|
Ultrasound breast complete
|
$690.00 |
$690.00 |
$690.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$555.00 |
$555.00 |
$555.00 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$355.00 |
$355.00 |
$355.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$300.00 |
$300.00 |
$300.00 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$172.50 |
$172.50 |
$172.50 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$207.50 |
$207.50 |
$207.50 |
$313.95
|
|
Ultrasound encephalogram
|
$520.00 |
$520.00 |
$520.00 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$515.00 |
$515.00 |
$515.00 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$382.50 |
$382.50 |
$382.50 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$625.00 |
$625.00 |
$625.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$225.00 |
$225.00 |
$225.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$295.00 |
$295.00 |
$295.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$590.00 |
$590.00 |
$590.00 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$440.00 |
$440.00 |
$440.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$327.50 |
$327.50 |
$327.50 |
$311.25
|
|
Ultrasound joint complete left
|
$675.00 |
$675.00 |
$675.00 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$402.50 |
$402.50 |
$402.50 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$442.50 |
$442.50 |
$442.50 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$382.50 |
$382.50 |
$382.50 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$940.00 |
$940.00 |
$940.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$500.00 |
$500.00 |
$500.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$530.00 |
$530.00 |
$530.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$415.00 |
$415.00 |
$415.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$705.00 |
$705.00 |
$705.00 |
$421.00
|
|
Unlistd noninvas vasc dx std
|
$67.50 |
$67.50 |
$67.50 |
$564.60
|
|
Unlisted chemotherapy px
|
$150.00 |
$150.00 |
$150.00 |
$143.75
|
|
Unlisted CT procedure
|
$467.50 |
$467.50 |
$467.50 |
$732.70
|
|
Unlisted fluoroscopic px
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$305.76
|
|
Unlisted mr procedure
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$1,163.00
|
|
Unlisted procedure colon
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$1,839.55
|
|
Unlisted procedure microbiology
|
$555.00 |
$555.00 |
$555.00 |
$530.00
|
|
Unlisted px biliary tract
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$142.50 |
$142.50 |
$142.50 |
$222.00
|
|
Unlisted px external ear
|
$362.50 |
$362.50 |
$362.50 |
$325.68
|
|
Unlisted px med radj physics
|
$540.00 |
$540.00 |
$540.00 |
$462.35
|
|
Unlisted px pelvis/hip joint
|
$900.00 |
$900.00 |
$900.00 |
$3,251.90
|
|
Unlisted px small intestine
|
$1,195.00 |
$1,195.00 |
$1,195.00 |
$2,118.35
|
|
Unlisted reprod med lab proc
|
$65.00 |
$65.00 |
$65.00 |
$70.00
|
|
Unlisted transfusion med px
|
$147.50 |
$147.50 |
$147.50 |
$147.50
|
|
Unlisted ultrasound procedure
|
$252.50 |
$252.50 |
$252.50 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$1,296.00
|
|
Upgrade pm system
|
$9,320.00 |
$9,320.00 |
$9,320.00 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$320.00 |
$320.00 |
$320.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,650.00 |
$2,650.00 |
$2,650.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$380.00 |
$380.00 |
$380.00 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$402.50 |
$402.50 |
$402.50 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$440.00 |
$440.00 |
