|
Ultrasound spinal canal and contents
|
$402.00 |
$402.00 |
$402.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$413.00 |
$413.00 |
$413.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$340.50 |
$340.50 |
$340.50 |
$558.35
|
|
Unlistd noninvas vasc dx std
|
$1,329.50 |
$1,329.50 |
$1,329.50 |
$528.80
|
|
Unlisted maaa
|
$463.00 |
$463.00 |
$463.00 |
$235.20
|
|
Unlisted orl service/px
|
$389.00 |
$389.00 |
$389.00 |
$132.60
|
|
Unlisted ultrasound procedure
|
$407.00 |
$407.00 |
$407.00 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,020.50 |
$1,020.50 |
$1,020.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$902.00 |
$902.00 |
$902.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$809.00 |
$809.00 |
$809.00 |
$2,034.41
|
|
Urea nitrogen
|
$23.00 |
$23.00 |
$23.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$58.50 |
$58.50 |
$58.50 |
$51.75
|
|
Urea nitrogen clearance
|
$110.50 |
$110.50 |
$110.50 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$615.00 |
$615.00 |
$615.00 |
$579.73
|
|
Urethrocystography void s&i
|
$570.00 |
$570.00 |
$570.00 |
$622.35
|
|
Uric acid blood
|
$32.50 |
$32.50 |
$32.50 |
$48.75
|
|
Uric acid urine
|
$53.00 |
$53.00 |
$53.00 |
$44.33
|
|
Urinalysis microscopic only
|
$14.00 |
$14.00 |
$14.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$41.50 |
$41.50 |
$41.50 |
$55.00
|
|
Urinalysis (without microscopy)
|
$24.50 |
$24.50 |
$24.50 |
$35.75
|
|
Urine Culture Test
|
$41.00 |
$41.00 |
$41.00 |
$81.50
|
|
Urine pregnancy test
|
$53.00 |
$53.00 |
$53.00 |
$67.20
|
|
Urography, antegrade
|
$464.50 |
$464.50 |
$464.50 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,084.76 |
$5,084.76 |
$5,084.76 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$37,645.70 |
$37,645.70 |
$37,645.70 |
$51,633.07
|
|
Vaccine dtap < 7 years im
|
$99.83 |
$99.83 |
$99.83 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$165.26 |
$165.26 |
$165.26 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$150.98 |
$150.98 |
$150.98 |
$105.95
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$61.05 |
$61.05 |
$61.05 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$170.44 |
$170.44 |
$170.44 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$238.59 |
$238.59 |
$238.59 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$127.36 |
$127.36 |
$127.36 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$249.58 |
$249.58 |
$249.58 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$296.22 |
$296.22 |
$296.22 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$95.62 |
$95.62 |
$95.62 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,062.82 |
$1,062.82 |
$1,062.82 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$66.09 |
$66.09 |
$66.09 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$29.05 |
$29.05 |
$29.05 |
$47.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$387.95 |
$387.95 |
$387.95 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$544.94 |
$544.94 |
$544.94 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$213.00 |
$213.00 |
$213.00 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$268.66 |
$268.66 |
$268.66 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$466.48 |
$466.48 |
$466.48 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$532.20 |
$532.20 |
$532.20 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$907.72 |
$907.72 |
$907.72 |
$90.70
|
|
Vaccine rabies im
|
$1,780.26 |
$1,780.26 |
$1,780.26 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$588.40 |
$588.40 |
$588.40 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,135.24 |
$1,135.24 |
$1,135.24 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,135.24 |
$1,135.24 |
$1,135.24 |
$997.44
|
|
Vaccine tdap >=7 years im
|
$160.60 |
$160.60 |
$160.60 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$159.04 |
