|
Unlisted px tongue flr mouth
|
$25,496.97 |
$25,496.97 |
$25,496.97 |
$282.50
|
|
Unlisted px vestibule mouth
|
$27,409.41 |
$27,409.41 |
$27,409.41 |
$456.96
|
|
Unlisted reprod med lab proc
|
$65.00 |
$65.00 |
$65.00 |
$70.00
|
|
Unlisted surgical path px
|
$18,965.45 |
$18,965.45 |
$18,965.45 |
$217.75
|
|
Unlisted transfusion med px
|
$34.65 |
$147.50 |
$147.50 |
$147.50
|
|
Unlisted ultrasound procedure
|
$72.93 |
$105.00 |
$257.50 |
$335.00
|
|
Unlisted urinalysis px
|
$114.10 |
$114.10 |
$114.10 |
$25.72
|
|
Unlstd laps px mat care&dlvr
|
$43,334.17 |
$43,334.17 |
$43,334.17 |
$5,741.00
|
|
Unlstd laps px sprmatic cord
|
$44,377.53 |
$44,377.53 |
$44,377.53 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$1,025.00 |
$1,025.00 |
$1,844.50 |
$1,316.90
|
|
Upgrade pm system
|
$6,242.61 |
$9,280.00 |
$16,790.00 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$108.57 |
$250.00 |
$619.50 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$571.56 |
$955.00 |
$2,947.00 |
$1,680.60
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$411.18 |
$855.00 |
$2,811.90 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,287.00 |
$2,125.00 |
$4,696.30 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,043.46 |
$1,450.00 |
$4,101.30 |
$2,410.98
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$949.41 |
$1,650.00 |
$3,809.40 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$89.76 |
$280.00 |
$697.90 |
$322.50
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$152.79 |
$435.00 |
$778.40 |
$381.75
|
|
Upper Endoscopy (EGD, diagnostic)
|
$4,437.85 |
$4,437.85 |
$4,437.85 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$10,335.13 |
$10,335.13 |
$10,335.13 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$440.00 |
$440.00 |
$1,048.60 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$214.17 |
$387.50 |
$822.50 |
$612.00
|
|
Uppr gi scope w/submuc inj
|
$16,539.54 |
$16,539.54 |
$16,539.54 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$71,246.28 |
$71,246.28 |
$71,246.28 |
$6,082.67
|
|
Urea nitrogen
|
$10.89 |
$37.50 |
$109.20 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$14.19 |
$37.50 |
$56.00 |
$51.77
|
|
Urea nitrogen clearance
|
$65.00 |
$65.00 |
$86.80 |
$34.02
|
|
Ureteral embolization/occl
|
$1,383.20 |
$2,660.00 |
$2,730.00 |
$2,079.31
|
|
Ureteral reflux study
|
$402.60 |
$402.60 |
$1,165.00 |
$952.50
|
|
Ureter endoscopy & biopsy
|
$42,375.89 |
$42,375.89 |
$42,375.89 |
$5,696.72
|
|
Ureter endoscopy & biopsy
|
$41,969.98 |
$41,969.98 |
$41,969.98 |
$5,986.78
|
|
Ureter endoscopy & catheter
|
$32,857.00 |
$32,857.00 |
$32,857.00 |
$3,326.40
|
|
Ureteroneocystostomy 50780
|
$206,357.98 |
$206,357.98 |
$206,357.98 |
$4,457.05
|
|
Ureteroureterostomy 50760
|
$93,267.34 |
$93,267.34 |
$93,267.34 |
$2,773.01
|
|
Urethrcystgrphy rtrgrde s&i
|
$430.65 |
$510.00 |
$839.30 |
$584.23
|
|
Urethrlys transvag with scope
|
$14,962.42 |
$14,962.42 |
$14,962.42 |
$4,081.37
|
|
Urethrocystography void s&i
|
$563.64 |
$695.00 |
$897.40 |
$637.80
|
|
Uric acid blood
|
$21.12 |
$45.00 |
$79.10 |
$48.96
|
|
Uric acid urine
|
$13.86 |
$62.50 |
$116.20 |
$44.35
|
|
Urinalysis microscopic only
|
$37.50 |
$37.50 |
$67.20 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$30.10 |
$30.10 |
$30.10 |
$25.72
|
|
Urinalysis (with microscopy)
|
$35.00 |
$35.00 |
$92.40 |
$54.60
|
|
Urinalysis (without microscopy)
|
$19.14 |
$32.50 |
$50.40 |
$35.75
|
|
Urine Culture Test
|
$29.37 |
$57.50 |
$192.50 |
$81.27
|
|
Urine flow measurement 51736
|
$267.50 |
$267.50 |
$267.50 |
$210.00
|
|
Urine pregnancy test
|
$57.50 |
$57.50 |
$142.10 |
$67.80
|
|
Urography, antegrade
|
$197.34 |
$965.00 |
$1,262.80 |
$622.35
|
|
Urography inf drip &/or bolus
|
$371.58 |
$371.58 |
$615.00 |
$642.50
|
|
Use 1st target lesion
|
$310.53 |
$310.53 |
$482.30 |
$336.50
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$37,584.40 |
$37,584.40 |
$37,584.40 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$49,433.12 |
