|
Ultrasound doppler velocimetry fetal umbilical artery
|
$509.20 |
$509.20 |
$509.20 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$193.00 |
$193.00 |
$193.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$385.60 |
$385.60 |
$385.60 |
$307.00
|
|
Ultrasound encephalogram
|
$549.00 |
$549.00 |
$549.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$569.00 |
$569.00 |
$569.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$773.00 |
$773.00 |
$773.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$232.20 |
$232.20 |
$232.20 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$522.00 |
$522.00 |
$522.00 |
$720.15
|
|
Ultrasound guide intraoperative
|
$149.20 |
$149.20 |
$149.20 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$571.80 |
$571.80 |
$571.80 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$455.60 |
$455.60 |
$455.60 |
$311.25
|
|
Ultrasound joint complete left
|
$549.00 |
$549.00 |
$549.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$666.60 |
$666.60 |
$666.60 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$228.00 |
$228.00 |
$228.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$228.00 |
$228.00 |
$228.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$134.40 |
$134.40 |
$134.40 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$46.40 |
$46.40 |
$46.40 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$422.20 |
$422.20 |
$422.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$383.00 |
$383.00 |
$383.00 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$95.40 |
$95.40 |
$95.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$381.60 |
$381.60 |
$381.60 |
$486.50
|
|
Ultrasound scrotum and contents
|
$571.40 |
$571.40 |
$571.40 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$764.80 |
$764.80 |
$764.80 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$47.20 |
$47.20 |
$47.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$378.60 |
$378.60 |
$378.60 |
$558.35
|
|
Unlisted misc path test
|
$1.87 |
$1.87 |
$1.87 |
$89.40
|
|
Unlisted procedure microbiology
|
$88.60 |
$88.60 |
$88.60 |
$523.50
|
|
Unlisted px casting/strpg
|
$109.00 |
$109.00 |
$109.00 |
$219.70
|
|
Unlisted special svc px/rprt
|
$6.00 |
$6.00 |
$6.00 |
$90.00
|
|
Unlisted transfusion med px
|
$13.00 |
$13.00 |
$13.00 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$491.00 |
$491.00 |
$491.00 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,459.20 |
$2,459.20 |
$2,459.20 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,419.40 |
$2,419.40 |
$2,419.40 |
$2,034.41
|
|
Urea nitrogen
|
$140.20 |
$140.20 |
$140.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$68.20 |
$68.20 |
$68.20 |
$51.75
|
|
Urea nitrogen clearance
|
$2.68 |
$2.68 |
$2.68 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$110.40 |
$110.40 |
$110.40 |
$579.73
|
|
Urethrocystography void s&i
|
$781.40 |
$781.40 |
$781.40 |
$622.35
|
|
Uric acid blood
|
$72.00 |
$72.00 |
$72.00 |
$48.75
|
|
Uric acid urine
|
$6.20 |
$6.20 |
$6.20 |
$44.33
|
|
Urinalysis microscopic only
|
$10.00 |
$10.00 |
$10.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$93.40 |
$93.40 |
$93.40 |
$55.00
|
|
Urinalysis (without microscopy)
|
$83.00 |
$83.00 |
$83.00 |
$35.75
|
|
Urinary bldr retent nuc study
|
$24.80 |
$24.80 |
$24.80 |
$350.66
|
|
Urine Culture Test
|
$102.60 |
$102.60 |
$102.60 |
$81.50
|
|
Urine pregnancy test
|
$96.80 |
$96.80 |
$96.80 |
$67.20
|
|
Urography, antegrade
|
$208.80 |
$208.80 |
$208.80 |
$622.35
|
|
Urography inf drip &/or bolus
|
$579.20 |
$579.20 |
$579.20 |
$642.50
|
|
Use 1st target lesion
|
$385.60 |
$385.60 |
$385.60 |
$332.00
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$86.97 |
