|
Urea nitrogen 24 hour urine
|
$4.15 |
$4.15 |
$4.15 |
$50.00
|
|
Urethrocystography void s&i
|
$3,885.45 |
$3,885.45 |
$3,885.45 |
$634.50
|
|
Urinalysis qual/semiquant excpt ia
|
$593.70 |
$593.70 |
$593.70 |
$25.72
|
|
Urinalysis (with microscopy)
|
$816.65 |
$816.65 |
$816.65 |
$48.14
|
|
Urine Culture Test
|
$890.35 |
$890.35 |
$890.35 |
$84.81
|
|
Vaccine dtap < 7 years im
|
$136.75 |
$136.75 |
$136.75 |
$87.80
|
|
Vaccine dtap-ipv/hib im
|
$519.50 |
$519.50 |
$519.50 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$77.00 |
$77.00 |
$77.00 |
$45.33
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$113.25 |
$113.25 |
$113.25 |
$79.04
|
|
Vaccine influenza nos 0.5ml dose im
|
$65.00 |
$65.00 |
$65.00 |
$36.80
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$117.25 |
$117.25 |
$117.25 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$89.00 |
$89.00 |
$89.00 |
$26.40
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$113.00 |
$113.00 |
$113.00 |
$32.50
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$586.00 |
$586.00 |
$586.00 |
$426.80
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$360.00 |
$360.00 |
$360.00 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$631.00 |
$631.00 |
$631.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$276.00 |
$276.00 |
$276.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$648.00 |
$648.00 |
$648.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$941.00 |
$941.00 |
$941.00 |
$385.45
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,906.75 |
$1,906.75 |
$1,906.75 |
$1,196.00
|
|
Vaccine td preservative free >= 7 years im
|
$247.00 |
$247.00 |
$247.00 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$261.15 |
$261.15 |
$261.15 |
$115.00
|
|
Vasopressin 20 unit/ml intravenous solution
|
$302.35 |
$302.35 |
$302.35 |
$394.13
|
|
Vein x-ray kidney
|
$8,167.00 |
$8,167.00 |
$8,167.00 |
$2,716.20
|
|
Vein x-ray liver without hemodyn
|
$6,624.05 |
$6,624.05 |
$6,624.05 |
$2,489.25
|
|
Venous sampling s&i
|
$8,167.00 |
$8,167.00 |
$8,167.00 |
$4,416.78
|
|
Ventilator each subsequent day
|
$5,667.30 |
$5,667.30 |
$5,667.30 |
$1,305.92
|
|
Ventilator initial day
|
$5,742.90 |
$5,742.90 |
$5,742.90 |
$1,540.80
|
|
Very long chain fatty acids
|
$127.65 |
$127.65 |
$127.65 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$12.50 |
$12.50 |
$12.50 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$1,592.00 |
$1,592.00 |
$1,592.00 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$29.00 |
$29.00 |
$29.00 |
$245.36
|
|
Virus isolation addl studies ea
|
$37.40 |
$37.40 |
$37.40 |
$90.35
|
|
Vital capacity test
|
$763.95 |
$763.95 |
$763.95 |
$173.33
|
|
Volume measurement urine timed
|
$19.65 |
$19.65 |
$19.65 |
$21.45
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$12.70 |
$12.70 |
$12.70 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$11.45 |
$11.45 |
$11.45 |
$69.55
|
|
Warde 3008005 oligoclonal bands
|
$30.90 |
$30.90 |
$30.90 |
$102.60
|
|
Warde 3016000 west nile virus antibody igg
|
$44.35 |
$44.35 |
$44.35 |
$69.00
|
|
Warde acetylcholine receptor blocking antibody
|
$35.00 |
$35.00 |
$35.00 |
$68.90
|
|
Warde adrenocorticotropic hormone (acth)
|
$7.30 |
$7.30 |
$7.30 |
$129.75
|
|
Warde aldolase
|
$2.60 |
$2.60 |
$2.60 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$109.25 |
$109.25 |
$109.25 |
$176.20
|
|
Warde analysis gene hfe common variants
|
$66.00 |
$66.00 |
$66.00 |
$260.94
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$103.55 |
$103.55 |
$103.55 |
$381.50
|
|
Warde anti-mullerian hormone
|
$1,343.00 |
$1,343.00 |
$1,343.00 |
$93.28
