|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$562.20 |
$562.20 |
$562.20 |
$562.20
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$230.40 |
$230.40 |
$230.40 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$78.40 |
$78.40 |
$78.40 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$76.00 |
$76.00 |
$76.00 |
$96.84
|
|
Vaccine influenza nos 0.5ml dose im
|
$18.40 |
$18.40 |
$18.40 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$22.40 |
$22.40 |
$22.40 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$20.00 |
$20.00 |
$20.00 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$72.80 |
$72.80 |
$72.80 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$26.40 |
$26.40 |
$26.40 |
$28.77
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$21.60 |
$21.60 |
$21.60 |
$33.21
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$16.00 |
$16.00 |
$16.00 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$28.00 |
$28.00 |
$28.00 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$30.40 |
$30.40 |
$30.40 |
$77.22
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$33.60 |
$33.60 |
$33.60 |
$23.20
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$209.60 |
$209.60 |
$209.60 |
$387.95
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$177.60 |
$177.60 |
$177.60 |
$406.05
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$156.00 |
$156.00 |
$156.00 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$235.20 |
$235.20 |
$235.20 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$86.40 |
$86.40 |
$86.40 |
$211.68
|
|
Vaccine mmrv live subcutaneous
|
$288.00 |
$288.00 |
$288.00 |
$466.88
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$128.80 |
$128.80 |
$128.80 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$248.00 |
$248.00 |
$248.00 |
$393.25
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$236.80 |
$236.80 |
$236.80 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$316.00 |
$316.00 |
$316.00 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.00 |
$40.00 |
$40.00 |
$90.70
|
|
Vaccine rabies im
|
$735.73 |
$735.73 |
$735.73 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$403.20 |
$403.20 |
$403.20 |
$521.74
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$792.00 |
$792.00 |
$792.00 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$592.00 |
$592.00 |
$592.00 |
$980.10
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$358.40 |
$358.40 |
$358.40 |
$407.74
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$129.60 |
$129.60 |
$129.60 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$108.00 |
$108.00 |
$108.00 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$146.07 |
$146.07 |
$146.07 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$35.20 |
$35.20 |
$35.20 |
$110.19
|
|
Vaccine typhoid vicps im
|
$126.40 |
$126.40 |
$126.40 |
$253.50
|
|
Vaccine varicella live subcutaneous
|
$165.60 |
$165.60 |
$165.60 |
$364.16
|
|
Vaccine yellow fever live subcutaneous
|
$186.40 |
$186.40 |
$186.40 |
$418.46
|
|
Vag hys/<250g/rmv tube/rpr entero 58263
|
$2,488.80 |
$2,488.80 |
$2,488.80 |
$5,345.59
|
|
Vag hyst incl t/o complex
|
$3,129.60 |
$3,129.60 |
$3,129.60 |
$5,813.46
|
|
Vag hyst including t/o
|
$2,317.60 |
$2,317.60 |
$2,317.60 |
$5,110.00
|
|
Vag hyst t/o & repair compl
|
$3,294.40 |
$3,294.40 |
$3,294.40 |
$8,081.64
|
|
Vag hyst w/enterocele compl 58294
|
$3,056.00 |
$3,056.00 |
$3,056.00 |
$5,468.70
|
|
Vag hyst w/enterocele repair
|
$2,227.20 |
$2,227.20 |
$2,227.20 |
$5,463.96
|
|
Vaginal bx
|
$1,067.48 |
$1,067.48 |
$1,067.48 |
$471.12
|
|
Vaginal delivery after cesarean delivery 59612
|
$5,688.17 |
$5,688.17 |
$5,688.17 |
$3,866.47
|
|
Vaginal Delivery (full care)
|
$4,552.00 |
$4,552.00 |
$4,552.00 |
$4,184.00
|
|
Vaginal hysterectomy
|
$2,087.20 |
$2,087.20 |
$2,087.20 |
$5,766.00
|
|
Vaginectomy partial w/nodes
|
$4,252.00 |
$4,252.00 |
$4,252.00 |
$4,252.00
|
|
