|
Tilt table study
|
$3,750.57 |
$3,750.57 |
$3,750.57 |
$1,548.30
|
|
Tobramycin non-comp unit
|
$91.75 |
$91.75 |
$91.75 |
$105.75
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$11,151.37 |
$11,151.37 |
$11,151.37 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$188.49 |
$188.49 |
$188.49 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$188.50 |
$188.50 |
$188.50 |
$68.43
|
|
Total tau
|
$925.00 |
$925.00 |
$925.00 |
$312.00
|
|
Toxoplasma antibody igg
|
$1,319.30 |
$1,319.30 |
$1,319.30 |
$89.24
|
|
Toxoplasma antibody igm
|
$880.61 |
$880.61 |
$880.61 |
$87.00
|
|
Transferrin
|
$1,069.10 |
$1,069.10 |
$1,069.10 |
$81.60
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$990.86 |
$990.86 |
$990.86 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$990.86 |
$990.86 |
$990.86 |
$143.48
|
|
Treponema pallidum antibody
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$69.60
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$226.10 |
$226.10 |
$226.10 |
$43.05
|
|
Trichomonas assay w/optic
|
$15.29 |
$15.29 |
$15.29 |
$55.50
|
|
Ultrasound abdomen aorta screening study aaa
|
$2,137.71 |
$2,137.71 |
$2,137.71 |
$394.20
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$819.76 |
$819.76 |
$819.76 |
$338.00
|
|
Ultrasound encephalogram
|
$1,293.31 |
$1,293.31 |
$1,293.31 |
$488.80
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$741.00 |
$741.00 |
$741.00 |
$477.10
|
|
Ultrasound spinal canal and contents
|
$2,137.91 |
$2,137.91 |
$2,137.91 |
$459.00
|
|
Unlisted ultrasound procedure
|
$2,200.03 |
$2,200.03 |
$2,200.03 |
$332.16
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$11,139.90 |
$11,139.90 |
$11,139.90 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$7,529.85 |
$7,529.85 |
$7,529.85 |
$2,034.41
|
|
Urea nitrogen 24 hour urine
|
$500.39 |
$500.39 |
$500.39 |
$51.84
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,979.56 |
$1,979.56 |
$1,979.56 |
$584.00
|
|
Urethrocystography void s&i
|
$1,979.56 |
$1,979.56 |
$1,979.56 |
$634.50
|
|
Uric acid urine
|
$831.86 |
$831.86 |
$831.86 |
$44.14
|
|
Urine Culture Test
|
$1,199.06 |
$1,199.06 |
$1,199.06 |
$80.60
|
|
Vaccine dtap < 7 years im
|
$249.54 |
$249.54 |
$249.54 |
$69.46
|
|
Vaccine dtap-ipv/hib im
|
$784.20 |
$784.20 |
$784.20 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$76.11 |
$76.11 |
$76.11 |
$42.90
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$148.23 |
$148.23 |
$148.23 |
$72.24
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$333.25 |
$333.25 |
$333.25 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$85.50 |
$85.50 |
$85.50 |
$47.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$912.35 |
$912.35 |
$912.35 |
$395.24
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$762.44 |
$762.44 |
$762.44 |
$407.20
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$535.96 |
$535.96 |
$535.96 |
$310.93
|
|
Vaccine mmr live subcutaneous
|
$1,075.74 |
$1,075.74 |
$1,075.74 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$960.39 |
$960.39 |
$960.39 |
$252.87
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$933.99 |
$933.99 |
$933.99 |
$414.46
|
|
Vaccine rabies im
|
$3,724.43 |
$3,724.43 |
$3,724.43 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,020.68 |
$2,020.68 |
$2,020.68 |
$1,104.47
|
|
Vaccine tdap >=7 years im
|
$282.27 |
$282.27 |
$282.27 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$219.28 |
$219.28 |
$219.28 |
$112.10
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$107.28 |
$107.28 |
$107.28 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$1,238.06 |
$1,238.06 |
$1,238.06 |
$114.48
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,107.51 |
$1,107.51 |
$1,107.51 |
$325.80
|
|
Veeg cont 2-12 hrs
|
$3,428.66 |
$3,428.66 |
$3,428.66 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$3,053.00 |
$3,053.00 |
$3,053.00 |
$3,017.00
|
|
Veeg intrmnt 2-12 hrs
|
$3,428.66 |
$3,428.66 |
$3,428.66 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$4,320.00 |
$4,320.00 |
$4,320.00 |
$1,671.09
