|
Upper Arm (Humerus) X-ray (left side)
|
$199.80 |
$290.95 |
$747.23 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,281.81 |
$1,748.37 |
$8,126.97 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$999.42 |
$1,289.00 |
$7,117.23 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,122.00 |
$2,429.31 |
$11,938.03 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,567.62 |
$2,001.87 |
$5,573.76 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,415.18 |
$1,762.41 |
$11,676.27 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$324.48 |
$455.00 |
$1,912.75 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$139.12 |
$523.00 |
$2,234.72 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$5,045.00 |
$5,045.00 |
$5,700.00 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,405.56 |
$1,405.56 |
$5,045.00 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$412.92 |
$738.66 |
$3,317.97 |
|
|
Upper GI Barium X-ray (barium only)
|
$273.51 |
$491.01 |
$3,072.19 |
|
|
Uppr gi scope w/submuc inj
|
$4,548.00 |
$4,548.00 |
$4,548.00 |
|
|
Urea nitrogen
|
$20.00 |
$58.50 |
$455.78 |
|
|
Urea nitrogen 24 hour urine
|
$15.40 |
$81.12 |
$342.26 |
|
|
Urea nitrogen clearance
|
$33.00 |
$163.80 |
$163.80 |
|
|
Ureteral embolization/occl
|
$754.00 |
$3,041.22 |
$3,041.22 |
|
|
Ureteral reflux study
|
$694.20 |
$694.20 |
$1,577.00 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$249.53 |
$253.50 |
$3,339.08 |
|
|
Urethrlys transvag with scope
|
$11,439.00 |
$11,439.00 |
$11,439.00 |
|
|
Urethrocystography void s&i
|
$317.02 |
$390.39 |
$3,339.08 |
|
|
Uric acid blood
|
$23.00 |
$74.49 |
$668.92 |
|
|
Uric acid urine
|
$8.29 |
$93.60 |
$668.92 |
|
|
Urinalysis microscopic only
|
$26.35 |
$49.14 |
$78.00 |
|
|
Urinalysis qual/semiquant excpt ia
|
$24.00 |
$46.80 |
$46.80 |
|
|
Urinalysis (with microscopy)
|
$10.07 |
$62.40 |
$558.04 |
|
|
Urinalysis (without microscopy)
|
$7.70 |
$74.88 |
$200.00 |
|
|
Urine Culture Test
|
$13.32 |
$202.80 |
$1,072.73 |
|
|
Urine flow measurement 51736
|
$274.17 |
$274.17 |
$274.17 |
|
|
Urine pregnancy test
|
$26.35 |
$98.67 |
$138.00 |
|
|
Urography, antegrade
|
$300.44 |
$489.45 |
$2,758.08 |
|
|
Urography inf drip &/or bolus
|
$599.82 |
$599.82 |
$599.82 |
|
|
Use 1st target lesion
|
$136.11 |
$136.11 |
$584.00 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$37.48 |
$37.48 |
$138,110.72 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$98,325.04 |
$98,325.04 |
$98,325.04 |
|
|
Vaccine Administration (one shot)
|
$62.79 |
$137.62 |
$221.00 |
|
|
Vaccine dtap < 7 years im
|
$122.71 |
$135.96 |
$135.96 |
|
|
Vaccine dtap-hep b-ipv im
|
$422.00 |
$422.00 |
$432.57 |
|
|
Vaccine dtap-ipv/hib im
|
$457.32 |
$457.32 |
$457.32 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$131.67 |
$131.84 |
$131.84 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$29.87 |
$29.87 |
$29.87 |
|
|
Vaccine hepatitis a (hepa) adult im
|
$98.28 |
$344.02 |
$856.28 |
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$550.23 |
$550.23 |
$2,478.60 |
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$61.66 |
$257.20 |
$1,266.30 |
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$638.60 |
$638.60 |
$1,308.30 |
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$122.33 |
$155.53 |
$155.53 |
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,109.31 |
$1,109.31 |
$4,689.62 |
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$0.08 |
$1,702.72 |
$1,720.40 |
|
|
Vaccine influenza inactivated adjuvant im
|
$48.03 |
$317.24 |
$758.01 |
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$24.93 |
$84.47 |
$496.50 |