Vagotomy pfrmd w/prtl dstl gstrct 43635
|
$616.00 |
$616.00 |
$616.00 |
$535.60
|
|
Vagotomy & pylorus repair
|
$2,948.00 |
$2,948.00 |
$2,948.00 |
$2,948.00
|
|
Vagotomy & pylorus repair 43640
|
$2,892.00 |
$2,892.00 |
$2,892.00 |
$2,215.20
|
|
Valproic acid total therapeutic drug level
|
$66.43 |
$66.43 |
$66.43 |
$114.48
|
|
Valvuloplasty aortic
|
$9,995.45 |
$9,995.45 |
$9,995.45 |
$7,830.80
|
|
Valvuloplasty aortic valve
|
$4,712.00 |
$4,712.00 |
$4,712.00 |
$5,068.00
|
|
Valvuloplasty mitral
|
$2,933.60 |
$2,933.60 |
$2,933.60 |
$10,851.48
|
|
Valvuloplasty pulmonary
|
$2,338.40 |
$2,338.40 |
$2,338.40 |
$11,945.20
|
|
Valvuloplasty/tv without ring insert 33463
|
$7,556.80 |
$7,556.80 |
$7,556.80 |
$7,556.80
|
|
Valvuloplasty/tv w/ring insertion 33464
|
$5,965.60 |
$5,965.60 |
$5,965.60 |
$5,965.60
|
|
Vancomycin 1,000 mg intravenous injection
|
$1.14 |
$1.14 |
$1.14 |
$246.70
|
|
Vancomycin 750 mg intravenous solution
|
$0.82 |
$0.82 |
$0.82 |
$90.33
|
|
Vancomycin hcl injection
|
$83.08 |
$83.08 |
$83.08 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$66.43 |
$66.43 |
$66.43 |
$129.14
|
|
Vanomycin dna amp probe
|
$87.20 |
$87.20 |
$87.20 |
$78.40
|
|
Varicella zoster antibody igg
|
$48.57 |
$48.57 |
$48.57 |
$86.80
|
|
Varicella-zoster immue globin im
|
$2,097.60 |
$2,097.60 |
$2,097.60 |
$3,816.19
|
|
Vasc graft into carpal bone
|
$3,588.80 |
$3,588.80 |
$3,588.80 |
$4,350.00
|
|
Vasectomy
|
$892.00 |
$892.00 |
$892.00 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$10.16 |
$10.16 |
$10.16 |
$325.80
|
|
Vbac delivery 59610
|
$4,492.00 |
$4,492.00 |
$4,492.00 |
$4,492.00
|
|
Vbac/include postpartum care 59614
|
$2,285.60 |
$2,285.60 |
$2,285.60 |
$2,285.60
|
|
Vedolizumab 300 mg intravenous solution
|
$44.85 |
$44.85 |
$44.85 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$2,156.63 |
$2,156.63 |
$2,156.63 |
$1,540.00
|
|
Veeg intrmnt 2-12 hrs
|
$1,124.01 |
$1,124.01 |
$1,124.01 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$2,156.63 |
$2,156.63 |
$2,156.63 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$1,124.01 |
$1,124.01 |
$1,124.01 |
$826.15
|
|
Vein bypass grft fem-popliteal 35583
|
$7,043.20 |
$7,043.20 |
$7,043.20 |
$2,888.40
|
|
Vein byp fem-tibial peroneal 35585
|
$8,161.60 |
$8,161.60 |
$8,161.60 |
$2,388.00
|
|
Vein byp pop-tibl peroneal
|
$6,646.40 |
$6,646.40 |
$6,646.40 |
$6,646.40
|
|
Vein gft fem a/p tib/pero/dis art 35566
|
$8,152.00 |
$8,152.00 |
$8,152.00 |
$8,152.00
|
|
Vein x-ray adrenal gland
|
$476.80 |
$476.80 |
$476.80 |
$2,870.00
|
|
Vein x-ray adrenal glands
|
$518.40 |
$518.40 |
$518.40 |
$3,480.10
|
|
Vein x-ray eye socket
|
$270.40 |
$270.40 |
$270.40 |
$1,438.32
|
|
Vein x-ray kidney
|
$2,573.60 |
$2,573.60 |
$2,573.60 |
$2,990.58
|
|
Vein x-ray liver
|
$470.40 |
$470.40 |
$470.40 |
$3,328.80
|
|
Vein x-ray liver w/hemodynam
|
$502.40 |
$502.40 |
$502.40 |
$3,635.28
|
|
Vein x-ray liver w/hemodynam
|
$468.80 |
$468.80 |
$468.80 |
$3,694.50
|
|
Vein x-ray liver without hemodyn
|
$504.00 |
$504.00 |
$504.00 |
$2,452.80
|
|
Vein x-ray skull
|
$480.80 |
$480.80 |
$480.80 |
$2,236.50
|
|
Vein x-ray skull epidural
|
$476.80 |
$476.80 |
$476.80 |
$1,596.00
|
|
Vein x-ray spleen/liver
|
$4,700.80 |
$4,700.80 |
$4,700.80 |
$3,434.00
|
|
Ven-artl shunt det mbubb njx
|
$420.00 |
$420.00 |
$420.00 |
$484.25
|
|
Ven blood coll snf/hha
|
$22.40 |
$22.40 |
$22.40 |
$15.65
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$71.82 |
$71.82 |
$71.82 |
$188.83
|
|
Venipuncture <3 yrs other vein
|
$41.60 |
$41.60 |
$41.60 |
$67.00
|
|
Venogram ext bil s&i
|
$1,361.52 |
$1,361.52 |
$1,361.52 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,048.08 |
$1,048.08 |
$1,048.08 |
$1,388.00
|
|
Venous mech thrombectomy
|
$9,419.20 |
$9,419.20 |
$9,419.20 |
$8,212.75
|
|
Venous m-thrombectomy add-on
|
$7,915.20 |
$7,915.20 |
$7,915.20 |
$5,288.32
|
|
Venous sampling s&i
|
$3,118.00 |
$3,118.00 |
$3,118.00 |
$4,270.50
|
