|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$85.00 |
$85.00 |
$85.00 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$36.70 |
$36.70 |
$36.70 |
|
|
Vaccine hepatitis a (hepa) adult im
|
$135.21 |
$163.15 |
$265.05 |
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$239.20 |
$239.20 |
$748.26 |
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$84.38 |
$84.38 |
$84.38 |
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$55.20 |
$55.20 |
$55.20 |
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$131.15 |
$131.15 |
$387.18 |
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$318.68 |
$318.68 |
$318.68 |
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$22.08 |
$22.08 |
$22.08 |
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$711.10 |
$711.10 |
$1,385.27 |
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$149.43 |
$149.43 |
$149.43 |
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$37.50 |
$37.50 |
$522.43 |
|
|
Vaccine influenza inactivated adjuvant im
|
$121.20 |
$121.20 |
$235.79 |
|
|
Vaccine influenza nos 0.5ml dose im
|
$45.70 |
$45.70 |
$45.70 |
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$49.60 |
$49.60 |
$157.89 |
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$16.33 |
$16.33 |
$134.49 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$37.50 |
$37.50 |
$37.50 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$16.33 |
$16.33 |
$16.33 |
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$28.83 |
$28.83 |
$28.83 |
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$132.36 |
$132.36 |
$259.10 |
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$400.03 |
$400.03 |
$790.26 |
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$426.80 |
$426.80 |
$426.80 |
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$66.63 |
$66.63 |
$66.63 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$264.20 |
$264.20 |
$763.01 |
|
|
Vaccine mmr live subcutaneous
|
$205.43 |
$205.43 |
$205.43 |
|
|
Vaccine mmrv live subcutaneous
|
$647.28 |
$647.28 |
$647.28 |
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$270.60 |
$270.60 |
$539.40 |
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$397.18 |
$397.18 |
$397.18 |
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$262.88 |
$262.88 |
$262.88 |
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$547.00 |
$547.00 |
$1,113.09 |
|
|
Vaccine polio (ipv) subcutaneous/im
|
$983.15 |
$983.15 |
$983.15 |
|
|
Vaccine rabies im
|
$1,020.98 |
$1,020.98 |
$1,020.98 |
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$624.00 |
$624.00 |
$624.00 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,177.25 |
$1,177.25 |
$1,177.25 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,628.38 |
$1,628.38 |
$1,628.38 |
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$572.98 |
$572.98 |
$572.98 |
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$200.70 |
$200.70 |
$200.70 |
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$77.23 |
$77.23 |
$77.23 |
|
|
Vaccine tdap >=7 years im
|
$136.80 |
$136.80 |
$364.60 |
|
|
Vaccine td preservative free >= 7 years im
|
$112.10 |
$112.10 |
$301.46 |
|
|
Vaccine typhoid vicps im
|
$338.73 |
$338.73 |
$338.73 |
|
|
Vaccine varicella live subcutaneous
|
$434.73 |
$434.73 |
$434.73 |
|
|
Vaccine yellow fever live subcutaneous
|
$427.50 |
$427.50 |
$427.50 |
|
|
Vacuum drain bottle/tube kit
|
$367.20 |
$367.20 |
$367.20 |
|
|
Vaginal bx
|
$366.65 |
$366.65 |
$366.65 |
|
|
Valproic acid total therapeutic drug level
|
$67.31 |
$114.48 |
$188.00 |
|
|
Valrubicin injection
|
$4,136.68 |
$4,136.68 |
$4,136.68 |
|
|
Valvuloplasty aortic
|
$6,526.00 |
