|
Trnscath plc stnt ante carotid art
|
$5,657.65 |
$5,657.65 |
$5,657.65 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,215.43 |
$11,215.43 |
$11,215.43 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$11,215.43 |
$11,215.43 |
$11,215.43 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,215.43 |
$11,215.43 |
$11,215.43 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,271.43 |
$3,271.43 |
$3,271.43 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,945.02 |
$4,945.02 |
$4,945.02 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,682.57 |
$6,682.57 |
$6,682.57 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,682.57 |
$6,682.57 |
$6,682.57 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$4,945.02 |
$4,945.02 |
$4,945.02 |
$4,329.36
|
|
Troponin quantitative
|
$152.43 |
$152.43 |
$152.43 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$23,030.48 |
$23,030.48 |
$23,030.48 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$20,936.84 |
$20,936.84 |
$20,936.84 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$64.39 |
$64.39 |
$64.39 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$641.67 |
$641.67 |
$641.67 |
$403.26
|
|
Ultrasound breast complete
|
$296.53 |
$296.53 |
$296.53 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$296.53 |
$296.53 |
$296.53 |
$449.35
|
|
Ultrasound chest
|
$689.85 |
$689.85 |
$689.85 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$157.68 |
$157.68 |
$157.68 |
$340.14
|
|
Ultrasound encephalogram
|
$632.91 |
$632.91 |
$632.91 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,062.59 |
$1,062.59 |
$1,062.59 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$271.13 |
$271.13 |
$271.13 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$220.32 |
$220.32 |
$220.32 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$656.13 |
$656.13 |
$656.13 |
$701.35
|
|
Ultrasound guide intraoperative
|
$168.20 |
$168.20 |
$168.20 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$112.57 |
$112.57 |
$112.57 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$180.90 |
$180.90 |
$180.90 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$180.90 |
$180.90 |
$180.90 |
$321.35
|
|
Ultrasound joint complete left
|
$606.20 |
$606.20 |
$606.20 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$181.77 |
$181.77 |
$181.77 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$635.54 |
$635.54 |
$635.54 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$288.65 |
$288.65 |
$288.65 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$270.25 |
$270.25 |
$270.25 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$373.62 |
$373.62 |
$373.62 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$289.08 |
$289.08 |
$289.08 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$324.56 |
$324.56 |
$324.56 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$730.15 |
$730.15 |
$730.15 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$417.86 |
$417.86 |
$417.86 |
$498.00
|
|
Ultrasound scrotum and contents
|
$793.66 |
$793.66 |
$793.66 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$584.73 |
$584.73 |
$584.73 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$180.90 |
$180.90 |
$180.90 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$766.50 |
$766.50 |
$766.50 |
$567.44
|
|
Unlisted procedure liver
|
$1,003.46 |
$1,003.46 |
$1,003.46 |
$2,694.00
|
|
Unlisted procedure rectum
|
$1,385.84 |
$1,385.84 |
$1,385.84 |
$1,278.72
|
|
Unlisted transfusion med px
|
$347.78 |
$347.78 |
$347.78 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$1,099.38 |
$1,099.38 |
$1,099.38 |
$1,480.70
|
|
Upgrade pm system
|
$14,636.21 |
$14,636.21 |
$14,636.21 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,060.31 |
$3,060.31 |
$3,060.31 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,686.30 |
$1,686.30 |
$1,686.30 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,081.82 |
$2,081.82 |
$2,081.82 |
$2,013.08
|
|
Urea nitrogen
|
$73.59 |
$73.59 |
$73.59 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$54.75 |
$54.75 |
$54.75 |
$50.00
|
|
Ureteral embolization/occl
|
$291.71 |
$291.71 |
$291.71 |
$3,041.22
|
|
Ureteral reflux study
|
$1,010.03 |
$1,010.03 |
$1,010.03 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$812.06 |
$812.06 |
$812.06 |
$574.40
|
|
Urethrocystography void s&i
|
$812.06 |
$812.06 |
$812.06 |
$634.50
|
|
Uric acid blood
|
$120.89 |
$120.89 |
$120.89 |
$46.64
|
|
Uric acid urine
|
$64.39 |
$64.39 |
$64.39 |
$46.75
|
|
Urinalysis microscopic only
|
$32.85 |
$32.85 |
$32.85 |
$26.35
|
|
Urinalysis (with microscopy)
|
$66.14 |
$66.14 |
$66.14 |
$48.14
|
|
Urinalysis (without microscopy)
|
$38.99 |
$38.99 |
$38.99 |
$38.99
|
|
Urinary reflex study
|
$90.23 |
$90.23 |
$90.23 |
$152.00
|
|
Urine Culture Test
|
$190.53 |
$190.53 |
$190.53 |
$84.81
|
|
Urine pregnancy test
|
$95.05 |
$95.05 |
$95.05 |
$66.40
|
|
Urography, antegrade
|
$444.57 |
$444.57 |
$444.57 |
$593.37
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$1,850.12 |
$1,850.12 |
$1,850.12 |
$5,521.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$78.60 |
$78.60 |
$78.60 |
$56,553.85
|
|
Vaccine dtap < 7 years im
|
$74.46 |
$74.46 |
$74.46 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$141.04 |
$141.04 |
$141.04 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$34.03 |
$34.03 |
$34.03 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$33.82 |
$33.82 |
$33.82 |
$45.33
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$77.19 |
$77.19 |
$77.19 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$41.61 |
$41.61 |
$41.61 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$113.01 |
$113.01 |
$113.01 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$31.10 |
$31.10 |
$31.10 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$38.11 |
$38.11 |
$38.11 |
$40.01
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$249.34 |
$249.34 |
$249.34 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$123.52 |
$123.52 |
$123.52 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$196.32 |
$196.32 |
$196.32 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$378.37 |
$378.37 |
$378.37 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$392.45 |
$392.45 |
$392.45 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$58.26 |
$58.26 |
$58.26 |
$119.17
|
|
Vaccine rabies im
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,196.00
|
|
Vaccine tdap >=7 years im
|
$70.08 |
$70.08 |
$70.08 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$56.94 |
$56.94 |
$56.94 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$148.49 |
$148.49 |
$148.49 |
$115.00
|
|
Valvuloplasty aortic
|
$5,149.13 |
$5,149.13 |
$5,149.13 |
$7,324.85
|
|
Valvuloplasty mitral
|
$5,950.23 |
$5,950.23 |
$5,950.23 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$5,950.23 |
$5,950.23 |
$5,950.23 |
$11,945.20
|
|
Vancomycin hcl injection
|
$65.70 |
$65.70 |
$65.70 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$132.72 |
$132.72 |
$132.72 |
$126.79
|
|
Varicella zoster antibody igg
|
$6.00 |
$6.00 |
$6.00 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$335.07 |
$335.07 |
$335.07 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$27.45 |
$27.45 |
$27.45 |
$20,730.98
|
|
Veeg cont 2-12 hrs
|
$707.81 |
$707.81 |
$707.81 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$1,337.22 |
$1,337.22 |
$1,337.22 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$374.49 |
$374.49 |
$374.49 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$707.81 |
$707.81 |
$707.81 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$374.49 |
$374.49 |
$374.49 |
$704.79
|
|
Vein x-ray kidney
|
$4,703.69 |
$4,703.69 |
$4,703.69 |
$2,716.20
|