|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$210.66 |
$210.66 |
$210.66 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$125.84 |
$125.84 |
$125.84 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$422.61 |
$422.61 |
$422.61 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$422.61 |
$422.61 |
$422.61 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$286.04 |
$286.04 |
$286.04 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$125.84 |
$125.84 |
$125.84 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$125.84 |
$125.84 |
$125.84 |
$380.82
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,109.47 |
$1,109.47 |
$1,109.47 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,109.47 |
$1,109.47 |
$1,109.47 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$210.66 |
$210.66 |
$210.66 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$210.66 |
$210.66 |
$210.66 |
$603.20
|
|
Uppr gi scope w/submuc inj
|
$1,109.47 |
$1,109.47 |
$1,109.47 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$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
|
$475.51 |
$475.51 |
$475.51 |
$952.50
|
|
Ureter endoscopy
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$3,326.40
|
|
Ureter endoscopy & biopsy
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,696.72
|
|
Ureter endoscopy & biopsy
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,986.78
|
|
Ureter endoscopy & catheter
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$3,326.40
|
|
Ureter endoscopy & treatment
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$6,015.75
|
|
Ureter endoscopy & treatment
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,631.74
|
|
Ureter endoscopy & treatment
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,986.78
|
|
Ureter endoscopy & treatment
|
$6,015.75 |
$6,015.75 |
$6,015.75 |
$5,631.74
|
|
Urethrcystgrphy rtrgrde s&i
|
$286.04 |
$286.04 |
$286.04 |
$592.80
|
|
Urethrlys transvag with scope
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,081.37
|
|
Urethrocystography void s&i
|
$286.04 |
$286.04 |
$286.04 |
$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
|
$70.29 |
$70.29 |
$70.29 |
$216.05
|
|
Urine Culture Test
|
$8.07 |
$8.07 |
$8.07 |
$81.00
|
|
Urine flow measurement 51736
|
$152.54 |
$152.54 |
$152.54 |
$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
|
$422.61 |
$422.61 |
$422.61 |
$622.35
|
|
Urography inf drip &/or bolus
|
$210.66 |
$210.66 |
$210.66 |
$642.50
|
|
Use 1st target lesion
|
$125.84 |
$125.84 |
$125.84 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$12.97 |
$12.97 |
$12.97 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$159.91 |
$159.91 |
$159.91 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$84.22 |
$84.22 |
$84.22 |
$67.74
|
|
Vaccine rabies im
|
$350.14 |
$350.14 |
$350.14 |
$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
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,345.59
|
|
Vag hyst incl t/o complex
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,813.46
|
|
Vag hyst including t/o
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,110.00
|
|
Vag hyst t/o & repair compl
|
$8,750.72 |
$8,750.72 |
$8,750.72 |
$8,081.64
|
|
Vag hyst w/enterocele compl 58294
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,468.70
|
|
Vag hyst w/enterocele repair
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,463.96
|
|
Vaginal bx
|
$238.06 |
$238.06 |
$238.06 |
$471.12
|
|
Vaginal delivery after cesarean delivery 59612
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$3,866.47
|
|
Vaginal hysterectomy
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,766.00
|
|
Vaginectomy partial w/nodes
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$4,252.00
|
|
Valproic acid total therapeutic drug level
|
$13.54 |
$13.54 |
$13.54 |
$114.48
|
|
Valrubicin injection
|
$1,437.08 |
$1,437.08 |
$1,437.08 |
$2,813.49
|
|
Valvuloplasty aortic
|
$6,746.95 |
$6,746.95 |
$6,746.95 |
$7,830.80
|
|
Valvuloplasty mitral
|
$13,419.98 |
$13,419.98 |
$13,419.98 |
$10,851.48
|
|
Valvuloplasty pulmonary
|
$13,419.98 |
$13,419.98 |
$13,419.98 |
$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
|
$2,250.71 |
$2,250.71 |
$2,250.71 |
$3,816.19
|
|
Vasc emb/occ w/prs cath
|
$21,249.26 |
$21,249.26 |
$21,249.26 |
$21,009.00
|
|
Vasc graft into carpal bone
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,350.00
|
|
Vasectomy
|
$2,424.12 |
$2,424.12 |
$2,424.12 |
$2,424.12
|
|
Vedolizumab 300 mg intravenous solution
|
$22.26 |
$22.26 |
$22.26 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$627.89 |
$627.89 |
$627.89 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$1,203.94 |
$1,203.94 |
$1,203.94 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$368.50 |
$368.50 |
$368.50 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$627.89 |
$627.89 |
$627.89 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$368.50 |
$368.50 |
$368.50 |
$826.15
|
|
Vein x-ray adrenal gland
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$2,870.00
|
|
Vein x-ray adrenal glands
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$3,480.10
|
|
Vein x-ray eye socket
|
$731.62 |
$731.62 |
$731.62 |
$1,438.32
|
|
Vein x-ray kidney
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$2,990.58
|
|
Vein x-ray liver
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$3,328.80
|
|
Vein x-ray liver w/hemodynam
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$3,635.28
|
|
Vein x-ray liver w/hemodynam
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$3,694.50
|
|
Vein x-ray liver without hemodyn
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$2,452.80
|
|
Vein x-ray skull
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$2,236.50
|
|
Vein x-ray skull epidural
|
$731.62 |
$731.62 |
$731.62 |
$1,596.00
|
|
Vein x-ray spleen/liver
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$3,434.00
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$370.20 |
$370.20 |
$370.20 |
$2,632.35
|
|
Vemp test i&r cervical
|
$185.15 |
$185.15 |
$185.15 |
$343.72
|
|
Vemp test i&r ocular
|
$185.15 |
$185.15 |
$185.15 |
$260.00
|
|
Vemp tst i&r cervical&ocular
|
$368.50 |
$368.50 |
$368.50 |
$591.50
|
|
Ven blood coll snf/hha
|
$11.09 |
$11.09 |
$11.09 |
$15.65
|
|
Venogram ext bil s&i
|
$1,838.28 |
$1,838.28 |
$1,838.28 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,838.28 |
$1,838.28 |
$1,838.28 |
$1,388.00
|
|
Venous mech thrombectomy
|
$13,419.98 |
$13,419.98 |
$13,419.98 |
$8,212.75
|
|
Venous m-thrombectomy add-on
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$5,288.32
|
|
Venous sampling s&i
|
$6,396.89 |
$6,396.89 |
$6,396.89 |
$4,270.50
|
|
Venous thrombosis imaging
|
$636.97 |
$636.97 |
$636.97 |
$697.20
|
|
Ven thrombosis images bilat
|
$475.51 |
$475.51 |
$475.51 |
$796.50
|
