|
Ultrasound pregnant uterus transvaginal
|
$4,570.75 |
$4,570.75 |
$4,570.75 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$3,269.75 |
$3,269.75 |
$3,269.75 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,709.25 |
$1,709.25 |
$1,709.25 |
$498.00
|
|
Ultrasound scrotum and contents
|
$4,707.75 |
$4,707.75 |
$4,707.75 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$4,570.75 |
$4,570.75 |
$4,570.75 |
$567.44
|
|
Unlisted mr procedure
|
$18,797.50 |
$18,797.50 |
$18,797.50 |
$1,032.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$21,800.25 |
$21,800.25 |
$21,800.25 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$17,137.50 |
$17,137.50 |
$17,137.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$6,129.50 |
$6,129.50 |
$6,129.50 |
$2,013.08
|
|
Urea nitrogen 24 hour urine
|
$4.25 |
$4.25 |
$4.25 |
$50.00
|
|
Ureteral reflux study
|
$3,458.75 |
$3,458.75 |
$3,458.75 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$7,890.75 |
$7,890.75 |
$7,890.75 |
$574.40
|
|
Urethrocystography void s&i
|
$5,758.50 |
$5,758.50 |
$5,758.50 |
$634.50
|
|
Uric acid blood
|
$157.75 |
$157.75 |
$157.75 |
$46.64
|
|
Urinalysis qual/semiquant excpt ia
|
$39.50 |
$39.50 |
$39.50 |
$25.72
|
|
Urinalysis (with microscopy)
|
$233.00 |
$233.00 |
$233.00 |
$48.14
|
|
Urine Culture Test
|
$777.75 |
$777.75 |
$777.75 |
$84.81
|
|
Urography, antegrade
|
$953.75 |
$953.75 |
$953.75 |
$593.37
|
|
Urography inf drip &/or bolus
|
$6,208.00 |
$6,208.00 |
$6,208.00 |
$641.69
|
|
Vaccine dtap < 7 years im
|
$127.00 |
$127.00 |
$127.00 |
$87.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$115.25 |
$115.25 |
$115.25 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$257.50 |
$257.50 |
$257.50 |
$45.33
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$342.00 |
$342.00 |
$342.00 |
$173.98
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$110.00 |
$110.00 |
$110.00 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$110.00 |
$110.00 |
$110.00 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$701.00 |
$701.00 |
$701.00 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$507.00 |
$507.00 |
$507.00 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$527.75 |
$527.75 |
$527.75 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$106.00 |
$106.00 |
$106.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$300.00 |
$300.00 |
$300.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$680.50 |
$680.50 |
$680.50 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$964.00 |
$964.00 |
$964.00 |
$385.45
|
|
Vaccine rabies im
|
$1,909.00 |
$1,909.00 |
$1,909.00 |
$945.46
|
|
Vaccine td preservative free >= 7 years im
|
$136.00 |
$136.00 |
$136.00 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$106.00 |
$106.00 |
$106.00 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$218.00 |
$218.00 |
$218.00 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$33.00 |
$33.00 |
$33.00 |
$204.01
|
|
Vasopressin 20 unit/ml intravenous solution
|
$910.00 |
$910.00 |
$910.00 |
$394.13
|
|
Vein x-ray adrenal glands
|
$9,321.50 |
$9,321.50 |
$9,321.50 |
$3,999.60
|
|
Vein x-ray liver without hemodyn
|
$10,731.00 |
$10,731.00 |
$10,731.00 |
$2,489.25
|
|
Vein x-ray spleen/liver
|
$6,176.75 |
$6,176.75 |
$6,176.75 |
$3,450.30
|
|
Venogram ext bil s&i
|
$1,299.25 |
$1,299.25 |
$1,299.25 |
$1,838.28
|
|
Venous sampling s&i
|
$5,815.00 |
$5,815.00 |
$5,815.00 |
$4,416.78
|
|
Ventilator initial day
|
$2,822.25 |
$2,822.25 |
$2,822.25 |
$1,540.80
|
|
Very long chain fatty acids
|
$381.25 |
$381.25 |
$381.25 |
$140.40
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$245.36
|
|
Vital capacity test
|
