|
Unlisted px med radj physics
|
$723.14 |
$723.14 |
$723.14 |
$462.35
|
|
Unlisted resp px dx nuc med
|
$1,457.13 |
$1,457.13 |
$1,457.13 |
$670.60
|
|
Unlisted surgical path px
|
$68.76 |
$68.76 |
$68.76 |
$217.75
|
|
Unlisted transfusion med px
|
$1,138.52 |
$1,138.52 |
$1,138.52 |
$147.50
|
|
Unlisted ultrasound procedure
|
$1,336.12 |
$1,336.12 |
$1,336.12 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$1,683.96 |
$1,683.96 |
$1,683.96 |
$1,268.17
|
|
Upgrade pm system
|
$72,805.03 |
$72,805.03 |
$72,805.03 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,507.36 |
$4,507.36 |
$4,507.36 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,258.04 |
$3,258.04 |
$3,258.04 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,225.02 |
$3,225.02 |
$3,225.02 |
$2,034.41
|
|
Upper ext fx orthosis rad/ul
|
$465.92 |
$465.92 |
$465.92 |
$619.49
|
|
Urea nitrogen
|
$46.61 |
$46.61 |
$46.61 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$57.15 |
$57.15 |
$57.15 |
$51.75
|
|
Ureteral reflux study
|
$1,879.76 |
$1,879.76 |
$1,879.76 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$954.82 |
$954.82 |
$954.82 |
$579.73
|
|
Urethrocystography void s&i
|
$2,184.91 |
$2,184.91 |
$2,184.91 |
$622.35
|
|
Uric acid blood
|
$55.98 |
$55.98 |
$55.98 |
$48.75
|
|
Uric acid urine
|
$58.32 |
$58.32 |
$58.32 |
$44.33
|
|
Urinalysis microscopic only
|
$35.00 |
$35.00 |
$35.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$52.47 |
$52.47 |
$52.47 |
$25.72
|
|
Urinalysis (with microscopy)
|
$39.60 |
$39.60 |
$39.60 |
$55.00
|
|
Urinalysis (without microscopy)
|
$28.00 |
$28.00 |
$28.00 |
$35.75
|
|
Urinary bldr retent nuc study
|
$479.41 |
$479.41 |
$479.41 |
$350.66
|
|
Urine Culture Test
|
$100.26 |
$100.26 |
$100.26 |
$81.50
|
|
Urine pregnancy test
|
$15.11 |
$15.11 |
$15.11 |
$67.20
|
|
Urography, antegrade
|
$2,083.16 |
$2,083.16 |
$2,083.16 |
$622.35
|
|
Use 1st target lesion
|
$942.66 |
$942.66 |
$942.66 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,748.88 |
$5,748.88 |
$5,748.88 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$154,889.53 |
$154,889.53 |
$154,889.53 |
$51,633.07
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$276.53 |
$276.53 |
$276.53 |
$224.25
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$334.80 |
$334.80 |
$334.80 |
$236.50
|
|
Vaccine dtap-ipv/hib im
|
$1,065.23 |
$1,065.23 |
$1,065.23 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$291.05 |
$291.05 |
$291.05 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$115.37 |
$115.37 |
$115.37 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$693.19 |
$693.19 |
$693.19 |
$166.62
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$301.11 |
$301.11 |
$301.11 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$481.00 |
$481.00 |
$481.00 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$1,417.81 |
$1,417.81 |
$1,417.81 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$218.30 |
$218.30 |
$218.30 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$3,162.56 |
$3,162.56 |
$3,162.56 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$669.65 |
$669.65 |
$669.65 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$155.18 |
$155.18 |
$155.18 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$634.66 |
$634.66 |
$634.66 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$205.07 |
$205.07 |
$205.07 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,694.69 |
$1,694.69 |
$1,694.69 |
$400.03
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1,508.46 |
$1,508.46 |
$1,508.46 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,139.54 |
$1,139.54 |
$1,139.54 |
$329.24
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,109.05 |
$1,109.05 |
$1,109.05 |
$251.64
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,631.03 |
