|
Ultrasound guide intraoperative
|
$1,211.46 |
$1,211.46 |
$1,211.46 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$350.75 |
$350.75 |
$350.75 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$421.51 |
$421.51 |
$421.51 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$395.89 |
$395.89 |
$395.89 |
$311.25
|
|
Ultrasound joint complete left
|
$691.74 |
$691.74 |
$691.74 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$571.57 |
$571.57 |
$571.57 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$576.45 |
$576.45 |
$576.45 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$604.51 |
$604.51 |
$604.51 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$395.28 |
$395.28 |
$395.28 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$421.51 |
$421.51 |
$421.51 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$645.38 |
$645.38 |
$645.38 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$522.77 |
$522.77 |
$522.77 |
$486.50
|
|
Ultrasound scrotum and contents
|
$719.19 |
$719.19 |
$719.19 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$511.18 |
$511.18 |
$511.18 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$651.48 |
$651.48 |
$651.48 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$253.76 |
$253.76 |
$253.76 |
$206.64
|
|
Unlisted fluoroscopic px
|
$958.92 |
$958.92 |
$958.92 |
$305.76
|
|
Unlisted mr procedure
|
$655.75 |
$655.75 |
$655.75 |
$1,163.00
|
|
Unlisted procedure spine
|
$3,536.17 |
$3,536.17 |
$3,536.17 |
$4,659.85
|
|
Unlisted px biliary tract
|
$2,411.33 |
$2,411.33 |
$2,411.33 |
$2,718.10
|
|
Unlisted px casting/strpg
|
$214.72 |
$214.72 |
$214.72 |
$219.70
|
|
Unlisted px external ear
|
$187.88 |
$187.88 |
$187.88 |
$325.68
|
|
Unlisted px hands/fingers
|
$184.83 |
$184.83 |
$184.83 |
$354.20
|
|
Unlisted px leg/ankle
|
$473.36 |
$473.36 |
$473.36 |
$811.00
|
|
Unlisted px pelvis/hip joint
|
$430.66 |
$430.66 |
$430.66 |
$3,118.44
|
|
Unlisted px small intestine
|
$2,292.38 |
$2,292.38 |
$2,292.38 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$161.65 |
$161.65 |
$161.65 |
$282.50
|
|
Unlisted transfusion med px
|
$73.81 |
$73.81 |
$73.81 |
$147.50
|
|
Unlisted ultrasound procedure
|
$387.35 |
$387.35 |
$387.35 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$888.16 |
$888.16 |
$888.16 |
$1,268.17
|
|
Upgrade pm system
|
$7,632.93 |
$7,632.93 |
$7,632.93 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,075.83 |
$2,075.83 |
$2,075.83 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,501.00 |
$2,501.00 |
$2,501.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,650.66 |
$1,650.66 |
$1,650.66 |
$2,034.41
|
|
Urea nitrogen
|
$40.87 |
$40.87 |
$40.87 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$47.58 |
$47.58 |
$47.58 |
$51.75
|
|
Ureteral embolization/occl
|
$203.74 |
$203.74 |
$203.74 |
$2,181.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$739.32 |
$739.32 |
$739.32 |
$579.73
|
|
Urethrocystography void s&i
|
$755.79 |
$755.79 |
$755.79 |
$622.35
|
|
Uric acid blood
|
$14.64 |
$14.64 |
$14.64 |
$48.75
|
|
Uric acid urine
|
$35.38 |
$35.38 |
$35.38 |
$44.33
|
|
Urinalysis microscopic only
|
$6.71 |
$6.71 |
$6.71 |
$26.35
|
|
Urinalysis (with microscopy)
|
$51.24 |
$51.24 |
$51.24 |
$55.00
|
|
Urinalysis (without microscopy)
|
$33.55 |
$33.55 |
$33.55 |
$35.75
|
|
Urine Culture Test
|
$67.10 |
$67.10 |
$67.10 |
$81.50
|
|
Urine pregnancy test
|
$74.42 |
$74.42 |
$74.42 |
$67.20
|
|
Urography, antegrade
|
$680.76 |
$680.76 |
$680.76 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$47.48 |
$47.48 |
$47.48 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$17,160.02 |
$17,160.02 |
$17,160.02 |
$51,633.07
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$226.92 |
$226.92 |
$226.92 |
$236.50
|
|
Vaccine dtap < 7 years im
|
$34.53 |
$34.53 |
$34.53 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$80.15 |
