|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.00 |
$44.00 |
$44.00 |
$28.90
|
|
Triamcinolone a inj prs-free
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$696.00
|
|
Trichomonas assay w/optic
|
$87.60 |
$87.60 |
$87.60 |
$68.90
|
|
Triglycerides
|
$120.00 |
$120.00 |
$120.00 |
$48.75
|
|
Trim nondyst nails
|
$215.40 |
$215.40 |
$215.40 |
$124.22
|
|
Triptorelin pamoate
|
$4,619.39 |
$4,619.39 |
$4,619.39 |
$4,619.39
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$27,143.40 |
$27,143.40 |
$27,143.40 |
$9,418.42
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$27,143.40 |
$27,143.40 |
$27,143.40 |
$9,565.92
|
|
Trnscath plc vas stent w/s&i ini vein
|
$29,272.20 |
$29,272.20 |
$29,272.20 |
$15,873.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$10,258.80 |
$10,258.80 |
$10,258.80 |
$5,555.55
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$12,519.00 |
$12,519.00 |
$12,519.00 |
$6,354.94
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,169.20 |
$6,169.20 |
$6,169.20 |
$4,770.98
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,310.40 |
$7,310.40 |
$7,310.40 |
$5,324.40
|
|
Trnscath tx thromblytc vein ini day
|
$12,519.00 |
$12,519.00 |
$12,519.00 |
$4,201.80
|
|
Troponin quantitative
|
$295.20 |
$295.20 |
$295.20 |
$112.80
|
|
Tube trach fen sz 6 uncuffed
|
$15.00 |
$15.00 |
$15.00 |
$132.40
|
|
Ultrasound abdomen aorta screening study aaa
|
$331.20 |
$331.20 |
$331.20 |
$394.20
|
|
Ultrasound breast complete
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$674.40 |
$674.40 |
$674.40 |
$427.00
|
|
Ultrasound chest
|
$235.20 |
$235.20 |
$235.20 |
$430.10
|
|
Ultrasound encephalogram
|
$324.60 |
$324.60 |
$324.60 |
$463.50
|
|
Ultrasound exam k transpl w/doppler
|
$405.00 |
$405.00 |
$405.00 |
$494.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$306.00 |
$306.00 |
$306.00 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$333.60 |
$333.60 |
$333.60 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$324.60 |
$324.60 |
$324.60 |
$629.64
|
|
Ultrasound guide intraoperative
|
$568.20 |
$568.20 |
$568.20 |
$628.80
|
|
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 |
$477.10
|
|
Ultrasound retroperitoneal limited
|
$239.40 |
$239.40 |
$239.40 |
$469.58
|
|
Ultrasound scrotum and contents
|
$382.20 |
$382.20 |
$382.20 |
$558.03
|
|
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 |
$523.20
|
|
Unlisted dx gi procedure
|
$3,231.00 |
$3,231.00 |
$3,231.00 |
$613.20
|
|
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 |
$1,794.00
|
|
Urea nitrogen
|
$87.60 |
$87.60 |
$87.60 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$94.80 |
$94.80 |
$94.80 |
$42.90
|
|
Ureteral embolization/occl
|
$1,817.40 |
$1,817.40 |
$1,817.40 |
$3,041.22
|
|
Ureteral reflux study
|
$603.60 |
$603.60 |
$603.60 |
$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
|
$115.20 |
$115.20 |
$115.20 |
$44.00
|
|
Uric acid urine
|
$87.60 |
$87.60 |
$87.60 |
$43.20
|
|
Urinalysis microscopic only
|
$63.60 |
$63.60 |
$63.60 |
$25.72
|
|
Urinalysis (with microscopy)
|
$115.20 |
$115.20 |
$115.20 |
$37.39
|
|
Urinalysis (without microscopy)
|
$79.80 |
$79.80 |
$79.80 |
$33.00
|
|
Urine Culture Test
|
$203.40 |
$203.40 |
$203.40 |
$63.84
|
|
Urine pregnancy test
|
$138.60 |
$138.60 |
$138.60 |
$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
|
|
Vaccine dtap < 7 years im
|
$49.35 |
$49.35 |
$49.35 |
$66.69
|
|
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 influenza (iiv) preservative free antigen content im
|
$179.55 |
$179.55 |
$179.55 |
$130.67
|
|
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 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 rabies im
|
$659.39 |
$659.39 |
$659.39 |
$800.00
|
|
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
|
|
Valproic acid total therapeutic drug level
|
$265.80 |
$265.80 |
$265.80 |
$100.80
|
|
Vancomycin peak therapeutic drug level
|
$292.80 |
$292.80 |
$292.80 |
$116.00
|
|
Varicella zoster antibody igg
|
$195.60 |
$195.60 |
$195.60 |
$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 |
$22,019.50
|
|
Veeg cont 2-12 hrs
|
$1,206.60 |
$1,206.60 |
$1,206.60 |
$1,303.97
|
|
Veeg ea 12-26hr cont mntr
|
$2,257.80 |
$2,257.80 |
$2,257.80 |
$3,447.00
|
|
Veeg intrmnt 2-12 hrs
|
$625.20 |
$625.20 |
$625.20 |
$870.22
|
|
Vein x-ray kidney
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$2,600.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$292.80 |
$292.80 |
$292.80 |
$123.00
|
|
Venipuncture <3 yrs other vein
|
$129.60 |
$129.60 |
$129.60 |
$46.80
|
|
Venogram extremity supervision & interpretation unilateral
|
$607.20 |
$607.20 |
$607.20 |
$1,270.23
|
|
Venous sampling s&i
|
$1,651.20 |
$1,651.20 |
$1,651.20 |
$3,800.23
|
|
Ventilator each subsequent day
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$1,138.50
|
|
Ventilator initial day
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$1,331.00
|
|
Version cephalic external
|
$1,043.40 |
$1,043.40 |
$1,043.40 |
$2,361.75
|
|
Very long chain fatty acids
|
$355.80 |
$355.80 |
$355.80 |
$157.30
|
|
Vinblastine 1 mg/ml intravenous solution
|
$202.14 |
$202.14 |
$202.14 |
$159.60
|
|
Vincristine 1 mg/ml intravenous solution
|
$191.12 |
$191.12 |
$191.12 |
$52.02
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$200.42 |
$200.42 |
$200.42 |
$177.04
|
|
Virus isolation addl studies ea
|
$112.80 |
$112.80 |
$112.80 |
$90.35
|
|
Visit established high 40-54 minutes/level 5
|
$189.60 |
$189.60 |
$189.60 |
$186.60
|
|
Vitamin b-12
|
$222.00 |
$222.00 |
$222.00 |
$89.70
|
|
Vitamin D Test
|
$395.40 |
$395.40 |
$395.40 |
$132.60
|
