|
Ultrasound exam k transpl w/doppler
|
$281.47 |
$311.68 |
$392.68 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$422.29 |
$422.29 |
$422.29 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$342.02 |
$785.15 |
$1,095.38 |
|
|
Ultrasound guidance for vascular access
|
$182.88 |
$619.51 |
$686.00 |
|
|
Ultrasound guide intraoperative
|
$159.14 |
$443.21 |
$618.34 |
|
|
Ultrasound hips infant dynamic
|
$261.99 |
$270.82 |
$365.51 |
|
|
Ultrasound infant hips ltd without stress
|
$164.03 |
$164.03 |
$164.03 |
|
|
Ultrasound joint complete left
|
$486.47 |
$538.68 |
$678.68 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$313.86 |
$347.54 |
$493.49 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$218.94 |
$242.44 |
$305.45 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$198.24 |
$219.51 |
$598.88 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$506.05 |
$917.99 |
$1,280.71 |
|
|
Ultrasound prostate/transrectal
|
$245.80 |
$313.40 |
$342.92 |
|
|
Ultrasound spinal canal and contents
|
$144.94 |
$160.49 |
$249.19 |
|
|
Ultrasound transabd ea addl gest
|
$47.56 |
$66.36 |
$669.38 |
|
|
Unlistd noninvas vasc dx std
|
$94.10 |
$94.10 |
$94.10 |
|
|
Unlisted cv px dx nuc med
|
$288.52 |
$288.52 |
$288.52 |
|
|
Unlisted hematology&coagj px
|
$12.30 |
$13.62 |
$27.47 |
|
|
Unlisted misc path test
|
$27.47 |
$30.42 |
$38.33 |
|
|
Unlisted procedure microbiology
|
$236.78 |
$262.19 |
$330.33 |
|
|
Unlisted px abdomen muscskel
|
$902.41 |
$902.41 |
$902.41 |
|
|
Unlisted surgical path px
|
$11.07 |
$12.26 |
$15.45 |
|
|
Unlisted transfusion med px
|
$202.88 |
$1,614.38 |
$2,252.25 |
|
|
Unsched dialysis esrd pt hos
|
$677.12 |
$749.79 |
$944.66 |
|
|
Upgrade pm system
|
$8,630.91 |
$8,630.91 |
$8,630.91 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$181.70 |
$287.41 |
$400.98 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,036.35 |
$2,900.34 |
$4,046.33 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$829.08 |
$1,443.00 |
$2,013.16 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,710.79 |
$2,203.96 |
$2,440.48 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,425.65 |
$1,939.51 |
$2,147.65 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,140.52 |
$1,300.32 |
$1,439.87 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$278.72 |
$278.72 |
$278.72 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$296.41 |
$438.50 |
$611.76 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$643.20 |
$643.20 |
$643.20 |
|
|
Upper GI Barium X-ray (barium only)
|
$477.04 |
$528.23 |
$665.53 |
|
|
Urea nitrogen
|
$20.73 |
$83.64 |
$116.69 |
|
|
Urea nitrogen 24 hour urine
|
$25.06 |
$56.38 |
$78.65 |
|
|
Urea nitrogen clearance
|
$34.22 |
$34.22 |
$34.22 |
|
|
Ureteral reflux study
|
$447.12 |
$447.12 |
$560.06 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$404.68 |
$415.54 |
$579.73 |
|
|
Urethrocystography void s&i
|
$415.54 |
$460.13 |
$579.73 |
|
|
Uric acid blood
|
$6.75 |
$106.81 |
$149.01 |
|
|
Uric acid urine
|
$34.70 |
$50.23 |
$70.07 |
|
|
Urinalysis microscopic only
|
$3.28 |
$3.64 |
$4.81 |
|
|
Urinalysis qual/semiquant excpt ia
|
$3.37 |
$28.29 |
$39.47 |
|
|
Urinalysis (with microscopy)
|
$26.45 |
$96.15 |
$134.14 |
|
|
Urinalysis (without microscopy)
|
$25.49 |
$99.63 |
$139.00 |
|
|
Urine Culture Test
|
$35.05 |
$215.46 |
$300.59 |
|
|
Urine pregnancy test
|
$27.90 |
$74.21 |
$103.54 |
|
|
Urography, antegrade
|
$462.57 |
$527.06 |
$735.31 |
|
|
Vaccine Administration (one shot)
|
