|
Unlisted transfusion med px
|
$128.00 |
$128.00 |
$128.00 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$982.08 |
$982.08 |
$982.08 |
$1,268.17
|
|
Upgrade pm system
|
$5,291.52 |
$5,291.52 |
$5,291.52 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,122.56 |
$1,122.56 |
$1,122.56 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$928.00 |
$928.00 |
$928.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$843.52 |
$843.52 |
$843.52 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$96.96 |
$96.96 |
$96.96 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$109.44 |
$109.44 |
$109.44 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$109.44 |
$109.44 |
$109.44 |
$1,872.00
|
|
Urea nitrogen
|
$43.20 |
$43.20 |
$43.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$21.44 |
$21.44 |
$21.44 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$301.12 |
$301.12 |
$301.12 |
$579.73
|
|
Urethrocystography void s&i
|
$327.04 |
$327.04 |
$327.04 |
$622.35
|
|
Uric acid blood
|
$50.24 |
$50.24 |
$50.24 |
$48.75
|
|
Uric acid urine
|
$43.20 |
$43.20 |
$43.20 |
$44.33
|
|
Urinalysis microscopic only
|
$10.24 |
$10.24 |
$10.24 |
$26.35
|
|
Urinalysis (with microscopy)
|
$34.88 |
$34.88 |
$34.88 |
$55.00
|
|
Urinalysis (without microscopy)
|
$24.00 |
$24.00 |
$24.00 |
$35.75
|
|
Urine Culture Test
|
$36.80 |
$36.80 |
$36.80 |
$81.50
|
|
Urine pregnancy test
|
$22.72 |
$22.72 |
$22.72 |
$67.20
|
|
Vaccine dtap < 7 years im
|
$14.40 |
$14.40 |
$14.40 |
$68.19
|
|
Vaccine dtap-ipv 4-6 years im
|
$92.80 |
$92.80 |
$92.80 |
$105.95
|
|
Vaccine dtap-ipv/hib im
|
$250.88 |
$250.88 |
$250.88 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$45.76 |
$45.76 |
$45.76 |
$43.12
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$22.12 |
$22.12 |
$22.12 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$44.16 |
$44.16 |
$44.16 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$41.57 |
$41.57 |
$41.57 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$125.44 |
$125.44 |
$125.44 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$21.76 |
$21.76 |
$21.76 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$112.31 |
$112.31 |
$112.31 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$28.04 |
$28.04 |
$28.04 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$16.00 |
$16.00 |
$16.00 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$10.24 |
$10.24 |
$10.24 |
$31.03
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$12.16 |
$12.16 |
$12.16 |
$33.60
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$67.84 |
$67.84 |
$67.84 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$66.75 |
$66.75 |
$66.75 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$95.36 |
$95.36 |
$95.36 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$212.80 |
$212.80 |
$212.80 |
$397.11
|
|
Vaccine polio (ipv) subcutaneous/im
|
$15.36 |
$15.36 |
$15.36 |
$90.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$54.40 |
$54.40 |
$54.40 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$69.28 |
$69.28 |
$69.28 |
$131.34
|
|
Vaccine varicella live subcutaneous
|
$78.80 |
$78.80 |
$78.80 |
$365.17
|
|
Vag hyst including t/o
|
$738.56 |
$738.56 |
$738.56 |
$4,827.18
|
|
Vaginal Delivery (full care)
|
$1,895.68 |
$1,895.68 |
$1,895.68 |
$4,263.60
|
|
Vaginal hysterectomy
|
$670.08 |
$670.08 |
$670.08 |
$5,766.00
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$12.58 |
$12.58 |
$12.58 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$76.48 |
$76.48 |
$76.48 |
$114.72
|
|
Valvuloplasty aortic
|
$5,378.88 |
$5,378.88 |
$5,378.88 |
$7,830.80
|
|
Valvuloplasty/tv w/ring insertion 33464
|
$863.04 |
$863.04 |
$863.04 |
$5,965.60
|
|
Vancomycin 1,000 mg intravenous injection
|
$42.63 |
$42.63 |
