|
Ultrasound guidance for vascular access
|
$505.00 |
$505.00 |
$978.00 |
|
|
Ultrasound guide intraoperative
|
$185.00 |
$625.15 |
$625.15 |
|
|
Ultrasound guide tissue ablation
|
$378.10 |
$378.10 |
$567.50 |
|
|
Ultrasound hips infant dynamic
|
$273.00 |
$364.15 |
$364.15 |
|
|
Ultrasound infant hips ltd without stress
|
$165.50 |
$364.15 |
$364.15 |
|
|
Ultrasound joint complete left
|
$503.35 |
$503.35 |
$1,134.00 |
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$404.00 |
$404.00 |
$404.00 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$241.55 |
$241.55 |
$1,253.00 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$196.53 |
$196.53 |
$957.81 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$553.05 |
$553.05 |
$693.00 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$241.00 |
$299.28 |
$646.00 |
|
|
Ultrasound prostate/transrectal
|
$475.98 |
$475.98 |
$1,014.00 |
|
|
Ultrasound spinal canal and contents
|
$406.38 |
$406.38 |
$891.00 |
|
|
Ultrasound transabd ea addl gest
|
$304.85 |
$304.85 |
$384.00 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$687.50 |
$687.50 |
$687.50 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$436.00 |
$436.00 |
$436.00 |
|
|
Ultraviolet therapy
|
$95.10 |
$95.10 |
$95.10 |
|
|
Umbilical artery cath newborn 36660
|
$115.10 |
$115.10 |
$115.10 |
|
|
Unlistd noninvas vasc dx std
|
$564.60 |
$564.60 |
$564.60 |
|
|
Unlisted chemotherapy px
|
$378.50 |
$378.50 |
$421.00 |
|
|
Unlisted CT procedure
|
$1,268.98 |
$1,268.98 |
$1,268.98 |
|
|
Unlisted dialysis procedure
|
$385.00 |
$766.68 |
$766.68 |
|
|
Unlisted dx gi procedure
|
$241.00 |
$241.00 |
$241.00 |
|
|
Unlisted fetal invas px w/us
|
$647.18 |
$647.18 |
$647.18 |
|
|
Unlisted fluoroscopic px
|
$324.85 |
$324.85 |
$324.85 |
|
|
Unlisted hematology&coagj px
|
$477.50 |
$477.50 |
$477.50 |
|
|
Unlisted mr procedure
|
$907.23 |
$907.23 |
$1,331.50 |
|
|
Unlisted muscskel px head
|
$2,538.50 |
$2,538.50 |
$2,538.50 |
|
|
Unlisted orl service/px
|
$292.80 |
$292.80 |
$292.80 |
|
|
Unlisted procedure colon
|
$1,331.00 |
$1,331.00 |
$1,331.00 |
|
|
Unlisted procedure microbiology
|
$650.13 |
$650.13 |
$2,820.50 |
|
|
Unlisted procedure orbit
|
$384.50 |
$384.50 |
$384.50 |
|
|
Unlisted procedure rectum
|
$1,249.00 |
$1,249.00 |
$1,249.00 |
|
|
Unlisted procedure spine
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
|
|
Unlisted px abdomen muscskel
|
$375.00 |
$375.00 |
$375.00 |
|
|
Unlisted px ant segment eye
|
$2,870.00 |
$2,870.00 |
$2,870.00 |
|
|
Unlisted px biliary tract
|
$568.23 |
$568.23 |
$2,039.00 |
|
|
Unlisted px external ear
|
$268.00 |
$268.00 |
$268.00 |
|
|
Unlisted px foot/toes
|
$1,069.50 |
$1,069.50 |
$1,069.50 |
|
|
Unlisted px forearm/wrist
|
$345.50 |
$345.50 |
$345.50 |
|
|
Unlisted px hands/fingers
|
$180.00 |
$180.00 |
$180.00 |
|
|
Unlisted px leg/ankle
|
$399.50 |
$399.50 |
$399.50 |
|
|
Unlisted px male genital sys
|
$220.00 |
$897.95 |
$897.95 |
|
|
Unlisted px med radj physics
|
$462.35 |
$462.35 |
$462.35 |
|
|
Unlisted px middle ear
|
$326.00 |
$326.00 |
$326.00 |
|
|
Unlisted px neck/thorax
|
$322.00 |
$322.00 |
$322.00 |
|
|
Unlisted px pelvis/hip joint
|
$383.00 |
$383.00 |
$383.00 |
|
|
Unlisted px salivry glnd/dux
|
$2,465.00 |
$2,465.00 |
$2,465.00 |
|
|
Unlisted px small intestine
|
$1,008.13 |
$1,008.13 |
$1,210.00 |
|
|
Unlisted px tongue flr mouth
|
$268.00 |
$268.00 |
$268.00 |
|
|
Unlisted surgical path px
