|
Ultrasound pregnant uterus follow up per fetus
|
$510.83 |
$510.83 |
$510.83 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$601.16 |
$601.16 |
$601.16 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$457.74 |
$457.74 |
$457.74 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$315.50 |
$315.50 |
$315.50 |
$421.00
|
|
Ultrasound trgt dyn mbubb 1st les
|
$333.31 |
$333.31 |
$333.31 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$174.89 |
$174.89 |
$174.89 |
$348.00
|
|
Ultraviolet therapy
|
$81.48 |
$81.48 |
$81.48 |
$39.76
|
|
Umbilical cord occlud w/us
|
$253.51 |
$253.51 |
$253.51 |
$754.00
|
|
Unit mobile power mpu
|
$14,266.56 |
$14,266.56 |
$14,266.56 |
$14,359.52
|
|
Unlisted chemotherapy px
|
$239.57 |
$239.57 |
$239.57 |
$148.18
|
|
Unlisted cv px dx nuc med
|
$665.62 |
$665.62 |
$665.62 |
$1,747.20
|
|
Unlisted cytogenetic study
|
$181.22 |
$181.22 |
$181.22 |
$160.00
|
|
Unlisted gi px dx nuc med
|
$673.46 |
$673.46 |
$673.46 |
$995.00
|
|
Unlisted gu px dx nuc med
|
$805.62 |
$805.62 |
$805.62 |
$805.62
|
|
Unlisted mr procedure
|
$2,772.11 |
$2,772.11 |
$2,772.11 |
$1,163.00
|
|
Unlisted muscskel px dx nuc
|
$665.62 |
$665.62 |
$665.62 |
$1,279.98
|
|
Unlisted muscskel px head
|
$335.94 |
$335.94 |
$335.94 |
$1,224.08
|
|
Unlisted orl service/px
|
$323.79 |
$323.79 |
$323.79 |
$132.60
|
|
Unlisted procedure liver
|
$845.26 |
$845.26 |
$845.26 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,911.66 |
$2,911.66 |
$2,911.66 |
$530.00
|
|
Unlisted procedure rectum
|
$1,149.23 |
$1,149.23 |
$1,149.23 |
$1,223.20
|
|
Unlisted px abdomen muscskel
|
$564.09 |
$564.09 |
$564.09 |
$1,956.50
|
|
Unlisted px casting/strpg
|
$81.48 |
$81.48 |
$81.48 |
$222.00
|
|
Unlisted px foot/toes
|
$751.46 |
$751.46 |
$751.46 |
$1,239.20
|
|
Unlisted px salivry glnd/dux
|
$545.72 |
$545.72 |
$545.72 |
$1,265.16
|
|
Unlisted px small intestine
|
$775.77 |
$775.77 |
$775.77 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$525.00 |
$525.00 |
$525.00 |
$282.50
|
|
Unlisted resp px dx nuc med
|
$665.62 |
$665.62 |
$665.62 |
$670.60
|
|
Unlisted transfusion med px
|
$414.90 |
$414.90 |
$414.90 |
$147.50
|
|
Unlisted ultrasound procedure
|
$544.71 |
$544.71 |
$544.71 |
$332.16
|
|
Unlisted urinalysis px
|
$46.48 |
$46.48 |
$46.48 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$1,854.89 |
$1,854.89 |
$1,854.89 |
$1,296.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$208.99 |
$208.99 |
$208.99 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,368.81 |
$1,368.81 |
$1,368.81 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$912.46 |
$912.46 |
$912.46 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,310.06 |
$2,310.06 |
$2,310.06 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,848.11 |
$1,848.11 |
$1,848.11 |
$2,384.25
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$212.02 |
$212.02 |
$212.02 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$139.33 |
$139.33 |
$139.33 |
$381.60
|
|
Upper ext fx orthosis rad/ul
|
$751.46 |
$751.46 |
$751.46 |
$619.49
|
|
Upper GI Barium X-ray (barium and gas)
|
$208.99 |
$208.99 |
$208.99 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$208.99 |
$208.99 |
$208.99 |
$607.20
|
|
Urea nitrogen
|
$80.86 |
$80.86 |
$80.86 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$33.04 |
$33.04 |
$33.04 |
$52.00
|
|
Ureteral embolization/occl
|
$1,520.90 |
$1,520.90 |
$1,520.90 |
$2,079.31
|
|
Ureteral reflux study
|
$1,073.58 |
$1,073.58 |
$1,073.58 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$358.06 |
$358.06 |
$358.06 |
$584.00
|
|
Urethrocystography void s&i
|
$417.98 |
$417.98 |
$417.98 |
$631.75
|
|
Uric acid blood
|
$23.52 |
$23.52 |
$23.52 |
$49.32
|
|
Uric acid urine
|
$30.91 |
$30.91 |
$30.91 |
$44.80
|
|
Urinalysis microscopic only
|
$34.61 |
$34.61 |