$57.23 |
$70.52 |
$98.39 |
|
|
Vaccine dtap < 7 years im
|
$29.52 |
$32.69 |
$41.19 |
|
|
Vaccine dtap-hep b-ipv im
|
$98.81 |
$98.81 |
$109.42 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$12.71 |
$12.71 |
$21.57 |
|
|
Vaccine hepatitis a (hepa) adult im
|
$81.39 |
$81.39 |
$90.12 |
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$57.20 |
$79.80 |
$84.22 |
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$29.11 |
$29.11 |
$32.24 |
|
|
Vaccine influenza inactivated adjuvant im
|
$80.98 |
$89.67 |
$112.97 |
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$21.73 |
$24.07 |
$30.32 |
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$261.99 |
$261.99 |
$290.11 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$163.39 |
$163.39 |
$180.92 |
|
|
Vaccine mmr live subcutaneous
|
$86.51 |
$95.80 |
$120.70 |
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$129.36 |
$143.24 |
$180.47 |
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$276.04 |
$276.04 |
$276.04 |
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$274.91 |
$274.91 |
$304.41 |
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.80 |
$40.80 |
$45.18 |
|
|
Vaccine rabies im
|
$418.82 |
$463.77 |
$655.80 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$605.64 |
$605.64 |
$605.64 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$605.64 |
$605.64 |
$605.64 |
|
|
Vaccine tdap >=7 years im
|
$49.20 |
$54.48 |
$68.64 |
|
|
Vaccine td preservative free >= 7 years im
|
$30.14 |
$30.14 |
$33.37 |
|
|
Valproic acid total therapeutic drug level
|
$31.81 |
$86.51 |
$120.70 |
|
|
Valvuloplasty aortic
|
$5,166.82 |
$5,166.82 |
$5,721.31 |
|
|
Valvuloplasty mitral
|
$7,708.00 |
$7,708.00 |
$8,535.20 |
|
|
Valvuloplasty pulmonary
|
$3,251.10 |
$3,251.10 |
$3,251.10 |
|
|
Vancomycin hcl injection
|
$42.85 |
$51.08 |
$64.35 |
|
|
Vancomycin peak therapeutic drug level
|
$19.76 |
$148.01 |
$206.50 |
|
|
Vanomycin dna amp probe
|
$27.68 |
$30.65 |
$38.61 |
|
|
Varicella zoster antibody igg
|
$30.53 |
$45.31 |
$63.21 |
|
|
Varus/valgus strap padded/li
|
$108.65 |
$120.31 |
$151.58 |
|
|
Vasc emb/occ w/prs cath
|
$10,800.02 |
$10,800.02 |
$11,959.05 |
|
|
Vasopressin 20 unit/ml intravenous solution
|
$234.73 |
$259.92 |
$327.47 |
|
|
Vedolizumab 300 mg intravenous solution
|
$2,482.55 |
$2,482.55 |
$2,748.97 |
|
|
Veeg cont 2-12 hrs
|
$306.68 |
$306.68 |
$427.86 |
|
|
Veeg ea 12-26hr cont mntr
|
$573.39 |
$634.92 |
$799.95 |
|
|
Veeg intrmnt 2-12 hrs
|
$159.49 |
$159.49 |
$222.51 |
|
|
Veeg unmon 12-26 hrs
|
$306.68 |
$339.60 |
$427.86 |
|
|
Veeg unmon 2-12 hrs
|
$159.49 |
$176.61 |
$222.51 |
|
|
Vein x-ray adrenal gland
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
|
|
Vein x-ray adrenal glands
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
|
|
Vein x-ray kidney
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
|
|
Vein x-ray liver w/hemodynam
|
$1,146.77 |
$1,146.77 |
$1,146.77 |
|
|
Vein x-ray liver w/hemodynam
|
$2,096.54 |
$2,096.54 |
$2,321.53 |
|
|
Vein x-ray liver without hemodyn
|
$1,327.79 |
$1,327.79 |
$1,470.28 |
|
|
Vein x-ray skull
|
$406.93 |
$406.93 |
$450.60 |
|
|
Vein x-ray skull epidural
|
$648.62 |
$648.62 |
$648.62 |
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$487.70 |
$540.04 |
$680.40 |
|
|
Venogram ext bil s&i
|
$486.15 |
$972.11 |
$1,356.22 |
|
|
Venogram extremity supervision & interpretation unilateral
|
$323.74 |
$826.36 |
$1,152.87 |
|
|
Venous mech thrombectomy
|
$7,708.00 |
$7,708.00 |
$8,535.20 |
|
