|
Ultrasound infant hips ltd without stress
|
$112.80 |
$112.80 |
$112.80 |
$311.25
|
|
Ultrasound joint complete left
|
$334.80 |
$334.80 |
$334.80 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$281.40 |
$281.40 |
$281.40 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$350.40 |
$350.40 |
$350.40 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$298.20 |
$298.20 |
$298.20 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$541.80 |
$541.80 |
$541.80 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$301.80 |
$301.80 |
$301.80 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$293.40 |
$293.40 |
$293.40 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$330.60 |
$330.60 |
$330.60 |
$476.40
|
|
Ultrasound prostate/transrectal
|
$462.60 |
$462.60 |
$462.60 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$239.40 |
$239.40 |
$324.60 |
$469.58
|
|
Ultrasound scrotum and contents
|
$382.20 |
$382.20 |
$382.20 |
$556.80
|
|
Ultrasound spinal canal and contents
|
$324.60 |
$324.60 |
$324.60 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$174.60 |
$174.60 |
$174.60 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$330.60 |
$330.60 |
$330.60 |
$522.69
|
|
Ultraviolet therapy
|
$42.60 |
$42.60 |
$42.60 |
$42.60
|
|
Umbilical artery cath newborn 36660
|
$2,196.60 |
$2,196.60 |
$2,196.60 |
$204.75
|
|
Unit mobile power mpu
|
$20,230.80 |
$20,230.80 |
$20,230.80 |
$18,857.25
|
|
Unlisted CT procedure
|
$542.40 |
$542.40 |
$542.40 |
$1,268.98
|
|
Unlisted dx gi procedure
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$613.20
|
|
Unlisted fluoroscopic px
|
$330.60 |
$330.60 |
$330.60 |
$256.00
|
|
Unlisted mr procedure
|
$582.60 |
$582.60 |
$582.60 |
$1,249.50
|
|
Unlisted orl service/px
|
$91.80 |
$153.60 |
$223.20 |
$153.60
|
|
Unlisted px casting/strpg
|
$124.20 |
$124.20 |
$124.20 |
$223.45
|
|
Unlisted transfusion med px
|
$250.20 |
$250.20 |
$250.20 |
$113.36
|
|
Unlisted ultrasound procedure
|
$164.40 |
$164.40 |
$164.40 |
$335.00
|
|
Upgrade pm system
|
$11,733.60 |
$11,733.60 |
$11,733.60 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$1,790.00
|
|
Urea nitrogen
|
$90.60 |
$90.60 |
$90.60 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$105.60 |
$105.60 |
$105.60 |
$42.00
|
|
Ureteral embolization/occl
|
$1,873.20 |
$1,873.20 |
$1,873.20 |
$3,041.22
|
|
Ureteral reflux study
|
$961.20 |
$961.20 |
$961.20 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$258.00 |
$258.00 |
$258.00 |
$554.28
|
|
Urethrocystography void s&i
|
$258.00 |
$258.00 |
$258.00 |
$586.50
|
|
Uric acid blood
|
$100.80 |
$100.80 |
$100.80 |
$44.00
|
|
Uric acid urine
|
$131.40 |
$131.40 |
$131.40 |
$43.20
|
|
Urinalysis microscopic only
|
$54.00 |
$54.00 |
$54.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$135.00 |
$135.00 |
$135.00 |
$37.39
|
|
Urinalysis (without microscopy)
|
$101.40 |
$101.40 |
$101.40 |
$33.00
|
|
Urine Culture Test
|
$223.80 |
$223.80 |
$223.80 |
$63.84
|
|
Urine pregnancy test
|
$159.60 |
$159.60 |
$159.60 |
$57.00
|
|
Urography, antegrade
|
$351.00 |
$351.00 |
$351.00 |
$593.37
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,183.44 |
$3,183.44 |
$3,183.44 |
$8,225.22
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$42,196.74 |
$42,196.74 |
$42,196.74 |
$89,537.92
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$313.80 |
$313.80 |
$313.80 |
$255.20
|
|
Vaccine dtap < 7 years im
|
$49.35 |
$49.35 |
$49.35 |
$66.69
|
|
Vaccine dtap-hep b-ipv im
|
$180.74 |
$180.74 |
$180.74 |
$169.85
|
|
Vaccine dtap-ipv 4-6 years im
|
$131.65 |
$131.65 |
$131.65 |
$129.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$52.77 |
$52.77 |
$52.77 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$48.82 |
$48.82 |
$48.82 |
$39.78
|
|
Vaccine hepatitis a (hepa) adult im
|
$178.07 |
$178.07 |
$178.07 |
$163.15
