|
Ugt1a1 gene analy common variants
|
$75.58 |
$244.78 |
$1,151.73 |
|
|
Ultrasound breast complete
|
$88.20 |
$246.96 |
$797.16 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$67.90 |
$167.81 |
$706.64 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$54.60 |
$136.11 |
$237.25 |
|
|
Ultrasound dx ophth b-scan
|
$65.86 |
$147.26 |
$199.60 |
|
|
Ultrasound elastography ea l target les
|
$27.38 |
$76.59 |
$278.25 |
|
|
Ultrasound elastography parenchyma
|
$58.16 |
$170.56 |
$556.50 |
|
|
Ultrasound encephalogram
|
$103.88 |
$244.55 |
$985.38 |
|
|
Ultrasound exam k transpl w/doppler
|
$78.12 |
$194.74 |
$490.47 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$89.04 |
$249.31 |
$604.73 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$109.20 |
$277.88 |
$1,472.87 |
|
|
Ultrasound guidance for vascular access
|
$56.20 |
$211.75 |
$732.36 |
|
|
Ultrasound guide intraoperative
|
$76.38 |
$236.97 |
$1,073.42 |
|
|
Ultrasound guide tissue ablation
|
$86.51 |
$193.43 |
$1,029.34 |
|
|
Ultrasound hips infant dynamic
|
$78.68 |
$220.30 |
$569.86 |
|
|
Ultrasound infant hips ltd without stress
|
$57.54 |
$142.21 |
$426.65 |
|
|
Ultrasound joint complete left
|
$65.52 |
$183.46 |
$557.99 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$74.06 |
$182.50 |
$516.11 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$48.72 |
$133.28 |
$427.40 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$155.39 |
$304.68 |
$604.44 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$71.12 |
$202.18 |
$529.25 |
|
|
Ultrasound prostate/transrectal
|
$50.46 |
$173.44 |
$313.63 |
|
|
Ultrasound spinal canal and contents
|
$109.76 |
$270.48 |
$405.88 |
|
|
Ultrasound transabd ea addl gest
|
$108.48 |
$253.62 |
$700.07 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$393.85 |
$393.85 |
$393.85 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$271.22 |
$271.22 |
$271.22 |
|
|
Umbilical artery cath newborn 36660
|
$806.22 |
$806.22 |
$806.22 |
|
|
Unit mobile power mpu
|
$7,855.87 |
$7,855.87 |
$8,517.84 |
|
|
Unlisted chemotherapy px
|
$50.50 |
$50.50 |
$50.50 |
|
|
Unlisted CT procedure
|
$112.31 |
$525.59 |
$676.12 |
|
|
Unlisted cytogenetic study
|
$1,680.04 |
$1,680.04 |
$1,680.04 |
|
|
Unlisted cytopathology px
|
$132.08 |
$132.08 |
$132.08 |
|
|
Unlisted dialysis procedure
|
$252.51 |
$252.51 |
$890.43 |
|
|
Unlisted dx gi procedure
|
$119.51 |
$125.00 |
$137.28 |
|
|
Unlisted fluoroscopic px
|
$407.16 |
$676.91 |
$689.66 |
|
|
Unlisted gi px dx nuc med
|
$1,826.81 |
$1,826.81 |
$1,826.81 |
|
|
Unlisted hematology&coagj px
|
$3.65 |
$10.89 |
$31.24 |
|
|
Unlisted laparoscopic liver biopy 47379
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
|
|
Unlisted laparoscopic procedure 49659
|
$9,088.02 |
$9,088.02 |
$9,088.02 |
|
|
Unlisted laparoscopic reduction intestine 44238
|
$9,088.02 |
$9,088.02 |
$9,088.02 |
|
|
Unlisted mr procedure
|
$594.78 |
$688.34 |
$782.02 |
|
|
Unlisted procedure liver
|
$3,230.59 |
$3,230.59 |
$3,275.71 |
|
|
Unlisted procedure microbiology
|
$185.00 |
$247.50 |
$3,132.02 |
|
|
Unlisted procedure rectum
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
|
|
Unlisted procedure spine
|
$1,370.78 |
$1,370.78 |
$2,368.47 |
|
|
Unlisted px accessory sinus
|
$747.42 |
$747.42 |
$747.42 |
|
|
Unlisted px arthroscopy
|
$362.10 |
$362.10 |
$362.10 |
|
|
Unlisted px biliary tract
|
$1,275.46 |
$1,275.46 |
$2,914.89 |
|
|
Unlisted px diaphragm
|
$19,031.56 |
$19,031.56 |
