|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$6.83 |
$6.83 |
$6.83 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$6.48 |
$6.48 |
$6.48 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$10.85 |
$10.85 |
$10.85 |
$178.07
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$10.85 |
$10.85 |
$10.85 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$9.63 |
$9.63 |
$9.63 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$0.01 |
$0.01 |
$0.01 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$5.78 |
$5.78 |
$5.78 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$8.65 |
$8.65 |
$8.65 |
$110.25
|
|
Vaccine influenza nos 0.5ml dose im
|
$2.80 |
$2.80 |
$2.80 |
$36.80
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$2.98 |
$2.98 |
$2.98 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$5.08 |
$5.08 |
$5.08 |
$42.90
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$63.88 |
$63.88 |
$63.88 |
$104.63
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$5.08 |
$5.08 |
$5.08 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$25.55 |
$25.55 |
$25.55 |
$40.01
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$5.08 |
$5.08 |
$5.08 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$7.00 |
$7.00 |
$7.00 |
$37.05
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$34.65 |
$34.65 |
$34.65 |
$499.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$30.63 |
$30.63 |
$30.63 |
$426.80
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$16.95 |
$16.95 |
$16.95 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$8.93 |
$8.93 |
$8.93 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$9.80 |
$9.80 |
$9.80 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$20.30 |
$20.30 |
$20.30 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$284.73 |
$284.73 |
$284.73 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$5.25 |
$5.25 |
$5.25 |
$119.17
|
|
Vaccine rabies im
|
$54.87 |
$54.87 |
$54.87 |
$945.46
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$12.25 |
$12.25 |
$12.25 |
$200.70
|
|
Vaccine tdap >=7 years im
|
$7.02 |
$7.02 |
$7.02 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$6.13 |
$6.13 |
$6.13 |
$131.77
|
|
Vaccine typhoid vicps im
|
$8.58 |
$8.58 |
$8.58 |
$205.22
|
|
Vaccine varicella live subcutaneous
|
$1,544.20 |
$1,544.20 |
$1,544.20 |
$447.80
|
|
Vaccine yellow fever live subcutaneous
|
$10.50 |
$10.50 |
$10.50 |
$421.20
|
|
Valproic acid total therapeutic drug level
|
$58.10 |
$58.10 |
$58.10 |
$115.00
|
|
Valvuloplasty aortic
|
$1,569.93 |
$1,569.93 |
$1,569.93 |
$7,324.85
|
|
Vancomycin hcl injection
|
$4.24 |
$4.24 |
$4.24 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$83.48 |
$83.48 |
$83.48 |
$126.79
|
|
Varicella zoster antibody igg
|
$40.25 |
$40.25 |
$40.25 |
$82.55
|
|
Vedolizumab 300 mg intravenous solution
|
$1,273.42 |
$1,273.42 |
$1,273.42 |
$20,730.98
|
|
Veeg cont 2-12 hrs
|
$327.08 |
$327.08 |
$327.08 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$432.25 |
$432.25 |
$432.25 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$452.73 |
$452.73 |
$452.73 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$327.08 |
$327.08 |
$327.08 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$292.08 |
$292.08 |
$292.08 |
$704.79
|
|
Vein x-ray adrenal gland
|
$493.85 |
$493.85 |
$493.85 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$851.20 |
$851.20 |
$851.20 |
$3,999.60
|
|
Vein x-ray kidney
|
$1,052.28 |
$1,052.28 |
$1,052.28 |
$2,716.20
|
|
Vein x-ray liver
|
$575.23 |
$575.23 |
$575.23 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$970.73 |
$970.73 |
$970.73 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$575.23 |
$575.23 |
$575.23 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$515.73 |
