|
Urethrocystography void s&i
|
$388.40 |
$388.40 |
$388.40 |
$622.35
|
|
Uric acid blood
|
$23.20 |
$23.20 |
$23.20 |
$48.75
|
|
Uric acid urine
|
$17.80 |
$17.80 |
$17.80 |
$44.33
|
|
Urinalysis qual/semiquant excpt ia
|
$4.00 |
$4.00 |
$4.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$18.00 |
$18.00 |
$18.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$13.00 |
$13.00 |
$13.00 |
$35.75
|
|
Urine Culture Test
|
$35.80 |
$35.80 |
$35.80 |
$81.50
|
|
Urine flow measurement 51736
|
$35.20 |
$35.20 |
$35.20 |
$210.00
|
|
Urine pregnancy test
|
$27.60 |
$27.60 |
$27.60 |
$67.20
|
|
Urography, antegrade
|
$369.60 |
$369.60 |
$369.60 |
$622.35
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$80.80 |
$80.80 |
$80.80 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$76.80 |
$76.80 |
$76.80 |
$209.40
|
|
Vaccine dtap < 7 years im
|
$90.44 |
$90.44 |
$90.44 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$55.60 |
$55.60 |
$55.60 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$20.80 |
$20.80 |
$20.80 |
$105.95
|
|
Vaccine dtap-ipv/hib im
|
$38.80 |
$38.80 |
$38.80 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$17.40 |
$17.40 |
$17.40 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$20.20 |
$20.20 |
$20.20 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$35.20 |
$35.20 |
$35.20 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$149.80 |
$149.80 |
$149.80 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$19.60 |
$19.60 |
$19.60 |
$79.15
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$37.60 |
$37.60 |
$37.60 |
$84.75
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$35.20 |
$35.20 |
$35.20 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$84.20 |
$84.20 |
$84.20 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$43.53 |
$43.53 |
$43.53 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$115.40 |
$115.40 |
$115.40 |
$576.48
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$62.60 |
$62.60 |
$62.60 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$36.80 |
$36.80 |
$36.80 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$117.62 |
$117.62 |
$117.62 |
$109.50
|
|
Vaccine influenza nos 0.5ml dose im
|
$11.00 |
$11.00 |
$11.00 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$29.37 |
$29.37 |
$29.37 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$10.60 |
$10.60 |
$10.60 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$38.60 |
$38.60 |
$38.60 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$11.80 |
$11.80 |
$11.80 |
$31.03
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$11.20 |
$11.20 |
$11.20 |
$33.60
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$10.40 |
$10.40 |
$10.40 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$11.80 |
$11.80 |
$11.80 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$36.80 |
$36.80 |
$36.80 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$8.80 |
$8.80 |
$8.80 |
$76.50
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$5.40 |
$5.40 |
$5.40 |
$31.20
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$105.20 |
$105.20 |
$105.20 |
$400.03
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$61.40 |
$61.40 |
$61.40 |
$409.35
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$209.00 |
$209.00 |
$209.00 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$72.00 |
$72.00 |
$72.00 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$90.28 |
$90.28 |
$90.28 |
$211.68
|
|
Vaccine mmrv live subcutaneous
|
$87.80 |
$87.80 |
$87.80 |
$424.32
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$66.80 |
$66.80 |
$66.80 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$129.00 |
$129.00 |
$129.00 |
$397.11
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$126.80 |
$126.80 |
$126.80 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$158.40 |
