|
Ultrasound breast unilateral limited (both sides)
|
$105.34 |
$105.34 |
$105.34 |
$449.35
|
|
Ultrasound chest
|
$113.62 |
$113.62 |
$113.62 |
$460.85
|
|
Ultrasound dx ophth b-scan
|
$71.99 |
$71.99 |
$71.99 |
$296.80
|
|
Ultrasound encephalogram
|
$168.59 |
$168.59 |
$168.59 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$204.01 |
$204.01 |
$204.01 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$284.28 |
$284.28 |
$284.28 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$107.18 |
$107.18 |
$107.18 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$283.13 |
$283.13 |
$283.13 |
$720.15
|
|
Ultrasound guide intraoperative
|
$316.02 |
$316.02 |
$316.02 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$461.61 |
$461.61 |
$461.61 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$92.92 |
$92.92 |
$92.92 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$87.17 |
$87.17 |
$87.17 |
$311.25
|
|
Ultrasound joint complete left
|
$168.59 |
$168.59 |
$168.59 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$120.29 |
$120.29 |
$120.29 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$80.50 |
$80.50 |
$80.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$80.50 |
$80.50 |
$80.50 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$468.28 |
$468.28 |
$468.28 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$166.98 |
$166.98 |
$166.98 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$228.62 |
$228.62 |
$228.62 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$180.78 |
$180.78 |
$180.78 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$233.68 |
$233.68 |
$233.68 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$224.71 |
$224.71 |
$224.71 |
$486.50
|
|
Ultrasound scrotum and contents
|
$153.87 |
$153.87 |
$153.87 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$118.91 |
$118.91 |
$118.91 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$190.21 |
$190.21 |
$190.21 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$196.65 |
$196.65 |
$196.65 |
$206.64
|
|
Unlisted chemotherapy px
|
$143.75 |
$143.75 |
$143.75 |
$150.00
|
|
Unlisted gi px dx nuc med
|
$538.20 |
$538.20 |
$538.20 |
$995.00
|
|
Unlisted maaa
|
$182.85 |
$182.85 |
$182.85 |
$235.20
|
|
Unlisted mr procedure
|
$381.11 |
$381.11 |
$381.11 |
$1,163.00
|
|
Unlisted procedure rectum
|
$265.88 |
$265.88 |
$265.88 |
$1,220.35
|
|
Unlisted px ant segment eye
|
$723.58 |
$723.58 |
$723.58 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$52.21 |
$52.21 |
$52.21 |
$219.70
|
|
Unlisted px male genital sys
|
$85.56 |
$85.56 |
$85.56 |
$343.55
|
|
Unlisted px palate uvula
|
$148.35 |
$148.35 |
$148.35 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$658.26 |
$658.26 |
$658.26 |
$1,265.16
|
|
Unlisted px tongue flr mouth
|
$70.38 |
$70.38 |
$70.38 |
$282.50
|
|
Unsched dialysis esrd pt hos
|
$400.89 |
$400.89 |
$400.89 |
$1,268.17
|
|
Upgrade pm system
|
$11,283.80 |
$11,283.80 |
$11,283.80 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,388.74 |
$1,388.74 |
$1,388.74 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,318.36 |
$1,318.36 |
$1,318.36 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,142.87 |
$1,142.87 |
$1,142.87 |
$2,034.41
|
|
Urea nitrogen
|
$31.74 |
$31.74 |
$31.74 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$36.34 |
$36.34 |
$36.34 |
$51.75
|
|
Urea nitrogen clearance
|
$37.26 |
$37.26 |
$37.26 |
$42.25
|
|
Ureteral embolization/occl
|
$431.25 |
$431.25 |
$431.25 |
$2,181.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$166.52 |
$166.52 |
$166.52 |
$579.73
|
|
Urethrocystography void s&i
|
$267.49 |
$267.49 |
$267.49 |
$622.35
|
|
Uric acid blood
|
$31.74 |
$31.74 |
$31.74 |
$48.75
|
|
Uric acid urine