|
$53.90 |
$53.90 |
$53.90 |
|
|
Unlisted transfusion med px
|
$350.35 |
$350.35 |
$350.35 |
|
|
Unlisted ultrasound procedure
|
$121.00 |
$426.63 |
$426.63 |
|
|
Unlisted urinalysis px
|
$7.50 |
$7.50 |
$7.50 |
|
|
Unsched dialysis esrd pt hos
|
$935.00 |
$1,000.93 |
$3,161.00 |
|
|
Upgrade pm system
|
$8,460.55 |
$8,460.55 |
$14,965.50 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$231.50 |
$231.50 |
$398.00 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,550.20 |
$1,550.20 |
$4,562.00 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,425.85 |
$1,425.85 |
$2,753.00 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,861.50 |
$2,656.05 |
$7,374.00 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,778.50 |
$2,413.48 |
$5,863.86 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,410.50 |
$2,013.08 |
$3,994.00 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$269.53 |
$269.53 |
$477.00 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$331.63 |
$331.63 |
$667.00 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,696.00 |
$1,696.00 |
$1,696.00 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,939.00 |
$1,939.00 |
$1,939.00 |
|
|
Upper ext fx orthosis rad/ul
|
$232.88 |
$232.88 |
$232.88 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$527.35 |
$527.35 |
$1,948.00 |
|
|
Upper GI Barium X-ray (barium only)
|
$497.93 |
$497.93 |
$880.43 |
|
|
Urea nitrogen
|
$46.23 |
$46.23 |
$96.00 |
|
|
Urea nitrogen 24 hour urine
|
$27.00 |
$57.10 |
$92.61 |
|
|
Urea nitrogen clearance
|
$49.43 |
$49.43 |
$66.00 |
|
|
Ureteral embolization/occl
|
$1,436.50 |
$1,436.50 |
$1,436.50 |
|
|
Ureteral reflux study
|
$914.00 |
$914.00 |
$914.00 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$371.00 |
$554.28 |
$1,009.00 |
|
|
Urethrocystography void s&i
|
$448.00 |
$586.50 |
$823.00 |
|
|
Uric acid blood
|
$53.50 |
$60.85 |
$76.02 |
|
|
Uric acid urine
|
$30.50 |
$52.75 |
$100.00 |
|
|
Urinalysis microscopic only
|
$24.00 |
$53.83 |
$71.00 |
|
|
Urinalysis (with microscopy)
|
$40.35 |
$40.35 |
$89.50 |
|
|
Urinalysis (without microscopy)
|
$39.48 |
$52.38 |
$162.00 |
|
|
Urinary pouch w/barrier
|
$5.70 |
$5.70 |
$5.70 |
|
|
Urine Culture Test
|
$82.32 |
$119.23 |
$178.00 |
|
|
Urine flow measurement 51736
|
$223.48 |
$223.48 |
$223.48 |
|
|
Urine pregnancy test
|
$71.60 |
$71.60 |
$157.00 |
|
|
Urography, antegrade
|
$464.50 |
$557.50 |
$1,264.41 |
|
|
Use 1st target lesion
|
$336.50 |
$336.50 |
$336.50 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$4,249.73 |
$4,249.73 |
$40,509.34 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$56,553.85 |
$56,553.85 |
$56,553.85 |
|
|
Vaccine Administration (one shot)
|
$59.08 |
$59.08 |
$183.00 |
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$72.96 |
$98.00 |
$98.00 |
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$44.45 |
$44.45 |
$72.96 |
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$65.55 |
$65.55 |
$65.55 |
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$43.89 |
$43.89 |
$43.89 |
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$32.68 |
$32.68 |
$32.68 |
|
|
Vaccine dtap < 7 years im
|
$81.65 |
$81.65 |
$81.65 |
|
|
Vaccine dtap-hep b-ipv im
|
$157.75 |
$157.75 |
$157.75 |
|
|
Vaccine dtap-ipv 4-6 years im
|
$138.80 |
$138.80 |
$138.80 |
|
|
Vaccine dtap-ipv-hib-hepb im
|
$158.30 |
$158.30 |
$158.30 |
|
|
Vaccine dtap-ipv/hib im
|
$266.03 |
$266.03 |
$266.03 |
|