|
Ultrasound hips infant dynamic
|
$588.00 |
$588.00 |
$588.00 |
$403.88
|
|
Ultrasound joint complete left
|
$565.60 |
$565.60 |
$565.60 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$431.20 |
$431.20 |
$431.20 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$507.20 |
$507.20 |
$507.20 |
$334.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$400.00 |
$400.00 |
$400.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$682.40 |
$682.40 |
$682.40 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$662.40 |
$662.40 |
$662.40 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$668.00 |
$668.00 |
$668.00 |
$419.50
|
|
Unlisted ultrasound procedure
|
$595.20 |
$595.20 |
$595.20 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$258.40 |
$258.40 |
$258.40 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,478.40 |
$2,478.40 |
$2,478.40 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,132.80 |
$2,132.80 |
$2,132.80 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,919.20 |
$3,919.20 |
$3,919.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,048.80 |
$3,048.80 |
$3,048.80 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,896.00 |
$2,896.00 |
$2,896.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$324.80 |
$324.80 |
$324.80 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$338.40 |
$338.40 |
$338.40 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$910.40 |
$910.40 |
$910.40 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$846.40 |
$846.40 |
$846.40 |
$607.20
|
|
Urea nitrogen
|
$29.60 |
$29.60 |
$29.60 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$32.00 |
$32.00 |
$32.00 |
$52.00
|
|
Ureteral reflux study
|
$1,489.60 |
$1,489.60 |
$1,489.60 |
$952.50
|
|
Urethrocystography void s&i
|
$914.40 |
$914.40 |
$914.40 |
$631.40
|
|
Uric acid blood
|
$35.20 |
$35.20 |
$35.20 |
$49.44
|
|
Uric acid urine
|
$29.60 |
$29.60 |
$29.60 |
$45.36
|
|
Urinalysis microscopic only
|
$25.60 |
$25.60 |
$25.60 |
$26.46
|
|
Urinalysis (with microscopy)
|
$38.40 |
$38.40 |
$38.40 |
$55.20
|
|
Urinalysis (without microscopy)
|
$24.80 |
$24.80 |
$24.80 |
$36.00
|
|
Urinary bldr retent nuc study
|
$220.00 |
$220.00 |
$220.00 |
$350.66
|
|
Urine Culture Test
|
$58.40 |
$58.40 |
$58.40 |
$83.00
|
|
Urine pregnancy test
|
$48.00 |
$48.00 |
$48.00 |
$68.78
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$2,619.99 |
$2,619.99 |
$2,619.99 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$18,526.28 |
$18,526.28 |
$18,526.28 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$100.80 |
$100.80 |
$100.80 |
$67.70
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$201.26 |
$201.26 |
$201.26 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$188.52 |
$188.52 |
$188.52 |
$209.40
|
|
Vaccine dtap-ipv 4-6 years im
|
$92.14 |
$92.14 |
$92.14 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$244.55 |
$244.55 |
$244.55 |
$174.72
|
|
Vaccine hepatitis a (hepa) adult im
|
$103.56 |
$103.56 |
$103.56 |
$166.62
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$85.32 |
$85.32 |
$85.32 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$226.64 |
$226.64 |
$226.64 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$69.67 |
$69.67 |
$69.67 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$57.48 |
$57.48 |
$57.48 |
$149.21
|
|
Vaccine influenza inactivated adjuvant im
|
$49.96 |
$49.96 |
$49.96 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$25.00 |
$25.00 |
$25.00 |
$48.59
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$27.43 |
$27.43 |
$27.43 |
$82.71
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$220.53 |
$220.53 |
$220.53 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$262.63 |
$262.63 |
$262.63 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$102.84 |
$102.84 |
$102.84 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$111.49 |
$111.49 |
$111.49 |
$252.87
