|
Tx open nsl sptl fx
|
$3,930.50 |
$3,930.50 |
$3,930.50 |
$4,289.04
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$140.00 |
$140.00 |
$140.00 |
$469.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$397.95 |
$397.95 |
$397.95 |
$403.26
|
|
Ultrasound breast complete
|
$866.25 |
$866.25 |
$866.25 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$650.30 |
$650.30 |
$650.30 |
$449.35
|
|
Ultrasound chest
|
$705.25 |
$705.25 |
$705.25 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$998.90 |
$998.90 |
$998.90 |
$340.14
|
|
Ultrasound encephalogram
|
$502.60 |
$502.60 |
$502.60 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$835.80 |
$835.80 |
$835.80 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$772.80 |
$772.80 |
$772.80 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$238.35 |
$238.35 |
$238.35 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$701.35
|
|
Ultrasound guide intraoperative
|
$326.20 |
$326.20 |
$326.20 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$486.85 |
$486.85 |
$486.85 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$243.25 |
$243.25 |
$243.25 |
$321.35
|
|
Ultrasound joint complete left
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$780.85 |
$780.85 |
$780.85 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$493.85 |
$493.85 |
$493.85 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$498.05 |
$498.05 |
$498.05 |
$326.54
|
|
Ultrasound pregnant uterus follow up per fetus
|
$499.10 |
$499.10 |
$499.10 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$499.10 |
$499.10 |
$499.10 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$866.25 |
$866.25 |
$866.25 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$742.35 |
$742.35 |
$742.35 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$583.45 |
$583.45 |
$583.45 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$486.85 |
$486.85 |
$486.85 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$866.25 |
$866.25 |
$866.25 |
$567.44
|
|
Umbilical artery cath newborn 36660
|
$793.80 |
$793.80 |
$793.80 |
$265.85
|
|
Unlisted chemotherapy px
|
$99.75 |
$99.75 |
$99.75 |
$153.85
|
|
Unlisted procedure rectum
|
$1,101.80 |
$1,101.80 |
$1,101.80 |
$1,278.72
|
|
Unlisted px hands/fingers
|
$227.15 |
$227.15 |
$227.15 |
$379.44
|
|
Unlisted px salivry glnd/dux
|
$169.75 |
$169.75 |
$169.75 |
$486.72
|
|
Unlisted px small intestine
|
$862.40 |
$862.40 |
$862.40 |
$2,118.35
|
|
Unlisted ultrasound procedure
|
$149.80 |
$149.80 |
$149.80 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$995.40 |
$995.40 |
$995.40 |
$1,469.76
|
|
Upgrade pm system
|
$4,134.20 |
$4,134.20 |
$4,134.20 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,054.10 |
$3,054.10 |
$3,054.10 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,429.00 |
$2,429.00 |
$2,429.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,238.25 |
$2,238.25 |
$2,238.25 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$530.60 |
$530.60 |
$530.60 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$530.60 |
$530.60 |
$530.60 |
$1,656.60
|
|
Urea nitrogen
|
$98.70 |
$98.70 |
$98.70 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$103.25 |
$103.25 |
$103.25 |
$50.00
|
|
Urea nitrogen clearance
|
$47.25 |
$47.25 |
$47.25 |
$33.57
|
|
Ureteral reflux study
|
$556.85 |
$556.85 |
$556.85 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$544.95 |
$544.95 |
$544.95 |
$574.40
|
|
Urethrocystography void s&i
|
$517.30 |
$517.30 |
$517.30 |
$634.50
|
|
Uric acid blood
|
$98.70 |
$98.70 |
$98.70 |
$46.64
|
|
Uric acid urine
|
$128.80 |
$128.80 |
$128.80 |
$46.75
|
|
Urinalysis qual/semiquant excpt ia
|
$261.10 |
$261.10 |
$261.10 |
$25.72
|
|
Urinalysis (with microscopy)
|
$276.50 |
$276.50 |
$276.50 |
$48.14
|
|
