|
Ultrasound joint/nonvascular extremity limited left
|
$320.40 |
$320.40 |
$320.40 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$462.60 |
$462.60 |
$462.60 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$298.20 |
$298.20 |
$298.20 |
$304.80
|
|
Ultrasound pregnant uterus follow up per fetus
|
$476.40 |
$476.40 |
$476.40 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$506.40 |
$506.40 |
$506.40 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$364.80 |
$364.80 |
$364.80 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$670.20 |
$670.20 |
$670.20 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$498.00 |
$498.00 |
$498.00 |
$469.58
|
|
Ultrasound scrotum and contents
|
$476.40 |
$476.40 |
$476.40 |
$558.03
|
|
Ultrasound transvaginal non obstetric
|
$373.20 |
$373.20 |
$373.20 |
$523.20
|
|
Unlisted orl service/px
|
$91.20 |
$91.20 |
$91.20 |
$153.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,298.00 |
$2,298.00 |
$2,298.00 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,915.80 |
$1,915.80 |
$1,915.80 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,532.40 |
$1,532.40 |
$1,532.40 |
$1,794.00
|
|
Urea nitrogen
|
$59.40 |
$59.40 |
$59.40 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$9.00 |
$9.00 |
$9.00 |
$42.90
|
|
Urethrocystography void s&i
|
$404.40 |
$404.40 |
$404.40 |
$586.50
|
|
Uric acid blood
|
$54.60 |
$54.60 |
$54.60 |
$44.00
|
|
Uric acid urine
|
$80.40 |
$80.40 |
$80.40 |
$43.20
|
|
Urinalysis microscopic only
|
$42.00 |
$42.00 |
$42.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$84.60 |
$84.60 |
$84.60 |
$37.39
|
|
Urinalysis (without microscopy)
|
$69.00 |
$69.00 |
$69.00 |
$33.00
|
|
Urine Culture Test
|
$118.20 |
$118.20 |
$118.20 |
$63.84
|
|
Urine pregnancy test
|
$93.00 |
$93.00 |
$93.00 |
$57.00
|
|
Vaccine dtap < 7 years im
|
$49.35 |
$49.35 |
$49.35 |
$66.69
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$175.91 |
$175.91 |
$175.91 |
$162.07
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$45.91 |
$45.91 |
$45.91 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$179.55 |
$179.55 |
$179.55 |
$130.67
|
|
Vaccine influenza nos 0.5ml dose im
|
$39.70 |
$39.70 |
$39.70 |
$31.00
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$47.88 |
$47.88 |
$47.88 |
$47.38
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$49.02 |
$49.02 |
$49.02 |
$29.60
|
|
Vaccine mmr live subcutaneous
|
$417.25 |
$417.25 |
$417.25 |
$222.36
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$166.40 |
$166.40 |
$166.40 |
$195.69
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$429.30 |
$429.30 |
$429.30 |
$393.25
|
|
Vaccine rabies im
|
$659.39 |
$659.39 |
$659.39 |
$800.00
|
|
Vaccine tdap >=7 years im
|
$131.34 |
$131.34 |
$131.34 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$120.13 |
$120.13 |
$120.13 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$205.20 |
$205.20 |
$205.20 |
$100.80
|
|
Vancomycin peak therapeutic drug level
|
$217.20 |
$217.20 |
$217.20 |
$116.00
|
|
Varicella zoster antibody igg
|
$213.00 |
$213.00 |
$213.00 |
$90.35
|
|
Vasopressin 20 unit/ml intravenous solution
|
$330.41 |
$330.41 |
$330.41 |
$330.41
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$286.80 |
$286.80 |
$286.80 |
$123.00
|
|
Very long chain fatty acids
|
$439.80 |
$439.80 |
$439.80 |
$157.30
|
|
Virus isolation addl studies ea
|
$61.80 |
$61.80 |
$61.80 |
$90.35
|
|
Visit established high 40-54 minutes/level 5
|
$179.40 |
$179.40 |
$179.40 |
$186.60
|
|
Visual audiometry (vra)
|
$224.40 |
$224.40 |
$224.40 |
$202.50
|
|
Vitamin b-12
|
$182.40 |
$182.40 |
$182.40 |
$89.70
|
|
Vitamin D Test
|
$225.00 |
$225.00 |
$225.00 |
$132.60
|
|
Volume measurement urine timed
|
$15.60 |
$15.60 |
$15.60 |
$17.40
|
|
Warde 1003990 aldosterone
|
$413.40 |
$413.40 |
$413.40 |
$182.65