$34.61 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$17.98 |
$17.98 |
$17.98 |
$25.72
|
|
Urinalysis (with microscopy)
|
$72.91 |
$72.91 |
$72.91 |
$55.20
|
|
Urinalysis (without microscopy)
|
$38.81 |
$38.81 |
$38.81 |
$36.00
|
|
Urinary reflex study
|
$216.05 |
$216.05 |
$216.05 |
$216.05
|
|
Urine Culture Test
|
$32.42 |
$32.42 |
$32.42 |
$82.32
|
|
Urine pregnancy test
|
$51.41 |
$51.41 |
$51.41 |
$68.21
|
|
Urography, antegrade
|
$794.08 |
$794.08 |
$794.08 |
$622.35
|
|
Urography inf drip &/or bolus
|
$278.77 |
$278.77 |
$278.77 |
$642.50
|
|
Use 1st target lesion
|
$405.94 |
$405.94 |
$405.94 |
$332.00
|
|
User adjustable heel height
|
$3,820.71 |
$3,820.71 |
$3,820.71 |
$2,004.80
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$6,670.33 |
$6,670.33 |
$6,670.33 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$45,901.36 |
$45,901.36 |
$45,901.36 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$30.63 |
$30.63 |
$30.63 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$214.00 |
$214.00 |
$214.00 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$196.97 |
$196.97 |
$196.97 |
$209.40
|
|
Vaccine dtap < 7 years im
|
$71.17 |
$71.17 |
$71.17 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$161.65 |
$161.65 |
$161.65 |
$165.26
|
|
Vaccine dtap-ipv 4-6 years im
|
$125.23 |
$125.23 |
$125.23 |
$105.95
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$83.56 |
$83.56 |
$83.56 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$493.68 |
$493.68 |
$493.68 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$166.62 |
$166.62 |
$166.62 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$232.51 |
$232.51 |
$232.51 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$84.07 |
$84.07 |
$84.07 |
$78.25
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$125.21 |
$125.21 |
$125.21 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$125.21 |
$125.21 |
$125.21 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$442.57 |
$442.57 |
$442.57 |
$576.48
|
|
Vaccine influenza inactivated adjuvant im
|
$67.93 |
$67.93 |
$67.93 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$95.23 |
$95.23 |
$95.23 |
$48.59
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$29.01 |
$29.01 |
$29.01 |
$82.71
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$301.09 |
$301.09 |
$301.09 |
$394.26
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$323.39 |
$323.39 |
$323.39 |
$327.37
|
|
Vaccine mmr live subcutaneous
|
$216.19 |
$216.19 |
$216.19 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$252.87 |
$252.87 |
$252.87 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$479.17 |
$479.17 |
$479.17 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$507.11 |
$507.11 |
$507.11 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$114.58 |
$114.58 |
$114.58 |
$90.70
|
|
Vaccine rabies im
|
$643.78 |
$643.78 |
$643.78 |
$858.95
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$219.28 |
$219.28 |
$219.28 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$199.82 |
$199.82 |
$199.82 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$101.72 |
$101.72 |
$101.72 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$109.97 |
$109.97 |
$109.97 |
$112.10
|
|
Vaccine typhoid vicps im
|
$310.18 |
$310.18 |
$310.18 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$400.60 |
$400.60 |
$400.60 |
$365.17
|
|
Vaccine yellow fever live subcutaneous
|
$166.40 |
$166.40 |
$166.40 |
$418.46
|
|
Vad battery clip set hmii 14-v li-ion
|
$2,254.00 |
$2,254.00 |
$2,254.00 |
$1,932.00
|
|
Vad univ batt charger hm 1440
|
$14,266.56 |
$14,266.56 |
$14,266.56 |
$14,814.14
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$86.41 |
$86.41 |
$86.41 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$37.97 |
$37.97 |
$37.97 |
$115.00
|
