|
Unlisted laparoscopic reduction intestine 44238
|
$9,088.02 |
$9,088.02 |
$9,088.02 |
$5,741.00
|
|
Unlisted procedure microbiology
|
$1,101.13 |
$1,101.13 |
$1,101.13 |
$487.50
|
|
Unlisted procedure rectum
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
$1,278.72
|
|
Unlisted procedure spine
|
$2,368.47 |
$2,368.47 |
$2,368.47 |
$4,706.35
|
|
Unlisted px arthroscopy
|
$362.10 |
$362.10 |
$362.10 |
$4,087.20
|
|
Unlisted px diaphragm
|
$19,031.56 |
$19,031.56 |
$19,031.56 |
$6,547.57
|
|
Unlisted px foot/toes
|
$157.31 |
$157.31 |
$157.31 |
$3,105.70
|
|
Unlisted px leg/ankle
|
$357.65 |
$357.65 |
$357.65 |
$811.00
|
|
Unlisted px male genital sys
|
$388.81 |
$388.81 |
$388.81 |
$897.95
|
|
Unlisted px neck/thorax
|
$358.39 |
$358.39 |
$358.39 |
$2,680.22
|
|
Unlisted px pelvis/hip joint
|
$357.65 |
$357.65 |
$357.65 |
$2,108.82
|
|
Unlisted reprod med lab proc
|
$115.01 |
$115.01 |
$115.01 |
$70.00
|
|
Unlisted surgical path px
|
$247.09 |
$247.09 |
$247.09 |
$71.65
|
|
Unlisted transfusion med px
|
$161.76 |
$161.76 |
$161.76 |
$141.35
|
|
Upgrade pm system
|
$18,042.48 |
$18,042.48 |
$18,042.48 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,943.73 |
$3,943.73 |
$3,943.73 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,856.92 |
$3,856.92 |
$3,856.92 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,443.63 |
$3,443.63 |
$3,443.63 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,966.30 |
$1,966.30 |
$1,966.30 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,966.30 |
$1,966.30 |
$1,966.30 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$1,638.34 |
$1,638.34 |
$1,638.34 |
$1,773.85
|
|
Urea nitrogen
|
$50.46 |
$50.46 |
$50.46 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$48.23 |
$48.23 |
$48.23 |
$50.00
|
|
Ureteral reflux study
|
$2,079.83 |
$2,079.83 |
$2,079.83 |
$961.20
|
|
Ureter endoscopy & treatment
|
$508.27 |
$508.27 |
$508.27 |
$5,339.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$661.87 |
$661.87 |
$661.87 |
$574.40
|
|
Urethrlys transvag with scope
|
$1,084.81 |
$1,084.81 |
$1,084.81 |
$4,081.37
|
|
Urethrocystography void s&i
|
$661.87 |
$661.87 |
$661.87 |
$634.50
|
|
Uric acid blood
|
$87.56 |
$87.56 |
$87.56 |
$46.64
|
|
Uric acid urine
|
$44.52 |
$44.52 |
$44.52 |
$46.75
|
|
Urinalysis qual/semiquant excpt ia
|
$25.97 |
$25.97 |
$25.97 |
$25.72
|
|
Urinalysis (with microscopy)
|
$5.20 |
$5.20 |
$5.20 |
$48.14
|
|
Urinalysis (without microscopy)
|
$71.24 |
$71.24 |
$71.24 |
$38.99
|
|
Urine Culture Test
|
$116.50 |
$116.50 |
$116.50 |
$84.81
|
|
Urine pregnancy test
|
$181.05 |
$181.05 |
$181.05 |
$66.40
|
|
Urography, antegrade
|
$865.92 |
$865.92 |
$865.92 |
$593.37
|
|
Use 1st target lesion
|
$556.50 |
$556.50 |
$556.50 |
$245.30
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$8,273.30 |
$8,273.30 |
$8,273.30 |
$5,521.54
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$0.01 |
$0.01 |
$0.01 |
$223.08
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$0.01 |
$0.01 |
$0.01 |
$218.88
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$181.05 |
$181.05 |
$181.05 |
$239.85
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$120.95 |
$120.95 |
$120.95 |
$131.67
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$90.53 |
$90.53 |
$90.53 |
$91.00
|
|
Vaccine dtap < 7 years im
|
$169.18 |
$169.18 |
$169.18 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$143.95 |
$143.95 |
$143.95 |
$193.83
|
|
Vaccine dtap-ipv 4-6 years im
|
$97.21 |
$97.21 |
$97.21 |
$126.84
|
|
Vaccine dtap-ipv-hib-hepb im
|
$198.12 |
$198.12 |
$198.12 |
$158.30
|
|
Vaccine dtap-ipv/hib im
|
$51.94 |
$51.94 |
$51.94 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$41.56 |
$41.56 |
$41.56 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$39.33 |
$39.33 |
$39.33 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$94.24 |
$94.24 |
$94.24 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$189.21 |
$189.21 |
