|
Ultrasound joint/nonvascular extremity limited left
|
$108.00 |
$108.00 |
$108.00 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$67.40 |
$67.40 |
$67.40 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$67.40 |
$67.40 |
$67.40 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$144.60 |
$144.60 |
$144.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$191.20 |
$191.20 |
$191.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$221.60 |
$221.60 |
$221.60 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$210.80 |
$210.80 |
$210.80 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$152.80 |
$152.80 |
$152.80 |
$486.50
|
|
Ultrasound scrotum and contents
|
$268.00 |
$268.00 |
$268.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$99.40 |
$99.40 |
$99.40 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$232.40 |
$232.40 |
$232.40 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$171.00 |
$171.00 |
$171.00 |
$206.64
|
|
Unlisted chemotherapy px
|
$99.60 |
$99.60 |
$99.60 |
$150.00
|
|
Unlisted mr procedure
|
$331.40 |
$331.40 |
$331.40 |
$1,163.00
|
|
Unlisted procedure rectum
|
$214.80 |
$214.80 |
$214.80 |
$1,220.35
|
|
Unlisted px ant segment eye
|
$577.20 |
$577.20 |
$577.20 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$36.00 |
$36.00 |
$36.00 |
$219.70
|
|
Unlisted px leg/ankle
|
$47.60 |
$47.60 |
$47.60 |
$811.00
|
|
Unlisted px male genital sys
|
$68.40 |
$68.40 |
$68.40 |
$343.55
|
|
Unlisted px med radj physics
|
$111.40 |
$111.40 |
$111.40 |
$462.35
|
|
Unlisted px palate uvula
|
$122.80 |
$122.80 |
$122.80 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$572.40 |
$572.40 |
$572.40 |
$1,265.16
|
|
Unlisted px tongue flr mouth
|
$57.00 |
$57.00 |
$57.00 |
$282.50
|
|
Unsched dialysis esrd pt hos
|
$234.80 |
$234.80 |
$234.80 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,017.80 |
$1,017.80 |
$1,017.80 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$948.00 |
$948.00 |
$948.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$822.40 |
$822.40 |
$822.40 |
$2,034.41
|
|
Urea nitrogen
|
$33.20 |
$33.20 |
$33.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$33.20 |
$33.20 |
$33.20 |
$51.75
|
|
Urea nitrogen clearance
|
$5.80 |
$5.80 |
$5.80 |
$42.25
|
|
Urethrocystography void s&i
|
$150.20 |
$150.20 |
$150.20 |
$622.35
|
|
Uric acid blood
|
$33.20 |
$33.20 |
$33.20 |
$48.75
|
|
Uric acid urine
|
$33.00 |
$33.00 |
$33.00 |
$44.33
|
|
Urinalysis glass test
|
$17.80 |
$17.80 |
$17.80 |
$11.20
|
|
Urinalysis microscopic only
|
$2.40 |
$2.40 |
$2.40 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$1.60 |
$1.60 |
$1.60 |
$25.72
|
|
Urinalysis (with microscopy)
|
$26.00 |
$26.00 |
$26.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$17.60 |
$17.60 |
$17.60 |
$35.75
|
|
Urine Culture Test
|
$31.20 |
$31.20 |
$31.20 |
$81.50
|
|
Urine pregnancy test
|
$40.00 |
$40.00 |
$40.00 |
$67.20
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$14.14 |
$14.14 |
$14.14 |
$143.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$3.66 |
$3.66 |
$3.66 |
$33.60
|
|
Vaginal bx
|
$37.00 |
$37.00 |
$37.00 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,508.60 |
$1,508.60 |
$1,508.60 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$52.40 |
$52.40 |
$52.40 |
$114.72
|
|
Valrubicin injection
|
$817.53 |
$817.53 |
$817.53 |
$2,813.49
|
|
Vancomycin hcl injection
|
$301.37 |
$301.37 |
$301.37 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$58.80 |
$58.80 |
$58.80 |
$136.13
|
|
Varicella zoster antibody igg
|
$56.60 |
$56.60 |
$56.60 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$955.39 |
$955.39 |
$955.39 |
$325.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$157.80 |
