|
Ultrasound abdomen aorta screening study aaa
|
$109.80 |
$109.80 |
$109.80 |
$394.20
|
|
Ultrasound breast complete
|
$102.60 |
$102.60 |
$102.60 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$144.00 |
$144.00 |
$144.00 |
$449.35
|
|
Ultrasound chest
|
$746.40 |
$746.40 |
$746.40 |
$460.85
|
|
Ultrasound encephalogram
|
$653.40 |
$653.40 |
$653.40 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$668.40 |
$668.40 |
$668.40 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$467.40 |
$467.40 |
$467.40 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$168.00 |
$168.00 |
$168.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$849.60 |
$849.60 |
$849.60 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$668.40 |
$668.40 |
$668.40 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$158.40 |
$158.40 |
$158.40 |
$311.25
|
|
Ultrasound joint complete left
|
$717.00 |
$717.00 |
$717.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$381.60 |
$381.60 |
$381.60 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$996.00 |
$996.00 |
$996.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$625.80 |
$625.80 |
$625.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$880.80 |
$880.80 |
$880.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$583.80 |
$583.80 |
$583.80 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$596.40 |
$596.40 |
$596.40 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$659.40 |
$659.40 |
$659.40 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$1,076.40 |
$1,076.40 |
$1,076.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$389.40 |
$389.40 |
$389.40 |
$486.50
|
|
Ultrasound scrotum and contents
|
$606.60 |
$606.60 |
$606.60 |
$608.90
|
|
Ultrasound transvaginal non obstetric
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$558.35
|
|
Unlisted chemotherapy px
|
$541.20 |
$541.20 |
$541.20 |
$150.00
|
|
Unlisted misc path test
|
$44.40 |
$44.40 |
$44.40 |
$89.40
|
|
Unlisted orl service/px
|
$40.80 |
$40.80 |
$40.80 |
$132.60
|
|
Unlisted procedure microbiology
|
$252.60 |
$252.60 |
$252.60 |
$523.50
|
|
Unlisted px hands/fingers
|
$378.00 |
$378.00 |
$378.00 |
$354.20
|
|
Unlisted px small intestine
|
$1,433.40 |
$1,433.40 |
$1,433.40 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$408.60 |
$408.60 |
$408.60 |
$282.50
|
|
Unlisted reprod med lab proc
|
$118.20 |
$118.20 |
$118.20 |
$70.00
|
|
Unlisted surgical path px
|
$279.60 |
$279.60 |
$279.60 |
$217.75
|
|
Unlisted ultrasound procedure
|
$388.80 |
$388.80 |
$388.80 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,969.40 |
$2,969.40 |
$2,969.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,997.00 |
$2,997.00 |
$2,997.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,178.60 |
$2,178.60 |
$2,178.60 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$7,376.68 |
$7,376.68 |
$7,376.68 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$7,839.59 |
$7,839.59 |
$7,839.59 |
$1,768.00
|
|
Urea nitrogen
|
$34.20 |
$34.20 |
$34.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$35.40 |
$35.40 |
$35.40 |
$51.75
|
|
Urea nitrogen clearance
|
$137.40 |
$137.40 |
$137.40 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$269.40 |
$269.40 |
$269.40 |
$579.73
|
|
Urethrocystography void s&i
|
$304.80 |
$304.80 |
$304.80 |
$622.35
|
|
Uric acid blood
|
$40.80 |
$40.80 |
$40.80 |
$48.75
|
|
Uric acid urine
|
$36.00 |
$36.00 |
$36.00 |
$44.33
|
|
Urinalysis microscopic only
|
$39.60 |
$39.60 |
$39.60 |
$26.35
|
|
Urinalysis (with microscopy)
|
$31.80 |
$31.80 |
$31.80 |
$55.00
|
|
Urinalysis (without microscopy)
|
$34.80 |
$34.80 |
$34.80 |
$35.75
|
|
Urine Culture Test
|
$36.60 |
$36.60 |
$36.60 |
$81.50
|
|
Urine pregnancy test
|
$34.80 |
$34.80 |
$34.80 |
$67.20
|
|
Urography, antegrade
|
$289.80 |
$289.80 |
$289.80 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$10,098.06 |
$10,098.06 |
