|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$840.50 |
$840.50 |
$840.50 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$561.00 |
$561.00 |
$561.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$512.50 |
$512.50 |
$539.50 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$458.50 |
$458.50 |
$458.50 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$356.00 |
$356.00 |
$356.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$423.00 |
$423.00 |
$423.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$422.50 |
$422.50 |
$422.50 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$434.00 |
$434.00 |
$434.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$357.50 |
$357.50 |
$357.50 |
$558.35
|
|
Unlistd noninvas vasc dx std
|
$1,396.50 |
$1,396.50 |
$1,396.50 |
$528.80
|
|
Unlisted maaa
|
$486.50 |
$486.50 |
$486.50 |
$235.20
|
|
Unlisted orl service/px
|
$408.50 |
$408.50 |
$408.50 |
$132.60
|
|
Unlisted px ther rad tx plng
|
$1,339.00 |
$1,339.00 |
$1,339.00 |
$182.00
|
|
Unlisted ultrasound procedure
|
$427.50 |
$427.50 |
$427.50 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$1,110.00 |
$1,110.00 |
$1,110.00 |
$1,268.17
|
|
Upgrade pm system
|
$18,399.50 |
$18,399.50 |
$18,399.50 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,072.00 |
$1,072.00 |
$1,072.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$947.50 |
$947.50 |
$947.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$850.00 |
$850.00 |
$850.00 |
$2,034.41
|
|
Urea nitrogen
|
$24.00 |
$24.00 |
$24.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$61.50 |
$61.50 |
$61.50 |
$51.75
|
|
Urea nitrogen clearance
|
$116.00 |
$116.00 |
$116.00 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$646.00 |
$646.00 |
$646.00 |
$579.73
|
|
Urethrocystography void s&i
|
$599.00 |
$599.00 |
$599.00 |
$622.35
|
|
Uric acid blood
|
$34.00 |
$34.00 |
$34.00 |
$48.75
|
|
Uric acid urine
|
$55.50 |
$55.50 |
$55.50 |
$44.33
|
|
Urinalysis microscopic only
|
$14.50 |
$14.50 |
$14.50 |
$26.35
|
|
Urinalysis (with microscopy)
|
$43.50 |
$43.50 |
$43.50 |
$55.00
|
|
Urinalysis (without microscopy)
|
$25.50 |
$25.50 |
$25.50 |
$35.75
|
|
Urine Culture Test
|
$43.00 |
$43.00 |
$43.00 |
$81.50
|
|
Urine pregnancy test
|
$55.50 |
$55.50 |
$55.50 |
$67.20
|
|
Urography, antegrade
|
$488.00 |
$488.00 |
$488.00 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,084.76 |
$5,084.76 |
$5,084.76 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$37,645.70 |
$37,645.70 |
$37,645.70 |
$51,633.07
|
|
Vaccine dtap < 7 years im
|
$99.83 |
$99.83 |
$99.83 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$165.26 |
$165.26 |
$165.26 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$150.98 |
$150.98 |
$150.98 |
$105.95
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$61.05 |
$61.05 |
$61.05 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$170.44 |
$170.44 |
$170.44 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$238.59 |
$238.59 |
$238.59 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$127.36 |
$127.36 |
$127.36 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$249.58 |
$249.58 |
$249.58 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$296.22 |
$296.22 |
$296.22 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$95.62 |
$95.62 |
$95.62 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,062.82 |
$1,062.82 |
$1,062.82 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$66.09 |
$66.09 |
$66.09 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$29.05 |
$29.05 |
$29.05 |
$47.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$387.95 |
$387.95 |
$387.95 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$544.94 |
$544.94 |
$544.94 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$213.00 |
