|
Unlisted px pelvis/hip joint
|
$282.50 |
$282.50 |
$282.50 |
$3,251.90
|
|
Unlisted px posterior segmnt
|
$2,685.92 |
$2,685.92 |
$2,685.92 |
$3,173.34
|
|
Unlisted px salivry glnd/dux
|
$273.48 |
$273.48 |
$273.48 |
$1,173.42
|
|
Unlisted px small intestine
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$2,118.35
|
|
Unlisted px temporal bone
|
$273.48 |
$273.48 |
$273.48 |
$571.20
|
|
Unlisted px ther rad tx plng
|
$156.36 |
$156.36 |
$156.36 |
$182.00
|
|
Unlisted px tongue flr mouth
|
$273.48 |
$273.48 |
$273.48 |
$282.50
|
|
Unlisted px vestibule mouth
|
$273.48 |
$273.48 |
$273.48 |
$456.96
|
|
Unlisted reprod med lab proc
|
$62.92 |
$62.92 |
$62.92 |
$70.00
|
|
Unlisted resp px dx nuc med
|
$473.22 |
$473.22 |
$473.22 |
$670.60
|
|
Unlisted spec derm svc/px
|
$234.00 |
$234.00 |
$234.00 |
$223.08
|
|
Unlisted surgical path px
|
$62.92 |
$62.92 |
$62.92 |
$216.00
|
|
Unlisted transfusion med px
|
$28.84 |
$28.84 |
$28.84 |
$147.50
|
|
Unlisted ultrasound procedure
|
$103.69 |
$103.69 |
$103.69 |
$335.00
|
|
Unlisted vasc endoscopy px
|
$728.10 |
$728.10 |
$728.10 |
$1,523.20
|
|
Unlstd hematop ret/endo lymp
|
$473.22 |
$473.22 |
$473.22 |
$473.22
|
|
Unlstd laps px mat care&dlvr
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,741.00
|
|
Unlstd laps px sprmatic cord
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$824.03 |
$824.03 |
$824.03 |
$1,316.90
|
|
Upgrade pm system
|
$12,324.60 |
$12,324.60 |
$12,324.60 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$103.69 |
$103.69 |
$103.69 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$209.65 |
$209.65 |
$209.65 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$125.23 |
$125.23 |
$125.23 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$420.58 |
$420.58 |
$420.58 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$420.58 |
$420.58 |
$420.58 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$284.66 |
$284.66 |
$284.66 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$125.23 |
$125.23 |
$125.23 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$125.23 |
$125.23 |
$125.23 |
$380.82
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$209.65 |
$209.65 |
$209.65 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$209.65 |
$209.65 |
$209.65 |
$603.20
|
|
Uppr gi scope w/submuc inj
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,082.67
|
|
Urea nitrogen
|
$3.95 |
$3.95 |
$3.95 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$5.56 |
$5.56 |
$5.56 |
$51.77
|
|
Urea nitrogen clearance
|
$7.20 |
$7.20 |
$7.20 |
$34.02
|
|
Urea nitrogen semi-quant
|
$5.13 |
$5.13 |
$5.13 |
$10.40
|
|
Ureteral reflux study
|
$473.22 |
$473.22 |
$473.22 |
$952.50
|
|
Ureter endoscopy
|
$4,061.71 |
$4,061.71 |
$4,061.71 |
$3,326.40
|
|
Ureter endoscopy & biopsy
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$5,696.72
|
|
Ureter endoscopy & biopsy
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$5,986.78
|
|
Ureter endoscopy & catheter
|
$4,061.71 |
$4,061.71 |
$4,061.71 |
$3,326.40
|
|
Ureter endoscopy & treatment
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$6,015.75
|
|
Ureter endoscopy & treatment
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$5,631.74
|
|
Ureter endoscopy & treatment
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$5,986.78
|
|
Ureter endoscopy & treatment
|
$5,986.78 |
$5,986.78 |
$5,986.78 |
$5,631.74
|
|
Urethrcystgrphy rtrgrde s&i
|
$284.66 |
$284.66 |
$284.66 |
$592.80
|
|
Urethrlys transvag with scope
|
$4,061.71 |
$4,061.71 |
$4,061.71 |
$4,081.37
|
|
Urethrocystography void s&i
|
$284.66 |
$284.66 |
$284.66 |
$631.75
|
|
Uric acid blood
|
$4.52 |
$4.52 |
$4.52 |
$48.96
|
|