$8,135.13 |
$8,135.13 |
|
|
Valvuloplasty mitral
|
$7,505.00 |
$8,135.13 |
$8,135.13 |
|
|
Valvuloplasty pulmonary
|
$9,256.50 |
$11,945.20 |
$11,945.20 |
|
|
Vancomycin 1,000 mg intravenous injection
|
$543.75 |
$543.75 |
$543.75 |
|
|
Vancomycin 750 mg intravenous solution
|
$313.43 |
$313.43 |
$313.43 |
|
|
Vancomycin hcl injection
|
$284.79 |
$1,012.50 |
$1,012.50 |
|
|
Vancomycin peak therapeutic drug level
|
$110.50 |
$136.13 |
$201.29 |
|
|
Varicella zoster antibody igg
|
$59.00 |
$97.05 |
$227.22 |
|
|
Varicella-zoster immue globin im
|
$4,561.53 |
$4,561.53 |
$4,561.53 |
|
|
Vasc emb/occ w/prs cath
|
$8,076.63 |
$8,076.63 |
$8,076.63 |
|
|
Vasectomy
|
$11,342.00 |
$11,342.00 |
$11,342.00 |
|
|
Vasopressin 20 unit/ml intravenous solution
|
$362.93 |
$704.50 |
$704.50 |
|
|
Vedolizumab 300 mg intravenous solution
|
$18,732.33 |
$18,732.33 |
$18,732.33 |
|
|
Veeg cont 2-12 hrs
|
$2,563.00 |
$2,563.00 |
$2,563.00 |
|
|
Veeg ea 12-26hr cont mntr
|
$2,563.00 |
$3,623.15 |
$3,623.15 |
|
|
Veeg intrmnt 2-12 hrs
|
$995.00 |
$995.00 |
$2,563.00 |
|
|
Veeg unmon 12-26 hrs
|
$2,563.00 |
$3,623.15 |
$4,444.00 |
|
|
Veeg unmon 2-12 hrs
|
$2,563.00 |
$3,623.15 |
$3,623.15 |
|
|
Vein x-ray adrenal gland
|
$3,662.50 |
$3,662.50 |
$3,662.50 |
|
|
Vein x-ray adrenal glands
|
$4,578.00 |
$4,578.00 |
$4,578.00 |
|
|
Vein x-ray eye socket
|
$2,268.50 |
$2,268.50 |
$2,268.50 |
|
|
Vein x-ray kidney
|
$1,807.68 |
$1,807.68 |
$3,654.50 |
|
|
Vein x-ray liver
|
$2,316.33 |
$2,316.33 |
$2,746.50 |
|
|
Vein x-ray liver w/hemodynam
|
$2,268.18 |
$2,268.18 |
$3,662.50 |
|
|
Vein x-ray liver w/hemodynam
|
$2,322.85 |
$2,322.85 |
$3,662.50 |
|
|
Vein x-ray liver without hemodyn
|
$1,010.68 |
$1,010.68 |
$1,513.50 |
|
|
Vein x-ray skull
|
$1,376.08 |
$1,376.08 |
$1,513.50 |
|
|
Vein x-ray spleen/liver
|
$2,615.50 |
$3,216.18 |
$3,216.18 |
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$2,978.05 |
$2,978.05 |
$2,978.05 |
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$34.00 |
$266.73 |
$266.73 |
|
|
Venipuncture <3 yrs other vein
|
$354.80 |
$354.80 |
$354.80 |
|
|
Venogram ext bil s&i
|
$1,627.00 |
$2,310.90 |
$2,310.90 |
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,155.45 |
$1,155.45 |
$1,241.50 |
|
|
Venous mech thrombectomy
|
$4,690.45 |
$4,690.45 |
$6,709.00 |
|
|
Venous m-thrombectomy add-on
|
$4,690.45 |
$4,690.45 |
$6,709.00 |
|
|
Venous sampling s&i
|
$1,841.18 |
$1,841.18 |
$3,654.50 |
|
|
Venous thrombosis imaging
|
$852.50 |
$852.50 |
$852.50 |
|
|
Ven thrombosis images bilat
|
$978.00 |
$978.00 |
$978.00 |
|
|
Ventilator each subsequent day
|
$685.48 |
$685.48 |
$3,706.00 |
|
|
Ventilator Management (first day)
|
$775.10 |
$775.10 |
$4,375.00 |
|
|
Ventricular puncture prev burr hole without inj 61020
|
$1,018.50 |
$1,018.50 |
$1,018.50 |
|
|
Version cephalic external
|
$615.45 |
$615.45 |
$2,343.00 |
|
|
Verteporfin injection
|
$3,244.43 |
$3,244.43 |
$3,244.43 |
|
|
Very long chain fatty acids
|
$253.75 |
$253.75 |
$253.75 |
|
|
Video Swallow Study (Modified Barium Swallow)
|
$363.98 |
$363.98 |
$1,080.03 |
|
|
Vinblastine 1 mg/ml intravenous solution
|
$225.00 |
$225.00 |
$816.52 |
|
|
Vincristine 1 mg/ml intravenous solution
|
$86.23 |
$225.00 |
$225.00 |
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$124.07 |
$227.50 |
$343.47 |
|
|
Virus isolation addl studies ea
|
$249.00 |
$947.83 |
$947.83 |
|
|
Visc & infraren abd 1 prosth
|
$23,709.68 |
$23,709.68 |
$23,709.68 |
|
|
Visc & infraren abd 2 prosth
|
$23,709.68 |
$23,709.68 |
$23,709.68 |
|
|
Visit established high 40-54 minutes/level 5
|
$240.50 |
$534.68 |
$534.68 |
|
|
Visual audiometry (vra)
|
$275.30 |
$275.30 |
$874.00 |
|