$515.73 |
$515.73 |
$2,489.25
|
|
Vein x-ray skull
|
$493.85 |
$493.85 |
$493.85 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$258.13 |
$258.13 |
$258.13 |
$1,344.60
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$16.98 |
$16.98 |
$16.98 |
$188.65
|
|
Venipuncture <3 yrs other vein
|
$42.70 |
$42.70 |
$42.70 |
$82.11
|
|
Venogram ext bil s&i
|
$356.65 |
$356.65 |
$356.65 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$639.45 |
$639.45 |
$639.45 |
$1,326.00
|
|
Venous mech thrombectomy
|
$3,817.45 |
$3,817.45 |
$3,817.45 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$1,087.98 |
$1,087.98 |
$1,087.98 |
$5,352.00
|
|
Venous sampling s&i
|
$851.20 |
$851.20 |
$851.20 |
$4,416.78
|
|
Ventilator each subsequent day
|
$1,000.30 |
$1,000.30 |
$1,000.30 |
$1,305.92
|
|
Ventilator initial day
|
$1,000.30 |
$1,000.30 |
$1,000.30 |
$1,540.80
|
|
Version cephalic external
|
$978.08 |
$978.08 |
$978.08 |
$2,598.57
|
|
Vinblastine 1 mg/ml intravenous solution
|
$5.17 |
$5.17 |
$5.17 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$1.66 |
$1.66 |
$1.66 |
$100.19
|
|
Visual audiometry (vra)
|
$10.33 |
$10.33 |
$10.33 |
$202.50
|
|
Vital capacity test
|
$76.13 |
$76.13 |
$76.13 |
$173.33
|
|
Vitamin b-12
|
$37.45 |
$37.45 |
$37.45 |
$94.90
|
|
Vitamin D Test
|
$73.15 |
$73.15 |
$73.15 |
$132.00
|
|
Voiding pressure study/intra-abd 51797
|
$27.65 |
$27.65 |
$27.65 |
$463.40
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$4.89 |
$4.89 |
$4.89 |
$215.60
|
|
Warde 1003990 aldosterone
|
$103.25 |
$103.25 |
$103.25 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$63.70 |
$63.70 |
$63.70 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$23.28 |
$23.28 |
$23.28 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$60.20 |
$60.20 |
$60.20 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$23.28 |
$23.28 |
$23.28 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$19.60 |
$19.60 |
$19.60 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$71.75 |
$71.75 |
$71.75 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$22.40 |
$22.40 |
$22.40 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$47.43 |
$47.43 |
$47.43 |
$69.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$27.30 |
$27.30 |
$27.30 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$93.80 |
$93.80 |
$93.80 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$2.41 |
$2.41 |
$2.41 |
$78.57
|
|
Warde 3400852 arsenic
|
$38.33 |
$38.33 |
$38.33 |
$105.12
|
|
Warde 3708165 mercury urine
|
$40.95 |
$40.95 |
$40.95 |
$72.80
|
|
Warde actin (smooth muscle) antibody each
|
$8.58 |
$8.58 |
$8.58 |
$45.58
|
|
Warde adenosine deaminase pleural fluid
|
$8.05 |
$8.05 |
$8.05 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$100.63 |
$100.63 |
$100.63 |
$129.75
|
|
Warde aldolase
|
$28.70 |
$28.70 |
$28.70 |
$49.20
|
|
Warde amiodarone therapeutic drug level
|
$67.90 |
$67.90 |
$67.90 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$289.10 |
$289.10 |
$289.10 |
$260.94
|
|
Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites
|
$33.78 |
$33.78 |
$33.78 |
$142.65
|
|
Warde apolipoprotein b
|
$8.58 |
$8.58 |
$8.58 |
$64.28
|
|
Warde bile acids
|
$19.95 |
$19.95 |
$19.95 |
$64.28
|
|
Warde calcitonin
|
$39.20 |
$39.20 |
$39.20 |
$89.40
|
|
Warde calculus (stone) infrared
|
$36.58 |
$36.58 |
$36.58 |
$61.73
|
|
Warde clozapine therapeutic drug level
|
$9.98 |
$9.98 |
$9.98 |
$63.00
|
|
Warde collagen cross links c-telopeptide
|
$43.58 |
$43.58 |
$43.58 |
$90.40
|
|
Warde complement total hemolytic
|
$60.73 |
$60.73 |
$60.73 |
$105.00
|
|
Warde copper
|
$146.30 |
$146.30 |
$146.30 |
$80.00
|
|
Warde cryoglobulin
|
$31.15 |
$31.15 |
$31.15 |
$43.45
|
|
Warde erythropoietin
|
$48.48 |
$48.48 |
$48.48 |
$90.35
|
