|
Ultrasound elastography parenchyma
|
$429.00 |
$429.00 |
$429.00 |
$284.25
|
|
Ultrasound encephalogram
|
$828.00 |
$828.00 |
$1,777.93 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,512.17 |
$1,512.17 |
$1,512.17 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$2,073.51 |
$2,073.51 |
$2,665.00 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$2,519.64 |
$2,519.64 |
$2,519.64 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$2,304.93 |
$2,304.93 |
$4,121.00 |
$701.35
|
|
Ultrasound guide intraoperative
|
$591.00 |
$591.00 |
$2,181.48 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,241.36 |
$1,241.36 |
$1,241.36 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$1,831.00 |
$1,831.00 |
$1,831.00 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$1,695.00 |
$1,695.00 |
$1,695.00 |
$321.35
|
|
Ultrasound joint complete left
|
$3,354.06 |
$3,354.06 |
$3,354.06 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$2,178.91 |
$2,178.91 |
$2,178.91 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,112.60 |
$1,112.60 |
$3,570.00 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,032.47 |
$1,032.47 |
$2,864.00 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$3,090.93 |
$3,090.93 |
$3,090.93 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$858.96 |
$858.96 |
$1,940.00 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$984.00 |
$984.00 |
$1,273.45 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,840.65 |
$1,840.65 |
$2,983.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$3,281.00 |
$3,281.00 |
$3,281.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,338.00 |
$1,338.00 |
$1,780.66 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,372.40 |
$2,372.40 |
$4,970.00 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,197.13 |
$1,197.13 |
$2,458.00 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$2,268.77 |
$2,268.77 |
$3,588.00 |
$567.44
|
|
Unlisted fluoroscopic px
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$324.85
|
|
Unlisted procedure microbiology
|
$565.45 |
$565.45 |
$565.45 |
$487.50
|
|
Unlisted transfusion med px
|
$332.34 |
$332.34 |
$332.34 |
$141.35
|
|
Unlisted ultrasound procedure
|
$773.00 |
$773.00 |
$773.00 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$8,984.06 |
$8,984.06 |
$8,984.06 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$7,252.00 |
$7,252.00 |
$10,664.66 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$5,153.00 |
$5,153.00 |
$8,280.01 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,147.00 |
$4,147.00 |
$6,888.97 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$8,918.21 |
$8,918.21 |
$8,918.21 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$8,918.21 |
$8,918.21 |
$8,918.21 |
$1,656.60
|
|
Urea nitrogen
|
$138.77 |
$138.77 |
$138.77 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$63.17 |
$63.17 |
$88.00 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$2,160.67 |
$2,160.67 |
$3,089.00 |
$574.40
|
|
Urethrocystography void s&i
|
$2,813.55 |
$2,813.55 |
$3,767.00 |
$634.50
|
|
Uric acid blood
|
$141.06 |
$141.06 |
$653.00 |
$46.64
|
|
Uric acid urine
|
$42.00 |
$42.00 |
$136.20 |
$46.75
|
|
Urinalysis microscopic only
|
$38.67 |
$38.67 |
$38.67 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$68.00 |
$68.00 |
$68.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$223.77 |
$223.77 |
$440.00 |
$48.14
|
|
Urinalysis (without microscopy)
|
$212.46 |
$212.46 |
$212.46 |
$38.99
|
|
Urine Culture Test
|
$407.23 |
$407.23 |
$648.00 |
$84.81
|
|
Urine pregnancy test
|
$445.79 |
$445.79 |
$1,490.00 |
$66.40
|
|
Urography, antegrade
|
$2,038.00 |
$2,038.00 |
$4,758.16 |
$593.37
|
|
Use 1st target lesion
|
$1,481.00 |
$1,481.00 |
$1,481.00 |
$245.30
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$90,839.33 |
$90,839.33 |
$90,839.33 |
$6,892.54
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$1.00 |
$1.00 |
$1.00 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$270.00 |
