|
Ultrasound prostate/transrectal
|
$413.28 |
$413.28 |
$413.28 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$362.09 |
$362.09 |
$362.09 |
$498.00
|
|
Ultrasound scrotum and contents
|
$697.53 |
$697.53 |
$697.53 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$456.84 |
$456.84 |
$456.84 |
$567.44
|
|
Unlisted orl service/px
|
$32.58 |
$32.58 |
$32.58 |
$121.50
|
|
Unlisted procedure microbiology
|
$1,105.30 |
$1,105.30 |
$1,105.30 |
$487.50
|
|
Unlisted px small intestine
|
$1,312.57 |
$1,312.57 |
$1,312.57 |
$2,118.35
|
|
Upgrade pm system
|
$1,792.26 |
$1,792.26 |
$1,792.26 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,111.17 |
$3,111.17 |
$3,111.17 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,240.21 |
$2,240.21 |
$2,240.21 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,022.37 |
$2,022.37 |
$2,022.37 |
$2,013.08
|
|
Urea nitrogen
|
$83.34 |
$83.34 |
$83.34 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$22.00 |
$22.00 |
$22.00 |
$50.00
|
|
Urea nitrogen clearance
|
$93.49 |
$93.49 |
$93.49 |
$33.57
|
|
Urethrcystgrphy rtrgrde s&i
|
$356.59 |
$356.59 |
$356.59 |
$574.40
|
|
Urethrocystography void s&i
|
$453.04 |
$453.04 |
$453.04 |
$634.50
|
|
Uric acid blood
|
$108.29 |
$108.29 |
$108.29 |
$46.64
|
|
Uric acid urine
|
$11.85 |
$11.85 |
$11.85 |
$46.75
|
|
Urinalysis microscopic only
|
$37.65 |
$37.65 |
$37.65 |
$26.35
|
|
Urinalysis (with microscopy)
|
$14.39 |
$14.39 |
$14.39 |
$48.14
|
|
Urinalysis (without microscopy)
|
$11.00 |
$11.00 |
$11.00 |
$38.99
|
|
Urine Culture Test
|
$19.04 |
$19.04 |
$19.04 |
$84.81
|
|
Urine pregnancy test
|
$37.65 |
$37.65 |
$37.65 |
$66.40
|
|
Urography, antegrade
|
$429.35 |
$429.35 |
$429.35 |
$593.37
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$42.68 |
$42.68 |
$42.68 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$140.45 |
$140.45 |
$140.45 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$88.12 |
$88.12 |
$88.12 |
$173.98
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$0.11 |
$0.11 |
$0.11 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$68.64 |
$68.64 |
$68.64 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$35.63 |
$35.63 |
$35.63 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$112.01 |
$112.01 |
$112.01 |
$104.63
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$102.46 |
$102.46 |
$102.46 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$300.19 |
$300.19 |
$300.19 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$206.10 |
$206.10 |
$206.10 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$163.88 |
$163.88 |
$163.88 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$180.58 |
$180.58 |
$180.58 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$349.99 |
$349.99 |
$349.99 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$423.33 |
$423.33 |
$423.33 |
$715.41
|
|
Vaccine rabies im
|
$605.17 |
$605.17 |
$605.17 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$86.64 |
$86.64 |
$86.64 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$72.13 |
$72.13 |
$72.13 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$225.46 |
$225.46 |
$225.46 |
$115.00
|
|
Valrubicin injection
|
$5,486.30 |
$5,486.30 |
$5,486.30 |
$2,813.49
|
|
Valvuloplasty aortic
|
$14,140.05 |
$14,140.05 |
$14,140.05 |
$7,324.85
|
|
Vancomycin 1,000 mg intravenous injection
|
$370.19 |
$370.19 |
$370.19 |
$246.70
|
|
Vancomycin peak therapeutic drug level
|
$47.80 |
$47.80 |
$47.80 |
$126.79
|
|
Varicella zoster antibody igg
|
$32.15 |
$32.15 |
$32.15 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$244.36 |
$244.36 |
$244.36 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$26,553.37 |
$26,553.37 |
$26,553.37 |
$20,730.98
|
|
Veeg unmon 12-26 hrs
|
$946.68 |
$946.68 |
$946.68 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$473.34 |