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$364.10 |
$364.10 |
$364.10 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$411.68 |
$411.68 |
$411.68 |
$563.36
|
|
Vaccine rabies im
|
$560.37 |
$560.37 |
$560.37 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$449.76 |
$449.76 |
$449.76 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$794.82 |
$794.82 |
$794.82 |
$1,105.21
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$691.81 |
$691.81 |
$691.81 |
$1,031.86
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$104.63 |
$104.63 |
$104.63 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$84.94 |
$84.94 |
$84.94 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$79.96 |
$79.96 |
$79.96 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$82.40 |
$82.40 |
$82.40 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$70.25 |
$70.25 |
$70.25 |
$259.05
|
|
Vancomycin 750 mg intravenous solution
|
$91.36 |
$91.36 |
$91.36 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$90.40 |
$90.40 |
$90.40 |
$136.13
|
|
Varicella zoster antibody igg
|
$46.40 |
$46.40 |
$46.40 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$69.02 |
$69.02 |
$69.02 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$9,441.12 |
$9,441.12 |
$9,441.12 |
$18,732.33
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$2,420.34 |
$2,420.34 |
$2,420.34 |
$2,632.35
|
|
Ven thrombosis images bilat
|
$1,562.40 |
$1,562.40 |
$1,562.40 |
$796.50
|
|
Ventilator Management (first day)
|
$1,585.60 |
$1,585.60 |
$1,585.60 |
$1,434.60
|
|
Video Swallow Study (Modified Barium Swallow)
|
$662.40 |
$662.40 |
$662.40 |
$524.50
|
|
Virus isolation addl studies ea
|
$74.40 |
$74.40 |
$74.40 |
$79.34
|
|
Vitamin b-12
|
$74.40 |
$74.40 |
$74.40 |
$100.28
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$132.00
|
|
Volume measurement urine timed
|
$23.20 |
$23.20 |
$23.20 |
$21.64
|
|
Walking (Gait) Training (each 15 minutes)
|
$113.60 |
$113.60 |
$113.60 |
$87.50
|
|
Warde 1003990 aldosterone
|
$197.60 |
$197.60 |
$197.60 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$76.00 |
$76.00 |
$76.00 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$46.40 |
$46.40 |
$46.40 |
$64.08
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$72.00 |
$72.00 |
$72.00 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$58.40 |
$58.40 |
$58.40 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$48.00 |
$48.00 |
$48.00 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$51.20 |
$51.20 |
$51.20 |
$39.36
|
|
Warde 3008005 oligoclonal bands
|
$72.80 |
$72.80 |
$72.80 |
$108.50
|
|
Warde 3016000 west nile virus antibody
|
$56.80 |
$56.80 |
$56.80 |
$71.60
|
|
Warde 3016000 west nile virus antibody igg
|
$74.40 |
$74.40 |
$74.40 |
$70.74
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$51.20 |
$51.20 |
$51.20 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$69.60 |
$69.60 |
$69.60 |
$73.60
|
|
Warde 3400852 arsenic
|
$111.20 |
$111.20 |
$111.20 |
$101.00
|
|
Warde 3708165 mercury urine
|
$132.80 |
$132.80 |
$132.80 |
$71.60
|
|
Warde actin (smooth muscle) antibody each
|
$52.80 |
$52.80 |
$52.80 |
$42.00
|
|
Warde adenosine deaminase pleural fluid
|
$64.80 |
$64.80 |
$64.80 |
$88.53
|
|
Warde adrenocorticotropic hormone (acth)
|
$92.00 |
$92.00 |
$92.00 |
$156.40
|
|
Warde aldolase
|
$44.00 |
$44.00 |
$44.00 |
$54.05
|
|
Warde amino acids 6 or more quantitative each specimen
|
$265.60 |
$265.60 |
$265.60 |
$200.16
|
|
Warde analysis gene hfe common variants
|
$168.80 |
$168.80 |
$168.80 |
$269.50
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$400.00 |
$400.00 |
$400.00 |
$368.00
|
|
Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites
|
$116.00 |
$116.00 |
$116.00 |
$126.43
|
|
Warde anti-mullerian hormone
|
$76.80 |
$76.80 |
$76.80 |
$82.50
|
|
Warde apolipoprotein b
|
$51.20 |
$51.20 |
$51.20 |
$61.82
|
|
Warde bile acids
|
$49.60 |
$49.60 |
$49.60 |
$64.28
|
