|
Ultrasound ob >=14wks ea addl gest
|
$175.04 |
$175.04 |
$175.04 |
$393.86
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$222.08 |
$222.08 |
$222.08 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$268.94 |
$268.94 |
$268.94 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$238.72 |
$238.72 |
$238.72 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$154.24 |
$154.24 |
$154.24 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$237.12 |
$237.12 |
$237.12 |
$490.00
|
|
Ultrasound prostate/transrectal
|
$298.24 |
$298.24 |
$298.24 |
$549.95
|
|
Ultrasound retroperitoneal limited
|
$229.92 |
$229.92 |
$229.92 |
$479.60
|
|
Ultrasound scrotum and contents
|
$380.80 |
$380.80 |
$380.80 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$137.28 |
$137.28 |
$137.28 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$116.96 |
$116.96 |
$116.96 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$286.56 |
$286.56 |
$286.56 |
$558.35
|
|
Unlisted CT procedure
|
$555.52 |
$555.52 |
$555.52 |
$700.80
|
|
Unlisted dialysis procedure
|
$238.72 |
$238.72 |
$238.72 |
$1,144.00
|
|
Unlisted maaa
|
$39.52 |
$39.52 |
$39.52 |
$228.00
|
|
Unlisted misc path test
|
$1.50 |
$1.50 |
$1.50 |
$89.40
|
|
Unlisted mr procedure
|
$329.28 |
$329.28 |
$329.28 |
$1,163.00
|
|
Unlisted procedure microbiology
|
$70.88 |
$70.88 |
$70.88 |
$490.70
|
|
Unlisted surgical path px
|
$100.48 |
$100.48 |
$100.48 |
$217.75
|
|
Unlisted transfusion med px
|
$12.80 |
$12.80 |
$12.80 |
$147.50
|
|
Unlisted ultrasound procedure
|
$64.00 |
$64.00 |
$64.00 |
$326.40
|
|
Unsched dialysis esrd pt hos
|
$377.12 |
$377.12 |
$377.12 |
$1,268.17
|
|
Upgrade pm system
|
$6,632.80 |
$6,632.80 |
$6,632.80 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,281.12 |
$1,281.12 |
$1,281.12 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,133.28 |
$1,133.28 |
$1,133.28 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$801.60 |
$801.60 |
$801.60 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$73.28 |
$73.28 |
$73.28 |
$1,794.22
|
|
Upper ext fx orthosis rad/ul
|
$88.32 |
$88.32 |
$88.32 |
$619.49
|
|
Urea nitrogen
|
$30.40 |
$30.40 |
$30.40 |
$40.95
|
|
Urea nitrogen 24 hour urine
|
$23.36 |
$23.36 |
$23.36 |
$52.00
|
|
Urea nitrogen clearance
|
$0.94 |
$0.94 |
$0.94 |
$45.12
|
|
Ureteral reflux study
|
$347.04 |
$347.04 |
$347.04 |
$962.42
|
|
Urethrcystgrphy rtrgrde s&i
|
$236.48 |
$236.48 |
$236.48 |
$584.00
|
|
Urethrocystography void s&i
|
$297.60 |
$297.60 |
$297.60 |
$648.05
|
|
Uric acid blood
|
$50.24 |
$50.24 |
$50.24 |
$49.44
|
|
Uric acid urine
|
$49.76 |
$49.76 |
$49.76 |
$44.22
|
|
Urinalysis microscopic only
|
$8.00 |
$8.00 |
$8.00 |
$26.46
|
|
Urinalysis (with microscopy)
|
$69.92 |
$69.92 |
$69.92 |
$55.44
|
|
Urinalysis (without microscopy)
|
$29.60 |
$29.60 |
$29.60 |
$36.00
|
|
Urine Culture Test
|
$92.16 |
$92.16 |
$92.16 |
$81.27
|
|
Urine pregnancy test
|
$57.44 |
$57.44 |
$57.44 |
$67.80
|
|
Urography, antegrade
|
$323.36 |
$323.36 |
$323.36 |
$622.35
|
|
Urography inf drip &/or bolus
|
$114.40 |
$114.40 |
$114.40 |
$659.60
|
|
Vaccine influenza inactivated adjuvant im
|
$59.95 |
$59.95 |
$59.95 |
$106.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$14.97 |
$14.97 |
$14.97 |
$47.88
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$134.08 |
$134.08 |
$134.08 |
$563.36
|
|
Vaccine rabies im
|
$212.78 |
$212.78 |
$212.78 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$36.97 |
$36.97 |
$36.97 |
$132.88
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$11.61 |
$11.61 |
$11.61 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$69.60 |
$69.60 |
$69.60 |
$114.48
|
|
Vancomycin 1,000 mg intravenous injection
