299.00
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$2,406.36 |
$2,406.36 |
$2,406.36 |
$271.44
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$5,458.37 |
$5,458.37 |
$5,458.37 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$6,111.70 |
$6,111.70 |
$6,111.70 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$808.18 |
$808.18 |
$808.18 |
$486.24
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$498.08 |
$498.08 |
$498.08 |
$559.65
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$8,446.76 |
$8,446.76 |
$8,446.76 |
$742.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$4,192.67 |
$4,192.67 |
$4,192.67 |
$557.70
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$1,305.91 |
$1,305.91 |
$1,305.91 |
$514.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$4,603.96 |
$4,603.96 |
$4,603.96 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$5,064.99 |
$5,064.99 |
$5,064.99 |
$555.04
|
|
X-ray xm phrnx&/crv esoph c+
|
$1,305.91 |
$1,305.91 |
$1,305.91 |
$324.20
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$106.56 |
$106.56 |
$106.56 |
$128.10
|