$440.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$387.50 |
$387.50 |
$387.50 |
$607.20
|
|
Urea nitrogen
|
$37.50 |
$37.50 |
$37.50 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$37.50 |
$37.50 |
$37.50 |
$51.84
|
|
Urea nitrogen clearance
|
$65.00 |
$65.00 |
$65.00 |
$34.02
|
|
Ureteral embolization/occl
|
$2,655.00 |
$2,655.00 |
$2,655.00 |
$2,079.31
|
|
Ureteral reflux study
|
$1,165.00 |
$1,165.00 |
$1,165.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$510.00 |
$510.00 |
$510.00 |
$584.00
|
|
Urethrocystography void s&i
|
$695.00 |
$695.00 |
$695.00 |
$634.50
|
|
Uric acid blood
|
$45.00 |
$45.00 |
$45.00 |
$49.32
|
|
Uric acid urine
|
$62.50 |
$62.50 |
$62.50 |
$44.52
|
|
Urinalysis microscopic only
|
$37.50 |
$37.50 |
$37.50 |
$26.35
|
|
Urinalysis (with microscopy)
|
$35.00 |
$35.00 |
$35.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$32.50 |
$32.50 |
$32.50 |
$35.91
|
|
Urine Culture Test
|
$57.50 |
$57.50 |
$57.50 |
$82.32
|
|
Urine pregnancy test
|
$57.50 |
$57.50 |
$57.50 |
$68.21
|
|
Urography, antegrade
|
$965.00 |
$965.00 |
$965.00 |
$622.35
|
|
Urography inf drip &/or bolus
|
$615.00 |
$615.00 |
$615.00 |
$642.50
|
|
Use 1st target lesion
|
$230.00 |
$230.00 |
$230.00 |
$332.00
|
|
Vaccine Administration (one shot)
|
$50.00 |
$50.00 |
$50.00 |
$67.74
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$119.35 |
$119.35 |
$119.35 |
$75.39
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$627.00 |
$627.00 |
$627.00 |
$327.37
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$255.00 |
$255.00 |
$255.00 |
$563.36
|
|
Vaccine rabies im
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$163.16 |
$163.16 |
$163.16 |
$131.34
|
|
Vaccine varicella live subcutaneous
|
$580.50 |
$580.50 |
$580.50 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$115.00
|
|
Valvuloplasty aortic
|
$7,310.00 |
$7,310.00 |
$7,310.00 |
$7,944.16
|
|
Valvuloplasty mitral
|
$17,995.00 |
$17,995.00 |
$17,995.00 |
$10,845.00
|
|
Vancomycin hcl injection
|
$147.03 |
$147.03 |
$147.03 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$135.60
|
|
Varicella zoster antibody igg
|
$72.50 |
$72.50 |
$72.50 |
$86.80
|
|
Vedolizumab 300 mg intravenous solution
|
$75.11 |
$75.11 |
$75.11 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$885.00 |
$885.00 |
$885.00 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$1,545.00 |
$1,545.00 |
$1,545.00 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$442.50 |
$442.50 |
$442.50 |
$994.91
|
|
Veeg unmon 12-26 hrs
|
$885.00 |
$885.00 |
$885.00 |
$1,737.12
|
|
Veeg unmon 2-12 hrs
|
$442.50 |
$442.50 |
$442.50 |
$826.15
|
|
Vein x-ray adrenal gland
|
$3,900.00 |
$3,900.00 |
$3,900.00 |
$2,833.34
|
|
Vein x-ray adrenal glands
|
$4,880.00 |
$4,880.00 |
$4,880.00 |
$3,480.10
|
|
Vein x-ray kidney
|
$2,600.00 |
$2,600.00 |
$2,600.00 |
$2,870.00
|
|
Vein x-ray liver
|
$2,740.00 |
$2,740.00 |
$2,740.00 |
$3,312.00
|
|
Vein x-ray liver w/hemodynam
|
$3,940.00 |
$3,940.00 |
$3,940.00 |
$3,619.84
|
|
Vein x-ray liver w/hemodynam
|
$3,040.00 |
$3,040.00 |
$3,040.00 |
$3,683.90
|
|
Vein x-ray liver without hemodyn
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$2,452.80
|
|
Vein x-ray skull
|
$2,330.00 |
$2,330.00 |
$2,330.00 |
$2,236.50
|
|
Vein x-ray skull epidural
|
$2,830.00 |
$2,830.00 |
$2,830.00 |
$1,596.00
|
|
Vein x-ray spleen/liver
|
$2,645.00 |
$2,645.00 |
$2,645.00 |
$3,434.00
|
|
Ven-artl shunt det mbubb njx
|
$760.00 |
$760.00 |
$760.00 |
$484.25
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$67.50 |
$67.50 |
$67.50 |
$197.04
|