$86.97 |
$86.97 |
$236.50
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$95.61 |
$95.61 |
$95.61 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$25.23 |
$25.23 |
$25.23 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$85.80 |
$85.80 |
$85.80 |
$576.48
|
|
Vaccine influenza inactivated adjuvant im
|
$71.14 |
$71.14 |
$71.14 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$17.77 |
$17.77 |
$17.77 |
$47.88
|
|
Vaccine mmr live subcutaneous
|
$75.00 |
$75.00 |
$75.00 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$75.00 |
$75.00 |
$75.00 |
$251.64
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$156.24 |
$156.24 |
$156.24 |
$563.36
|
|
Vaccine rabies im
|
$266.06 |
$266.06 |
$266.06 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$220.90 |
$220.90 |
$220.90 |
$538.84
|
|
Vaccine tdap >=7 years im
|
$56.80 |
$56.80 |
$56.80 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$152.40 |
$152.40 |
$152.40 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$23.49 |
$23.49 |
$23.49 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$42.12 |
$42.12 |
$42.12 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$73.60 |
$73.60 |
$73.60 |
$136.13
|
|
Varicella zoster antibody igg
|
$50.60 |
$50.60 |
$50.60 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$92.45 |
$92.45 |
$92.45 |
$325.80
|
|
Veeg cont 2-12 hrs
|
$318.40 |
$318.40 |
$318.40 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$610.60 |
$610.60 |
$610.60 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$187.00 |
$187.00 |
$187.00 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$318.40 |
$318.40 |
$318.40 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$187.00 |
$187.00 |
$187.00 |
$826.15
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$26.80 |
$26.80 |
$26.80 |
$202.80
|
|
Venipuncture <3 yrs other vein
|
$17.20 |
$17.20 |
$17.20 |
$67.00
|
|
Venogram ext bil s&i
|
$2,482.40 |
$2,482.40 |
$2,482.40 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$668.60 |
$668.60 |
$668.60 |
$1,366.20
|
|
Venous mech thrombectomy
|
$12,679.20 |
$12,679.20 |
$12,679.20 |
$7,965.00
|
|
Venous thrombosis imaging
|
$281.00 |
$281.00 |
$281.00 |
$697.20
|
|
Ven thrombosis images bilat
|
$169.00 |
$169.00 |
$169.00 |
$796.50
|
|
Ventilator each subsequent day
|
$176.40 |
$176.40 |
$176.40 |
$1,204.00
|
|
Ventilator initial day
|
$176.40 |
$176.40 |
$176.40 |
$1,431.43
|
|
Vent mgmt nf per day
|
$158.20 |
$158.20 |
$158.20 |
$110.40
|
|
Very long chain fatty acids
|
$3.21 |
$3.21 |
$3.21 |
$139.88
|
|
Virus isolation addl studies ea
|
$4.80 |
$4.80 |
$4.80 |
$77.50
|
|
Vital capacity test
|
$59.80 |
$59.80 |
$59.80 |
$170.00
|
|
Vitamin b-12
|
$148.40 |
$148.40 |
$148.40 |
$100.00
|
|
Vitamin D Test
|
$80.00 |
$80.00 |
$80.00 |
$132.00
|
|
Vkorc1 gene
|
$10.00 |
$10.00 |
$10.00 |
$176.80
|
|
Volume measurement urine timed
|
$30.80 |
$30.80 |
$30.80 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$41.18 |
$41.18 |
$41.18 |
$165.81
|
|
Warde 1003990 aldosterone
|
$8.40 |
$8.40 |
$8.40 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$28.60 |
$28.60 |
$28.60 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$42.56 |
$42.56 |
$42.56 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$5.20 |
$5.20 |
$5.20 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$2.76 |
$2.76 |
$2.76 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$3.45 |
$3.45 |
$3.45 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$1.47 |
$1.47 |
$1.47 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$12.07 |
$12.07 |
$12.07 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$5.00 |
$5.00 |
$5.00 |
$69.60
|
