|
Ultrasound chest
|
$480.00 |
$480.00 |
$480.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$316.80 |
$316.80 |
$316.80 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$430.40 |
$430.40 |
$430.40 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$249.60 |
$249.60 |
$249.60 |
$307.00
|
|
Ultrasound encephalogram
|
$588.80 |
$588.80 |
$588.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$544.00 |
$544.00 |
$544.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$501.60 |
$501.60 |
$501.60 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$504.00 |
$504.00 |
$504.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$780.80 |
$780.80 |
$780.80 |
$720.15
|
|
Ultrasound joint/nonvascular extremity limited left
|
$468.00 |
$468.00 |
$468.00 |
$425.45
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$317.60 |
$317.60 |
$317.60 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,104.80 |
$1,104.80 |
$1,104.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$789.60 |
$789.60 |
$789.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$544.00 |
$544.00 |
$544.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$652.80 |
$652.80 |
$652.80 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$612.80 |
$612.80 |
$612.80 |
$486.50
|
|
Ultrasound scrotum and contents
|
$617.60 |
$617.60 |
$617.60 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$501.60 |
$501.60 |
$501.60 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$315.20 |
$315.20 |
$315.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$592.00 |
$592.00 |
$592.00 |
$558.35
|
|
Unlistd noninvas vasc dx std
|
$439.20 |
$439.20 |
$439.20 |
$528.80
|
|
Unlisted CT procedure
|
$1,177.60 |
$1,177.60 |
$1,177.60 |
$732.70
|
|
Unlisted mr procedure
|
$400.00 |
$400.00 |
$400.00 |
$1,163.00
|
|
Unlisted transfusion med px
|
$208.80 |
$208.80 |
$208.80 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$684.00 |
$684.00 |
$684.00 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$700.50 |
$700.50 |
$700.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$633.50 |
$633.50 |
$633.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$454.00 |
$454.00 |
$454.00 |
$2,034.41
|
|
Urea nitrogen
|
$16.00 |
$16.00 |
$16.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$23.20 |
$23.20 |
$23.20 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$672.00 |
$672.00 |
$672.00 |
$579.73
|
|
Urethrocystography void s&i
|
$600.00 |
$600.00 |
$600.00 |
$622.35
|
|
Uric acid blood
|
$15.00 |
$15.00 |
$15.00 |
$48.75
|
|
Uric acid urine
|
$20.80 |
$20.80 |
$20.80 |
$44.33
|
|
Urinalysis microscopic only
|
$12.00 |
$12.00 |
$12.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$10.00 |
$10.00 |
$10.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$10.00 |
$10.00 |
$10.00 |
$35.75
|
|
Urine Culture Test
|
$25.00 |
$25.00 |
$25.00 |
$81.50
|
|
Urine pregnancy test
|
$35.20 |
$35.20 |
$35.20 |
$67.20
|
|
Urography, antegrade
|
$531.20 |
$531.20 |
$531.20 |
$622.35
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$690.40 |
$690.40 |
$690.40 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$222.20 |
$222.20 |
$222.20 |
$75.39
|
|
Vaccine influenza inactivated adjuvant im
|
$531.80 |
$531.80 |
$531.80 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$119.60 |
$119.60 |
$119.60 |
$47.88
|
|
Vaccine mmr live subcutaneous
|
$199.00 |
$199.00 |
$199.00 |
$211.68
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,742.00 |
$1,742.00 |
$1,742.00 |
$563.36
|
|
Vaccine rabies im
|
$1,222.20 |
$1,222.20 |
$1,222.20 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$750.80 |
$750.80 |
$750.80 |
$1,104.47
|
|
Vaccine tdap >=7 years im
|
$385.80 |
$385.80 |
$385.80 |
$131.34
|
|
Vaccine varicella live subcutaneous
|
$1,154.40 |
$1,154.40 |