$473.34 |
$473.34 |
$704.79
|
|
Vein bypass grft fem-popliteal 35583
|
$4,510.03 |
$4,510.03 |
$4,510.03 |
$7,043.20
|
|
Vein byp fem-tibial peroneal 35585
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$8,161.60
|
|
Vein gft fem a/p tib/pero/dis art 35566
|
$4,735.49 |
$4,735.49 |
$4,735.49 |
$8,152.00
|
|
Vein x-ray kidney
|
$4,839.55 |
$4,839.55 |
$4,839.55 |
$2,716.20
|
|
Vein x-ray liver
|
$4,839.55 |
$4,839.55 |
$4,839.55 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$2,352.73 |
$2,352.73 |
$2,352.73 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$2,848.49 |
$2,848.49 |
$2,848.49 |
$2,489.25
|
|
Vein x-ray skull
|
$4,877.19 |
$4,877.19 |
$4,877.19 |
$2,301.09
|
|
Venogram ext bil s&i
|
$821.47 |
$821.47 |
$821.47 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$774.94 |
$774.94 |
$774.94 |
$1,326.00
|
|
Venous mech thrombectomy
|
$6,428.76 |
$6,428.76 |
$6,428.76 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$6,621.65 |
$6,621.65 |
$6,621.65 |
$5,352.00
|
|
Venous sampling s&i
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$4,416.78
|
|
Ventilator each subsequent day
|
$935.68 |
$935.68 |
$935.68 |
$1,305.92
|
|
Ventilator initial day
|
$972.90 |
$972.90 |
$972.90 |
$1,540.80
|
|
Very long chain fatty acids
|
$148.05 |
$148.05 |
$148.05 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$308.06 |
$308.06 |
$308.06 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$200.14 |
$200.14 |
$200.14 |
$100.19
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$307.78 |
$307.78 |
$307.78 |
$226.75
|
|
Virus isolation addl studies ea
|
$35.54 |
$35.54 |
$35.54 |
$90.35
|
|
Visc & infraren abd 1 prosth
|
$2,588.34 |
$2,588.34 |
$2,588.34 |
$11,467.68
|
|
Visc & infraren abd 2 prosth
|
$2,588.34 |
$2,588.34 |
$2,588.34 |
$14,123.24
|
|
Visc & infraren abd 3 prosth
|
$2,717.78 |
$2,717.78 |
$2,717.78 |
$16,560.51
|
|
Vital capacity test
|
$230.96 |
$230.96 |
$230.96 |
$173.33
|
|
Vitamin b-12
|
$49.50 |
$49.50 |
$49.50 |
$94.90
|
|
Vitamin D Test
|
$133.25 |
$133.25 |
$133.25 |
$132.00
|
|
Voiding pressure study/intra-abd 51797
|
$228.85 |
$228.85 |
$228.85 |
$463.40
|
|
Volume measurement urine timed
|
$11.00 |
$11.00 |
$11.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$240.50 |
$240.50 |
$240.50 |
$215.60
|
|
Vsrctv std tcd icr art compl
|
$194.16 |
$194.16 |
$194.16 |
$434.85
|
|
Warde 1003990 aldosterone
|
$105.75 |
$105.75 |
$105.75 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$70.65 |
$70.65 |
$70.65 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$24.54 |
$24.54 |
$24.54 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$61.76 |
$61.76 |
$61.76 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$28.77 |
$28.77 |
$28.77 |
$69.55
|
|
Warde 1015200 kappa light chain free
|
$34.27 |
$34.27 |
$34.27 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$13.96 |
$13.96 |
$13.96 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$68.53 |
$68.53 |
$68.53 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$38.07 |
$38.07 |
$38.07 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$35.11 |
$35.11 |
$35.11 |
$69.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$14.81 |
$14.81 |
$14.81 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$31.31 |
$31.31 |
$31.31 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$55.42 |
$55.42 |
$55.42 |
$78.57
|
|
Warde 3400852 arsenic
|
$55.84 |
$55.84 |
$55.84 |
$105.12
|
|
Warde 3708165 mercury urine
|
$82.07 |
$82.07 |
$82.07 |
$72.80
|
|
Warde acetylcholine receptor blocking antibody
|
$31.73 |
$31.73 |
$31.73 |
$68.90
|
|
Warde actin (smooth muscle) antibody each
|
$24.54 |
$24.54 |
$24.54 |
$45.58
|
|
Warde adenosine deaminase pleural fluid
|
$31.73 |
$31.73 |
$31.73 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$93.91 |
$93.91 |
$93.91 |
$129.75
|