|
|
Warde cadmium blood
|
$17.95 |
$17.95 |
$17.95 |
$77.00
|
|
Warde calcitonin
|
$10.15 |
$10.15 |
$10.15 |
$89.40
|
|
Warde calculus (stone) infrared
|
$69.65 |
$69.65 |
$69.65 |
$61.73
|
|
Warde clozapine therapeutic drug level
|
$14.70 |
$14.70 |
$14.70 |
$63.00
|
|
Warde cobalt heavy metal quantitative each nes
|
$63.20 |
$63.20 |
$63.20 |
$122.50
|
|
Warde complement total hemolytic
|
$5.10 |
$5.10 |
$5.10 |
$105.00
|
|
Warde cryoglobulin
|
$5.95 |
$5.95 |
$5.95 |
$43.45
|
|
Warde folic acid rbc
|
$3.60 |
$3.60 |
$3.60 |
$81.60
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$9.35 |
$9.35 |
$9.35 |
$43.55
|
|
Warde growth hormone (hgh)
|
$2.85 |
$2.85 |
$2.85 |
$81.24
|
|
Warde hepatitis a antibody
|
$6.85 |
$6.85 |
$6.85 |
$83.70
|
|
Warde hepatitis be antibody
|
$3.80 |
$3.80 |
$3.80 |
$50.00
|
|
Warde hepatitis delta agent antibody
|
$92.65 |
$92.65 |
$92.65 |
$92.30
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$3.20 |
$3.20 |
$3.20 |
$48.75
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$85.30 |
$85.30 |
$85.30 |
$636.09
|
|
Warde lipoprotein (a)
|
$13.70 |
$13.70 |
$13.70 |
$69.96
|
|
Warde neutralization rabies
|
$101.75 |
$101.75 |
$101.75 |
$106.50
|
|
Warde protein c antigen
|
$22.15 |
$22.15 |
$22.15 |
$88.80
|
|
Warde somatomedin
|
$6.60 |
$6.60 |
$6.60 |
$111.80
|
|
Warde t3 (triiodothyronine) reverse
|
$7.25 |
$7.25 |
$7.25 |
$70.85
|
|
Warde topiramate therapeutic drug level
|
$15.30 |
$15.30 |
$15.30 |
$71.19
|
|
Warde viscosity
|
$16.35 |
$16.35 |
$16.35 |
$52.65
|
|
Warde vitamin a
|
$14.90 |
$14.90 |
$14.90 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$18.95 |
$18.95 |
$18.95 |
$78.65
|
|
Warde vitamin b6 (pyridoxine)
|
$8.50 |
$8.50 |
$8.50 |
$116.00
|
|
Warde vitamin c (ascorbic acid)
|
$17.55 |
$17.55 |
$17.55 |
$45.60
|
|
Warde vitamin d (1 25 dihydroxy)
|
$10.10 |
$10.10 |
$10.10 |
$138.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$5.35 |
$5.35 |
$5.35 |
$55.00
|
|
Wet mounts/ w preparations
|
$291.45 |
$291.45 |
$291.45 |
$19.54
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$1,695.20 |
$1,695.20 |
$1,695.20 |
$558.97
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$1,695.20 |
$1,695.20 |
$1,695.20 |
$611.25
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$5,267.20 |
$5,267.20 |
$5,267.20 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$6,389.50 |
$6,389.50 |
$6,389.50 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$2,930.25 |
$2,930.25 |
$2,930.25 |
$486.24
|
|
X-ray knee ap standing bilateral
|
$1,957.30 |
$1,957.30 |
$1,957.30 |
$276.25
|
|
X-ray sella turcica
|
$1,088.30 |
$1,088.30 |
$1,088.30 |
$162.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$3,023.85 |
$3,023.85 |
$3,023.85 |
$557.70
|
|
X-ray small intestine follow-through study
|
$1,221.90 |
$1,221.90 |
$1,221.90 |
$504.14
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$2,885.75 |
$2,885.75 |
$2,885.75 |
$263.49
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$2,930.25 |
$2,930.25 |
$2,930.25 |
$514.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$392.25 |
$392.25 |
$392.25 |
$256.85
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$1,103.40 |
$1,103.40 |
$1,103.40 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$1,221.90 |
$1,221.90 |
$1,221.90 |
$555.04
|
|
Zika virus igm antibody
|
$48.60 |
$48.60 |
$48.60 |
$75.40
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$573.00 |
$573.00 |
$573.00 |
$128.10
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$4,701.00 |
$4,701.00 |
$4,701.00 |
$9.54
|
|
Zoster vaccine-live inj
|
$773.00 |
$773.00 |
$773.00 |
$235.20
|