$2,631.03 |
$2,631.03 |
$563.36
|
|
Vaccine rabies im
|
$4,287.26 |
$4,287.26 |
$4,287.26 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,156.09 |
$2,156.09 |
$2,156.09 |
$1,104.47
|
|
Vaccine tdap >=7 years im
|
$492.05 |
$492.05 |
$492.05 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$426.72 |
$426.72 |
$426.72 |
$112.10
|
|
Vaginal bx
|
$904.22 |
$904.22 |
$904.22 |
$455.94
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$48.27 |
$48.27 |
$48.27 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$39.60 |
$39.60 |
$39.60 |
$114.72
|
|
Valrubicin injection
|
$57,090.00 |
$57,090.00 |
$57,090.00 |
$2,813.49
|
|
Valvuloplasty aortic
|
$41,237.97 |
$41,237.97 |
$41,237.97 |
$7,830.80
|
|
Valvuloplasty mitral
|
$41,237.97 |
$41,237.97 |
$41,237.97 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$35,549.19 |
$35,549.19 |
$35,549.19 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$2,698.80 |
$2,698.80 |
$2,698.80 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$2.06 |
$2.06 |
$2.06 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$168.90 |
$168.90 |
$168.90 |
$136.13
|
|
Varicella zoster antibody igg
|
$163.16 |
$163.16 |
$163.16 |
$86.80
|
|
Varicella-zoster immue globin im
|
$22,655.07 |
$22,655.07 |
$22,655.07 |
$3,816.19
|
|
Vasopressin 20 unit/ml intravenous solution
|
$259.61 |
$259.61 |
$259.61 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$308.90 |
$308.90 |
$308.90 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$5,908.59 |
$5,908.59 |
$5,908.59 |
$826.15
|
|
Vein x-ray adrenal gland
|
$7,906.71 |
$7,906.71 |
$7,906.71 |
$2,845.80
|
|
Vein x-ray eye socket
|
$4,417.56 |
$4,417.56 |
$4,417.56 |
$1,438.32
|
|
Vein x-ray kidney
|
$11,062.28 |
$11,062.28 |
$11,062.28 |
$2,766.73
|
|
Vein x-ray liver
|
$15,813.32 |
$15,813.32 |
$15,813.32 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$15,813.32 |
$15,813.32 |
$15,813.32 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$15,826.55 |
$15,826.55 |
$15,826.55 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$5,351.96 |
$5,351.96 |
$5,351.96 |
$2,452.80
|
|
Vein x-ray skull
|
$5,657.24 |
$5,657.24 |
$5,657.24 |
$2,141.00
|
|
Vein x-ray skull epidural
|
$5,352.04 |
$5,352.04 |
$5,352.04 |
$1,746.50
|
|
Vein x-ray spleen/liver
|
$15,813.32 |
$15,813.32 |
$15,813.32 |
$3,427.50
|
|
Ven-artl shunt det mbubb njx
|
$883.31 |
$883.31 |
$883.31 |
$484.25
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$188.79 |
$188.79 |
$188.79 |
$202.80
|
|
Venogram ext bil s&i
|
$6,899.24 |
$6,899.24 |
$6,899.24 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,449.61 |
$3,449.61 |
$3,449.61 |
$1,366.20
|
|
Venous m-thrombectomy add-on
|
$5,649.82 |
$5,649.82 |
$5,649.82 |
$5,094.75
|
|
Venous sampling s&i
|
$10,823.85 |
$10,823.85 |
$10,823.85 |
$4,193.20
|
|
Ventilator each subsequent day
|
$1,368.84 |
$1,368.84 |
$1,368.84 |
$1,204.00
|
|
Ventilator initial day
|
$1,368.84 |
$1,368.84 |
$1,368.84 |
$1,431.43
|
|
Ventricular puncture prev burr hole without inj 61020
|
$4,134.11 |
$4,134.11 |
$4,134.11 |
$1,314.30
|
|
Version cephalic external
|
$9,740.43 |
$9,740.43 |
$9,740.43 |
$2,361.75
|
|
Very long chain fatty acids
|
$270.32 |
$270.32 |
$270.32 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$49.67 |
$49.67 |
$49.67 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$392.99 |
$392.99 |
$392.99 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$432.33 |
$432.33 |
$432.33 |
$223.55
|
|
Virus isolation addl studies ea
|
$442.82 |
$442.82 |
$442.82 |
$77.50
|
|
Visit esketamine, > 56m
|
$3,554.57 |
$3,554.57 |
$3,554.57 |
$1,716.46
|
|
Visit esketamine 56m or less
|
$2,432.66 |
$2,432.66 |
$2,432.66 |
$1,413.85
|
|
Visit established high 40-54 minutes/level 5
|
$593.21 |
$593.21 |
$593.21 |
$227.50
|
