|
Ultrasound transabd ea addl gest
|
$800.00 |
$800.00 |
$800.00 |
$417.15
|
|
Unlisted chemotherapy px
|
$292.00 |
$292.00 |
$292.00 |
$149.15
|
|
Unlisted fluoroscopic px
|
$317.00 |
$317.00 |
$317.00 |
$305.76
|
|
Unlisted mr procedure
|
$4,440.00 |
$4,440.00 |
$4,440.00 |
$1,165.00
|
|
Unlisted procedure rectum
|
$4,905.00 |
$4,905.00 |
$4,905.00 |
$1,278.72
|
|
Unlisted px abdomen muscskel
|
$6,564.00 |
$6,564.00 |
$6,564.00 |
$2,053.50
|
|
Unlisted px ant segment eye
|
$7,839.00 |
$7,839.00 |
$7,839.00 |
$2,698.92
|
|
Unlisted px foot/toes
|
$918.00 |
$918.00 |
$918.00 |
$1,225.50
|
|
Unlisted px leg/ankle
|
$10,432.00 |
$10,432.00 |
$10,432.00 |
$813.24
|
|
Unlisted px male genital sys
|
$22,817.00 |
$22,817.00 |
$22,817.00 |
$362.00
|
|
Unlisted px small intestine
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$2,118.35
|
|
Unsched dialysis esrd pt hos
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
$1,316.90
|
|
Upgrade pm system
|
$41,691.00 |
$41,691.00 |
$41,691.00 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$378.00 |
$378.00 |
$378.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,759.00 |
$5,759.00 |
$5,759.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,601.00 |
$3,601.00 |
$3,601.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,522.00 |
$3,522.00 |
$3,522.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$393.00 |
$393.00 |
$393.00 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$461.00 |
$461.00 |
$461.00 |
$380.82
|
|
Upper GI Barium X-ray (barium and gas)
|
$693.00 |
$693.00 |
$693.00 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$629.00 |
$629.00 |
$629.00 |
$603.20
|
|
Urea nitrogen
|
$19.00 |
$19.00 |
$19.00 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$42.00 |
$42.00 |
$42.00 |
$51.77
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,168.00 |
$1,168.00 |
$1,168.00 |
$592.80
|
|
Urethrocystography void s&i
|
$1,058.00 |
$1,058.00 |
$1,058.00 |
$631.75
|
|
Uric acid blood
|
$20.00 |
$20.00 |
$20.00 |
$48.96
|
|
Uric acid urine
|
$21.00 |
$21.00 |
$21.00 |
$44.14
|
|
Urinalysis (with microscopy)
|
$20.00 |
$20.00 |
$20.00 |
$54.60
|
|
Urinalysis (without microscopy)
|
$13.00 |
$13.00 |
$13.00 |
$35.15
|
|
Urine Culture Test
|
$63.00 |
$63.00 |
$63.00 |
$81.00
|
|
Urine pregnancy test
|
$21.00 |
$21.00 |
$21.00 |
$66.87
|
|
Urography, antegrade
|
$1,319.00 |
$1,319.00 |
$1,319.00 |
$622.35
|
|
Use 1st target lesion
|
$494.00 |
$494.00 |
$494.00 |
$332.00
|
|
Vaccine Administration (one shot)
|
$131.00 |
$131.00 |
$131.00 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$270.00 |
$270.00 |
$270.00 |
$227.04
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$301.00 |
$301.00 |
$301.00 |
$211.89
|
|
Vaccine dtap < 7 years im
|
$65.00 |
$65.00 |
$65.00 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$213.00 |
$213.00 |
$213.00 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$111.00 |
$111.00 |
$111.00 |
$105.95
|
|
Vaccine dtap-ipv/hib im
|
$160.00 |
$160.00 |
$160.00 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$62.00 |
$62.00 |
$62.00 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$170.00 |
$170.00 |
$170.00 |
$169.35
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$250.00 |
$250.00 |
$250.00 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$88.00 |
$88.00 |
$88.00 |
$80.28
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$182.00 |
$182.00 |
$182.00 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$128.00 |
$128.00 |
$128.00 |
$274.93
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$446.00 |
$446.00 |
$446.00 |
$562.20
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$100.00 |
$100.00 |
$100.00 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$89.00 |
$89.00 |
$89.00 |
$96.84
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$66.00 |