$158.40 |
$158.40 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$21.60 |
$21.60 |
$21.60 |
$90.70
|
|
Vaccine rabies im
|
$412.01 |
$412.01 |
$412.01 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$290.60 |
$290.60 |
$290.60 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$726.75 |
$726.75 |
$726.75 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$457.40 |
$457.40 |
$457.40 |
$997.44
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$125.00 |
$125.00 |
$125.00 |
$499.62
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$58.20 |
$58.20 |
$58.20 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$56.40 |
$56.40 |
$56.40 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$72.53 |
$72.53 |
$72.53 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$22.51 |
$22.51 |
$22.51 |
$112.10
|
|
Vaccine typhoid vicps im
|
$50.60 |
$50.60 |
$50.60 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$63.40 |
$63.40 |
$63.40 |
$365.17
|
|
Vag hys/<250g/rmv tube/rpr entero 58263
|
$675.80 |
$675.80 |
$675.80 |
$5,345.59
|
|
Vag hyst incl t/o complex
|
$840.20 |
$840.20 |
$840.20 |
$5,735.60
|
|
Vag hyst including t/o
|
$630.80 |
$630.80 |
$630.80 |
$4,827.18
|
|
Vaginal bx
|
$104.20 |
$104.20 |
$104.20 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$585.20 |
$585.20 |
$585.20 |
$3,843.60
|
|
Vaginal Delivery (full care)
|
$1,614.60 |
$1,614.60 |
$1,614.60 |
$4,263.60
|
|
Vaginal hysterectomy
|
$571.60 |
$571.60 |
$571.60 |
$5,766.00
|
|
Vagotomy & pylorus repair 43640
|
$796.40 |
$796.40 |
$796.40 |
$2,628.12
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$13.16 |
$13.16 |
$13.16 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$55.00 |
$55.00 |
$55.00 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$40.42 |
$40.42 |
$40.42 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$34.97 |
$34.97 |
$34.97 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$69.40 |
$69.40 |
$69.40 |
$136.13
|
|
Varicella zoster antibody igg
|
$31.20 |
$31.20 |
$31.20 |
$86.80
|
|
Vasc graft into carpal bone
|
$516.40 |
$516.40 |
$516.40 |
$3,839.54
|
|
Vasectomy
|
$613.20 |
$613.20 |
$613.20 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$52.20 |
$52.20 |
$52.20 |
$325.80
|
|
Vbac delivery 59610
|
$1,676.80 |
$1,676.80 |
$1,676.80 |
$4,492.00
|
|
Vbac/include postpartum care 59614
|
$757.80 |
$757.80 |
$757.80 |
$2,285.60
|
|
Vedolizumab 300 mg intravenous solution
|
$6,000.00 |
$6,000.00 |
$6,000.00 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$497.40 |
$497.40 |
$497.40 |
$1,540.00
|
|
Veeg intrmnt 2-12 hrs
|
$251.80 |
$251.80 |
$251.80 |
$961.00
|
|
Veeg unmon 2-12 hrs
|
$271.60 |
$271.60 |
$271.60 |
$826.15
|
|
Vein bypass grft fem-popliteal 35583
|
$913.20 |
$913.20 |
$913.20 |
$3,013.56
|
|
Vein byp fem-tibial peroneal 35585
|
$1,055.80 |
$1,055.80 |
$1,055.80 |
$2,931.20
|
|
Vein gft fem a/p tib/pero/dis art 35566
|
$1,049.40 |
$1,049.40 |
$1,049.40 |
$8,152.00
|
|
Vein x-ray kidney
|
$39.60 |
$39.60 |
$39.60 |
$2,766.73
|
|
Vein x-ray liver
|
$40.40 |
$40.40 |
$40.40 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$40.00 |
$40.00 |
$40.00 |
$3,483.84
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$127.60 |
$127.60 |
$127.60 |
$202.80
|
|
Venogram ext bil s&i
|
$2,031.40 |
$2,031.40 |
$2,031.40 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$728.80 |
$728.80 |
$728.80 |
$1,366.20
|
|
Venous mech thrombectomy
|
$256.20 |
$256.20 |
$256.20 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$183.40 |
$183.40 |
$183.40 |
$5,094.75
|
|
Venous sampling s&i
|
$19.60 |
$19.60 |
$19.60 |
$4,193.20
|
|
Ven thrombosis images bilat
|
$33.60 |
$33.60 |
$33.60 |
$796.50
|
|
Ventilator each subsequent day
|
$974.40 |
$974.40 |
$974.40 |
$1,204.00
|
|
Ventilator initial day
|
$974.40 |
$974.40 |
$974.40 |
$1,431.43
|