Uric acid urine
|
$5.08 |
$5.08 |
$5.08 |
$44.14
|
|
Urinalysis glass test
|
$4.70 |
$4.70 |
$4.70 |
$11.20
|
|
Urinalysis microscopic only
|
$3.05 |
$3.05 |
$3.05 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$2.17 |
$2.17 |
$2.17 |
$25.72
|
|
Urinalysis (with microscopy)
|
$3.17 |
$3.17 |
$3.17 |
$54.60
|
|
Urinalysis (without microscopy)
|
$2.25 |
$2.25 |
$2.25 |
$35.15
|
|
Urinary reflex study
|
$69.95 |
$69.95 |
$69.95 |
$216.05
|
|
Urine Culture Test
|
$8.07 |
$8.07 |
$8.07 |
$81.00
|
|
Urine flow measurement 51736
|
$151.80 |
$151.80 |
$151.80 |
$210.00
|
|
Urine pregnancy test
|
$8.61 |
$8.61 |
$8.61 |
$66.87
|
|
Urine screen for bacteria
|
$29.98 |
$29.98 |
$29.98 |
$55.64
|
|
Urography, antegrade
|
$420.58 |
$420.58 |
$420.58 |
$622.35
|
|
Urography inf drip &/or bolus
|
$209.65 |
$209.65 |
$209.65 |
$642.50
|
|
Use 1st target lesion
|
$125.23 |
$125.23 |
$125.23 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$13.29 |
$13.29 |
$13.29 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$157.68 |
$157.68 |
$157.68 |
$51,633.07
|
|
U/s trtmt, not leiomyomata
|
$15,152.74 |
$15,152.74 |
$15,152.74 |
$17,653.66
|
|
Vaccine Administration (one shot)
|
$83.81 |
$83.81 |
$83.81 |
$67.74
|
|
Vaccine rabies im
|
$312.03 |
$312.03 |
$312.03 |
$858.95
|
|
Vaccinia vrs vac 0.3 ml perq
|
$0.01 |
$0.01 |
$0.01 |
$0.01
|
|
Vag hys/<250g/rmv tube/rpr entero 58263
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,345.59
|
|
Vag hyst incl t/o complex
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,813.46
|
|
Vag hyst including t/o
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,110.00
|
|
Vag hyst t/o & repair compl
|
$8,708.57 |
$8,708.57 |
$8,708.57 |
$8,081.64
|
|
Vag hyst w/enterocele compl 58294
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,468.70
|
|
Vag hyst w/enterocele repair
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,463.96
|
|
Vaginal bx
|
$236.91 |
$236.91 |
$236.91 |
$471.12
|
|
Vaginal delivery after cesarean delivery 59612
|
$3,744.41 |
$3,744.41 |
$3,744.41 |
$3,866.47
|
|
Vaginal hysterectomy
|
$5,813.46 |
$5,813.46 |
$5,813.46 |
$5,766.00
|
|
Vaginectomy partial w/nodes
|
$3,744.41 |
$3,744.41 |
$3,744.41 |
$4,252.00
|
|
Valproic acid total therapeutic drug level
|
$13.54 |
$13.54 |
$13.54 |
$114.48
|
|
Valrubicin injection
|
$1,376.79 |
$1,376.79 |
$1,376.79 |
$2,813.49
|
|
Valvuloplasty aortic
|
$6,714.45 |
$6,714.45 |
$6,714.45 |
$7,830.80
|
|
Valvuloplasty mitral
|
$13,355.34 |
$13,355.34 |
$13,355.34 |
$10,851.48
|
|
Valvuloplasty pulmonary
|
$13,355.34 |
$13,355.34 |
$13,355.34 |
$11,945.20
|
|
Vancomycin peak therapeutic drug level
|
$13.54 |
$13.54 |
$13.54 |
$129.14
|
|
Vanomycin dna amp probe
|
$35.09 |
$35.09 |
$35.09 |
$78.40
|
|
Varicella zoster antibody igg
|
$12.88 |
$12.88 |
$12.88 |
$86.80
|
|
Varicella-zoster immue globin im
|
$2,359.90 |
$2,359.90 |
$2,359.90 |
$3,816.19
|
|
Vasc emb/occ w/prs cath
|
$21,146.91 |
$21,146.91 |
$21,146.91 |
$21,009.00
|
|
Vasc graft into carpal bone
|
$3,821.05 |
$3,821.05 |
$3,821.05 |
$4,350.00
|
|
Vasectomy
|
$2,412.45 |
$2,412.45 |
$2,412.45 |
$2,424.12
|
|
Vedolizumab 300 mg intravenous solution
|
$22.06 |
$22.06 |
$22.06 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$624.87 |
$624.87 |
$624.87 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$1,198.14 |
$1,198.14 |
$1,198.14 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$366.72 |
$366.72 |
$366.72 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$624.87 |
$624.87 |
$624.87 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$366.72 |
$366.72 |
$366.72 |
$826.15
|
|
Vein x-ray adrenal gland
|
$3,706.68 |
$3,706.68 |
$3,706.68 |
$2,870.00
|
