|
Urethrocystography void s&i
|
$4,281.00 |
$4,281.00 |
$4,281.00 |
$634.50
|
|
Urography, antegrade
|
$2,147.00 |
$2,147.00 |
$2,147.00 |
$593.37
|
|
Urography inf drip &/or bolus
|
$7,743.00 |
$7,743.00 |
$7,743.00 |
$641.69
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$9,824.00 |
$9,824.00 |
$9,824.00 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$339.26 |
$339.26 |
$339.26 |
$173.98
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$160.00 |
$160.00 |
$160.00 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$1,507.00 |
$1,507.00 |
$1,507.00 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1,018.26 |
$1,018.26 |
$1,018.26 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,734.00 |
$1,734.00 |
$1,734.00 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$967.00 |
$967.00 |
$967.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$2,140.00 |
$2,140.00 |
$2,140.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,711.00 |
$1,711.00 |
$1,711.00 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,151.29 |
$2,151.29 |
$2,151.29 |
$715.41
|
|
Vaccine rabies im
|
$4,545.00 |
$4,545.00 |
$4,545.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$459.00 |
$459.00 |
$459.00 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$260.00 |
$260.00 |
$260.00 |
$131.77
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,616.00 |
$1,616.00 |
$1,616.00 |
$394.13
|
|
Vedolizumab 300 mg intravenous solution
|
$70,994.00 |
$70,994.00 |
$70,994.00 |
$23,003.79
|
|
Vein x-ray adrenal glands
|
$4,758.00 |
$4,758.00 |
$4,758.00 |
$3,999.60
|
|
Vein x-ray liver
|
$11,745.00 |
$11,745.00 |
$11,745.00 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$11,459.00 |
$11,459.00 |
$11,459.00 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$11,749.00 |
$11,749.00 |
$11,749.00 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$9,166.00 |
$9,166.00 |
$9,166.00 |
$2,489.25
|
|
Vein x-ray skull
|
$4,113.00 |
$4,113.00 |
$4,113.00 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$16,728.00 |
$16,728.00 |
$16,728.00 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$3,578.00 |
$3,578.00 |
$3,578.00 |
$3,450.30
|
|
Venogram ext bil s&i
|
$4,474.00 |
$4,474.00 |
$4,474.00 |
$1,838.28
|
|
Venous sampling s&i
|
$11,006.00 |
$11,006.00 |
$11,006.00 |
$4,416.78
|
|
Ven thrombosis images bilat
|
$3,209.00 |
$3,209.00 |
$3,209.00 |
$779.56
|
|
Ventilator each subsequent day
|
$16,205.00 |
$16,205.00 |
$16,205.00 |
$1,305.92
|
|
Ventilator initial day
|
$17,956.00 |
$17,956.00 |
$17,956.00 |
$1,540.80
|
|
Very long chain fatty acids
|
$754.00 |
$754.00 |
$754.00 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$33.49 |
$33.49 |
$33.49 |
$186.71
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$493.00 |
$493.00 |
$493.00 |
$245.36
|
|
Vital capacity test
|
$512.00 |
$512.00 |
$512.00 |
$173.33
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$743.00 |
$743.00 |
$743.00 |
$224.40
|
|
Warde 1003990 aldosterone
|
$177.00 |
$177.00 |
$177.00 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$122.00 |
$122.00 |
$122.00 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$171.00 |
$171.00 |
$171.00 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$64.90 |
$64.90 |
$64.90 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$659.00 |
$659.00 |
$659.00 |
$40.70
|
|
Warde 3708165 mercury urine
|
$97.00 |
$97.00 |
$97.00 |
$72.80
|
|
Warde acetylcholine receptor blocking antibody
|
$453.00 |
$453.00 |
$453.00 |
$68.90
|
|
Warde adrenocorticotropic hormone (acth)
|
$171.00 |
$171.00 |
$171.00 |
$129.75
|
|
Warde aldolase
|
$34.10 |
$34.10 |
$34.10 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$477.00 |
$477.00 |
$477.00 |
$176.20
|
|
