|
Unlisted ultrasound procedure
|
$507.10 |
$507.10 |
$507.10 |
$335.00
|
|
Upgrade pm system
|
$41,076.90 |
$41,076.90 |
$41,076.90 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$457.50 |
$457.50 |
$457.50 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,306.60 |
$2,306.60 |
$2,306.60 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,920.60 |
$1,920.60 |
$1,920.60 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,191.75 |
$2,191.75 |
$2,191.75 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,864.50 |
$1,864.50 |
$1,864.50 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,296.25 |
$1,296.25 |
$1,296.25 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$627.55 |
$627.55 |
$627.55 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$738.30 |
$738.30 |
$738.30 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$1,550.85 |
$1,550.85 |
$1,550.85 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$1,503.55 |
$1,503.55 |
$1,503.55 |
$607.20
|
|
Urea nitrogen
|
$90.80 |
$90.80 |
$90.80 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$144.30 |
$144.30 |
$144.30 |
$51.84
|
|
Urea nitrogen clearance
|
$18.00 |
$18.00 |
$18.00 |
$34.02
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,507.90 |
$1,507.90 |
$1,507.90 |
$584.00
|
|
Urethrocystography void s&i
|
$2,395.65 |
$2,395.65 |
$2,395.65 |
$634.50
|
|
Uric acid blood
|
$99.25 |
$99.25 |
$99.25 |
$49.32
|
|
Uric acid urine
|
$153.00 |
$153.00 |
$153.00 |
$44.52
|
|
Urinalysis microscopic only
|
$90.80 |
$90.80 |
$90.80 |
$26.35
|
|
Urinalysis (with microscopy)
|
$150.20 |
$150.20 |
$150.20 |
$55.20
|
|
Urinalysis (without microscopy)
|
$59.35 |
$59.35 |
$59.35 |
$35.91
|
|
Urine Culture Test
|
$120.00 |
$120.00 |
$120.00 |
$82.32
|
|
Urine pregnancy test
|
$90.10 |
$90.10 |
$90.10 |
$68.21
|
|
Urography, antegrade
|
$1,064.20 |
$1,064.20 |
$1,064.20 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,061.30 |
$5,061.30 |
$5,061.30 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$34,803.95 |
$34,803.95 |
$34,803.95 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$103.90 |
$103.90 |
$103.90 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$160.00 |
$160.00 |
$160.00 |
$224.25
|
|
Vaccine dtap < 7 years im
|
$288.80 |
$288.80 |
$288.80 |
$71.17
|
|
Vaccine hepatitis a (hepa) adult im
|
$840.82 |
$840.82 |
$840.82 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$1,292.50 |
$1,292.50 |
$1,292.50 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$758.24 |
$758.24 |
$758.24 |
$78.25
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$705.05 |
$705.05 |
$705.05 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,301.47 |
$1,301.47 |
$1,301.47 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$716.01 |
$716.01 |
$716.01 |
$149.21
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$228.93 |
$228.93 |
$228.93 |
$48.59
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,731.61 |
$1,731.61 |
$1,731.61 |
$394.26
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1,678.41 |
$1,678.41 |
$1,678.41 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,627.43 |
$1,627.43 |
$1,627.43 |
$327.37
|
|
Vaccine mmr live subcutaneous
|
$929.14 |
$929.14 |
$929.14 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,142.68 |
$1,142.68 |
$1,142.68 |
$252.87
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,068.14 |
$2,068.14 |
$2,068.14 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$189.26 |
$189.26 |
$189.26 |
$90.70
|
|
Vaccine rabies im
|
$1,751.21 |
$1,751.21 |
$1,751.21 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$480.18 |
$480.18 |
$480.18 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$393.38 |
$393.38 |
$393.38 |
$112.10
|
|
Vaccine typhoid vicps im
|
$1,430.49 |
$1,430.49 |
$1,430.49 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$1,786.06 |
$1,786.06 |
$1,786.06 |
$365.17
|
|
Vaccine yellow fever live subcutaneous
