|
Urinalysis (without microscopy)
|
$113.03 |
$113.03 |
$113.03 |
$35.91
|
|
Urine Culture Test
|
$414.46 |
$414.46 |
$414.46 |
$84.00
|
|
Urine pregnancy test
|
$438.26 |
$438.26 |
$438.26 |
$69.48
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$373.37 |
$373.37 |
$373.37 |
$74.42
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$110.81 |
$110.81 |
$110.81 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$430.25 |
$430.25 |
$430.25 |
$31.91
|
|
Vaccine mmr live subcutaneous
|
$831.41 |
$831.41 |
$831.41 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,051.74 |
$1,051.74 |
$1,051.74 |
$252.90
|
|
Vaccine rabies im
|
$3,965.82 |
$3,965.82 |
$3,965.82 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$503.00 |
$503.00 |
$503.00 |
$136.80
|
|
Vaccine td preservative free >= 7 years im
|
$440.64 |
$440.64 |
$440.64 |
$112.10
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$153.92 |
$153.92 |
$153.92 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$289.54 |
$289.54 |
$289.54 |
$115.00
|
|
Varicella zoster antibody igg
|
$279.62 |
$279.62 |
$279.62 |
$85.05
|
|
Vasopressin 20 unit/ml intravenous solution
|
$2,199.09 |
$2,199.09 |
$2,199.09 |
$342.98
|
|
Venogram ext bil s&i
|
$8,034.03 |
$8,034.03 |
$8,034.03 |
$1,794.54
|
|
Very long chain fatty acids
|
$166.57 |
$166.57 |
$166.57 |
$139.88
|
|
Virus isolation addl studies ea
|
$70.70 |
$70.70 |
$70.70 |
$79.34
|
|
Vitamin b-12
|
$394.63 |
$394.63 |
$394.63 |
$100.00
|
|
Vitamin D Test
|
$473.00 |
$473.00 |
$473.00 |
$132.00
|
|
Volume measurement urine timed
|
$231.03 |
$231.03 |
$231.03 |
$21.00
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$83.14 |
$83.14 |
$83.14 |
$165.81
|
|
Warde 1003990 aldosterone
|
$866.61 |
$866.61 |
$866.61 |
$144.73
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$741.67 |
$741.67 |
$741.67 |
$78.60
|
|
Warde 3004000 immunoglobulin subclass 1
|
$99.15 |
$99.15 |
$99.15 |
$39.60
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$501.71 |
$501.71 |
$501.71 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$140.40 |
$140.40 |
$140.40 |
$70.20
|
|
Warde acetylcholine receptor blocking antibody
|
$214.92 |
$214.92 |
$214.92 |
$70.56
|
|
Warde actin (smooth muscle) antibody each
|
$1,082.02 |
$1,082.02 |
$1,082.02 |
$40.20
|
|
Warde adenosine deaminase pleural fluid
|
$383.76 |
$383.76 |
$383.76 |
$88.68
|
|
Warde adrenocorticotropic hormone (acth)
|
$832.90 |
$832.90 |
$832.90 |
$150.60
|
|
Warde aldolase
|
$208.22 |
$208.22 |
$208.22 |
$54.50
|
|
Warde amiodarone therapeutic drug level
|
$1,049.04 |
$1,049.04 |
$1,049.04 |
$53.25
|
|
Warde anti-mullerian hormone
|
$970.44 |
$970.44 |
$970.44 |
$80.08
|
|
Warde bile acids
|
$196.31 |
$196.31 |
$196.31 |
$64.28
|
|
Warde calcitonin
|
$571.11 |
$571.11 |
$571.11 |
$101.40
|
|
Warde calculus (stone) infrared
|
$182.44 |
$182.44 |
$182.44 |
$59.52
|
|
Warde clozapine therapeutic drug level
|
$400.59 |
$400.59 |
$400.59 |
$66.43
|
|
Warde cobalt heavy metal quantitative each nes
|
$326.16 |
$326.16 |
$326.16 |
$116.16
|
|
Warde complement total hemolytic
|
$436.28 |
$436.28 |
$436.28 |
$105.78
|
|
Warde copper
|
$263.75 |
$263.75 |
$263.75 |
$76.70
|
|
Warde cryoglobulin
|
$916.43 |
$916.43 |
$916.43 |
$50.35
|
|
Warde erythropoietin
|
$402.56 |
$402.56 |
$402.56 |
$90.36
|
|
Warde fluorescent antibody screen endomysial iga
|
$712.34 |
$712.34 |
$712.34 |
$46.56
|
|
Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative
|
$436.28 |
$436.28 |
$436.28 |
$44.64
|
|
Warde hemoglobin fractionation/quantitation electrophoresis
|
$1,609.58 |
$1,609.58 |
$1,609.58 |
$78.80
|
|
Warde hepatitis a antibody
|
$263.75 |
$263.75 |
$263.75 |
$83.70
|
|
Warde lipoprotein (a)
|
$144.76 |
$144.76 |
$144.76 |
$65.65
|
|
Warde mitochondrial antibody each
|
$1,675.04 |
$1,675.04 |
$1,675.04 |
$59.28
|
|
Warde oxcarbazepine therapeutic drug level
|
$523.67 |
$523.67 |
$523.67 |
$65.80
|
|
Warde pancreatic elastase fecal quantitative
|
$166.57 |
$166.57 |
