|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,595.74 |
$1,595.74 |
$1,595.74 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$3,198.77 |
$3,198.77 |
$3,198.77 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,414.91 |
$1,414.91 |
$1,414.91 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,180.21 |
$1,180.21 |
$1,180.21 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,728.92 |
$1,728.92 |
$1,728.92 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,282.98 |
$1,282.98 |
$1,282.98 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$2,267.71 |
$2,267.71 |
$2,267.71 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,229.12 |
$2,229.12 |
$2,229.12 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,381.02 |
$1,381.02 |
$1,381.02 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$753.41 |
$753.41 |
$753.41 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$2,986.01 |
$2,986.01 |
$2,986.01 |
$567.44
|
|
Ultrasound trgt dyn mbubb 1st les
|
$2,640.82 |
$2,640.82 |
$2,640.82 |
$479.72
|
|
Umbilical artery cath newborn 36660
|
$1,024.29 |
$1,024.29 |
$1,024.29 |
$265.85
|
|
Unlisted fluoroscopic px
|
$986.70 |
$986.70 |
$986.70 |
$324.85
|
|
Unlisted procedure microbiology
|
$485.63 |
$485.63 |
$485.63 |
$487.50
|
|
Unlisted transfusion med px
|
$304.65 |
$304.65 |
$304.65 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$2,529.12 |
$2,529.12 |
$2,529.12 |
$1,505.29
|
|
Upgrade pm system
|
$15,758.20 |
$15,758.20 |
$15,758.20 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$8,270.26 |
$8,270.26 |
$8,270.26 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$6,617.86 |
$6,617.86 |
$6,617.86 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$5,992.06 |
$5,992.06 |
$5,992.06 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$8,175.03 |
$8,175.03 |
$8,175.03 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$8,175.03 |
$8,175.03 |
$8,175.03 |
$1,656.60
|
|
Urea nitrogen
|
$91.06 |
$91.06 |
$91.06 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$85.82 |
$85.82 |
$85.82 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$2,833.35 |
$2,833.35 |
$2,833.35 |
$574.40
|
|
Urethrocystography void s&i
|
$1,558.31 |
$1,558.31 |
$1,558.31 |
$634.50
|
|
Uric acid blood
|
$275.38 |
$275.38 |
$275.38 |
$46.64
|
|
Uric acid urine
|
$223.85 |
$223.85 |
$223.85 |
$46.75
|
|
Urinalysis (with microscopy)
|
$324.92 |
$324.92 |
$324.92 |
$48.14
|
|
Urinalysis (without microscopy)
|
$217.41 |
$217.41 |
$217.41 |
$38.99
|
|
Urine Culture Test
|
$169.52 |
$169.52 |
$169.52 |
$84.81
|
|
Urine pregnancy test
|
$435.68 |
$435.68 |
$435.68 |
$66.40
|
|
Urography, antegrade
|
$1,700.88 |
$1,700.88 |
$1,700.88 |
$593.37
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$152,489.90 |
$152,489.90 |
$152,489.90 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$898.75 |
$898.75 |
$898.75 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$2,603.99 |
$2,603.99 |
$2,603.99 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$1,329.73 |
$1,329.73 |
$1,329.73 |
$173.98
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$5,175.77 |
$5,175.77 |
$5,175.77 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,807.04 |
$1,807.04 |
$1,807.04 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$795.46 |
$795.46 |
$795.46 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$520.58 |
$520.58 |
$520.58 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$437.98 |
$437.98 |
$437.98 |
$42.90
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$877.74 |
$877.74 |
$877.74 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$2,935.40 |
$2,935.40 |
$2,935.40 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$2,832.80 |
$2,832.80 |
$2,832.80 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,990.82 |
$1,990.82 |
$1,990.82 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$4,150.95 |
$4,150.95 |
$4,150.95 |
$715.41
|
|
Vaccine tdap >=7 years im
|
$1,250.06 |
$1,250.06 |
