|
Treat humerus fracture
|
$1,793.40 |
$1,793.40 |
$1,793.40 |
$1,790.00
|
|
Treat humerus fracture
|
$1,659.30 |
$1,659.30 |
$1,659.30 |
$12,653.00
|
|
Treat humerus fracture
|
$1,477.25 |
$1,477.25 |
$1,477.25 |
$1,790.00
|
|
Treat kneecap dislocation
|
$1,282.70 |
$1,282.70 |
$1,282.70 |
$1,068.06
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$68.10 |
$68.10 |
$68.10 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$54.80 |
$54.80 |
$54.80 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$215.30 |
$215.30 |
$215.30 |
$523.20
|
|
Treatment of thigh fracture
|
$958.65 |
$958.65 |
$958.65 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$133.70 |
$133.70 |
$133.70 |
$371.40
|
|
Treat ulnar fracture
|
$697.60 |
$697.60 |
$697.60 |
$1,677.20
|
|
Treponema pallidum antibody
|
$191.50 |
$191.50 |
$191.50 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$65.89 |
$65.89 |
$65.89 |
$43.09
|
|
Triglycerides
|
$194.25 |
$194.25 |
$194.25 |
$58.50
|
|
Trim nondyst nails
|
$215.30 |
$215.30 |
$215.30 |
$113.88
|
|
Troponin quantitative
|
$191.65 |
$191.65 |
$191.65 |
$127.60
|
|
Tx closed distal humerus fx
|
$808.55 |
$808.55 |
$808.55 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$972.55 |
$972.55 |
$972.55 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,672.30 |
$1,672.30 |
$1,672.30 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$276.80 |
$276.80 |
$276.80 |
$535.60
|
|
Ua w/micro/comp poc
|
$24.45 |
$24.45 |
$24.45 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$585.00 |
$585.00 |
$585.00 |
$438.75
|
|
Ultrasound breast complete
|
$614.85 |
$614.85 |
$614.85 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$308.70 |
$308.70 |
$308.70 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$867.60 |
$867.60 |
$867.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$265.85 |
$265.85 |
$265.85 |
$296.80
|
|
Ultrasound exam k transpl w/doppler
|
$1,297.50 |
$1,297.50 |
$1,297.50 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,687.40 |
$1,687.40 |
$1,687.40 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$759.90 |
$759.90 |
$759.90 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$377.95 |
$377.95 |
$377.95 |
$388.08
|
|
Ultrasound hips infant dynamic
|
$709.30 |
$709.30 |
$709.30 |
$403.88
|
|
Ultrasound joint complete left
|
$560.25 |
$560.25 |
$560.25 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,334.20 |
$2,334.20 |
$2,334.20 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$653.40 |
$653.40 |
$653.40 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,328.15 |
$1,328.15 |
$1,328.15 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$867.60 |
$867.60 |
$867.60 |
$425.60
|
|
Unlisted chemotherapy px
|
$64.15 |
$64.15 |
$64.15 |
$149.15
|
|
Unlisted px small intestine
|
$1,046.15 |
$1,046.15 |
$1,046.15 |
$2,118.35
|
|
Unlisted surgical path px
|
$1,112.50 |
$1,112.50 |
$1,112.50 |
$217.75
|
|
Unlisted transfusion med px
|
$419.20 |
$419.20 |
$419.20 |
$147.50
|
|
Upper Arm (Humerus) X-ray (left side)
|
$403.25 |
$403.25 |
$403.25 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,054.75 |
$2,054.75 |
$2,054.75 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,267.40 |
$1,267.40 |
$1,267.40 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,301.70 |
$3,301.70 |
$3,301.70 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,702.50 |
$2,702.50 |
$2,702.50 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,335.65 |
$2,335.65 |
$2,335.65 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$428.50 |
$428.50 |
$428.50 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$446.35 |
$446.35 |
$446.35 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$1,761.90 |
$1,761.90 |
$1,761.90 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$1,278.85 |
$1,278.85 |
$1,278.85 |
$607.20
|
|
Urea nitrogen
|
$95.40 |
