|
Upper Endoscopy (EGD, with biopsy)
|
$3,055.00 |
$3,055.00 |
$3,055.00 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$6,102.00 |
$6,102.00 |
$6,102.00 |
$1,773.85
|
|
Urea nitrogen
|
$129.00 |
$129.00 |
$129.00 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$3.86 |
$3.86 |
$280.00 |
$50.00
|
|
Ureteral embolization/occl
|
$11,026.00 |
$11,026.00 |
$11,026.00 |
$3,041.22
|
|
Ureteral reflux study
|
$3,209.00 |
$3,209.00 |
$3,209.00 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,601.00 |
$3,398.80 |
$3,861.15 |
$574.40
|
|
Urethrocystography void s&i
|
$1,647.00 |
$4,915.12 |
$5,584.10 |
$634.50
|
|
Uric acid blood
|
$123.00 |
$1,167.35 |
$1,193.25 |
$46.64
|
|
Uric acid urine
|
$303.00 |
$303.00 |
$303.00 |
$46.75
|
|
Urinalysis microscopic only
|
$74.00 |
$74.00 |
$318.90 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$6.25 |
$6.25 |
$78.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$348.00 |
$348.00 |
$915.50 |
$48.14
|
|
Urinalysis (without microscopy)
|
$291.00 |
$291.00 |
$291.00 |
$38.99
|
|
Urine Culture Test
|
$415.00 |
$928.09 |
$948.00 |
$84.81
|
|
Urine pregnancy test
|
$256.00 |
$389.11 |
$398.35 |
$66.40
|
|
Urography, antegrade
|
$1,230.00 |
$1,230.00 |
$1,230.00 |
$593.37
|
|
Urography inf drip &/or bolus
|
$2,082.00 |
$2,082.00 |
$2,082.00 |
$641.69
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$86,608.31 |
$86,608.31 |
$86,608.31 |
$5,521.54
|
|
Vaccine dtap < 7 years im
|
$159.00 |
$159.00 |
$159.00 |
$87.80
|
|
Vaccine dtap-ipv/hib im
|
$392.75 |
$392.75 |
$392.75 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$116.00 |
$116.00 |
$116.00 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$195.00 |
$195.00 |
$256.25 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$628.84 |
$628.84 |
$628.84 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$1,844.03 |
$1,844.03 |
$1,844.03 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$935.97 |
$935.97 |
$935.97 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$193.00 |
$193.00 |
$193.00 |
$306.24
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$2,930.69 |
$2,930.69 |
$2,930.69 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,276.11 |
$1,276.11 |
$1,276.11 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$555.24 |
$555.24 |
$555.24 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$359.36 |
$359.36 |
$359.36 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$300.50 |
$300.50 |
$300.50 |
$42.90
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$255.00 |
$255.00 |
$255.00 |
$104.63
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$29.00 |
$107.00 |
$114.75 |
$40.01
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$613.88 |
$613.88 |
$613.88 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$751.25 |
$751.25 |
$1,658.11 |
$499.00
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$566.60 |
$566.60 |
$566.60 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$573.00 |
$618.25 |
$1,599.83 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$106.00 |
$106.00 |
$394.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$408.00 |
$595.60 |
$1,121.57 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$58.00 |
$841.00 |
$907.50 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$3,573.00 |
$3,573.00 |
$3,573.00 |
$715.41
|
|
Vaccine rabies im
|
$1,839.00 |
$1,839.00 |
$1,839.00 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,721.25 |
$1,721.25 |
$1,721.25 |
$1,196.00
|
|
Vaccine tdap >=7 years im
|
$142.75 |
$267.00 |
$879.19 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$136.00 |
$142.75 |
$720.41 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$60.00 |
$60.00 |
$64.75 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$418.00 |
$1,231.57 |
$1,258.90 |
$115.00
|
|
Valvuloplasty aortic
|
$27,595.00 |
$27,595.00 |
$27,595.00 |
$7,324.85
|
|