$1,250.06 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$1,027.24 |
$1,027.24 |
$1,027.24 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$531.65 |
$531.65 |
$531.65 |
$115.00
|
|
Valvuloplasty aortic
|
$16,776.71 |
$16,776.71 |
$16,776.71 |
$7,324.85
|
|
Vancomycin hcl injection
|
$1,075.62 |
$1,075.62 |
$1,075.62 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$366.56 |
$366.56 |
$366.56 |
$126.79
|
|
Varicella zoster antibody igg
|
$94.38 |
$94.38 |
$94.38 |
$82.55
|
|
Vasc emb/occ w/prs cath
|
$28,913.36 |
$28,913.36 |
$28,913.36 |
$21,249.26
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,173.72 |
$1,173.72 |
$1,173.72 |
$394.13
|
|
Veeg cont 2-12 hrs
|
$2,065.92 |
$2,065.92 |
$2,065.92 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$11,837.51 |
$11,837.51 |
$11,837.51 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$1,036.17 |
$1,036.17 |
$1,036.17 |
$904.90
|
|
Vein x-ray adrenal gland
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$2,489.25
|
|
Vein x-ray kidney
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$2,716.20
|
|
Vein x-ray liver w/hemodynam
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$8,333.83 |
$8,333.83 |
$8,333.83 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$2,489.25
|
|
Vein x-ray skull
|
$26,854.65 |
$26,854.65 |
$26,854.65 |
$2,301.09
|
|
Venogram ext bil s&i
|
$6,080.06 |
$6,080.06 |
$6,080.06 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$4,342.90 |
$4,342.90 |
$4,342.90 |
$1,326.00
|
|
Venous mech thrombectomy
|
$23,236.73 |
$23,236.73 |
$23,236.73 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$29,196.03 |
$29,196.03 |
$29,196.03 |
$5,352.00
|
|
Venous sampling s&i
|
$46,619.20 |
$46,619.20 |
$46,619.20 |
$4,416.78
|
|
Ventilator each subsequent day
|
$4,715.84 |
$4,715.84 |
$4,715.84 |
$1,305.92
|
|
Ventilator initial day
|
$5,010.47 |
$5,010.47 |
$5,010.47 |
$1,540.80
|
|
Version cephalic external
|
$10,573.78 |
$10,573.78 |
$10,573.78 |
$2,598.57
|
|
Vinblastine 1 mg/ml intravenous solution
|
$660.36 |
$660.36 |
$660.36 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$210.20 |
$210.20 |
$210.20 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$333.29 |
$333.29 |
$333.29 |
$245.36
|
|
Virus isolation addl studies ea
|
$311.79 |
$311.79 |
$311.79 |
$90.35
|
|
Vital capacity test
|
$526.91 |
$526.91 |
$526.91 |
$173.33
|
|
Vitamin b-12
|
$302.07 |
$302.07 |
$302.07 |
$94.90
|
|
Vitamin D Test
|
$117.74 |
$117.74 |
$117.74 |
$132.00
|
|
Voiding pressure study/intra-abd 51797
|
$681.35 |
$681.35 |
$681.35 |
$463.40
|
|
Warde 1003990 aldosterone
|
$628.98 |
$628.98 |
$628.98 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$429.09 |
$429.09 |
$429.09 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$199.11 |
$199.11 |
$199.11 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$125.34 |
$125.34 |
$125.34 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$239.24 |
$239.24 |
$239.24 |
$69.55
|
|
Warde 1015200 kappa light chain free
|
$85.82 |
$85.82 |
$85.82 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$142.02 |
$142.02 |
$142.02 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$422.76 |
$422.76 |
$422.76 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$260.09 |
$260.09 |
$260.09 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$222.11 |
$222.11 |
$222.11 |
$69.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$189.08 |
$189.08 |
$189.08 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$212.35 |
$212.35 |
$212.35 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$277.53 |
$277.53 |
$277.53 |
$78.57
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$2,201.49 |
$2,201.49 |
$2,201.49 |
$219.13
|
|
Warde 3400852 arsenic
|
$292.80 |
$292.80 |
$292.80 |
$105.12
|
|
Warde 3708165 mercury urine
|
$80.67 |
$80.67 |
$80.67 |
$72.80
|
|
Warde acetylcholine receptor blocking antibody
|
$177.96 |
$177.96 |
$177.96 |
$68.90
|
|
Warde actin (smooth muscle) antibody each
|
$238.38 |
$238.38 |
$238.38 |
$45.58
|