$157.80 |
$157.80 |
$202.80
|
|
Venogram ext bil s&i
|
$510.20 |
$510.20 |
$510.20 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$485.80 |
$485.80 |
$485.80 |
$1,366.20
|
|
Ventilator each subsequent day
|
$339.20 |
$339.20 |
$339.20 |
$1,204.00
|
|
Ventilator initial day
|
$428.20 |
$428.20 |
$428.20 |
$1,431.43
|
|
Version cephalic external
|
$912.80 |
$912.80 |
$912.80 |
$2,361.75
|
|
Very long chain fatty acids
|
$211.80 |
$211.80 |
$211.80 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$29.54 |
$29.54 |
$29.54 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$5.92 |
$5.92 |
$5.92 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$211.90 |
$211.90 |
$211.90 |
$223.55
|
|
Visit established high 40-54 minutes/level 5
|
$56.00 |
$56.00 |
$56.00 |
$227.50
|
|
Vitamin b-12
|
$57.00 |
$57.00 |
$57.00 |
$100.00
|
|
Vitamin D Test
|
$157.20 |
$157.20 |
$157.20 |
$132.00
|
|
Volume measurement urine timed
|
$6.00 |
$6.00 |
$6.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$48.57 |
$48.57 |
$48.57 |
$165.81
|
|
Warde 1003990 aldosterone
|
$151.00 |
$151.00 |
$151.00 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$96.40 |
$96.40 |
$96.40 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$58.80 |
$58.80 |
$58.80 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$145.40 |
$145.40 |
$145.40 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$88.00 |
$88.00 |
$88.00 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$24.00 |
$24.00 |
$24.00 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$181.80 |
$181.80 |
$181.80 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$94.80 |
$94.80 |
$94.80 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$51.00 |
$51.00 |
$51.00 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$51.00 |
$51.00 |
$51.00 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$22.60 |
$22.60 |
$22.60 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$43.20 |
$43.20 |
$43.20 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$18.40 |
$18.40 |
$18.40 |
$72.50
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$92.60 |
$92.60 |
$92.60 |
$218.40
|
|
Warde 3400852 arsenic
|
$31.20 |
$31.20 |
$31.20 |
$100.88
|
|
Warde 3708165 mercury urine
|
$52.40 |
$52.40 |
$52.40 |
$71.50
|
|
Warde acetylcholine receptor blocking antibody
|
$11.40 |
$11.40 |
$11.40 |
$75.00
|
|
Warde actin (smooth muscle) antibody each
|
$7.40 |
$7.40 |
$7.40 |
$40.20
|
|
Warde adenosine deaminase pleural fluid
|
$122.40 |
$122.40 |
$122.40 |
$90.00
|
|
Warde adrenocorticotropic hormone (acth)
|
$119.40 |
$119.40 |
$119.40 |
$151.20
|
|
Warde aldolase
|
$52.80 |
$52.80 |
$52.80 |
$53.30
|
|
Warde amino acids 6 or more quantitative each specimen
|
$89.00 |
$89.00 |
$89.00 |
$193.80
|
|
Warde amiodarone therapeutic drug level
|
$14.80 |
$14.80 |
$14.80 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$536.00 |
$536.00 |
$536.00 |
$267.28
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$241.40 |
$241.40 |
$241.40 |
$368.00
|
|
Warde anti-mullerian hormone
|
$24.20 |
$24.20 |
$24.20 |
$80.08
|
|
Warde apolipoprotein b
|
$48.40 |
$48.40 |
$48.40 |
$61.75
|
|
Warde bile acids
|
$30.60 |
$30.60 |
$30.60 |
$63.70
|
|
Warde calcitonin
|
$124.00 |
$124.00 |
$124.00 |
$96.97
|
|
Warde calculus (stone) infrared
|
$77.80 |
$77.80 |
$77.80 |
$59.50
|
|
Warde clozapine therapeutic drug level
|
$10.20 |
$10.20 |
$10.20 |
$66.43
|
|
Warde cobalt heavy metal quantitative each nes
|
$123.80 |
$123.80 |
$123.80 |
$113.09
|
|
Warde collagen cross links c-telopeptide
|
$156.20 |
$156.20 |
$156.20 |
$96.85
|
|
Warde complement total hemolytic
|
$56.60 |
$56.60 |
$56.60 |
$104.82
|
|
Warde copper
|
$139.40 |
$139.40 |
$139.40 |
$80.00
|
