|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,121.77 |
$3,121.77 |
$3,121.77 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,294.38 |
$2,294.38 |
$2,294.38 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,427.68 |
$2,427.68 |
$2,427.68 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$288.20 |
$288.20 |
$288.20 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$315.18 |
$315.18 |
$315.18 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$688.12 |
$688.12 |
$688.12 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$644.88 |
$644.88 |
$644.88 |
$607.20
|
|
Urea nitrogen
|
$35.37 |
$35.37 |
$35.37 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$42.34 |
$42.34 |
$42.34 |
$51.84
|
|
Urethrcystgrphy rtrgrde s&i
|
$551.51 |
$551.51 |
$551.51 |
$584.00
|
|
Uric acid blood
|
$42.34 |
$42.34 |
$42.34 |
$49.32
|
|
Uric acid urine
|
$62.98 |
$62.98 |
$62.98 |
$44.52
|
|
Urinalysis microscopic only
|
$36.82 |
$36.82 |
$36.82 |
$26.35
|
|
Urinalysis (with microscopy)
|
$48.26 |
$48.26 |
$48.26 |
$55.20
|
|
Urinalysis (without microscopy)
|
$31.69 |
$31.69 |
$31.69 |
$35.91
|
|
Urine Culture Test
|
$42.34 |
$42.34 |
$42.34 |
$82.32
|
|
Urine pregnancy test
|
$38.66 |
$38.66 |
$38.66 |
$68.21
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$24.09 |
$24.09 |
$24.09 |
$5,205.00
|
|
Vaccine Administration (one shot)
|
$62.58 |
$62.58 |
$62.58 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$184.16 |
$184.16 |
$184.16 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$169.03 |
$169.03 |
$169.03 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$191.10 |
$191.10 |
$191.10 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$122.85 |
$122.85 |
$122.85 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$91.57 |
$91.57 |
$91.57 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$46.85 |
$46.85 |
$46.85 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$100.70 |
$100.70 |
$100.70 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$73.18 |
$73.18 |
$73.18 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$205.71 |
$205.71 |
$205.71 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$144.44 |
$144.44 |
$144.44 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$41.94 |
$41.94 |
$41.94 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$17.71 |
$17.71 |
$17.71 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$58.44 |
$58.44 |
$58.44 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$368.60 |
$368.60 |
$368.60 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$43.39 |
$43.39 |
$43.39 |
$78.25
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$104.40 |
$104.40 |
$104.40 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$51.88 |
$51.88 |
$51.88 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$396.44 |
$396.44 |
$396.44 |
$576.48
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$386.70 |
$386.70 |
$386.70 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$111.51 |
$111.51 |
$111.51 |
$149.21
|
|
Vaccine influenza nos 0.5ml dose im
|
$29.39 |
$29.39 |
$29.39 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$31.49 |
$31.49 |
$31.49 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$26.44 |
$26.44 |
$26.44 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$91.73 |
$91.73 |
$91.73 |
$33.60
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$37.25 |
$37.25 |
$37.25 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$91.25 |
$91.25 |
$91.25 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$49.35 |
$49.35 |
$49.35 |
$82.71
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$266.21 |
$266.21 |
$266.21 |
$394.26
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$218.91 |
$218.91 |
$218.91 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$170.54 |
$170.54 |
$170.54 |
$327.37
|
|
Vaccine mmr live subcutaneous
|
$176.90 |
$176.90 |
$176.90 |
$213.00
|
|
Vaccine mmrv live subcutaneous
