|
Ultrasound ob >=14wks ea addl gest
|
$352.39 |
$352.39 |
$352.39 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$128.23 |
$128.23 |
$128.23 |
$326.54
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$429.52 |
$429.52 |
$429.52 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$245.37 |
$245.37 |
$245.37 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$2,043.91 |
$2,043.91 |
$2,043.91 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$343.71 |
$343.71 |
$343.71 |
$498.00
|
|
Ultrasound scrotum and contents
|
$501.34 |
$501.34 |
$501.34 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$317.68 |
$317.68 |
$317.68 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$524.48 |
$524.48 |
$524.48 |
$567.44
|
|
Umbilical artery cath newborn 36660
|
$32.30 |
$32.30 |
$32.30 |
$265.85
|
|
Unlisted dx gi procedure
|
$180.29 |
$180.29 |
$180.29 |
$482.90
|
|
Unlisted procedure esophagus
|
$1,045.58 |
$1,045.58 |
$1,045.58 |
$1,215.50
|
|
Unlisted procedure microbiology
|
$228.98 |
$228.98 |
$228.98 |
$487.50
|
|
Unlisted px palate uvula
|
$274.78 |
$274.78 |
$274.78 |
$257.04
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,615.85 |
$1,615.85 |
$1,615.85 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,169.95 |
$1,169.95 |
$1,169.95 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$928.44 |
$928.44 |
$928.44 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,040.76 |
$1,040.76 |
$1,040.76 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,095.71 |
$1,095.71 |
$1,095.71 |
$1,656.60
|
|
Urea nitrogen
|
$41.46 |
$41.46 |
$41.46 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$53.03 |
$53.03 |
$53.03 |
$50.00
|
|
Ureteral reflux study
|
$449.76 |
$449.76 |
$449.76 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$255.01 |
$255.01 |
$255.01 |
$574.40
|
|
Urethrocystography void s&i
|
$255.01 |
$255.01 |
$255.01 |
$634.50
|
|
Uric acid blood
|
$36.16 |
$36.16 |
$36.16 |
$46.64
|
|
Uric acid urine
|
$32.78 |
$32.78 |
$32.78 |
$46.75
|
|
Urinalysis microscopic only
|
$13.98 |
$13.98 |
$13.98 |
$26.35
|
|
Urinalysis (with microscopy)
|
$31.34 |
$31.34 |
$31.34 |
$48.14
|
|
Urinalysis (without microscopy)
|
$11.57 |
$11.57 |
$11.57 |
$38.99
|
|
Urine Culture Test
|
$55.92 |
$55.92 |
$55.92 |
$84.81
|
|
Urine pregnancy test
|
$51.58 |
$51.58 |
$51.58 |
$66.40
|
|
Urography inf drip &/or bolus
|
$627.64 |
$627.64 |
$627.64 |
$641.69
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,913.75 |
$5,913.75 |
$5,913.75 |
$6,892.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$77,086.38 |
$77,086.38 |
$77,086.38 |
$66,658.97
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$44.24 |
$44.24 |
$44.24 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$138.80 |
$138.80 |
$138.80 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$100.43 |
$100.43 |
$100.43 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$54.31 |
$54.31 |
$54.31 |
$79.04
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$54.05 |
$54.05 |
$54.05 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$309.06 |
$309.06 |
$309.06 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$267.28 |
$267.28 |
$267.28 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$171.46 |
$171.46 |
$171.46 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$205.79 |
$205.79 |
$205.79 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$387.48 |
$387.48 |
$387.48 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$432.28 |
$432.28 |
$432.28 |
$715.41
|
|
Vaccine rabies im
|
$583.16 |
$583.16 |
$583.16 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$100.43 |
$100.43 |
$100.43 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$82.22 |
$82.22 |
$82.22 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$63.07 |
$63.07 |
$63.07 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$37.61 |