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$77.25 |
$77.25 |
$417.92 |
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$78.38 |
$280.16 |
$280.16 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$71.70 |
$84.46 |
$84.46 |
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$311.06 |
$311.06 |
$311.06 |
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$135.77 |
$140.08 |
$836.29 |
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$210.06 |
$2,298.23 |
$2,660.55 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$144.23 |
$679.80 |
$2,567.62 |
|
|
Vaccine mmr live subcutaneous
|
$114.68 |
$409.94 |
$409.99 |
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$126.36 |
$902.28 |
$1,805.04 |
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$244.91 |
$244.91 |
$244.91 |
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$296.23 |
$1,172.79 |
$3,761.45 |
|
|
Vaccine polio (ipv) subcutaneous/im
|
$184.37 |
$184.37 |
$187.35 |
|
|
Vaccine rabies im
|
$423.47 |
$1,756.67 |
$1,756.67 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,284.41 |
$1,284.41 |
$1,334.72 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
|
|
Vaccine tdap >=7 years im
|
$60.63 |
$202.91 |
$1,190.50 |
|
|
Vaccine td preservative free >= 7 years im
|
$50.48 |
$170.98 |
$978.52 |
|
|
Vad battery clip set hmii 14-v li-ion
|
$823.90 |
$1,159.43 |
$1,159.43 |
|
|
Vad cable power module dc input
|
$731.74 |
$731.74 |
$731.74 |
|
|
Vad univ batt charger hm 1440
|
$10,776.70 |
$14,170.94 |
$14,170.94 |
|
|
Vag hyst incl t/o complex
|
$9,290.00 |
$9,290.00 |
$9,290.00 |
|
|
Vag hyst including t/o
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
|
|
Vaginal bx
|
$4,428.06 |
$4,428.06 |
$9,791.00 |
|
|
Vaginal delivery after cesarean delivery 59612
|
$12,187.00 |
$12,187.00 |
$12,187.00 |
|
|
Vaginal hysterectomy
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
|
|
Valproic acid total therapeutic drug level
|
$62.00 |
$121.68 |
$725.69 |
|
|
Valrubicin injection
|
$3,839.12 |
$3,839.12 |
$3,839.12 |
|
|
Valvuloplasty aortic
|
$4,057.56 |
$4,057.56 |
$48,840.42 |
|
|
Valvuloplasty mitral
|
$5,573.10 |
$5,573.10 |
$83,190.14 |
|
|
Valvuloplasty pulmonary
|
$7,809.36 |
$7,809.36 |
$8,687.00 |
|
|
Valvuloplasty/tv without ring insert 33463
|
$42,480.00 |
$42,480.00 |
$42,480.00 |
|
|
Vancomycin 1,000 mg intravenous injection
|
$259.05 |
$912.38 |
$912.38 |
|
|
Vancomycin 750 mg intravenous solution
|
$898.84 |
$898.84 |
$898.84 |
|
|
Vancomycin hcl injection
|
$149.49 |
$149.49 |
$1,497.78 |
|
|
Vancomycin peak therapeutic drug level
|
$33.45 |
$246.87 |
$847.44 |
|
|
Varicella zoster antibody igg
|
$22.50 |
$128.70 |
$558.04 |
|
|
Vasc emb/occ w/prs cath
|
$21,172.71 |
$21,172.71 |
$46,160.00 |
|
|
Vasc graft into carpal bone
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
|
|
Vasectomy
|
$2,256.54 |
$2,256.54 |
$10,780.00 |
|
|
Vasopressin 20 unit/ml intravenous solution
|
$170.99 |
$787.50 |
$1,927.57 |
|
|
Vbac delivery 59610
|
$12,187.00 |
$12,187.00 |
$12,187.00 |
|
|
Vedolizumab 300 mg intravenous solution
|
$69.20 |
$69.20 |
$32,135.69 |
|
|
Veeg cont 2-12 hrs
|
$841.23 |
$841.23 |
$5,904.80 |
|
|
Veeg ea 12-26hr cont mntr
|
$3,277.00 |
$3,530.67 |
$6,424.36 |
|
|
Veeg intrmnt 2-12 hrs
|
$645.06 |
$645.06 |
$3,786.43 |
|
|
Veeg unmon 12-26 hrs
|
$662.45 |
$822.90 |
$6,536.53 |
|
|
Veeg unmon 2-12 hrs
|
$331.23 |
$441.09 |
$1,061.00 |
|
|
Vein bypass grft fem-popliteal 35583
|
$3,155.96 |
$3,155.96 |
$3,155.96 |
|
|
Vein byp fem-tibial peroneal 35585
|
$3,313.72 |
$3,313.72 |
$3,313.72 |
|
|
Vein gft fem a/p tib/pero/dis art 35566
|
$3,313.72 |
$3,313.72 |
$3,313.72 |
|
