|
Unlisted special svc px/rprt
|
$1.20 |
$1.20 |
$1.20 |
$90.00
|
|
Unlisted transfusion med px
|
$12.30 |
$12.30 |
$12.30 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$166.80 |
$166.80 |
$166.80 |
$1,268.17
|
|
Upgrade pm system
|
$4,780.35 |
$4,780.35 |
$4,780.35 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,357.39
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$426.60 |
$426.60 |
$426.60 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$384.60 |
$384.60 |
$384.60 |
$1,768.00
|
|
Urea nitrogen
|
$6.90 |
$6.90 |
$6.90 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$7.95 |
$7.95 |
$7.95 |
$51.75
|
|
Ureteral reflux study
|
$182.70 |
$182.70 |
$182.70 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$119.55 |
$119.55 |
$119.55 |
$579.34
|
|
Urethrocystography void s&i
|
$119.55 |
$119.55 |
$119.55 |
$622.35
|
|
Uric acid blood
|
$7.95 |
$7.95 |
$7.95 |
$48.75
|
|
Uric acid urine
|
$8.40 |
$8.40 |
$8.40 |
$44.22
|
|
Urinalysis microscopic only
|
$5.40 |
$5.40 |
$5.40 |
$26.00
|
|
Urinalysis qual/semiquant excpt ia
|
$3.75 |
$3.75 |
$3.75 |
$25.72
|
|
Urinalysis (with microscopy)
|
$5.70 |
$5.70 |
$5.70 |
$53.00
|
|
Urinalysis (without microscopy)
|
$3.90 |
$3.90 |
$3.90 |
$35.75
|
|
Urine Culture Test
|
$13.95 |
$13.95 |
$13.95 |
$81.00
|
|
Urine pregnancy test
|
$11.10 |
$11.10 |
$11.10 |
$66.60
|
|
Urography, antegrade
|
$119.55 |
$119.55 |
$119.55 |
$622.35
|
|
Vaccine dtap < 7 years im
|
$57.05 |
$57.05 |
$57.05 |
$68.19
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$55.60 |
$55.60 |
$55.60 |
$75.39
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$23.12 |
$23.12 |
$23.12 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$290.32 |
$290.32 |
$290.32 |
$400.03
|
|
Vaccine mmr live subcutaneous
|
$155.02 |
$155.02 |
$155.02 |
$211.68
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$326.57 |
$326.57 |
$326.57 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$359.12 |
$359.12 |
$359.12 |
$563.36
|
|
Vaccine rabies im
|
$584.36 |
$584.36 |
$584.36 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$79.54 |
$79.54 |
$79.54 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$67.32 |
$67.32 |
$67.32 |
$112.10
|
|
Vaginal bx
|
$246.60 |
$246.60 |
$246.60 |
$455.94
|
|
Valproic acid total therapeutic drug level
|
$23.70 |
$23.70 |
$23.70 |
$114.48
|
|
Valvuloplasty aortic
|
$4,357.65 |
$4,357.65 |
$4,357.65 |
$7,830.80
|
|
Vancomycin 1,000 mg intravenous injection
|
$313.30 |
$313.30 |
$313.30 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$90.33 |
$90.33 |
$90.33 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$23.70 |
$23.70 |
$23.70 |
$135.60
|
|
Varicella zoster antibody igg
|
$22.50 |
$22.50 |
$22.50 |
$86.80
|
|
Vasc emb/occ w/prs cath
|
$7,261.35 |
$7,261.35 |
$7,261.35 |
$21,009.00
|
|
Vasectomy
|
$898.95 |
$898.95 |
$898.95 |
$2,424.12
|
|
Vedolizumab 300 mg intravenous solution
|
$8,544.72 |
$8,544.72 |
$8,544.72 |
$18,719.82
|
|
Veeg cont 2-12 hrs
|
$505.35 |
$505.35 |
$505.35 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$945.90 |
$945.90 |
$945.90 |
$3,120.21
|
|
Veeg intrmnt 2-12 hrs
|
$289.80 |
$289.80 |
$289.80 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$505.35 |
$505.35 |
$505.35 |
$1,647.00
|
|
Veeg unmon 2-12 hrs
|
$263.55 |
$263.55 |
$263.55 |
$826.15
|
|
Vein x-ray adrenal glands
|
$2,036.70 |
$2,036.70 |
$2,036.70 |
$3,833.50
|
|
Vein x-ray kidney
|
$1,293.15 |
$1,293.15 |
$1,293.15 |
$2,766.73
|
|
Vein x-ray liver
|
$1,293.15 |
$1,293.15 |
$1,293.15 |
$3,169.80
|
|
Vein x-ray liver w/hemodynam