|
$43.20 |
$43.20 |
$43.20 |
$246.70
|
|
Vancomycin peak therapeutic drug level
|
$91.84 |
$91.84 |
$91.84 |
$132.72
|
|
Varicella zoster antibody igg
|
$36.32 |
$36.32 |
$36.32 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$56.64 |
$56.64 |
$56.64 |
$325.80
|
|
Veeg cont 2-12 hrs
|
$620.16 |
$620.16 |
$620.16 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$579.36 |
$579.36 |
$579.36 |
$3,053.00
|
|
Veeg intrmnt 2-12 hrs
|
$440.80 |
$440.80 |
$440.80 |
$994.91
|
|
Veeg unmon 12-26 hrs
|
$798.40 |
$798.40 |
$798.40 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$456.64 |
$456.64 |
$456.64 |
$826.15
|
|
Vein x-ray adrenal gland
|
$934.88 |
$934.88 |
$934.88 |
$2,947.68
|
|
Vein x-ray kidney
|
$813.28 |
$813.28 |
$813.28 |
$2,990.58
|
|
Vein x-ray liver
|
$819.84 |
$819.84 |
$819.84 |
$3,332.55
|
|
Vein x-ray liver w/hemodynam
|
$1,036.80 |
$1,036.80 |
$1,036.80 |
$3,483.84
|
|
Vein x-ray liver w/hemodynam
|
$1,325.76 |
$1,325.76 |
$1,325.76 |
$3,662.50
|
|
Vein x-ray liver without hemodyn
|
$829.60 |
$829.60 |
$829.60 |
$2,489.25
|
|
Vein x-ray spleen/liver
|
$1,253.28 |
$1,253.28 |
$1,253.28 |
$3,434.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$140.96 |
$140.96 |
$140.96 |
$197.04
|
|
Venogram ext bil s&i
|
$530.08 |
$530.08 |
$530.08 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$656.80 |
$656.80 |
$656.80 |
$1,382.58
|
|
Venous mech thrombectomy
|
$2,881.92 |
$2,881.92 |
$2,881.92 |
$8,184.00
|
|
Venous m-thrombectomy add-on
|
$2,518.08 |
$2,518.08 |
$2,518.08 |
$5,094.75
|
|
Venous sampling s&i
|
$1,373.76 |
$1,373.76 |
$1,373.76 |
$4,294.50
|
|
Venous thrombosis imaging
|
$391.68 |
$391.68 |
$391.68 |
$697.20
|
|
Ven thrombosis images bilat
|
$637.12 |
$637.12 |
$637.12 |
$800.50
|
|
Ventilator each subsequent day
|
$742.88 |
$742.88 |
$742.88 |
$1,184.00
|
|
Ventilator initial day
|
$1,005.44 |
$1,005.44 |
$1,005.44 |
$1,416.96
|
|
Ventricular puncture prev burr hole without inj 61020
|
$204.48 |
$204.48 |
$204.48 |
$1,231.50
|
|
Version cephalic external
|
$192.00 |
$192.00 |
$192.00 |
$2,361.75
|
|
Very long chain fatty acids
|
$2.57 |
$2.57 |
$2.57 |
$139.88
|
|
Virus isolation addl studies ea
|
$8.64 |
$8.64 |
$8.64 |
$74.36
|
|
Vital capacity test
|
$55.68 |
$55.68 |
$55.68 |
$170.00
|
|
Vitamin b-12
|
$52.80 |
$52.80 |
$52.80 |
$100.00
|
|
Vitamin D Test
|
$96.80 |
$96.80 |
$96.80 |
$132.00
|
|
Vkorc1 gene
|
$8.00 |
$8.00 |
$8.00 |
$176.80
|
|
Volume measurement urine timed
|
$9.12 |
$9.12 |
$9.12 |
$21.03
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$84.01 |
$84.01 |
$84.01 |
$165.81
|
|
Warde 1003990 aldosterone
|
$5.80 |
$5.80 |
$5.80 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$22.88 |
$22.88 |
$22.88 |
$96.00
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$34.05 |
$34.05 |
$34.05 |
$65.40
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$3.59 |
$3.59 |
$3.59 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$2.70 |
$2.70 |
$2.70 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$2.76 |
$2.76 |
$2.76 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$1.14 |
$1.14 |
$1.14 |
$39.60
|
|
Warde 3008005 oligoclonal bands
|
$3.50 |
$3.50 |
$3.50 |
$103.95
|
|
Warde 3016000 west nile virus antibody
|
$2.40 |
$2.40 |
$2.40 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$2.05 |
$2.05 |
$2.05 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$26.24 |
$26.24 |
$26.24 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$56.32 |
$56.32 |
$56.32 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$49.60 |
$49.60 |
$49.60 |
$70.85
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$22.82 |
$22.82 |
$22.82 |
$219.13
|