|
|
Venogram ext bil s&i
|
$4,077.28 |
$4,077.28 |
$4,077.28 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,373.87 |
$3,373.87 |
$3,373.87 |
$1,379.20
|
|
Ventilator each subsequent day
|
$4,526.52 |
$4,526.52 |
$4,526.52 |
$1,184.00
|
|
Ventilator initial day
|
$7,062.68 |
$7,062.68 |
$7,062.68 |
$1,416.96
|
|
Virus isolation addl studies ea
|
$56.06 |
$56.06 |
$56.06 |
$74.36
|
|
Vital capacity test
|
$408.63 |
$408.63 |
$408.63 |
$170.00
|
|
Vitamin b-12
|
$1,013.86 |
$1,013.86 |
$1,013.86 |
$100.00
|
|
Vitamin D Test
|
$926.08 |
$926.08 |
$926.08 |
$132.00
|
|
Volume measurement urine timed
|
$194.96 |
$194.96 |
$194.96 |
$21.00
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$1,852.55 |
$1,852.55 |
$1,852.55 |
$165.81
|
|
Warde 1003990 aldosterone
|
$3,038.33 |
$3,038.33 |
$3,038.33 |
$144.67
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$1,195.81 |
$1,195.81 |
$1,195.81 |
$65.40
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$1,371.29 |
$1,371.29 |
$1,371.29 |
$70.85
|
|
Warde 3004000 immunoglobulin subclass 1
|
$1,511.03 |
$1,511.03 |
$1,511.03 |
$39.56
|
|
Warde 3008005 oligoclonal bands
|
$786.38 |
$786.38 |
$786.38 |
$103.95
|
|
Warde 3016000 west nile virus antibody
|
$714.86 |
$714.86 |
$714.86 |
$68.64
|
|
Warde 3016000 west nile virus antibody igg
|
$714.86 |
$714.86 |
$714.86 |
$69.00
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$1,017.08 |
$1,017.08 |
$1,017.08 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$49.89 |
$49.89 |
$49.89 |
$70.70
|
|
Warde 3400852 arsenic
|
$1,134.06 |
$1,134.06 |
$1,134.06 |
$100.88
|
|
Warde 3708165 mercury urine
|
$1,627.99 |
$1,627.99 |
$1,627.99 |
$70.85
|
|
Warde acetylcholine receptor blocking antibody
|
$195.30 |
$195.30 |
$195.30 |
$71.50
|
|
Warde actin (smooth muscle) antibody each
|
$913.11 |
$913.11 |
$913.11 |
$43.32
|
|
Warde adenosine deaminase pleural fluid
|
$640.13 |
$640.13 |
$640.13 |
$87.60
|
|
Warde adrenocorticotropic hormone (acth)
|
$1,202.31 |
$1,202.31 |
$1,202.31 |
$149.20
|
|
Warde aldolase
|
$1,004.08 |
$1,004.08 |
$1,004.08 |
$53.30
|
|
Warde amino acids 6 or more quantitative each specimen
|
$5,020.56 |
$5,020.56 |
$5,020.56 |
$192.40
|
|
Warde analysis gene hfe common variants
|
$717.03 |
$717.03 |
$717.03 |
$266.00
|
|
Warde anti-mullerian hormone
|
$96.55 |
$96.55 |
$96.55 |
$80.08
|
|
Warde bile acids
|
$1,153.56 |
$1,153.56 |
$1,153.56 |
$63.05
|
|
Warde cadmium blood
|
$1,627.99 |
$1,627.99 |
$1,627.99 |
$76.50
|
|
Warde calcitonin
|
$968.34 |
$968.34 |
$968.34 |
$96.97
|
|
Warde calculus (stone) infrared
|
$36.92 |
$36.92 |
$36.92 |
$58.00
|
|
Warde cobalt heavy metal quantitative each nes
|
$54.90 |
$54.90 |
$54.90 |
$116.16
|
|
Warde complement total hemolytic
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$104.82
|
|
Warde cryoglobulin
|
$773.37 |
$773.37 |
$773.37 |
$51.00
|
|
Warde erythropoietin
|
$1,673.51 |
$1,673.51 |
$1,673.51 |
$90.36
|
|
Warde fluorescent antibody screen endomysial iga
|
$601.14 |
$601.14 |
$601.14 |
$43.20
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$851.36 |
$851.36 |
$851.36 |
$43.55
|
|
Warde gastrin
|
$1,426.51 |
$1,426.51 |
$1,426.51 |
$75.25
|
|
Warde growth hormone (hgh)
|
$1,101.00 |
$1,101.00 |
$1,101.00 |
$77.55
|
|
Warde helminth antibody strongyloides igg
|
$274.08 |
$274.08 |
$274.08 |
$100.80
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$1,358.30 |
$1,358.30 |
$1,358.30 |
$76.70
|
|
Warde hepatitis a antibody
|
$968.34 |
$968.34 |
$968.34 |
$83.40
|
|
Warde hepatitis be antibody
|
$935.85 |
$935.85 |
$935.85 |
$52.20
|
|
Warde hepatitis delta agent antibody
|
$1,631.26 |
$1,631.26 |
$1,631.26 |
$93.00
|
|
Warde immunofixation electrophoresis urine
|
$877.36 |
$877.36 |
$877.36 |
$161.28
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$1,166.57 |
$1,166.57 |
$1,166.57 |
$57.50
|
|
Warde infectious agent nucleic acid genotype hepatitis c
|
$2,882.34 |
$2,882.34 |
$2,882.34 |
$636.09
|
|
Warde islet cell antibody zinc transporter 8
|
$926.08 |
$926.08 |
$926.08 |
$137.55
|