$301.75 |
$301.75 |
$301.75 |
$173.33
|
|
Vkorc1 gene
|
$356.50 |
$356.50 |
$356.50 |
$176.80
|
|
Volume measurement urine timed
|
$41.00 |
$41.00 |
$41.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$841.00 |
$841.00 |
$841.00 |
$224.40
|
|
Warde 1005020 citrate 24 hour urine
|
$22.50 |
$22.50 |
$22.50 |
$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 3004000 immunoglobulin subclass 1
|
$7.00 |
$7.00 |
$7.00 |
$40.70
|
|
Warde acetylcholine receptor blocking antibody
|
$35.25 |
$35.25 |
$35.25 |
$68.90
|
|
Warde actin (smooth muscle) antibody each
|
$6.25 |
$6.25 |
$6.25 |
$45.58
|
|
Warde adrenocorticotropic hormone (acth)
|
$15.00 |
$15.00 |
$15.00 |
$129.75
|
|
Warde aldolase
|
$2.25 |
$2.25 |
$2.25 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$134.25 |
$134.25 |
$134.25 |
$176.20
|
|
Warde amiodarone therapeutic drug level
|
$9.50 |
$9.50 |
$9.50 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$71.25 |
$71.25 |
$71.25 |
$260.94
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$807.50 |
$807.50 |
$807.50 |
$381.50
|
|
Warde bile acids
|
$10.75 |
$10.75 |
$10.75 |
$64.28
|
|
Warde calcitonin
|
$22.75 |
$22.75 |
$22.75 |
$89.40
|
|
Warde clozapine therapeutic drug level
|
$19.75 |
$19.75 |
$19.75 |
$63.00
|
|
Warde collagen cross links c-telopeptide
|
$63.00 |
$63.00 |
$63.00 |
$90.40
|
|
Warde complement total hemolytic
|
$4.50 |
$4.50 |
$4.50 |
$105.00
|
|
Warde cryoglobulin
|
$5.50 |
$5.50 |
$5.50 |
$43.45
|
|
Warde fluorescent antibody screen endomysial iga
|
$11.50 |
$11.50 |
$11.50 |
$48.57
|
|
Warde folic acid rbc
|
$7.25 |
$7.25 |
$7.25 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$8.75 |
$8.75 |
$8.75 |
$43.55
|
|
Warde gastrin
|
$6.75 |
$6.75 |
$6.75 |
$75.25
|
|
Warde growth hormone (hgh)
|
$11.25 |
$11.25 |
$11.25 |
$81.24
|
|
Warde hepatitis be antibody
|
$3.50 |
$3.50 |
$3.50 |
$50.00
|
|
Warde hepatitis delta agent antibody
|
$75.25 |
$75.25 |
$75.25 |
$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
|
$95.00 |
$95.00 |
$95.00 |
$636.09
|
|
Warde islet cell antibody zinc transporter 8
|
$43.00 |
$43.00 |
$43.00 |
$137.55
|
|
Warde lipoprotein (a)
|
$10.25 |
$10.25 |
$10.25 |
$69.96
|
|
Warde lipoprotein-associated phospholipase a2
|
$87.50 |
$87.50 |
$87.50 |
$97.00
|
|
Warde neutralization rabies
|
$10.25 |
$10.25 |
$10.25 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$9.50 |
$9.50 |
$9.50 |
$64.50
|
|
Warde pancreatic elastase fecal quantitative
|
$285.75 |
$285.75 |
$285.75 |
$94.25
|
|
Warde protein c antigen
|
$115.75 |
$115.75 |
$115.75 |
$88.80
|
|
Warde sex hormone binding globulin
|
$23.50 |
$23.50 |
$23.50 |
$86.59
|
|
Warde t3 (triiodothyronine) reverse
|
$8.00 |
$8.00 |
$8.00 |
$70.85
|
|
Warde thyroid stimulating immunoglobulins
|
$35.00 |
$35.00 |
$35.00 |
$173.50
|
|
Warde topiramate therapeutic drug level
|
$51.50 |
$51.50 |
$51.50 |
$71.19
|
|
Warde viscosity
|
$15.00 |
$15.00 |
$15.00 |
$52.65
|
|
Warde vitamin a
|
$13.75 |
$13.75 |
$13.75 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$19.50 |
$19.50 |
$19.50 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$31.00 |
$31.00 |
$31.00 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$13.25 |
$13.25 |
$13.25 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$11.25 |
$11.25 |
$11.25 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$10.75 |
$10.75 |
$10.75 |
$55.00
|
|
Wet mounts/ w preparations
|
$505.25 |
$505.25 |
$505.25 |
$19.54
|
|
Wilate injection
|
$5.00 |
$5.00 |
$5.00 |
$1.28
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$3,457.00 |
$3,457.00 |
$3,457.00 |
$288.91
|
|
Xe133 xenon 10mci
|
$988.25 |
$988.25 |
$988.25 |
$299.00
|