$19,031.56 |
|
|
Unlisted px foot/toes
|
$157.31 |
$157.31 |
$157.31 |
|
|
Unlisted px leg/ankle
|
$357.65 |
$357.65 |
$4,138.61 |
|
|
Unlisted px male genital sys
|
$388.81 |
$388.81 |
$388.81 |
|
|
Unlisted px mediastinum
|
$646.50 |
$646.50 |
$646.50 |
|
|
Unlisted px neck/thorax
|
$358.39 |
$358.39 |
$3,313.83 |
|
|
Unlisted px pelvis/hip joint
|
$357.65 |
$357.65 |
$665.88 |
|
|
Unlisted reprod med lab proc
|
$115.01 |
$115.01 |
$115.01 |
|
|
Unlisted spec derm svc/px
|
$216.20 |
$216.20 |
$216.20 |
|
|
Unlisted surgical path px
|
$247.09 |
$247.09 |
$247.09 |
|
|
Unlisted transfusion med px
|
$20.90 |
$69.41 |
$261.67 |
|
|
Unlisted ultrasound procedure
|
$134.86 |
$134.86 |
$134.86 |
|
|
Unsched dialysis esrd pt hos
|
$253.44 |
$435.60 |
$1,117.35 |
|
|
Upgrade pm system
|
$3,539.78 |
$4,523.77 |
$18,042.48 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$66.88 |
$104.54 |
$938.63 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$354.58 |
$599.10 |
$3,139.41 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$283.59 |
$479.18 |
$2,936.10 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$418.30 |
$627.44 |
$3,943.73 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$348.58 |
$522.87 |
$3,856.92 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$278.86 |
$418.30 |
$3,443.63 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$61.94 |
$96.82 |
$378.03 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$71.44 |
$116.56 |
$655.19 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$150.72 |
$1,382.08 |
$1,966.30 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$169.56 |
$169.56 |
$1,966.30 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$116.85 |
$184.20 |
$839.95 |
|
|
Upper GI Barium X-ray (barium only)
|
$115.14 |
$174.53 |
$882.98 |
|
|
Uppr gi scope w/submuc inj
|
$169.56 |
$169.56 |
$1,638.34 |
|
|
Urea nitrogen
|
$13.94 |
$23.35 |
$91.12 |
|
|
Urea nitrogen 24 hour urine
|
$4.37 |
$8.63 |
$59.60 |
|
|
Ureteral embolization/occl
|
$1,085.39 |
$1,355.44 |
$2,546.42 |
|
|
Ureteral reflux study
|
$220.97 |
$461.72 |
$2,079.83 |
|
|
Ureter endoscopy & treatment
|
$508.27 |
$508.27 |
$508.27 |
|
|
Ureteroureterostomy 50760
|
$746.73 |
$746.73 |
$746.73 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$161.70 |
$271.87 |
$661.87 |
|
|
Urethrlys transvag with scope
|
$1,084.81 |
$1,084.81 |
$1,084.81 |
|
|
Urethrocystography void s&i
|
$130.72 |
$213.28 |
$719.99 |
|
|
Uric acid blood
|
$6.58 |
$22.12 |
$87.56 |
|
|
Uric acid urine
|
$5.00 |
$11.52 |
$44.52 |
|
|
Urinalysis microscopic only
|
$1.23 |
$2.67 |
$18.50 |
|
|
Urinalysis qual/semiquant excpt ia
|
$0.86 |
$1.95 |
$336.34 |
|
|
Urinalysis (with microscopy)
|
$5.20 |
$27.71 |
$85.50 |
|
|
Urinalysis (without microscopy)
|
$9.10 |
$26.00 |
$71.24 |
|
|
Urinary bldr retent nuc study
|
$76.51 |
$112.49 |
$179.29 |
|
|
Urine Culture Test
|
$11.82 |
$55.27 |
$267.47 |
|
|
Urine pregnancy test
|
$7.13 |
$52.33 |
$181.05 |
|
|
Urography, antegrade
|
$177.00 |
$330.13 |
$865.92 |
|
|
Urography inf drip &/or bolus
|
$444.41 |
$570.72 |
$725.09 |
|
|
Use 1st target lesion
|
$48.40 |
$135.38 |
$556.50 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$8,273.30 |
$8,273.30 |
$8,273.30 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$40,347.99 |
$40,347.99 |
$40,347.99 |
|
|
Vaccine Administration (one shot)
|
$8.71 |
$23.31 |
$153.60 |
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$0.01 |
$0.01 |
$0.01 |
|