$42.63 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$28.56 |
$28.56 |
$28.56 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$64.32 |
$64.32 |
$64.32 |
$136.13
|
|
Varicella zoster antibody igg
|
$71.36 |
$71.36 |
$71.36 |
$86.80
|
|
Vasectomy
|
$189.12 |
$189.12 |
$189.12 |
$2,424.12
|
|
Vbac delivery 59610
|
$1,968.96 |
$1,968.96 |
$1,968.96 |
$4,492.00
|
|
Vedolizumab 300 mg intravenous solution
|
$6,720.00 |
$6,720.00 |
$6,720.00 |
$18,732.33
|
|
Veeg unmon 12-26 hrs
|
$813.76 |
$813.76 |
$813.76 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$208.32 |
$208.32 |
$208.32 |
$826.15
|
|
Vein bypass grft fem-popliteal 35583
|
$1,054.72 |
$1,054.72 |
$1,054.72 |
$3,013.56
|
|
Vein x-ray kidney
|
$1,227.84 |
$1,227.84 |
$1,227.84 |
$2,766.73
|
|
Vein x-ray liver
|
$1,227.84 |
$1,227.84 |
$1,227.84 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$1,227.84 |
$1,227.84 |
$1,227.84 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,377.60 |
$1,377.60 |
$1,377.60 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$1,791.04 |
$1,791.04 |
$1,791.04 |
$2,452.80
|
|
Vein x-ray spleen/liver
|
$1,791.04 |
$1,791.04 |
$1,791.04 |
$3,427.50
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$8.64 |
$8.64 |
$8.64 |
$202.80
|
|
Venogram ext bil s&i
|
$593.60 |
$593.60 |
$593.60 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,437.12 |
$1,437.12 |
$1,437.12 |
$1,366.20
|
|
Venous mech thrombectomy
|
$6,452.80 |
$6,452.80 |
$6,452.80 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$1,899.52 |
$1,899.52 |
$1,899.52 |
$5,094.75
|
|
Venous sampling s&i
|
$2,117.12 |
$2,117.12 |
$2,117.12 |
$4,193.20
|
|
Ven thrombosis images bilat
|
$412.16 |
$412.16 |
$412.16 |
$796.50
|
|
Ventilator each subsequent day
|
$1,210.88 |
$1,210.88 |
$1,210.88 |
$1,204.00
|
|
Ventilator initial day
|
$1,424.64 |
$1,424.64 |
$1,424.64 |
$1,431.43
|
|
Version cephalic external
|
$384.00 |
$384.00 |
$384.00 |
$2,361.75
|
|
Very long chain fatty acids
|
$5.14 |
$5.14 |
$5.14 |
$139.88
|
|
Vincristine 1 mg/ml intravenous solution
|
$25.92 |
$25.92 |
$25.92 |
$87.15
|
|
Virus isolation addl studies ea
|
$87.68 |
$87.68 |
$87.68 |
$77.50
|
|
Visc & infraren abd 1 prosth
|
$573.76 |
$573.76 |
$573.76 |
$9,715.02
|
|
Vital capacity test
|
$102.72 |
$102.72 |
$102.72 |
$170.00
|
|
Vitamin b-12
|
$45.12 |
$45.12 |
$45.12 |
$100.00
|
|
Vitamin D Test
|
$65.28 |
$65.28 |
$65.28 |
$132.00
|
|
Vkorc1 gene
|
$32.00 |
$32.00 |
$32.00 |
$176.80
|
|
Volume measurement urine timed
|
$11.52 |
$11.52 |
$11.52 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$49.73 |
$49.73 |
$49.73 |
$165.81
|
|
Vulvectomy simple partial
|
$487.04 |
$487.04 |
$487.04 |
$3,986.00
|
|
Warde 1003990 aldosterone
|
$191.04 |
$191.04 |
$191.04 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$46.40 |
$46.40 |
$46.40 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$111.04 |
$111.04 |
$111.04 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$148.16 |
$148.16 |
$148.16 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$83.52 |
$83.52 |
$83.52 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$85.44 |
$85.44 |
$85.44 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$10.24 |
$10.24 |
$10.24 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$146.56 |
$146.56 |
$146.56 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$124.16 |
$124.16 |
$124.16 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$124.16 |
$124.16 |
$124.16 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$117.12 |
$117.12 |
$117.12 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$39.68 |
$39.68 |
$39.68 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$33.28 |
$33.28 |
$33.28 |
$72.50
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$85.76 |
$85.76 |
$85.76 |
$218.40
|
