|
Ureter endoscopy & treatment
|
$1,803.20 |
$1,803.20 |
$1,803.20 |
$5,631.74
|
|
Ureteroneocystostomy 50780
|
$5,564.80 |
$5,564.80 |
$5,564.80 |
$4,457.05
|
|
Ureteroureterostomy 50760
|
$5,649.60 |
$5,649.60 |
$5,649.60 |
$2,773.01
|
|
Urethrcystgrphy rtrgrde s&i
|
$989.31 |
$989.31 |
$989.31 |
$592.80
|
|
Urethrlys transvag with scope
|
$1,883.20 |
$1,883.20 |
$1,883.20 |
$4,081.37
|
|
Urethrocystography void s&i
|
$667.60 |
$667.60 |
$667.60 |
$631.75
|
|
Uric acid blood
|
$33.57 |
$33.57 |
$33.57 |
$48.96
|
|
Uric acid urine
|
$33.57 |
$33.57 |
$33.57 |
$44.14
|
|
Urinalysis glass test
|
$11.20 |
$11.20 |
$11.20 |
$11.20
|
|
Urinalysis microscopic only
|
$25.72 |
$25.72 |
$25.72 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$25.72 |
$25.72 |
$25.72 |
$25.72
|
|
Urinalysis (with microscopy)
|
$25.72 |
$25.72 |
$25.72 |
$54.60
|
|
Urinalysis (without microscopy)
|
$25.72 |
$25.72 |
$25.72 |
$35.15
|
|
Urinary bldr retent nuc study
|
$173.60 |
$173.60 |
$173.60 |
$350.66
|
|
Urinary reflex study
|
$605.60 |
$605.60 |
$605.60 |
$216.05
|
|
Urine Culture Test
|
$38.58 |
$38.58 |
$38.58 |
$81.00
|
|
Urine flow measurement 51736
|
$34.40 |
$34.40 |
$34.40 |
$210.00
|
|
Urine pregnancy test
|
$25.72 |
$25.72 |
$25.72 |
$66.87
|
|
Urine screen for bacteria
|
$60.00 |
$60.00 |
$60.00 |
$55.64
|
|
Urine specimen collect mult
|
$18.40 |
$18.40 |
$18.40 |
$16.80
|
|
Urography, antegrade
|
$734.36 |
$734.36 |
$734.36 |
$622.35
|
|
Urography inf drip &/or bolus
|
$476.28 |
$476.28 |
$476.28 |
$642.50
|
|
Urokinase 250,000 iu inj
|
$522.40 |
$522.40 |
$522.40 |
$522.40
|
|
Use 1st target lesion
|
$167.20 |
$167.20 |
$167.20 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$24.32 |
$24.32 |
$24.32 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$253.60 |
$253.60 |
$253.60 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$91.09 |
$91.09 |
$91.09 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$233.60 |
$233.60 |
$233.60 |
$227.04
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$233.60 |
$233.60 |
$233.60 |
$211.89
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$255.20 |
$255.20 |
$255.20 |
$234.36
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$171.20 |
$171.20 |
$171.20 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$128.00 |
$128.00 |
$128.00 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$116.08 |
$116.08 |
$116.08 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$92.00 |
$92.00 |
$92.00 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$89.60 |
$89.60 |
$89.60 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$320.60 |
$320.60 |
$320.60 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$107.20 |
$107.20 |
$107.20 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$36.00 |
$36.00 |
$36.00 |
$72.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$91.48 |
$91.48 |
$91.48 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$77.60 |
$77.60 |
$77.60 |
$169.35
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$119.20 |
$119.20 |
$119.20 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$40.00 |
$40.00 |
$40.00 |
$80.28
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im
|
$42.40 |
$42.40 |
$42.40 |
$57.20
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$105.60 |
$105.60 |
$105.60 |
$90.35
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$105.60 |
$105.60 |
$105.60 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$306.24 |
$306.24 |
$306.24 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$48.00 |
$48.00 |
$48.00 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$278.40 |
$278.40 |
$278.40 |
$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
|
$428.00 |
$428.00 |
$428.00 |
$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
|
$321.80 |
$321.80 |
$321.80 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$222.36 |
$222.36 |
$222.36 |
$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
|
$501.64 |
$501.64 |
$501.64 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.00 |
$40.00 |
$40.00 |
$90.70
|
|
Vaccine rabies im
|
$791.88 |
$791.88 |
$791.88 |
$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
|
$901.60 |
$901.60 |
$901.60 |
$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
|
$146.39 |
$146.39 |
$146.39 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$136.24 |
$136.24 |
$136.24 |
$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
|
|
Vacuum drain bottle/tube kit
|
$182.54 |
$182.54 |
$182.54 |
$325.20
|
|
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
|
$411.60 |
$411.60 |
$411.60 |
$471.12
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,839.20 |
$1,839.20 |
$1,839.20 |
$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
|