|
$1,635.54 |
$1,635.54 |
$1,635.54 |
$418.46
|
|
Valproic acid total therapeutic drug level
|
$92.00 |
$92.00 |
$92.00 |
$115.00
|
|
Vancomycin hcl injection
|
$867.94 |
$867.94 |
$867.94 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$92.00 |
$92.00 |
$92.00 |
$135.60
|
|
Varicella zoster antibody igg
|
$129.75 |
$129.75 |
$129.75 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$232.06 |
$232.06 |
$232.06 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$22,349.59 |
$22,349.59 |
$22,349.59 |
$18,732.33
|
|
Veeg unmon 12-26 hrs
|
$954.15 |
$954.15 |
$954.15 |
$1,737.12
|
|
Veeg unmon 2-12 hrs
|
$517.25 |
$517.25 |
$517.25 |
$826.15
|
|
Vein x-ray adrenal gland
|
$2,628.40 |
$2,628.40 |
$2,628.40 |
$2,833.34
|
|
Vein x-ray adrenal glands
|
$3,141.75 |
$3,141.75 |
$3,141.75 |
$3,480.10
|
|
Vein x-ray eye socket
|
$1,962.05 |
$1,962.05 |
$1,962.05 |
$1,438.32
|
|
Vein x-ray kidney
|
$2,628.40 |
$2,628.40 |
$2,628.40 |
$2,870.00
|
|
Vein x-ray liver
|
$1,577.30 |
$1,577.30 |
$1,577.30 |
$3,312.00
|
|
Vein x-ray liver w/hemodynam
|
$8,782.60 |
$8,782.60 |
$8,782.60 |
$3,683.90
|
|
Vein x-ray skull
|
$2,628.40 |
$2,628.40 |
$2,628.40 |
$2,236.50
|
|
Vein x-ray spleen/liver
|
$2,628.40 |
$2,628.40 |
$2,628.40 |
$3,434.00
|
|
Vemp test i&r cervical
|
$273.00 |
$273.00 |
$273.00 |
$343.72
|
|
Vemp test i&r ocular
|
$273.00 |
$273.00 |
$273.00 |
$257.50
|
|
Vemp tst i&r cervical&ocular
|
$517.25 |
$517.25 |
$517.25 |
$591.50
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$279.40 |
$279.40 |
$279.40 |
$197.04
|
|
Venipuncture <3 yrs other vein
|
$155.00 |
$155.00 |
$155.00 |
$62.40
|
|
Venogram ext bil s&i
|
$1,654.60 |
$1,654.60 |
$1,654.60 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,519.85 |
$3,519.85 |
$3,519.85 |
$1,382.58
|
|
Venous mech thrombectomy
|
$12,677.90 |
$12,677.90 |
$12,677.90 |
$8,184.00
|
|
Venous m-thrombectomy add-on
|
$12,677.90 |
$12,677.90 |
$12,677.90 |
$5,110.00
|
|
Venous sampling s&i
|
$2,628.40 |
$2,628.40 |
$2,628.40 |
$4,200.00
|
|
Ventilator each subsequent day
|
$2,300.80 |
$2,300.80 |
$2,300.80 |
$1,178.74
|
|
Ventilator Management (first day)
|
$2,700.50 |
$2,700.50 |
$2,700.50 |
$1,434.60
|
|
Ventricular puncture prev burr hole without inj 61020
|
$1,314.30 |
$1,314.30 |
$1,314.30 |
$1,257.55
|
|
Version cephalic external
|
$8,050.80 |
$8,050.80 |
$8,050.80 |
$2,361.75
|
|
Very long chain fatty acids
|
$40.50 |
$40.50 |
$40.50 |
$139.88
|
|
Video Swallow Study (Modified Barium Swallow)
|
$1,031.20 |
$1,031.20 |
$1,031.20 |
$524.50
|
|
Vinblastine 1 mg/ml intravenous solution
|
$524.69 |
$524.69 |
$524.69 |
$163.80
|
|
Vincristine 1 mg/ml intravenous solution
|
$178.69 |
$178.69 |
$178.69 |
$87.15
|
|
Visual audiometry (vra)
|
$176.85 |
$176.85 |
$176.85 |
$220.60
|
|
Vital capacity test
|
$210.55 |
$210.55 |
$210.55 |
$173.18
|
|
Vitamin b-12
|
$198.75 |
$198.75 |
$198.75 |
$100.20
|
|
Vitamin D Test
|
$167.40 |
$167.40 |
$167.40 |
$132.60
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$714.81 |
$714.81 |
$714.81 |
$165.81
|
|
Walking (Gait) Training (each 15 minutes)
|
$167.35 |
$167.35 |
$167.35 |
$87.50
|
|
Warde 1003990 aldosterone
|
$53.45 |
$53.45 |
$53.45 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$39.85 |
$39.85 |
$39.85 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$34.85 |
$34.85 |
$34.85 |
$65.40
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$27.35 |
$27.35 |
$27.35 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$42.45 |
$42.45 |
$42.45 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$157.35 |
$157.35 |
$157.35 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$14.85 |
$14.85 |
$14.85 |
$39.60
|
|
Warde 3008005 oligoclonal bands
|
$64.85 |
$64.85 |
$64.85 |
$108.50
|
|
Warde 3016000 west nile virus antibody
|
$43.85 |
$43.85 |
$43.85 |
$72.00
|
|
Warde 3016000 west nile virus antibody igg
|
$37.45 |
$37.45 |
$37.45 |
$70.85
|