|
$36.34 |
$36.34 |
$36.34 |
$44.33
|
|
Urinalysis glass test
|
$8.51 |
$8.51 |
$8.51 |
$11.20
|
|
Urinalysis qual/semiquant excpt ia
|
$1.84 |
$1.84 |
$1.84 |
$25.72
|
|
Urinalysis (with microscopy)
|
$2.30 |
$2.30 |
$2.30 |
$55.00
|
|
Urinalysis (without microscopy)
|
$36.57 |
$36.57 |
$36.57 |
$35.75
|
|
Urine Culture Test
|
$44.16 |
$44.16 |
$44.16 |
$81.50
|
|
Urine pregnancy test
|
$30.13 |
$30.13 |
$30.13 |
$67.20
|
|
Urography, antegrade
|
$379.04 |
$379.04 |
$379.04 |
$622.35
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$16.26 |
$16.26 |
$16.26 |
$143.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$4.21 |
$4.21 |
$4.21 |
$33.60
|
|
Vaginal bx
|
$62.10 |
$62.10 |
$62.10 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,828.50 |
$1,828.50 |
$1,828.50 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$39.56 |
$39.56 |
$39.56 |
$114.72
|
|
Valrubicin injection
|
$940.16 |
$940.16 |
$940.16 |
$2,813.49
|
|
Valvuloplasty aortic
|
$5,206.28 |
$5,206.28 |
$5,206.28 |
$7,830.80
|
|
Vancomycin hcl injection
|
$346.57 |
$346.57 |
$346.57 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$51.06 |
$51.06 |
$51.06 |
$136.13
|
|
Varicella zoster antibody igg
|
$76.59 |
$76.59 |
$76.59 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,098.70 |
$1,098.70 |
$1,098.70 |
$325.80
|
|
Vein x-ray kidney
|
$1,883.24 |
$1,883.24 |
$1,883.24 |
$2,766.73
|
|
Vein x-ray liver w/hemodynam
|
$1,265.92 |
$1,265.92 |
$1,265.92 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,793.54 |
$1,793.54 |
$1,793.54 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$1,201.52 |
$1,201.52 |
$1,201.52 |
$2,452.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$188.83 |
$188.83 |
$188.83 |
$202.80
|
|
Venogram ext bil s&i
|
$610.19 |
$610.19 |
$610.19 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$610.19 |
$610.19 |
$610.19 |
$1,366.20
|
|
Venous mech thrombectomy
|
$3,213.56 |
$3,213.56 |
$3,213.56 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$3,213.56 |
$3,213.56 |
$3,213.56 |
$5,094.75
|
|
Venous sampling s&i
|
$1,883.24 |
$1,883.24 |
$1,883.24 |
$4,193.20
|
|
Ven thrombosis images bilat
|
$228.62 |
$228.62 |
$228.62 |
$796.50
|
|
Ventilator each subsequent day
|
$375.82 |
$375.82 |
$375.82 |
$1,204.00
|
|
Ventilator initial day
|
$539.58 |
$539.58 |
$539.58 |
$1,431.43
|
|
Version cephalic external
|
$1,115.50 |
$1,115.50 |
$1,115.50 |
$2,361.75
|
|
Very long chain fatty acids
|
$115.69 |
$115.69 |
$115.69 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$33.97 |
$33.97 |
$33.97 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$6.80 |
$6.80 |
$6.80 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$243.69 |
$243.69 |
$243.69 |
$223.55
|
|
Visit established high 40-54 minutes/level 5
|
$48.30 |
$48.30 |
$48.30 |
$227.50
|
|
Vital capacity test
|
$42.78 |
$42.78 |
$42.78 |
$170.00
|
|
Vitamin b-12
|
$106.95 |
$106.95 |
$106.95 |
$100.00
|
|
Vitamin D Test
|
$47.61 |
$47.61 |
$47.61 |
$132.00
|
|
Vkorc1 gene
|
$71.30 |
$71.30 |
$71.30 |
$176.80
|
|
Volume measurement urine timed
|
$8.05 |
$8.05 |
$8.05 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$55.86 |
$55.86 |
$55.86 |
$165.81
|
|
Warde 1003990 aldosterone
|
$149.73 |
$149.73 |
$149.73 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$33.12 |
$33.12 |
$33.12 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$125.81 |
$125.81 |
$125.81 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$125.81 |
$125.81 |
$125.81 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$66.01 |
$66.01 |
$66.01 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$28.75 |
$28.75 |
$28.75 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$253.92 |
$253.92 |
$253.92 |
$39.00
|