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$213.00 |
$213.00 |
$213.00 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$316.80 |
$316.80 |
$316.80 |
$128.05
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$236.40 |
$236.40 |
$236.40 |
$83.06
|
|
Warde 3004000 immunoglobulin subclass 1
|
$13.80 |
$13.80 |
$13.80 |
$51.20
|
|
Warde 3008005 oligoclonal bands
|
$213.60 |
$213.60 |
$213.60 |
$117.13
|
|
Warde 3016000 west nile virus antibody
|
$148.80 |
$148.80 |
$148.80 |
$78.65
|
|
Warde 3016000 west nile virus antibody igg
|
$148.80 |
$148.80 |
$148.80 |
$78.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$125.40 |
$125.40 |
$125.40 |
$70.85
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$147.00 |
$147.00 |
$147.00 |
$60.00
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$86.40 |
$86.40 |
$86.40 |
$79.30
|
|
Warde 3400852 arsenic
|
$126.00 |
$126.00 |
$126.00 |
$107.38
|
|
Warde 3708165 mercury urine
|
$160.80 |
$160.80 |
$160.80 |
$82.20
|
|
Warde adenosine deaminase pleural fluid
|
$79.20 |
$79.20 |
$79.20 |
$96.03
|
|
Warde adrenocorticotropic hormone (acth)
|
$333.00 |
$333.00 |
$333.00 |
$147.55
|
|
Warde aldolase
|
$138.60 |
$138.60 |
$138.60 |
$60.00
|
|
Warde amino acids 6 or more quantitative each specimen
|
$390.00 |
$390.00 |
$390.00 |
$177.60
|
|
Warde analysis gene hfe common variants
|
$280.80 |
$280.80 |
$280.80 |
$284.70
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$402.00 |
$402.00 |
$402.00 |
$403.20
|
|
Warde apolipoprotein b
|
$123.60 |
$123.60 |
$123.60 |
$80.60
|
|
Warde bile acids
|
$124.80 |
$124.80 |
$124.80 |
$76.70
|
|
Warde calcitonin
|
$255.60 |
$255.60 |
$255.60 |
$120.25
|
|
Warde calculus (stone) infrared
|
$194.40 |
$194.40 |
$194.40 |
$67.50
|
|
Warde clozapine therapeutic drug level
|
$118.80 |
$118.80 |
$118.80 |
$71.20
|
|
Warde cobalt heavy metal quantitative each nes
|
$186.60 |
$186.60 |
$186.60 |
$126.08
|
|
Warde collagen cross links c-telopeptide
|
$190.80 |
$190.80 |
$190.80 |
$94.80
|
|
Warde complement total hemolytic
|
$190.80 |
$190.80 |
$190.80 |
$108.55
|
|
Warde copper
|
$172.80 |
$172.80 |
$172.80 |
$88.20
|
|
Warde cryoglobulin
|
$108.60 |
$108.60 |
$108.60 |
$52.45
|
|
Warde erythropoietin
|
$236.40 |
$236.40 |
$236.40 |
$92.50
|
|
Warde folic acid rbc
|
$228.00 |
$228.00 |
$228.00 |
$91.85
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$119.40 |
$119.40 |
$119.40 |
$65.00
|
|
Warde gastrin
|
$181.80 |
$181.80 |
$181.80 |
$94.68
|
|
Warde growth hormone (hgh)
|
$187.20 |
$187.20 |
$187.20 |
$81.24
|
|
Warde helminth antibody strongyloides igg
|
$177.00 |
$177.00 |
$177.00 |
$115.05
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$49.80 |
$49.80 |
$49.80 |
$78.80
|
|
Warde hepatitis a antibody
|
$162.00 |
$162.00 |
$162.00 |
$85.15
|
|
Warde hepatitis be antibody
|
$97.80 |
$97.80 |
$97.80 |
$64.80
|
|
Warde hepatitis delta agent antibody
|
$110.40 |
$110.40 |
$110.40 |
$102.70
|
|
Warde immunofixation electrophoresis urine
|
$168.00 |
$168.00 |
$168.00 |
$151.71
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$125.40 |
$125.40 |
$125.40 |
$62.50
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$915.60 |
$915.60 |
$915.60 |
$672.75
|
|
Warde islet cell antibody zinc transporter 8
|
$178.80 |
$178.80 |
$178.80 |
$137.55
|
|
Warde lipoprotein (a)
|
$148.80 |
$148.80 |
$148.80 |
$72.90
|
|
Warde mitochondrial antibody each
|
$45.60 |
$45.60 |
$45.60 |
$62.40
|
|
Warde neutralization rabies
|
$52.20 |
$52.20 |
$52.20 |
$106.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$174.00 |
$174.00 |
$174.00 |
$71.20
|
|
Warde protein c antigen
|
$233.40 |
$233.40 |
$233.40 |
$89.70
|
|
Warde sex hormone binding globulin
|
$182.40 |
$182.40 |
$182.40 |
$104.28
|
|
Warde somatomedin
|
$312.00 |
$312.00 |
$312.00 |
$127.40
|
|
Warde sugars single qualitative each specimen stool
|
$47.40 |
$47.40 |
$47.40 |
$39.42
|