$49,433.12 |
$49,433.12 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$29.70 |
$50.00 |
$54.60 |
$67.74
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$137.90 |
$137.90 |
$137.90 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$92.40 |
$92.40 |
$92.40 |
$123.20
|
|
Vaccine dtap < 7 years im
|
$139.77 |
$139.77 |
$463.40 |
$68.19
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$118.94 |
$118.94 |
$118.94 |
$72.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$70.60 |
$70.60 |
$97.12 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$378.17 |
$378.17 |
$378.17 |
$168.95
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$509.77 |
$509.77 |
$509.77 |
$231.56
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$1,123.50 |
$1,123.50 |
$1,123.50 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$302.43 |
$302.43 |
$708.75 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$105.43 |
$119.09 |
$459.72 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,678.95 |
$1,678.95 |
$1,678.95 |
$570.87
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$347.20 |
$347.20 |
$347.20 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$302.40 |
$302.40 |
$302.40 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$81.20 |
$81.20 |
$85.06 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$33.60 |
$33.60 |
$33.60 |
$33.21
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,158.50 |
$1,158.50 |
$1,158.50 |
$400.03
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1,021.30 |
$1,021.30 |
$1,021.30 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$848.92 |
$848.92 |
$848.92 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$200.53 |
$200.53 |
$505.22 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,237.60 |
$1,237.60 |
$1,237.60 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$275.80 |
$275.80 |
$275.80 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$581.91 |
$581.91 |
$1,842.40 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$230.30 |
$230.30 |
$1,598.12 |
$90.70
|
|
Vaccine rabies im
|
$859.33 |
$1,048.00 |
$2,027.72 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$1,048.25 |
$1,048.25 |
$1,048.25 |
$521.74
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,458.40 |
$2,458.40 |
$2,458.40 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$2,458.40 |
$2,458.40 |
$2,458.40 |
$980.10
|
|
Vaccine tdap >=7 years im
|
$109.52 |
$163.41 |
$775.42 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$665.17 |
$665.17 |
$665.17 |
$110.19
|
|
Vaccine varicella live subcutaneous
|
$362.43 |
$362.43 |
$362.43 |
$364.16
|
|
Vag hyst incl t/o complex
|
$48,803.60 |
$48,803.60 |
$48,803.60 |
$5,813.46
|
|
Vag hyst including t/o
|
$34,232.03 |
$34,232.03 |
$34,232.03 |
$5,110.00
|
|
Vaginal bx
|
$22,427.17 |
$22,427.17 |
$22,427.17 |
$471.12
|
|
Vaginal hysterectomy
|
$56,155.70 |
$56,155.70 |
$56,155.70 |
$5,766.00
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$92.57 |
$92.57 |
$92.57 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$50.49 |
$90.00 |
$150.50 |
$115.00
|
|
Valrubicin injection
|
$5,142.55 |
$5,142.55 |
$5,142.55 |
$2,813.49
|
|
Valvuloplasty aortic
|
$6,925.00 |
$6,925.00 |
$16,396.80 |
$8,052.60
|
|
Valvuloplasty mitral
|
$9,664.90 |
$9,664.90 |
$12,885.00 |
$10,851.48
|
|
Valvuloplasty pulmonary
|
$6,469.40 |
$6,469.40 |
$6,469.40 |
$11,945.20
|
|
Valvuloplasty/tv w/ring insertion 33464
|
$21,092.40 |
$21,092.40 |
$21,092.40 |
$5,965.60
|
|
Vancomycin 1,000 mg intravenous injection
|
$1,839.77 |
$1,839.77 |
$1,839.77 |
$251.86
|
|
Vancomycin hcl injection
|
$36.74 |
$224.00 |
$697.41 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$48.51 |
$112.50 |
$347.90 |
$135.00
|
|
Varicella zoster antibody igg
|
$64.35 |
$72.50 |
$267.40 |
$86.80
|
|
Varicella-zoster immue globin im
|
$47,469.10 |
$47,469.10 |
$47,469.10 |
$3,816.19
|
|
Vasc emb/occ w/prs cath
|
$20,240.00 |
$20,240.00 |
$31,976.00 |
$21,009.00
|