|
$422.52 |
$422.52 |
$422.52 |
$424.32
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$183.01 |
$183.01 |
$183.01 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$361.24 |
$361.24 |
$361.24 |
$393.25
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$338.10 |
$338.10 |
$338.10 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$404.11 |
$404.11 |
$404.11 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$87.34 |
$87.34 |
$87.34 |
$90.70
|
|
Vaccine rabies im
|
$500.46 |
$500.46 |
$500.46 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$391.27 |
$391.27 |
$391.27 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$779.44 |
$779.44 |
$779.44 |
$1,105.21
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$779.44 |
$779.44 |
$779.44 |
$997.44
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$407.74 |
$407.74 |
$407.74 |
$499.62
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$166.56 |
$166.56 |
$166.56 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$125.58 |
$125.58 |
$125.58 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$59.11 |
$59.11 |
$59.11 |
$131.34
|
|
Vaccine varicella live subcutaneous
|
$256.93 |
$256.93 |
$256.93 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$107.17 |
$107.17 |
$107.17 |
$115.00
|
|
Vancomycin hcl injection
|
$15.96 |
$15.96 |
$15.96 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$128.52 |
$128.52 |
$128.52 |
$135.60
|
|
Varicella zoster antibody igg
|
$150.97 |
$150.97 |
$150.97 |
$86.80
|
|
Vedolizumab 300 mg intravenous solution
|
$43.45 |
$43.45 |
$43.45 |
$18,732.33
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$110.81 |
$110.81 |
$110.81 |
$197.04
|
|
Ventilator each subsequent day
|
$373.74 |
$373.74 |
$373.74 |
$1,178.74
|
|
Ventilator Management (first day)
|
$410.21 |
$410.21 |
$410.21 |
$1,434.60
|
|
Version cephalic external
|
$6,395.56 |
$6,395.56 |
$6,395.56 |
$2,361.75
|
|
Video Swallow Study (Modified Barium Swallow)
|
$163.58 |
$163.58 |
$163.58 |
$524.50
|
|
Virus isolation addl studies ea
|
$42.91 |
$42.91 |
$42.91 |
$77.60
|
|
Vital capacity test
|
$53.04 |
$53.04 |
$53.04 |
$173.18
|
|
Vitamin b-12
|
$122.65 |
$122.65 |
$122.65 |
$100.20
|
|
Vitamin D Test
|
$122.65 |
$122.65 |
$122.65 |
$132.60
|
|
Volume measurement urine timed
|
$33.53 |
$33.53 |
$33.53 |
$21.64
|
|
Walking (Gait) Training (each 15 minutes)
|
$67.29 |
$67.29 |
$67.29 |
$87.50
|
|
Warde 1003990 aldosterone
|
$324.03 |
$324.03 |
$324.03 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$329.95 |
$329.95 |
$329.95 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$115.64 |
$115.64 |
$115.64 |
$65.40
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$267.34 |
$267.34 |
$267.34 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$139.21 |
$139.21 |
$139.21 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$36.69 |
$36.69 |
$36.69 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$74.39 |
$74.39 |
$74.39 |
$39.60
|
|
Warde 3008005 oligoclonal bands
|
$37.56 |
$37.56 |
$37.56 |
$108.50
|
|
Warde 3016000 west nile virus antibody igg
|
$28.06 |
$28.06 |
$28.06 |
$70.85
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$136.24 |
$136.24 |
$136.24 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$32.79 |
$32.79 |
$32.79 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$77.71 |
$77.71 |
$77.71 |
$74.16
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$308.03 |
$308.03 |
$308.03 |
$219.13
|
|
Warde 3400852 arsenic
|
$159.82 |
$159.82 |
$159.82 |
$101.00
|
|
Warde 3708165 mercury urine
|
$146.19 |
$146.19 |
$146.19 |
$71.76
|
|
Warde acetylcholine receptor blocking antibody
|
$35.88 |
$35.88 |
$35.88 |
$75.00
|
|
Warde actin (smooth muscle) antibody each
|
$24.49 |
$24.49 |
$24.49 |
$42.18
|
|
Warde adenosine deaminase pleural fluid
|
$459.92 |
$459.92 |
$459.92 |
$88.20
|
|
Warde adrenocorticotropic hormone (acth)
|
$76.62 |
$76.62 |
$76.62 |
$160.59
|