$37.61 |
$37.61 |
$115.00
|
|
Valrubicin injection
|
$4,523.14 |
$4,523.14 |
$4,523.14 |
$2,929.63
|
|
Vancomycin hcl injection
|
$110.21 |
$110.21 |
$110.21 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$126.79 |
$126.79 |
$126.79 |
$126.79
|
|
Varicella zoster antibody igg
|
$59.30 |
$59.30 |
$59.30 |
$82.55
|
|
Vedolizumab 300 mg intravenous solution
|
$24,143.71 |
$24,143.71 |
$24,143.71 |
$23,003.79
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$2,698.91 |
$2,698.91 |
$2,698.91 |
$2,277.99
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$46.28 |
$46.28 |
$46.28 |
$188.65
|
|
Venous thrombosis imaging
|
$445.91 |
$445.91 |
$445.91 |
$636.97
|
|
Ven thrombosis images bilat
|
$708.62 |
$708.62 |
$708.62 |
$779.56
|
|
Ventilator each subsequent day
|
$296.47 |
$296.47 |
$296.47 |
$1,305.92
|
|
Ventilator initial day
|
$435.78 |
$435.78 |
$435.78 |
$1,540.80
|
|
Vinblastine 1 mg/ml intravenous solution
|
$276.82 |
$276.82 |
$276.82 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$223.65 |
$223.65 |
$223.65 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$311.16 |
$311.16 |
$311.16 |
$245.36
|
|
Vital capacity test
|
$46.76 |
$46.76 |
$46.76 |
$173.33
|
|
Vitamin b-12
|
$54.96 |
$54.96 |
$54.96 |
$94.90
|
|
Vitamin D Test
|
$136.43 |
$136.43 |
$136.43 |
$132.00
|
|
Volume measurement urine timed
|
$10.13 |
$10.13 |
$10.13 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$0.13 |
$0.13 |
$0.13 |
$224.40
|
|
Warde 1003990 aldosterone
|
$104.61 |
$104.61 |
$104.61 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$77.62 |
$77.62 |
$77.62 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$59.78 |
$59.78 |
$59.78 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$68.46 |
$68.46 |
$68.46 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$86.29 |
$86.29 |
$86.29 |
$69.55
|
|
Warde 1015200 kappa light chain free
|
$9.16 |
$9.16 |
$9.16 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$123.89 |
$123.89 |
$123.89 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$41.94 |
$41.94 |
$41.94 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$47.25 |
$47.25 |
$47.25 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$47.25 |
$47.25 |
$47.25 |
$69.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$94.97 |
$94.97 |
$94.97 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$43.87 |
$43.87 |
$43.87 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$92.08 |
$92.08 |
$92.08 |
$78.57
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$108.95 |
$108.95 |
$108.95 |
$219.13
|
|
Warde 3400852 arsenic
|
$79.54 |
$79.54 |
$79.54 |
$105.12
|
|
Warde 3708165 mercury urine
|
$68.46 |
$68.46 |
$68.46 |
$72.80
|
|
Warde acetylcholine receptor blocking antibody
|
$22.18 |
$22.18 |
$22.18 |
$68.90
|
|
Warde actin (smooth muscle) antibody each
|
$3.86 |
$3.86 |
$3.86 |
$45.58
|
|
Warde adenosine deaminase pleural fluid
|
$157.64 |
$157.64 |
$157.64 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$187.04 |
$187.04 |
$187.04 |
$129.75
|
|
Warde aldolase
|
$65.56 |
$65.56 |
$65.56 |
$49.20
|
|
Warde amino acids 6 or more quantitative each specimen
|
$267.06 |
$267.06 |
$267.06 |
$176.20
|
|
Warde analysis gene hfe common variants
|
$63.64 |
$63.64 |
$63.64 |
$260.94
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$375.53 |
$375.53 |
$375.53 |
$381.50
|
|
Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites
|
$182.70 |
$182.70 |
$182.70 |
$142.65
|
|
Warde anti-mullerian hormone
|
$682.11 |
$682.11 |
$682.11 |
$93.28
|
|
Warde apolipoprotein b
|
$48.21 |
$48.21 |
$48.21 |
$64.28
|
|
Warde bile acids
|
$49.17 |
$49.17 |
$49.17 |
$64.28
|
|
Warde cadmium blood
|
$54.00 |
$54.00 |
$54.00 |
$77.00
|
|
Warde calcitonin
|
$232.84 |
$232.84 |
$232.84 |
$89.40
|
|
Warde calculus (stone) infrared
|
$40.02 |
$40.02 |
$40.02 |
$61.73
|