$95.40 |
$95.40 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$99.85 |
$99.85 |
$99.85 |
$52.00
|
|
Urea nitrogen clearance
|
$99.85 |
$99.85 |
$99.85 |
$38.35
|
|
Ureteral reflux study
|
$1,859.85 |
$1,859.85 |
$1,859.85 |
$952.50
|
|
Urethrocystography void s&i
|
$1,706.00 |
$1,706.00 |
$1,706.00 |
$631.40
|
|
Uric acid blood
|
$95.80 |
$95.80 |
$95.80 |
$49.44
|
|
Uric acid urine
|
$53.10 |
$53.10 |
$53.10 |
$45.36
|
|
Urinalysis microscopic only
|
$37.25 |
$37.25 |
$37.25 |
$26.46
|
|
Urinalysis (with microscopy)
|
$129.10 |
$129.10 |
$129.10 |
$55.20
|
|
Urinalysis (without microscopy)
|
$97.60 |
$97.60 |
$97.60 |
$36.00
|
|
Urine Culture Test
|
$74.50 |
$74.50 |
$74.50 |
$83.00
|
|
Urine pregnancy test
|
$29.10 |
$29.10 |
$29.10 |
$68.78
|
|
Urography, antegrade
|
$920.90 |
$920.90 |
$920.90 |
$622.35
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$35,748.44 |
$35,748.44 |
$35,748.44 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$56.15 |
$56.15 |
$56.15 |
$67.70
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$160.00 |
$160.00 |
$160.00 |
$224.25
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$425.09 |
$425.09 |
$425.09 |
$149.21
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$125.76 |
$125.76 |
$125.76 |
$48.59
|
|
Vaccine mmr live subcutaneous
|
$551.63 |
$551.63 |
$551.63 |
$213.00
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,276.35 |
$1,276.35 |
$1,276.35 |
$563.36
|
|
Vaccine tdap >=7 years im
|
$285.08 |
$285.08 |
$285.08 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$233.55 |
$233.55 |
$233.55 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$824.74 |
$824.74 |
$824.74 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$70.50 |
$70.50 |
$70.50 |
$115.00
|
|
Vancomycin hcl injection
|
$515.29 |
$515.29 |
$515.29 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$270.20 |
$270.20 |
$270.20 |
$136.13
|
|
Varicella zoster antibody igg
|
$115.35 |
$115.35 |
$115.35 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$127.48 |
$127.48 |
$127.48 |
$325.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$2,313.15 |
$2,313.15 |
$2,313.15 |
$188.83
|
|
Venipuncture <3 yrs other vein
|
$21.85 |
$21.85 |
$21.85 |
$67.00
|
|
Venogram ext bil s&i
|
$1,537.00 |
$1,537.00 |
$1,537.00 |
$1,829.42
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,016.70 |
$1,016.70 |
$1,016.70 |
$1,382.58
|
|
Ventilator each subsequent day
|
$744.75 |
$744.75 |
$744.75 |
$1,184.00
|
|
Ventilator Management (first day)
|
$1,032.25 |
$1,032.25 |
$1,032.25 |
$1,434.60
|
|
Version cephalic external
|
$1,171.30 |
$1,171.30 |
$1,171.30 |
$2,361.75
|
|
Very long chain fatty acids
|
$157.00 |
$157.00 |
$157.00 |
$139.88
|
|
Video Swallow Study (Modified Barium Swallow)
|
$543.00 |
$543.00 |
$543.00 |
$524.50
|
|
Vinblastine 1 mg/ml intravenous solution
|
$311.51 |
$311.51 |
$311.51 |
$165.00
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$521.49 |
$521.49 |
$521.49 |
$223.55
|
|
Vital capacity test
|
$64.15 |
$64.15 |
$64.15 |
$173.18
|
|
Vitamin b-12
|
$326.05 |
$326.05 |
$326.05 |
$100.28
|
|
Vitamin D Test
|
$220.30 |
$220.30 |
$220.30 |
$132.00
|
|
Vol reduction of blood/prod
|
$335.40 |
$335.40 |
$335.40 |
$172.78
|
|
Walking (Gait) Training (each 15 minutes)
|
$188.00 |
$188.00 |
$188.00 |
$87.50
|
|
Warde 1003990 aldosterone
|
$173.40 |
$173.40 |
$173.40 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$80.85 |
$80.85 |
$80.85 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$215.60 |
$215.60 |
$215.60 |
$64.08
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$157.20 |
$157.20 |
$157.20 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$66.80 |
$66.80 |
$66.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$449.95 |
$449.95 |
$449.95 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$51.55 |
$51.55 |
$51.55 |
$39.36
|