$213.00 |
$213.00 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$268.66 |
$268.66 |
$268.66 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$466.48 |
$466.48 |
$466.48 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$532.20 |
$532.20 |
$532.20 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$907.72 |
$907.72 |
$907.72 |
$90.70
|
|
Vaccine rabies im
|
$1,780.26 |
$1,780.26 |
$1,780.26 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$588.40 |
$588.40 |
$588.40 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,135.24 |
$1,135.24 |
$1,135.24 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,135.24 |
$1,135.24 |
$1,135.24 |
$997.44
|
|
Vaccine tdap >=7 years im
|
$160.60 |
$160.60 |
$160.60 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$159.04 |
$159.04 |
$159.04 |
$112.10
|
|
Vaccine typhoid vicps im
|
$325.62 |
$325.62 |
$325.62 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$409.26 |
$409.26 |
$409.26 |
$365.17
|
|
Vaginal bx
|
$63.18 |
$63.18 |
$63.18 |
$455.94
|
|
Valproic acid total therapeutic drug level
|
$148.50 |
$148.50 |
$148.50 |
$114.72
|
|
Valvuloplasty aortic
|
$11,425.00 |
$11,425.00 |
$11,425.00 |
$7,830.80
|
|
Vancomycin hcl injection
|
$154.40 |
$154.40 |
$154.40 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$136.13
|
|
Vanomycin dna amp probe
|
$51.00 |
$51.00 |
$51.00 |
$78.40
|
|
Vantas implant
|
$12,207.65 |
$12,207.65 |
$12,207.65 |
$12,207.65
|
|
Varicella zoster antibody igg
|
$122.50 |
$122.50 |
$122.50 |
$86.80
|
|
Varicella-zoster immue globin im
|
$4,062.76 |
$4,062.76 |
$4,062.76 |
$3,816.19
|
|
Vasopressin 20 unit/ml intravenous solution
|
$80.23 |
$80.23 |
$80.23 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$21,692.45 |
$21,692.45 |
$21,692.45 |
$18,732.33
|
|
Veeg unmon 12-26 hrs
|
$2,153.00 |
$2,153.00 |
$2,153.00 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$1,594.50 |
$1,594.50 |
$1,594.50 |
$826.15
|
|
Vein x-ray kidney
|
$2,661.00 |
$2,661.00 |
$2,661.00 |
$2,766.73
|
|
Vein x-ray liver w/hemodynam
|
$2,191.50 |
$2,191.50 |
$2,191.50 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
$3,483.84
|
|
Vein x-ray skull
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$2,141.00
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$3,678.15 |
$3,678.15 |
$3,678.15 |
$2,632.35
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$136.00 |
$136.00 |
$136.00 |
$202.80
|
|
Venogram ext bil s&i
|
$1,278.00 |
$1,278.00 |
$1,278.00 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$1,366.20
|
|
Venous mech thrombectomy
|
$2,068.50 |
$2,068.50 |
$2,068.50 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$5,048.00 |
$5,048.00 |
$5,048.00 |
$5,094.75
|
|
Ventilator each subsequent day
|
$695.50 |
$695.50 |
$695.50 |
$1,204.00
|
|
Ventilator initial day
|
$695.50 |
$695.50 |
$695.50 |
$1,431.43
|
|
Very long chain fatty acids
|
$235.00 |
$235.00 |
$235.00 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$298.22 |
$298.22 |
$298.22 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$81.36 |
$81.36 |
$81.36 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$105.20 |
$105.20 |
$105.20 |
$223.55
|
|
Visual audiometry (vra)
|
$288.00 |
$288.00 |
$288.00 |
$215.25
|
|
Vital capacity test
|
$118.50 |
$118.50 |
$118.50 |
$170.00
|
|
Vitamin b-12
|
$105.00 |
$105.00 |
$105.00 |
$100.00
|
|
Vitamin D Test
|
$141.50 |
$141.50 |
$141.50 |
$132.00
|
|
Volume measurement urine timed
|
$8.50 |
$8.50 |
$8.50 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$92.96 |
$92.96 |
$92.96 |
$165.81
|
|
Vulvectomy simple partial
|
$361.38 |
$361.38 |
$361.38 |
$3,986.00
|
|
Warde 1003990 aldosterone
|
$215.00 |
$215.00 |
$215.00 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$144.00 |
$144.00 |
$144.00 |
$97.50
|