Warde amiodarone therapeutic drug level
|
$440.00 |
$440.00 |
$440.00 |
$53.95
|
|
Warde bile acids
|
$230.00 |
$230.00 |
$230.00 |
$64.28
|
|
Warde calcitonin
|
$122.00 |
$122.00 |
$122.00 |
$89.40
|
|
Warde cryoglobulin
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$43.45
|
|
Warde erythropoietin
|
$261.00 |
$261.00 |
$261.00 |
$90.35
|
|
Warde estrogen fractionated
|
$328.00 |
$328.00 |
$328.00 |
$112.18
|
|
Warde folic acid rbc
|
$555.00 |
$555.00 |
$555.00 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$166.00 |
$166.00 |
$166.00 |
$43.55
|
|
Warde gastrin
|
$59.40 |
$59.40 |
$59.40 |
$75.25
|
|
Warde haloperidol therapeutic drug level
|
$140.00 |
$140.00 |
$140.00 |
$68.16
|
|
Warde hepatitis a antibody
|
$1,353.00 |
$1,353.00 |
$1,353.00 |
$83.70
|
|
Warde hepatitis be antibody
|
$1,353.00 |
$1,353.00 |
$1,353.00 |
$50.00
|
|
Warde hepatitis delta agent antibody
|
$109.00 |
$109.00 |
$109.00 |
$92.30
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$1,327.00 |
$1,327.00 |
$1,327.00 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$636.09
|
|
Warde islet cell antibody zinc transporter 8
|
$100.00 |
$100.00 |
$100.00 |
$137.55
|
|
Warde lipoprotein (a)
|
$637.00 |
$637.00 |
$637.00 |
$69.96
|
|
Warde lipoprotein-associated phospholipase a2
|
$444.00 |
$444.00 |
$444.00 |
$97.00
|
|
Warde sex hormone binding globulin
|
$73.00 |
$73.00 |
$73.00 |
$86.59
|
|
Warde t3 (triiodothyronine) reverse
|
$430.00 |
$430.00 |
$430.00 |
$70.85
|
|
Warde topiramate therapeutic drug level
|
$192.00 |
$192.00 |
$192.00 |
$71.19
|
|
Warde viscosity
|
$171.00 |
$171.00 |
$171.00 |
$52.65
|
|
Warde vitamin a
|
$249.00 |
$249.00 |
$249.00 |
$59.66
|
|
Warde vitamin b6 (pyridoxine)
|
$76.00 |
$76.00 |
$76.00 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$48.40 |
$48.40 |
$48.40 |
$45.60
|
|
Warde vitamin e (alpha-tocopherol)
|
$94.00 |
$94.00 |
$94.00 |
$55.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$341.00 |
$341.00 |
$341.00 |
$288.91
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$602.00 |
$602.00 |
$602.00 |
$436.15
|
|
X-ray bone age studies
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$246.75
|
|
X-ray bone length studies
|
$1,974.00 |
$1,974.00 |
$1,974.00 |
$287.25
|
|
X-ray bone survey infant
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$410.73
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$4,415.00 |
$4,415.00 |
$4,415.00 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,820.00 |
$1,820.00 |
$1,820.00 |
$486.24
|
|
X-ray exam of middle ear
|
$2,760.00 |
$2,760.00 |
$2,760.00 |
$341.25
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$4,321.00 |
$4,321.00 |
$4,321.00 |
$364.75
|
|
X-ray nose to rectum for foreign body child
|
$1,292.00 |
$1,292.00 |
$1,292.00 |
$225.96
|
|
X-ray sella turcica
|
$2,064.00 |
$2,064.00 |
$2,064.00 |
$162.50
|
|
X-ray sinuses paranasal complete > 3 views
|
$2,455.00 |
$2,455.00 |
$2,455.00 |
$339.00
|
|
X-ray slg plne bdy sect without urogr
|
$3,147.00 |
$3,147.00 |
$3,147.00 |
$387.00
|
|
X-ray small intestine follow-through study
|
$2,237.00 |
$2,237.00 |
$2,237.00 |
$504.14
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$2,822.00 |
$2,822.00 |
$2,822.00 |
$256.85
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$3,826.00 |
$3,826.00 |
$3,826.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$3,826.00 |
$3,826.00 |
$3,826.00 |
$555.04
|
|
Xylose absorption test blood &/or urine
|
$670.00 |
$670.00 |
$670.00 |
$64.28
|
|
Yttrium y-90 ibritumomab ther
|
$289,284.00 |
$289,284.00 |
$289,284.00 |
$55,035.00
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$106.94
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$427.00 |
$427.00 |
$427.00 |
$128.10
|