$1,154.40 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$56.80 |
$56.80 |
$56.80 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$1,396.00 |
$1,396.00 |
$1,396.00 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$179.40 |
$179.40 |
$179.40 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$55.20 |
$55.20 |
$55.20 |
$136.13
|
|
Varicella zoster antibody igg
|
$53.60 |
$53.60 |
$53.60 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$232.20 |
$232.20 |
$232.20 |
$325.80
|
|
Ven blood coll snf/hha
|
$20.00 |
$20.00 |
$20.00 |
$15.65
|
|
Venogram ext bil s&i
|
$4,980.00 |
$4,980.00 |
$4,980.00 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,320.00 |
$3,320.00 |
$3,320.00 |
$1,366.20
|
|
Ventilator each subsequent day
|
$3,471.20 |
$3,471.20 |
$3,471.20 |
$1,204.00
|
|
Ventilator initial day
|
$3,613.60 |
$3,613.60 |
$3,613.60 |
$1,431.43
|
|
Version cephalic external
|
$848.00 |
$848.00 |
$848.00 |
$2,361.75
|
|
Very long chain fatty acids
|
$82.40 |
$82.40 |
$82.40 |
$139.88
|
|
Vincristine 1 mg/ml intravenous solution
|
$139.20 |
$139.20 |
$139.20 |
$87.15
|
|
Vital capacity test
|
$226.40 |
$226.40 |
$226.40 |
$170.00
|
|
Vitamin b-12
|
$40.00 |
$40.00 |
$40.00 |
$100.00
|
|
Vitamin D Test
|
$100.00 |
$100.00 |
$100.00 |
$132.00
|
|
Warde 1003990 aldosterone
|
$166.40 |
$166.40 |
$166.40 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$116.00 |
$116.00 |
$116.00 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$54.40 |
$54.40 |
$54.40 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$104.80 |
$104.80 |
$104.80 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$64.80 |
$64.80 |
$64.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$71.20 |
$71.20 |
$71.20 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$32.80 |
$32.80 |
$32.80 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$112.00 |
$112.00 |
$112.00 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$69.60 |
$69.60 |
$69.60 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$60.00 |
$60.00 |
$60.00 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$50.40 |
$50.40 |
$50.40 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$37.60 |
$37.60 |
$37.60 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$75.20 |
$75.20 |
$75.20 |
$72.50
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$398.40 |
$398.40 |
$398.40 |
$218.40
|
|
Warde 3400852 arsenic
|
$79.20 |
$79.20 |
$79.20 |
$100.88
|
|
Warde 3708165 mercury urine
|
$67.20 |
$67.20 |
$67.20 |
$71.50
|
|
Warde acetylcholine receptor blocking antibody
|
$76.80 |
$76.80 |
$76.80 |
$75.00
|
|
Warde actin (smooth muscle) antibody each
|
$49.60 |
$49.60 |
$49.60 |
$40.20
|
|
Warde adenosine deaminase pleural fluid
|
$33.60 |
$33.60 |
$33.60 |
$90.00
|
|
Warde adrenocorticotropic hormone (acth)
|
$160.80 |
$160.80 |
$160.80 |
$151.20
|
|
Warde aldolase
|
$40.80 |
$40.80 |
$40.80 |
$53.30
|
|
Warde amino acids 6 or more quantitative each specimen
|
$68.80 |
$68.80 |
$68.80 |
$193.80
|
|
Warde amiodarone therapeutic drug level
|
$77.60 |
$77.60 |
$77.60 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$267.20 |
$267.20 |
$267.20 |
$267.28
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$682.40 |
$682.40 |
$682.40 |
$368.00
|
|
Warde anti-mullerian hormone
|
$160.80 |
$160.80 |
$160.80 |
$80.08
|
|
Warde apolipoprotein b
|
$85.60 |
$85.60 |
$85.60 |
$61.75
|
|
Warde cadmium blood
|
$98.40 |
$98.40 |
$98.40 |
$76.50
|
|
Warde calcitonin
|
$111.20 |
$111.20 |
$111.20 |
$96.97
|
|
Warde calculus (stone) infrared
|
$52.80 |
$52.80 |
$52.80 |
$59.50
|
|
Warde clozapine therapeutic drug level
|
$84.00 |
$84.00 |
$84.00 |
$66.43
|
|
Warde cobalt heavy metal quantitative each nes
|
$91.20 |
$91.20 |
$91.20 |
$113.09
|
|
Warde collagen cross links c-telopeptide
|
$77.60 |
$77.60 |
$77.60 |
$96.85
|