$270.00 |
$583.52 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$1,679.61 |
$1,679.61 |
$1,679.61 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$488.00 |
$488.00 |
$860.54 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$272.00 |
$272.00 |
$272.00 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$3,089.61 |
$3,089.61 |
$3,089.61 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,167.35 |
$1,167.35 |
$1,167.35 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$517.13 |
$517.13 |
$517.13 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$118.21 |
$118.21 |
$340.44 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$287.35 |
$287.35 |
$442.36 |
$42.90
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$49.00 |
$49.00 |
$49.00 |
$40.01
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$570.02 |
$570.02 |
$570.02 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,755.10 |
$1,755.10 |
$1,755.10 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,693.99 |
$1,693.99 |
$1,693.99 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$550.00 |
$550.00 |
$550.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$437.00 |
$437.00 |
$1,192.45 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,479.16 |
$2,479.16 |
$2,479.16 |
$715.41
|
|
Vaccine rabies im
|
$2,540.00 |
$2,540.00 |
$2,540.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$551.00 |
$551.00 |
$809.33 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$205.00 |
$205.00 |
$666.11 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$168.86 |
$168.86 |
$1,148.00 |
$115.00
|
|
Vancomycin hcl injection
|
$1,239.28 |
$1,239.28 |
$1,239.28 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$207.42 |
$207.42 |
$207.42 |
$126.79
|
|
Varicella zoster antibody igg
|
$44.00 |
$44.00 |
$44.00 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$495.00 |
$495.00 |
$1,594.18 |
$394.13
|
|
Vein x-ray kidney
|
$29,295.99 |
$29,295.99 |
$29,295.99 |
$2,716.20
|
|
Vein x-ray liver
|
$29,295.99 |
$29,295.99 |
$29,295.99 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$29,295.99 |
$29,295.99 |
$29,295.99 |
$3,413.25
|
|
Venogram ext bil s&i
|
$14,155.30 |
$14,155.30 |
$14,155.30 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,423.79 |
$3,423.79 |
$3,423.79 |
$1,326.00
|
|
Venous mech thrombectomy
|
$24,270.32 |
$24,270.32 |
$24,270.32 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$8,761.85 |
$8,761.85 |
$8,761.85 |
$5,352.00
|
|
Ventilator each subsequent day
|
$2,138.00 |
$2,138.00 |
$5,465.97 |
$1,305.92
|
|
Ventilator initial day
|
$3,224.00 |
$3,224.00 |
$5,465.97 |
$1,540.80
|
|
Version cephalic external
|
$9,586.87 |
$9,586.87 |
$9,586.87 |
$2,598.57
|
|
Very long chain fatty acids
|
$172.50 |
$172.50 |
$224.38 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$518.12 |
$518.12 |
$1,642.00 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$185.16 |
$185.16 |
$185.16 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$131.00 |
$131.00 |
$290.90 |
$245.36
|
|
Viper venom prothrombin time
|
$763.00 |
$763.00 |
$763.00 |
$35.20
|
|
Virus isolation addl studies ea
|
$254.13 |
$254.13 |
$577.00 |
$90.35
|
|
Vital capacity test
|
$377.00 |
$377.00 |
$492.87 |
$173.33
|
|
Vitamin b-12
|
$158.00 |
$158.00 |
$199.43 |
$94.90
|
|
Vitamin D Test
|
$308.84 |
$308.84 |
$308.84 |
$132.00
|
|
Voiding pressure study/intra-abd 51797
|
$799.24 |
$799.24 |
$799.24 |
$463.40
|
|
Volume measurement urine timed
|
$70.00 |
$70.00 |
$70.00 |
$21.45
|
|
Warde 1003990 aldosterone
|
$462.95 |
$462.95 |
$462.95 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$315.84 |
$315.84 |
$315.84 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$146.55 |
$146.55 |
$146.55 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$374.82 |
$374.82 |
$374.82 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$7.10 |
$7.10 |
$176.09 |
$69.55
|
|
Warde 1015200 kappa light chain free
|
$56.06 |
$56.06 |
$56.06 |
$64.28
|
