|
Ultrasound abdomen aorta screening study aaa
|
$395.20 |
$395.20 |
$395.20 |
$403.26
|
|
Ultrasound breast complete
|
$1,251.90 |
$1,251.90 |
$1,251.90 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,001.00 |
$1,001.00 |
$1,001.00 |
$449.35
|
|
Ultrasound chest
|
$531.05 |
$531.05 |
$531.05 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$592.15 |
$592.15 |
$592.15 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$506.35 |
$506.35 |
$506.35 |
$284.25
|
|
Ultrasound encephalogram
|
$668.85 |
$668.85 |
$668.85 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$524.55 |
$524.55 |
$524.55 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$805.35 |
$805.35 |
$805.35 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$825.50 |
$825.50 |
$825.50 |
$701.35
|
|
Ultrasound guide intraoperative
|
$991.90 |
$991.90 |
$991.90 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,216.15 |
$1,216.15 |
$1,216.15 |
$498.40
|
|
Ultrasound joint complete left
|
$848.90 |
$848.90 |
$848.90 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$536.25 |
$536.25 |
$536.25 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$380.25 |
$380.25 |
$380.25 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$339.30 |
$339.30 |
$339.30 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$902.20 |
$902.20 |
$902.20 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$711.75 |
$711.75 |
$711.75 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$438.75 |
$438.75 |
$438.75 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$601.90 |
$601.90 |
$601.90 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$887.25 |
$887.25 |
$887.25 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$523.90 |
$523.90 |
$523.90 |
$498.00
|
|
Ultrasound scrotum and contents
|
$622.05 |
$622.05 |
$622.05 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$665.60 |
$665.60 |
$665.60 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$535.60 |
$535.60 |
$535.60 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$717.60 |
$717.60 |
$717.60 |
$567.44
|
|
Unlisted CT procedure
|
$1,888.90 |
$1,888.90 |
$1,888.90 |
$1,043.00
|
|
Unlisted fluoroscopic px
|
$1,747.85 |
$1,747.85 |
$1,747.85 |
$324.85
|
|
Unlisted mr procedure
|
$308.10 |
$308.10 |
$308.10 |
$1,032.20
|
|
Unlisted procedure colon
|
$549.25 |
$549.25 |
$549.25 |
$1,580.44
|
|
Unlisted procedure microbiology
|
$565.50 |
$565.50 |
$565.50 |
$487.50
|
|
Unlisted procedure pancreas
|
$1,646.45 |
$1,646.45 |
$1,646.45 |
$2,967.75
|
|
Unlisted procedure spine
|
$4,256.20 |
$4,256.20 |
$4,256.20 |
$4,706.35
|
|
Unlisted px biliary tract
|
$1,646.45 |
$1,646.45 |
$1,646.45 |
$2,718.10
|
|
Unlisted px male genital sys
|
$468.00 |
$468.00 |
$468.00 |
$897.95
|
|
Unlisted px pelvis/hip joint
|
$1,519.70 |
$1,519.70 |
$1,519.70 |
$2,108.82
|
|
Unlisted px small intestine
|
$549.25 |
$549.25 |
$549.25 |
$2,118.35
|
|
Unlisted reprod med lab proc
|
$197.60 |
$197.60 |
$197.60 |
$70.00
|
|
Unlisted ultrasound procedure
|
$1,065.35 |
$1,065.35 |
$1,065.35 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$3,386.50 |
$3,386.50 |
$3,386.50 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,143.70 |
$2,143.70 |
$2,143.70 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,859.65 |
$1,859.65 |
$1,859.65 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,742.65 |
$1,742.65 |
$1,742.65 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,899.00 |
$2,899.00 |
$2,899.00 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$3,080.35 |
$3,080.35 |
$3,080.35 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$3,515.85 |
$3,515.85 |
$3,515.85 |
$1,773.85
|
|
Urea nitrogen
|
$9.75 |
$9.75 |
$9.75 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$78.00 |
$78.00 |
$78.00 |
$50.00
|
|
Urea nitrogen clearance
|
$51.35 |
$51.35 |
$51.35 |
$33.57
|
|
Ureteral embolization/occl
|