$80.15 |
$80.15 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$58.76 |
$58.76 |
$58.76 |
$105.95
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$34.28 |
$34.28 |
$34.28 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$7.77 |
$7.77 |
$7.77 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$41.53 |
$41.53 |
$41.53 |
$166.62
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$34.11 |
$34.11 |
$34.11 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$27.82 |
$27.82 |
$27.82 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$25.86 |
$25.86 |
$25.86 |
$75.39
|
|
Vaccine influenza inactivated adjuvant im
|
$78.34 |
$78.34 |
$78.34 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$18.37 |
$18.37 |
$18.37 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$62.77 |
$62.77 |
$62.77 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$19.57 |
$19.57 |
$19.57 |
$33.60
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$14.95 |
$14.95 |
$14.95 |
$37.05
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$31.38 |
$31.38 |
$31.38 |
$76.50
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$203.73 |
$203.73 |
$203.73 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$67.71 |
$67.71 |
$67.71 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$158.93 |
$158.93 |
$158.93 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$137.84 |
$137.84 |
$137.84 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$236.04 |
$236.04 |
$236.04 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$285.24 |
$285.24 |
$285.24 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$50.04 |
$50.04 |
$50.04 |
$90.70
|
|
Vaccine rabies im
|
$200.26 |
$200.26 |
$200.26 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$641.64 |
$641.64 |
$641.64 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$320.82 |
$320.82 |
$320.82 |
$997.44
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$24.77 |
$24.77 |
$24.77 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$57.95 |
$57.95 |
$57.95 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$47.51 |
$47.51 |
$47.51 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$106.08 |
$106.08 |
$106.08 |
$365.17
|
|
Vacuum drain bottle/tube kit
|
$57.43 |
$57.43 |
$57.43 |
$325.20
|
|
Valproic acid total therapeutic drug level
|
$95.77 |
$95.77 |
$95.77 |
$114.72
|
|
Valrubicin injection
|
$203.84 |
$203.84 |
$203.84 |
$2,813.49
|
|
Vancomycin peak therapeutic drug level
|
$120.17 |
$120.17 |
$120.17 |
$136.13
|
|
Varicella zoster antibody igg
|
$81.13 |
$81.13 |
$81.13 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$50.91 |
$50.91 |
$50.91 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$5,709.55 |
$5,709.55 |
$5,709.55 |
$18,732.33
|
|
Vein x-ray kidney
|
$1,613.45 |
$1,613.45 |
$1,613.45 |
$2,766.73
|
|
Vein x-ray liver w/hemodynam
|
$2,673.02 |
$2,673.02 |
$2,673.02 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,613.45 |
$1,613.45 |
$1,613.45 |
$3,483.84
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$164.09 |
$164.09 |
$164.09 |
$202.80
|
|
Venogram ext bil s&i
|
$1,561.60 |
$1,561.60 |
$1,561.60 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,259.04 |
$1,259.04 |
$1,259.04 |
$1,366.20
|
|
Venous mech thrombectomy
|
$9,154.88 |
$9,154.88 |
$9,154.88 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$7,049.16 |
$7,049.16 |
$7,049.16 |
$5,094.75
|
|
Venous sampling s&i
|
$1,883.07 |
$1,883.07 |
$1,883.07 |
$4,193.20
|
|
Venous thrombosis imaging
|
$407.48 |
$407.48 |
$407.48 |
$697.20
|
|
Ventilator each subsequent day
|
$914.39 |
$914.39 |
$914.39 |
$1,204.00
|
|
Ventilator initial day
|
$1,224.88 |
$1,224.88 |
$1,224.88 |
$1,431.43
|
|
Ventricular puncture prev burr hole without inj 61020
|
$1,226.71 |
$1,226.71 |
$1,226.71 |
$1,314.30
|
|
Version cephalic external
|
$1,833.05 |
$1,833.05 |
$1,833.05 |
$2,361.75
|