Urinalysis (without microscopy)
|
$166.25 |
$166.25 |
$166.25 |
$38.99
|
|
Urinary bldr retent nuc study
|
$509.60 |
$509.60 |
$509.60 |
$309.22
|
|
Urine Culture Test
|
$256.55 |
$256.55 |
$256.55 |
$84.81
|
|
Urine pregnancy test
|
$100.80 |
$100.80 |
$100.80 |
$66.40
|
|
Urography, antegrade
|
$625.10 |
$625.10 |
$625.10 |
$593.37
|
|
Vaccine dtap < 7 years im
|
$83.60 |
$83.60 |
$83.60 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$258.72 |
$258.72 |
$258.72 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$112.66 |
$112.66 |
$112.66 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$72.02 |
$72.02 |
$72.02 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$270.95 |
$270.95 |
$270.95 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$495.41 |
$495.41 |
$495.41 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$74.42 |
$74.42 |
$74.42 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$277.66 |
$277.66 |
$277.66 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$57.04 |
$57.04 |
$57.04 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$257.31 |
$257.31 |
$257.31 |
$104.63
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$99.80 |
$99.80 |
$99.80 |
$103.88
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$408.70 |
$408.70 |
$408.70 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$350.71 |
$350.71 |
$350.71 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$439.44 |
$439.44 |
$439.44 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$467.44 |
$467.44 |
$467.44 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$834.65 |
$834.65 |
$834.65 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$167.57 |
$167.57 |
$167.57 |
$119.17
|
|
Vaccine rabies im
|
$1,116.66 |
$1,116.66 |
$1,116.66 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,759.01 |
$1,759.01 |
$1,759.01 |
$1,196.00
|
|
Vaccine tdap >=7 years im
|
$157.41 |
$157.41 |
$157.41 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$159.09 |
$159.09 |
$159.09 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$530.72 |
$530.72 |
$530.72 |
$447.80
|
|
Vad battery clip set hmii 14-v li-ion
|
$1,008.32 |
$1,008.32 |
$1,008.32 |
$1,683.99
|
|
Vad univ batt charger hm 1440
|
$11,376.29 |
$11,376.29 |
$11,376.29 |
$14,893.34
|
|
Vaginal bx
|
$227.15 |
$227.15 |
$227.15 |
$441.75
|
|
Vaginal delivery after cesarean delivery 59612
|
$2,017.75 |
$2,017.75 |
$2,017.75 |
$4,109.28
|
|
Valproic acid total therapeutic drug level
|
$393.75 |
$393.75 |
$393.75 |
$115.00
|
|
Valvuloplasty aortic
|
$1,786.40 |
$1,786.40 |
$1,786.40 |
$7,324.85
|
|
Valvuloplasty mitral
|
$5,593.35 |
$5,593.35 |
$5,593.35 |
$10,435.39
|
|
Vancomycin 1,000 mg intravenous injection
|
$146.16 |
$146.16 |
$146.16 |
$246.70
|
|
Vancomycin 750 mg intravenous solution
|
$72.22 |
$72.22 |
$72.22 |
$100.15
|
|
Vancomycin peak therapeutic drug level
|
$393.75 |
$393.75 |
$393.75 |
$126.79
|
|
Varicella zoster antibody igg
|
$53.90 |
$53.90 |
$53.90 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$6,122.43 |
$6,122.43 |
$6,122.43 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$36,507.39 |
$36,507.39 |
$36,507.39 |
$20,730.98
|
|
Veeg cont 2-12 hrs
|
$1,485.05 |
$1,485.05 |
$1,485.05 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$4,456.20 |
$4,456.20 |
$4,456.20 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$1,104.25 |
$1,104.25 |
$1,104.25 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$2,227.75 |
$2,227.75 |
$2,227.75 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$688.45 |
$688.45 |
$688.45 |
$704.79
|
|
Vein x-ray kidney
|
$8,212.05 |
$8,212.05 |
$8,212.05 |
$2,716.20
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$911.75 |
$911.75 |
$911.75 |
$188.65
|
|
Venipuncture <3 yrs other vein
|
$77.35 |
$77.35 |
$77.35 |
$82.11
|