$895.70 |
$895.70 |
$895.70 |
$3,041.22
|
|
Urethrcystgrphy rtrgrde s&i
|
$734.50 |
$734.50 |
$734.50 |
$574.40
|
|
Urethrocystography void s&i
|
$702.65 |
$702.65 |
$702.65 |
$634.50
|
|
Uric acid blood
|
$19.50 |
$19.50 |
$19.50 |
$46.64
|
|
Uric acid urine
|
$134.55 |
$134.55 |
$134.55 |
$46.75
|
|
Urinalysis microscopic only
|
$32.50 |
$32.50 |
$32.50 |
$26.35
|
|
Urinalysis (with microscopy)
|
$16.90 |
$16.90 |
$16.90 |
$48.14
|
|
Urinalysis (without microscopy)
|
$22.75 |
$22.75 |
$22.75 |
$38.99
|
|
Urine Culture Test
|
$116.35 |
$116.35 |
$116.35 |
$84.81
|
|
Urine pregnancy test
|
$141.05 |
$141.05 |
$141.05 |
$66.40
|
|
Urography, antegrade
|
$990.60 |
$990.60 |
$990.60 |
$593.37
|
|
Vaccine dtap < 7 years im
|
$93.63 |
$93.63 |
$93.63 |
$87.80
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$109.69 |
$109.69 |
$109.69 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$303.88 |
$303.88 |
$303.88 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$89.80 |
$89.80 |
$89.80 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$78.31 |
$78.31 |
$78.31 |
$40.01
|
|
Vaccine mmr live subcutaneous
|
$294.94 |
$294.94 |
$294.94 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$397.72 |
$397.72 |
$397.72 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$835.92 |
$835.92 |
$835.92 |
$715.41
|
|
Vaccine rabies im
|
$938.82 |
$938.82 |
$938.82 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$148.10 |
$148.10 |
$148.10 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$144.53 |
$144.53 |
$144.53 |
$131.77
|
|
Vaginal bx
|
$549.25 |
$549.25 |
$549.25 |
$441.75
|
|
Valproic acid total therapeutic drug level
|
$101.40 |
$101.40 |
$101.40 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$105.85 |
$105.85 |
$105.85 |
$180.00
|
|
Vancomycin hcl injection
|
$17.00 |
$17.00 |
$17.00 |
$92.63
|
|
Vancomycin peak therapeutic drug level
|
$78.65 |
$78.65 |
$78.65 |
$126.79
|
|
Varicella zoster antibody igg
|
$158.60 |
$158.60 |
$158.60 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$36.46 |
$36.46 |
$36.46 |
$382.25
|
|
Vedolizumab 300 mg intravenous solution
|
$30,377.88 |
$30,377.88 |
$30,377.88 |
$21,250.13
|
|
Veeg cont 2-12 hrs
|
$5,936.45 |
$5,936.45 |
$5,936.45 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$10,367.50 |
$10,367.50 |
$10,367.50 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$5,936.45 |
$5,936.45 |
$5,936.45 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$10,367.50 |
$10,367.50 |
$10,367.50 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$5,936.45 |
$5,936.45 |
$5,936.45 |
$704.79
|
|
Vein x-ray adrenal gland
|
$2,891.20 |
$2,891.20 |
$2,891.20 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$6,376.50 |
$6,376.50 |
$6,376.50 |
$3,999.60
|
|
Vein x-ray kidney
|
$6,896.50 |
$6,896.50 |
$6,896.50 |
$2,716.20
|
|
Vein x-ray liver
|
$4,310.15 |
$4,310.15 |
$4,310.15 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$9,536.15 |
$9,536.15 |
$9,536.15 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$9,223.50 |
$9,223.50 |
$9,223.50 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$6,513.65 |
$6,513.65 |
$6,513.65 |
$2,489.25
|
|
Vein x-ray skull
|
$4,845.75 |
$4,845.75 |
$4,845.75 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$2,761.20 |
$2,761.20 |
$2,761.20 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$6,282.25 |
$6,282.25 |
$6,282.25 |
$3,450.30
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$772.20 |
$772.20 |
$772.20 |
$188.65
|
|
Venogram ext bil s&i
|
$4,657.90 |
$4,657.90 |
$4,657.90 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$4,325.10 |
$4,325.10 |
$4,325.10 |
$1,326.00
|
|
Venous sampling s&i
|
$9,536.15 |
$9,536.15 |
$9,536.15 |
$4,416.78
|
|
Ventilator each subsequent day
|
$689.00 |
$689.00 |
$689.00 |
$1,305.92
|
|
Ventilator initial day
|
$1,087.45 |
$1,087.45 |
$1,087.45 |
$1,540.80
|