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,483.84
|
|
Vein x-ray liver w/hemodynam
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,483.84
|
|
Vein x-ray skull
|
$492.60 |
$492.60 |
$492.60 |
$2,141.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$496.20 |
$496.20 |
$496.20 |
$202.80
|
|
Venogram ext bil s&i
|
$450.60 |
$450.60 |
$450.60 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$429.15 |
$429.15 |
$429.15 |
$1,366.20
|
|
Venous mech thrombectomy
|
$2,004.00 |
$2,004.00 |
$2,004.00 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$1,564.20 |
$1,564.20 |
$1,564.20 |
$5,094.75
|
|
Ventilator each subsequent day
|
$405.60 |
$405.60 |
$405.60 |
$1,204.00
|
|
Ventilator initial day
|
$198.90 |
$198.90 |
$198.90 |
$1,431.43
|
|
Version cephalic external
|
$863.40 |
$863.40 |
$863.40 |
$2,361.75
|
|
Viper venom prothrombin time
|
$16.65 |
$16.65 |
$16.65 |
$85.80
|
|
Virus isolation addl studies ea
|
$34.20 |
$34.20 |
$34.20 |
$77.50
|
|
Visit established high 40-54 minutes/level 5
|
$65.55 |
$65.55 |
$65.55 |
$227.50
|
|
Vital capacity test
|
$28.35 |
$28.35 |
$28.35 |
$170.00
|
|
Vitamin b-12
|
$26.40 |
$26.40 |
$26.40 |
$100.00
|
|
Vitamin D Test
|
$52.05 |
$52.05 |
$52.05 |
$132.00
|
|
Vkorc1 gene
|
$115.50 |
$115.50 |
$115.50 |
$176.80
|
|
Voiding pressure study/intra-abd 51797
|
$31.50 |
$31.50 |
$31.50 |
$433.20
|
|
Volume measurement urine timed
|
$5.40 |
$5.40 |
$5.40 |
$21.24
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$216.25 |
$216.25 |
$216.25 |
$165.81
|
|
Warde 1003990 aldosterone
|
$68.70 |
$68.70 |
$68.70 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$48.60 |
$48.60 |
$48.60 |
$95.55
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$22.65 |
$22.65 |
$22.65 |
$62.58
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$44.10 |
$44.10 |
$44.10 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$27.15 |
$27.15 |
$27.15 |
$70.40
|
|
Warde 1015200 kappa light chain free
|
$38.40 |
$38.40 |
$38.40 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$13.95 |
$13.95 |
$13.95 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$35.25 |
$35.25 |
$35.25 |
$103.95
|
|
Warde 3016000 west nile virus antibody
|
$26.10 |
$26.10 |
$26.10 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$11.70 |
$11.70 |
$11.70 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$15.60 |
$15.60 |
$15.60 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$31.50 |
$31.50 |
$31.50 |
$72.40
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$183.00 |
$183.00 |
$183.00 |
$218.40
|
|
Warde 3400852 arsenic
|
$33.30 |
$33.30 |
$33.30 |
$100.88
|
|
Warde 3708165 mercury urine
|
$28.50 |
$28.50 |
$28.50 |
$71.50
|
|
Warde acetylcholine receptor blocking antibody
|
$23.70 |
$23.70 |
$23.70 |
$73.60
|
|
Warde actin (smooth muscle) antibody each
|
$28.20 |
$28.20 |
$28.20 |
$40.20
|
|
Warde adenosine deaminase pleural fluid
|
$12.30 |
$12.30 |
$12.30 |
$90.00
|
|
Warde adrenocorticotropic hormone (acth)
|
$67.50 |
$67.50 |
$67.50 |
$151.20
|
|
Warde aldolase
|
$16.95 |
$16.95 |
$16.95 |
$53.25
|
|
Warde amino acids 6 or more quantitative each specimen
|
$28.50 |
$28.50 |
$28.50 |
$196.50
|
|
Warde amiodarone therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$114.45 |
$114.45 |
$114.45 |
$267.17
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$287.10 |
$287.10 |
$287.10 |
$368.00
|
|
Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites
|
$19.20 |
$19.20 |
$19.20 |
$126.43
|
|
Warde anti-mullerian hormone
|
$67.50 |
$67.50 |
$67.50 |
$80.08
|
|
Warde apolipoprotein b
|
$27.15 |
$27.15 |
$27.15 |
$61.75
|