$159.04 |
$159.04 |
$112.10
|
|
Vaccine typhoid vicps im
|
$325.62 |
$325.62 |
$325.62 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$409.26 |
$409.26 |
$409.26 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$141.50 |
$141.50 |
$141.50 |
$114.72
|
|
Vancomycin hcl injection
|
$154.40 |
$154.40 |
$154.40 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$85.50 |
$85.50 |
$85.50 |
$136.13
|
|
Vanomycin dna amp probe
|
$48.50 |
$48.50 |
$48.50 |
$78.40
|
|
Vantas implant
|
$12,207.65 |
$12,207.65 |
$12,207.65 |
$12,207.65
|
|
Varicella zoster antibody igg
|
$116.50 |
$116.50 |
$116.50 |
$86.80
|
|
Varicella-zoster immue globin im
|
$4,062.76 |
$4,062.76 |
$4,062.76 |
$3,816.19
|
|
Vasopressin 20 unit/ml intravenous solution
|
$80.23 |
$80.23 |
$80.23 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$21,692.45 |
$21,692.45 |
$21,692.45 |
$18,732.33
|
|
Veeg unmon 12-26 hrs
|
$2,049.50 |
$2,049.50 |
$2,049.50 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$1,518.00 |
$1,518.00 |
$1,518.00 |
$826.15
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$3,678.15 |
$3,678.15 |
$3,678.15 |
$2,632.35
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$129.50 |
$129.50 |
$129.50 |
$202.80
|
|
Venogram ext bil s&i
|
$1,216.50 |
$1,216.50 |
$1,216.50 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$959.00 |
$959.00 |
$959.00 |
$1,366.20
|
|
Ventilator each subsequent day
|
$662.00 |
$662.00 |
$662.00 |
$1,204.00
|
|
Ventilator initial day
|
$662.00 |
$662.00 |
$662.00 |
$1,431.43
|
|
Very long chain fatty acids
|
$223.50 |
$223.50 |
$223.50 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$298.22 |
$298.22 |
$298.22 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$81.36 |
$81.36 |
$81.36 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$105.20 |
$105.20 |
$105.20 |
$223.55
|
|
Visual audiometry (vra)
|
$274.00 |
$274.00 |
$274.00 |
$215.25
|
|
Vital capacity test
|
$113.00 |
$113.00 |
$113.00 |
$170.00
|
|
Vitamin b-12
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Vitamin D Test
|
$134.50 |
$134.50 |
$134.50 |
$132.00
|
|
Volume measurement urine timed
|
$8.00 |
$8.00 |
$8.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$92.96 |
$92.96 |
$92.96 |
$165.81
|
|
Warde 1003990 aldosterone
|
$204.50 |
$204.50 |
$204.50 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$137.00 |
$137.00 |
$137.00 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$108.00 |
$108.00 |
$108.00 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$178.50 |
$178.50 |
$178.50 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$125.50 |
$125.50 |
$125.50 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$77.00 |
$77.00 |
$77.00 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$36.50 |
$36.50 |
$36.50 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$70.00 |
$70.00 |
$70.00 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$122.50 |
$122.50 |
$122.50 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$117.00 |
$117.00 |
$117.00 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$43.50 |
$43.50 |
$43.50 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$46.00 |
$46.00 |
$46.00 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$46.00 |
$46.00 |
$46.00 |
$72.50
|
|
Warde 3400852 arsenic
|
$101.00 |
$101.00 |
$101.00 |
$100.88
|
|
Warde 3708165 mercury urine
|
$58.50 |
$58.50 |
$58.50 |
$71.50
|
|
Warde acetylcholine receptor blocking antibody
|
$97.00 |
$97.00 |
$97.00 |
$75.00
|
|
Warde actin (smooth muscle) antibody each
|
$133.50 |
$133.50 |
$133.50 |
$40.20
|
|
Warde adrenocorticotropic hormone (acth)
|
$187.00 |
$187.00 |
$187.00 |
$151.20
|
|
Warde aldolase
|
$49.50 |
$49.50 |
$49.50 |
$53.30
|
|
Warde amino acids 6 or more quantitative each specimen
|
$294.00 |
$294.00 |
$294.00 |
$193.80
|