$10,098.06 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$268.20 |
$268.20 |
$268.20 |
$51,633.07
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$193.20 |
$193.20 |
$193.20 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$193.20 |
$193.20 |
$193.20 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$181.80 |
$181.80 |
$181.80 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$116.40 |
$116.40 |
$116.40 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$87.00 |
$87.00 |
$87.00 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$62.16 |
$62.16 |
$62.16 |
$68.19
|
|
Vaccine dtap-ipv 4-6 years im
|
$64.80 |
$64.80 |
$64.80 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$138.00 |
$138.00 |
$138.00 |
$174.72
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$49.80 |
$49.80 |
$49.80 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$198.00 |
$198.00 |
$198.00 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.06 |
$0.06 |
$0.06 |
$75.39
|
|
Vaccine influenza inactivated adjuvant im
|
$75.00 |
$75.00 |
$75.00 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$25.20 |
$25.20 |
$25.20 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$96.00 |
$96.00 |
$96.00 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$28.80 |
$28.80 |
$28.80 |
$33.60
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$130.68 |
$130.68 |
$130.68 |
$76.50
|
|
Vaccine mmr live subcutaneous
|
$205.80 |
$205.80 |
$205.80 |
$211.68
|
|
Vaccine mmrv live subcutaneous
|
$166.20 |
$166.20 |
$166.20 |
$424.32
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$594.78 |
$594.78 |
$594.78 |
$563.36
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$222.60 |
$222.60 |
$222.60 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$172.20 |
$172.20 |
$172.20 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$343.80 |
$343.80 |
$343.80 |
$997.44
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$205.20 |
$205.20 |
$205.20 |
$499.62
|
|
Vaccine tdap >=7 years im
|
$102.42 |
$102.42 |
$102.42 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$88.74 |
$88.74 |
$88.74 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$135.00 |
$135.00 |
$135.00 |
$365.17
|
|
Vad univ batt charger hm 1440
|
$17,505.41 |
$17,505.41 |
$17,505.41 |
$14,827.28
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$26.58 |
$26.58 |
$26.58 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$105.60 |
$105.60 |
$105.60 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$63.00 |
$63.00 |
$63.00 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$95.52 |
$95.52 |
$95.52 |
$90.33
|
|
Vancomycin hcl injection
|
$148.80 |
$148.80 |
$148.80 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$108.60 |
$108.60 |
$108.60 |
$136.13
|
|
Varicella zoster antibody igg
|
$154.80 |
$154.80 |
$154.80 |
$86.80
|
|
Varus/valgus strap padded/li
|
$124.52 |
$124.52 |
$124.52 |
$115.53
|
|
Vasopressin 20 unit/ml intravenous solution
|
$195.60 |
$195.60 |
$195.60 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$22,295.34 |
$22,295.34 |
$22,295.34 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$1,540.00
|
|
Veeg intrmnt 2-12 hrs
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$961.00
|
|
Vein x-ray liver w/hemodynam
|
$3,119.40 |
$3,119.40 |
$3,119.40 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$3,119.40 |
$3,119.40 |
$3,119.40 |
$3,483.84
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$2,316.60 |
$2,316.60 |
$2,316.60 |
$202.80
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,924.20 |
$1,924.20 |
$1,924.20 |
$1,366.20
|
|
Ventilator each subsequent day
|
$441.00 |
$441.00 |
$441.00 |
$1,204.00
|
|
Ventilator initial day
|
$607.80 |
$607.80 |
$607.80 |
$1,431.43
|
|
Very long chain fatty acids
|
$107.40 |
$107.40 |
$107.40 |
$139.88
|
|
Vest large holster
|
$1,291.39 |
$1,291.39 |
$1,291.39 |
$1,078.25
|
