|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,226.48 |
$1,226.48 |
$1,226.48 |
$997.44
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$173.60 |
$173.60 |
$173.60 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$115.36 |
$115.36 |
$115.36 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$97.37 |
$97.37 |
$97.37 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$404.00 |
$404.00 |
$404.00 |
$365.17
|
|
Vaginal bx
|
$2,480.00 |
$2,480.00 |
$2,480.00 |
$459.42
|
|
Valvuloplasty aortic
|
$11,906.40 |
$11,906.40 |
$11,906.40 |
$7,944.16
|
|
Valvuloplasty mitral
|
$16,380.00 |
$16,380.00 |
$16,380.00 |
$10,845.00
|
|
Valvuloplasty pulmonary
|
$13,767.20 |
$13,767.20 |
$13,767.20 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$691.48 |
$691.48 |
$691.48 |
$251.86
|
|
Varus/valgus strap padded/li
|
$52.88 |
$52.88 |
$52.88 |
$114.24
|
|
Vasc emb/occ w/prs cath
|
$27,533.60 |
$27,533.60 |
$27,533.60 |
$21,009.00
|
|
Vasopressin 20 unit/ml intravenous solution
|
$76.96 |
$76.96 |
$76.96 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$14,973.97 |
$14,973.97 |
$14,973.97 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$3,673.60 |
$3,673.60 |
$3,673.60 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$4,259.20 |
$4,259.20 |
$4,259.20 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$3,331.20 |
$3,331.20 |
$3,331.20 |
$994.91
|
|
Veeg unmon 12-26 hrs
|
$2,948.00 |
$2,948.00 |
$2,948.00 |
$1,737.12
|
|
Veeg unmon 2-12 hrs
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$826.15
|
|
Vein byp fem-tibial peroneal 35585
|
$1,303.20 |
$1,303.20 |
$1,303.20 |
$2,388.00
|
|
Vein x-ray adrenal gland
|
$1,641.60 |
$1,641.60 |
$1,641.60 |
$2,833.34
|
|
Vein x-ray kidney
|
$3,418.40 |
$3,418.40 |
$3,418.40 |
$2,870.00
|
|
Vein x-ray liver
|
$3,126.40 |
$3,126.40 |
$3,126.40 |
$3,312.00
|
|
Vein x-ray liver w/hemodynam
|
$2,788.00 |
$2,788.00 |
$2,788.00 |
$3,619.84
|
|
Vein x-ray liver w/hemodynam
|
$2,756.00 |
$2,756.00 |
$2,756.00 |
$3,683.90
|
|
Vein x-ray liver without hemodyn
|
$358.40 |
$358.40 |
$358.40 |
$2,452.80
|
|
Vein x-ray skull
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$2,236.50
|
|
Vein x-ray spleen/liver
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$3,434.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$179.20 |
$179.20 |
$179.20 |
$197.04
|
|
Venipuncture <3 yrs other vein
|
$124.00 |
$124.00 |
$124.00 |
$62.40
|
|
Venogram ext bil s&i
|
$1,860.80 |
$1,860.80 |
$1,860.80 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,472.00 |
$1,472.00 |
$1,472.00 |
$1,382.58
|
|
Venous mech thrombectomy
|
$7,480.00 |
$7,480.00 |
$7,480.00 |
$8,184.00
|
|
Venous m-thrombectomy add-on
|
$5,789.60 |
$5,789.60 |
$5,789.60 |
$5,110.00
|
|
Venous sampling s&i
|
$2,037.60 |
$2,037.60 |
$2,037.60 |
$4,200.00
|
|
Ventilator each subsequent day
|
$1,107.20 |
$1,107.20 |
$1,107.20 |
$1,178.74
|
|
Ventilator Management (first day)
|
$1,478.40 |
$1,478.40 |
$1,478.40 |
$1,434.60
|
|
Version cephalic external
|
$3,419.20 |
$3,419.20 |
$3,419.20 |
$2,361.75
|
|
Video Swallow Study (Modified Barium Swallow)
|
$734.40 |
$734.40 |
$734.40 |
$524.50
|
|
Vinblastine 1 mg/ml intravenous solution
|
$78.24 |
$78.24 |
$78.24 |
$163.80
|
|
Vincristine 1 mg/ml intravenous solution
|
$43.54 |
$43.54 |
$43.54 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$193.44 |
$193.44 |
$193.44 |
$223.55
|
|
Visc & infraren abd 1 prosth
|
$5,717.60 |
$5,717.60 |
$5,717.60 |
$7,571.20
|
|
Visc & infraren abd 2 prosth
|
$6,208.80 |
$6,208.80 |
$6,208.80 |
$8,957.30
|
|
Visc & infraren abd 3 prosth
|
$6,098.40 |
$6,098.40 |
$6,098.40 |
$9,670.00
|
|
Visc & infraren abd 4+ prost
|
$6,289.60 |
$6,289.60 |
$6,289.60 |
$10,660.00
|
|
Visual audiometry (vra)
|
$167.20 |
$167.20 |
$167.20 |
$220.60
|
|
Vital capacity test
|
$101.60 |
$101.60 |
$101.60 |
$173.18
|
|
Volume deplete of harvest
|
$2,138.40 |