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$201.80 |
$201.80 |
$201.80 |
$201.80
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$120.25 |
$120.25 |
$120.25 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$175.91 |
$175.91 |
$175.91 |
$162.07
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$446.88 |
$446.88 |
$446.88 |
$310.70
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$45.91 |
$45.91 |
$45.91 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$441.38 |
$441.38 |
$441.38 |
$521.70
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$418.42 |
$418.42 |
$418.42 |
$230.40
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$179.55 |
$179.55 |
$179.55 |
$132.15
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$47.88 |
$47.88 |
$47.88 |
$47.38
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$47.65 |
$47.65 |
$47.65 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$49.02 |
$49.02 |
$49.02 |
$29.60
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$53.06 |
$53.06 |
$53.06 |
$72.00
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$322.90 |
$322.90 |
$322.90 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$329.24 |
$329.24 |
$329.24 |
$321.80
|
|
Vaccine mmr live subcutaneous
|
$417.25 |
$417.25 |
$417.25 |
$222.36
|
|
Vaccine mmrv live subcutaneous
|
$424.32 |
$424.32 |
$424.32 |
$604.50
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$166.40 |
$166.40 |
$166.40 |
$195.69
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$429.30 |
$429.30 |
$429.30 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$633.56 |
$633.56 |
$633.56 |
$579.50
|
|
Vaccine polio (ipv) subcutaneous/im
|
$119.17 |
$119.17 |
$119.17 |
$100.00
|
|
Vaccine rabies im
|
$659.39 |
$659.39 |
$659.39 |
$800.00
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$659.71 |
$659.71 |
$659.71 |
$534.92
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,105.21 |
$1,105.21 |
$1,105.21 |
$1,159.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,105.21 |
$1,105.21 |
$1,105.21 |
$997.44
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$191.74 |
$191.74 |
$191.74 |
$108.00
|
|
Vaccine tdap >=7 years im
|
$131.34 |
$131.34 |
$131.34 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$120.13 |
$120.13 |
$120.13 |
$112.10
|
|
Vaccine typhoid vicps im
|
$202.54 |
$202.54 |
$202.54 |
$253.50
|
|
Vaccine varicella live subcutaneous
|
$313.70 |
$313.70 |
$313.70 |
$434.73
|
|
Vad battery clip set hmii 14-v li-ion
|
$1,515.60 |
$1,515.60 |
$1,515.60 |
$2,592.00
|
|
Vad cable power module dc input
|
$4,133.40 |
$4,133.40 |
$4,133.40 |
$391.95
|
|
Vad univ batt charger hm 1440
|
$18,673.20 |
$18,673.20 |
$18,673.20 |
$16,971.75
|
|
Valproic acid total therapeutic drug level
|
$291.00 |
$291.00 |
$291.00 |
$100.80
|
|
Valrubicin injection
|
$2,929.63 |
$2,929.63 |
$2,929.63 |
$2,929.63
|
|
Valvuloplasty aortic
|
$19,238.40 |
$19,238.40 |
$20,032.80 |
$7,944.16
|
|
Valvuloplasty mitral
|
$19,238.40 |
$19,238.40 |
$20,032.80 |
$10,505.04
|
|
Valvuloplasty pulmonary
|
$19,238.40 |
$19,238.40 |
$19,238.40 |
$11,945.20
|
|
Valvuloplasty/tv without ring insert 33463
|
$1,514.40 |
$1,514.40 |
$20,557.80 |
$7,556.80
|
|
Vancomycin peak therapeutic drug level
|
$316.80 |
$316.80 |
$316.80 |
$115.00
|
|
Varicella zoster antibody igg
|
$280.80 |
$280.80 |
$280.80 |
$90.35
|
|
Vasopressin 20 unit/ml intravenous solution
|
$543.52 |
$543.52 |
$543.52 |
$330.41
|
|
Vedolizumab 300 mg intravenous solution
|
$46.29 |
$46.29 |
$46.29 |
$14,392.18
|
|
Veeg cont 2-12 hrs
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$1,303.97
|
|
Veeg ea 12-26hr cont mntr
|
$2,229.60 |
$2,229.60 |
$2,229.60 |
$3,447.00
|
|
Veeg intrmnt 2-12 hrs
|
$616.80 |
$616.80 |
$616.80 |
$870.22
|
|
Vein x-ray adrenal gland
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$5,493.00 |
$5,493.00 |
$5,493.00 |
$3,353.84
|