$189.21 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$127.63 |
$127.63 |
$127.63 |
$84.38
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im
|
$127.63 |
$127.63 |
$127.63 |
$48.10
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$102.40 |
$102.40 |
$102.40 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$223.35 |
$223.35 |
$223.35 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$520.15 |
$520.15 |
$520.15 |
$686.67
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$201.83 |
$201.83 |
$201.83 |
$226.20
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$235.22 |
$235.22 |
$235.22 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$103.14 |
$103.14 |
$103.14 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$104.63 |
$104.63 |
$104.63 |
$104.63
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$31.91 |
$31.91 |
$31.91 |
$40.01
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$42.30 |
$42.30 |
$42.30 |
$37.05
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,149.36 |
$1,149.36 |
$1,149.36 |
$499.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$344.29 |
$344.29 |
$344.29 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$178.08 |
$178.08 |
$178.08 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$157.31 |
$157.31 |
$157.31 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$528.31 |
$528.31 |
$528.31 |
$224.04
|
|
Vaccine mmrv live subcutaneous
|
$256.74 |
$256.74 |
$256.74 |
$474.24
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$179.57 |
$179.57 |
$179.57 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$322.77 |
$322.77 |
$322.77 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$179.57 |
$179.57 |
$179.57 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$460.04 |
$460.04 |
$460.04 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.81 |
$40.81 |
$40.81 |
$119.17
|
|
Vaccine rabies im
|
$2,352.89 |
$2,352.89 |
$2,352.89 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$778.36 |
$778.36 |
$778.36 |
$1,196.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,557.46 |
$1,557.46 |
$1,557.46 |
$1,159.00
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$126.14 |
$126.14 |
$126.14 |
$108.00
|
|
Vaccine tdap >=7 years im
|
$52.69 |
$52.69 |
$52.69 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$171.41 |
$171.41 |
$171.41 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$242.64 |
$242.64 |
$242.64 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$225.57 |
$225.57 |
$225.57 |
$115.00
|
|
Valvuloplasty aortic
|
$11,220.53 |
$11,220.53 |
$11,220.53 |
$7,324.85
|
|
Valvuloplasty aortic valve
|
$5,772.76 |
$5,772.76 |
$5,772.76 |
$4,712.00
|
|
Valvuloplasty/tv without ring insert 33463
|
$4,773.29 |
$4,773.29 |
$4,773.29 |
$7,556.80
|
|
Valvuloplasty/tv w/ring insertion 33464
|
$3,692.94 |
$3,692.94 |
$3,692.94 |
$5,965.60
|
|
Vancomycin 1,000 mg intravenous injection
|
$86.82 |
$86.82 |
$86.82 |
$246.70
|
|
Vancomycin 750 mg intravenous solution
|
$310.16 |
$310.16 |
$310.16 |
$100.15
|
|
Vancomycin peak therapeutic drug level
|
$205.54 |
$205.54 |
$205.54 |
$126.79
|
|
Vanomycin dna amp probe
|
$143.21 |
$143.21 |
$143.21 |
$87.20
|
|
Varicella zoster antibody igg
|
$93.50 |
$93.50 |
$93.50 |
$82.55
|
|
Vasectomy
|
$518.66 |
$518.66 |
$518.66 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$100.17 |
$100.17 |
$100.17 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$32,023.98 |
$32,023.98 |
$32,023.98 |
$20,730.98
|
|
Vein bypass grft fem-popliteal 35583
|
$2,177.03 |
$2,177.03 |
$2,177.03 |
$7,043.20
|
|
Vein byp fem-tibial peroneal 35585
|
$20,776.00 |
$20,776.00 |
$20,776.00 |
$8,161.60
|
|
Vein byp pop-tibl peroneal
|
$20,902.14 |
$20,902.14 |
$20,902.14 |
$6,646.40
|
|
Vein gft fem a/p tib/pero/dis art 35566
|
$2,506.48 |
$2,506.48 |
$2,506.48 |
$8,152.00
|
|
Vein x-ray kidney
|
$5,286.75 |
$5,286.75 |
$5,286.75 |
$2,716.20
|
|
Vein x-ray liver w/hemodynam
|
$6,279.55 |
$6,279.55 |
$6,279.55 |
$3,413.25
|