$2,138.40 |
$2,138.40 |
$1,443.33
|
|
Vonvendi inj 1 iu vwf:rco
|
$16.80 |
$16.80 |
$16.80 |
$5.42
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$172.61 |
$172.61 |
$172.61 |
$165.81
|
|
Walking (Gait) Training (each 15 minutes)
|
$117.60 |
$117.60 |
$117.60 |
$87.50
|
|
Wash harvest stem cells
|
$3,927.20 |
$3,927.20 |
$3,927.20 |
$1,263.60
|
|
Wcd device interrogate
|
$172.00 |
$172.00 |
$172.00 |
$109.20
|
|
Whfo w/joint(s) custom fab
|
$451.75 |
$451.75 |
$451.75 |
$452.38
|
|
Whole blood for transfusion
|
$1,070.40 |
$1,070.40 |
$1,070.40 |
$504.00
|
|
Whole-Body Bone Scan (Nuclear Medicine)
|
$1,819.20 |
$1,819.20 |
$1,819.20 |
$1,570.65
|
|
Whole Skeleton X-ray Survey
|
$809.60 |
$809.60 |
$809.60 |
$636.46
|
|
Wound Cleaning and Dead Tissue Removal (up to 20 sq cm)
|
$391.20 |
$391.20 |
$391.20 |
$353.40
|
|
Wound therapy negative pressure per session <= 50 sq cm
|
$159.20 |
$159.20 |
$159.20 |
$574.40
|
|
Wound therapy negative pressure per session > 50 sq cm
|
$703.20 |
$703.20 |
$703.20 |
$594.00
|
|
Wound therapy negative pressure per session <= 50 sq cm dme
|
$316.00 |
$316.00 |
$316.00 |
$284.70
|
|
Wound therapy negative pressure per session > 50 sq cm dme
|
$488.80 |
$488.80 |
$488.80 |
$442.22
|
|
Wrist X-ray
|
$417.60 |
$417.60 |
$417.60 |
$350.40
|
|
Wrist X-ray (2 views, both wrists)
|
$379.20 |
$379.20 |
$379.20 |
$291.20
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,470.40 |
$2,470.40 |
$2,470.40 |
$2,707.20
|
|
Xpos opn fmrl eprst aor uni add-on
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$1,859.09
|
|
X-ray abdomen >=3 views
|
$485.60 |
$485.60 |
$485.60 |
$344.12
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$794.00
|
|
X-ray bone length studies
|
$370.40 |
$370.40 |
$370.40 |
$285.30
|
|
X-ray bone survey infant
|
$230.40 |
$230.40 |
$230.40 |
$394.80
|
|
X-ray exam entire spi 4/5 vw
|
$434.40 |
$434.40 |
$434.40 |
$455.91
|
|
X-ray exam entire spi 6/> vw
|
$448.80 |
$448.80 |
$448.80 |
$519.00
|
|
X-ray exam of arm infant
|
$152.80 |
$152.80 |
$152.80 |
$248.82
|
|
X-ray exam of femur 1
|
$379.20 |
$379.20 |
$379.20 |
$237.60
|
|
X-ray exam of jaw joint
|
$372.80 |
$372.80 |
$372.80 |
$194.36
|
|
X-ray exam of jaw joint
|
$382.40 |
$382.40 |
$382.40 |
$452.00
|
|
X-ray exam of mastoids
|
$88.00 |
$88.00 |
$88.00 |
$193.41
|
|
X-ray exam of middle ear
|
$126.40 |
$126.40 |
$126.40 |
$349.35
|
|
X-ray exam of penis
|
$138.40 |
$138.40 |
$138.40 |
$593.46
|
|
X-ray exam of perineum
|
$240.80 |
$240.80 |
$240.80 |
$588.00
|
|
X-ray exam of salivary gland
|
$86.40 |
$86.40 |
$86.40 |
$162.60
|
|
X-ray exam of teeth
|
$34.40 |
$34.40 |
$34.40 |
$138.40
|
|
X-ray exam of teeth
|
$103.20 |
$103.20 |
$103.20 |
$385.39
|
|
X-ray exam si joints
|
$88.80 |
$88.80 |
$88.80 |
$246.98
|
|
X-ray exam thorac spine4/>vw
|
$132.00 |
$132.00 |
$132.00 |
$395.00
|
|
X-ray eye detection foreign body (both sides)
|
$301.60 |
$301.60 |
$301.60 |
$238.29
|
|
X-ray fallopian tube
|
$660.00 |
$660.00 |
$660.00 |
$565.40
|
|
X-ray head for orthodontia
|
$188.80 |
$188.80 |
$188.80 |
$158.50
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$453.60 |
$453.60 |
$453.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$601.60 |
$601.60 |
$601.60 |
$513.56
|
|
X-ray joint survey 1 view
|
$116.80 |
$116.80 |
$116.80 |
$232.00
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$221.60 |
$221.60 |
$221.60 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$151.20 |
$151.20 |
$151.20 |
$364.75
|
|
X-ray mandible ltd <4 views
|
$88.00 |
$88.00 |
$88.00 |
$238.00
|
|
X-ray nose to rectum for foreign body child
|
$215.20 |
$215.20 |
$215.20 |
$226.85
|
|
X-ray optic foramina
|
$86.40 |
$86.40 |
$86.40 |
$185.95
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$765.60
|
|
X-ray ribs 2 views left
|
$424.80 |
$424.80 |
$424.80 |
$296.32
|
|
X-ray sella turcica
|
$70.40 |
$70.40 |
$70.40 |
$162.50
|