Valvuloplasty mitral
|
$27,595.00 |
$27,595.00 |
$27,595.00 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$27,595.00 |
$27,595.00 |
$27,595.00 |
$11,945.20
|
|
Vancomycin hcl injection
|
$754.89 |
$754.89 |
$754.89 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$504.00 |
$504.00 |
$504.00 |
$126.79
|
|
Vanomycin dna amp probe
|
$160.00 |
$160.00 |
$160.00 |
$87.20
|
|
Varicella zoster antibody igg
|
$533.00 |
$533.00 |
$533.00 |
$82.55
|
|
Varicella-zoster immue globin im
|
$4,722.45 |
$4,722.45 |
$4,722.45 |
$2,372.84
|
|
Vasectomy
|
$5,140.00 |
$5,140.00 |
$5,140.00 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$165.00 |
$165.00 |
$897.51 |
$362.93
|
|
Veeg cont 2-12 hrs
|
$2,106.00 |
$2,106.00 |
$2,106.00 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$3,940.00 |
$3,940.00 |
$3,940.00 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$1,097.00 |
$1,097.00 |
$1,097.00 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$3,542.00 |
$3,542.00 |
$3,542.00 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$1,921.00 |
$1,921.00 |
$1,921.00 |
$704.79
|
|
Vein x-ray adrenal gland
|
$33,603.00 |
$33,603.00 |
$33,603.00 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$7,939.90 |
$7,939.90 |
$57,977.00 |
$3,999.60
|
|
Vein x-ray eye socket
|
$10,836.00 |
$10,836.00 |
$10,836.00 |
$1,128.41
|
|
Vein x-ray kidney
|
$5,260.00 |
$5,260.00 |
$5,260.00 |
$2,716.20
|
|
Vein x-ray liver
|
$4,747.40 |
$10,815.00 |
$15,056.50 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$8,889.50 |
$9,198.00 |
$15,056.50 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$10,815.00 |
$10,815.00 |
$15,056.50 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$5,097.00 |
$7,501.25 |
$9,140.60 |
$2,489.25
|
|
Vein x-ray skull
|
$5,445.00 |
$5,445.00 |
$5,445.00 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$4,930.00 |
$4,930.00 |
$4,930.00 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$5,261.07 |
$5,261.07 |
$57,389.00 |
$3,450.30
|
|
Vemp test i&r cervical
|
$1,177.00 |
$1,177.00 |
$1,177.00 |
$205.09
|
|
Vemp tst i&r cervical&ocular
|
$2,357.00 |
$2,357.00 |
$2,357.00 |
$368.50
|
|
Venogram ext bil s&i
|
$1,106.35 |
$1,106.35 |
$4,155.00 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$2,713.00 |
$2,713.00 |
$2,713.00 |
$1,326.00
|
|
Venous mech thrombectomy
|
$14,546.00 |
$14,546.00 |
$14,546.00 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$14,612.00 |
$14,612.00 |
$14,612.00 |
$5,352.00
|
|
Venous sampling s&i
|
$4,953.31 |
$10,439.85 |
$14,801.00 |
$4,416.78
|
|
Ventilator each subsequent day
|
$3,307.00 |
$3,991.89 |
$4,363.45 |
$1,305.92
|
|
Ventilator initial day
|
$3,308.00 |
$3,975.40 |
$4,344.45 |
$1,540.80
|
|
Version cephalic external
|
$1,757.00 |
$1,757.00 |
$1,757.00 |
$2,598.57
|
|
Very long chain fatty acids
|
$165.65 |
$165.65 |
$510.00 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$31.47 |
$33.75 |
$1,714.04 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$54.00 |
$58.25 |
$489.22 |
$100.19
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$761.50 |
$828.28 |
$1,008.00 |
$226.75
|
|
Virus isolation addl studies ea
|
$95.99 |
$95.99 |
$119.00 |
$90.35
|
|
Visual audiometry (vra)
|
$223.00 |
$223.00 |
$223.00 |
$202.50
|
|
Vital capacity test
|
$265.94 |
$385.10 |
$439.00 |
$173.33
|
|
Vitamin b-12
|
$425.00 |
$425.00 |
$565.42 |
$94.90
|
|
Vitamin D Test
|
$655.00 |
$655.00 |
$655.00 |
$132.00
|
|
Vkorc1 gene
|
$362.87 |
$362.87 |
$362.87 |
$176.80
|
|
Vngrph chd vnvn cltrl at/abv
|
$1,827.00 |
$1,827.00 |
$1,827.00 |
$384.00
|
|
Vngrph chd vnvn cltrl below
|
$1,845.00 |
$1,845.00 |
$1,845.00 |
$388.80
|
|
Voiding pressure study/intra-abd 51797
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$463.40
|
|
Vol reduction of blood/prod
|
$865.00 |
$865.00 |
$865.00 |
$131.25
|
|
Volume deplete of harvest
|
$615.00 |
$615.00 |
$615.00 |
$1,443.33
|