$166.57 |
$92.50
|
|
Warde protein c antigen
|
$257.80 |
$257.80 |
$257.80 |
$93.80
|
|
Warde sex hormone binding globulin
|
$325.22 |
$325.22 |
$325.22 |
$83.20
|
|
Warde somatomedin
|
$446.19 |
$446.19 |
$446.19 |
$114.08
|
|
Warde t3 (triiodothyronine) reverse
|
$230.04 |
$230.04 |
$230.04 |
$66.00
|
|
Warde thyroid stimulating immunoglobulins
|
$402.56 |
$402.56 |
$402.56 |
$176.70
|
|
Warde topiramate therapeutic drug level
|
$192.36 |
$192.36 |
$192.36 |
$76.04
|
|
Warde vitamin a
|
$174.51 |
$174.51 |
$174.51 |
$59.66
|
|
Warde vitamin b-1 (thiamine)
|
$446.19 |
$446.19 |
$446.19 |
$83.99
|
|
Warde vitamin b6 (pyridoxine)
|
$596.91 |
$596.91 |
$596.91 |
$118.30
|
|
Warde vitamin c (ascorbic acid)
|
$214.16 |
$214.16 |
$214.16 |
$50.00
|
|
Warde vitamin d (1 25 dihydroxy)
|
$819.00 |
$819.00 |
$819.00 |
$137.50
|
|
Warde vitamin e (alpha-tocopherol)
|
$214.16 |
$214.16 |
$214.16 |
$57.20
|
|
Warde zinc
|
$247.88 |
$247.88 |
$247.88 |
$67.20
|
|
Wbc automated
|
$55.52 |
$55.52 |
$55.52 |
$33.15
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$1,185.26 |
$1,185.26 |
$1,185.26 |
$574.40
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$1,185.26 |
$1,185.26 |
$1,185.26 |
$611.25
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$709.48 |
$709.48 |
$709.48 |
$284.40
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$695.53 |
$695.53 |
$695.53 |
$431.28
|
|
X-ray abdomen 1 view
|
$1,142.19 |
$1,142.19 |
$1,142.19 |
$257.10
|
|
X-ray abdomen 2 views
|
$2,134.76 |
$2,134.76 |
$2,134.76 |
$316.30
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$1,037.23 |
$1,037.23 |
$1,037.23 |
$406.90
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$1,096.61 |
$1,096.61 |
$1,096.61 |
$270.20
|
|
X-ray bone age studies
|
$632.56 |
$632.56 |
$632.56 |
$248.85
|
|
X-ray bone length studies
|
$508.26 |
$508.26 |
$508.26 |
$285.30
|
|
X-ray bone survey complete
|
$1,200.21 |
$1,200.21 |
$1,200.21 |
$660.00
|
|
X-ray bone survey infant
|
$1,599.38 |
$1,599.38 |
$1,599.38 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$1,012.37 |
$1,012.37 |
$1,012.37 |
$333.11
|
|
X-ray cervical spine 4-5 views
|
$1,740.22 |
$1,740.22 |
$1,740.22 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$875.63 |
$875.63 |
$875.63 |
$508.50
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$1,033.09 |
$1,033.09 |
$1,033.09 |
$665.70
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,588.29 |
$1,588.29 |
$1,588.29 |
$820.15
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$1,096.61 |
$1,096.61 |
$1,096.61 |
$483.50
|
|
X-ray exam of eye sockets
|
$990.64 |
$990.64 |
$990.64 |
$328.35
|
|
X-ray exam thorac spine4/>vw
|
$1,305.17 |
$1,305.17 |
$1,305.17 |
$395.00
|
|
X-ray facial bones complete > 3 views
|
$1,256.82 |
$1,256.82 |
$1,256.82 |
$381.75
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$1,142.19 |
$1,142.19 |
$1,142.19 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$1,142.19 |
$1,142.19 |
$1,142.19 |
$419.50
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$2,707.12 |
$2,707.12 |
$2,707.12 |
$496.80
|
|
X-ray knee ap standing bilateral
|
$1,030.32 |
$1,030.32 |
$1,030.32 |
$253.35
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$934.37 |
$934.37 |
$934.37 |
$370.20
|
|
X-ray lumbosacral spine >= 4 views
|
$1,200.21 |
$1,200.21 |
$1,200.21 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$1,200.21 |
$1,200.21 |
$1,200.21 |
$540.60
|
|
X-ray mandible complete > 4 views
|
$2,135.80 |
$2,135.80 |
$2,135.80 |
$362.05
|
|
X-ray mandible ltd <4 views
|
$1,218.15 |
$1,218.15 |
$1,218.15 |
$237.60
|
|
X-ray nasal bones complete > 3 views
|
$1,012.37 |
$1,012.37 |
$1,012.37 |
$274.65
|
|
X-ray neck soft tissue
|
$501.36 |
$501.36 |
$501.36 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$1,033.09 |
$1,033.09 |
$1,033.09 |
$223.00
|
|
X-ray pelvis 1-2 views
|
$1,033.09 |
$1,033.09 |
$1,033.09 |
$279.96
|
|
X-ray pelvis complete > 3 views
|
$1,118.71 |
$1,118.71 |
$1,118.71 |
$349.57
|