$66.00 |
$66.00 |
$48.59
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$460.00 |
$460.00 |
$460.00 |
$387.95
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$99.99 |
$99.99 |
$99.99 |
$406.05
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$287.00 |
$287.00 |
$287.00 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$160.00 |
$160.00 |
$160.00 |
$211.68
|
|
Vaccine mmrv live subcutaneous
|
$471.00 |
$471.00 |
$471.00 |
$466.88
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$221.00 |
$221.00 |
$221.00 |
$251.64
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$975.00 |
$975.00 |
$975.00 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$385.00 |
$385.00 |
$385.00 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$65.00 |
$65.00 |
$65.00 |
$90.70
|
|
Vaccine rabies im
|
$309.00 |
$309.00 |
$309.00 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$381.00 |
$381.00 |
$381.00 |
$521.74
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$640.00 |
$640.00 |
$640.00 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$640.00 |
$640.00 |
$640.00 |
$980.10
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$362.00 |
$362.00 |
$362.00 |
$407.74
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$233.00 |
$233.00 |
$233.00 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$87.00 |
$87.00 |
$87.00 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$85.00 |
$85.00 |
$85.00 |
$110.19
|
|
Vaccine typhoid vicps im
|
$99.99 |
$99.99 |
$99.99 |
$253.50
|
|
Vaccine varicella live subcutaneous
|
$303.00 |
$303.00 |
$303.00 |
$364.16
|
|
Vaginal bx
|
$3,753.00 |
$3,753.00 |
$3,753.00 |
$471.12
|
|
Valproic acid total therapeutic drug level
|
$104.00 |
$104.00 |
$104.00 |
$114.48
|
|
Valvuloplasty aortic
|
$18,549.00 |
$18,549.00 |
$18,549.00 |
$7,830.80
|
|
Valvuloplasty mitral
|
$35,038.00 |
$35,038.00 |
$35,038.00 |
$10,851.48
|
|
Vancomycin peak therapeutic drug level
|
$116.00 |
$116.00 |
$116.00 |
$129.14
|
|
Varicella zoster antibody igg
|
$124.00 |
$124.00 |
$124.00 |
$86.80
|
|
Vasectomy
|
$8,014.00 |
$8,014.00 |
$8,014.00 |
$2,424.12
|
|
Veeg cont 2-12 hrs
|
$1,843.00 |
$1,843.00 |
$1,843.00 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$3,447.00 |
$3,447.00 |
$3,447.00 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$961.00 |
$961.00 |
$961.00 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$1,843.00 |
$1,843.00 |
$1,843.00 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$961.00 |
$961.00 |
$961.00 |
$826.15
|
|
Vein x-ray adrenal gland
|
$9,530.00 |
$9,530.00 |
$9,530.00 |
$2,870.00
|
|
Vein x-ray kidney
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$2,990.58
|
|
Vein x-ray liver
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,328.80
|
|
Vein x-ray liver w/hemodynam
|
$5,493.00 |
$5,493.00 |
$5,493.00 |
$3,635.28
|
|
Vein x-ray liver w/hemodynam
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$3,694.50
|
|
Vein x-ray liver without hemodyn
|
$5,493.00 |
$5,493.00 |
$5,493.00 |
$2,452.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$67.00 |
$67.00 |
$67.00 |
$188.83
|
|
Venipuncture <3 yrs other vein
|
$67.00 |
$67.00 |
$67.00 |
$67.00
|
|
Venogram ext bil s&i
|
$5,493.00 |
$5,493.00 |
$5,493.00 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$4,511.00 |
$4,511.00 |
$4,511.00 |
$1,388.00
|
|
Venous mech thrombectomy
|
$20,453.00 |
$20,453.00 |
$20,453.00 |
$8,212.75
|
|
Venous m-thrombectomy add-on
|
$18,690.00 |
$18,690.00 |
$18,690.00 |
$5,288.32
|
|
Venous sampling s&i
|
$15,621.00 |
$15,621.00 |
$15,621.00 |
$4,270.50
|
|
Ventilator each subsequent day
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,168.86
|
|
Ventilator Management (first day)
|
$2,524.00 |
$2,524.00 |
$2,524.00 |
$1,433.60
|
|
Version cephalic external
|
$3,736.00 |
$3,736.00 |
$3,736.00 |
$2,372.65
|
