|
Ultrasound scrotum and contents
|
$534.30 |
$534.30 |
$534.30 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$525.20 |
$525.20 |
$525.20 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$546.00 |
$546.00 |
$546.00 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$458.90 |
$458.90 |
$458.90 |
$567.44
|
|
Unlisted CT procedure
|
$1,713.40 |
$1,713.40 |
$1,713.40 |
$1,043.00
|
|
Unlisted fluoroscopic px
|
$2,819.05 |
$2,819.05 |
$2,819.05 |
$324.85
|
|
Unlisted mr procedure
|
$325.65 |
$325.65 |
$325.65 |
$1,032.20
|
|
Unlisted procedure microbiology
|
$131.30 |
$131.30 |
$131.30 |
$487.50
|
|
Unlisted procedure pancreas
|
$1,317.55 |
$1,317.55 |
$1,317.55 |
$2,967.75
|
|
Unlisted procedure spine
|
$3,405.35 |
$3,405.35 |
$3,405.35 |
$4,706.35
|
|
Unlisted px biliary tract
|
$1,317.55 |
$1,317.55 |
$1,317.55 |
$2,718.10
|
|
Unlisted px male genital sys
|
$374.40 |
$374.40 |
$374.40 |
$897.95
|
|
Unlisted px pelvis/hip joint
|
$1,216.15 |
$1,216.15 |
$1,216.15 |
$2,108.82
|
|
Unlisted px small intestine
|
$439.40 |
$439.40 |
$439.40 |
$2,118.35
|
|
Unlisted reprod med lab proc
|
$152.10 |
$152.10 |
$152.10 |
$70.00
|
|
Unlisted ultrasound procedure
|
$289.25 |
$289.25 |
$289.25 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$2,709.20 |
$2,709.20 |
$2,709.20 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,925.30 |
$1,925.30 |
$1,925.30 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,604.85 |
$1,604.85 |
$1,604.85 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,337.05 |
$1,337.05 |
$1,337.05 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,868.75 |
$1,868.75 |
$1,868.75 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,868.75 |
$1,868.75 |
$1,868.75 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$1,868.75 |
$1,868.75 |
$1,868.75 |
$1,773.85
|
|
Urea nitrogen
|
$20.15 |
$20.15 |
$20.15 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$24.05 |
$24.05 |
$24.05 |
$50.00
|
|
Urea nitrogen clearance
|
$42.25 |
$42.25 |
$42.25 |
$33.57
|
|
Ureteral embolization/occl
|
$716.95 |
$716.95 |
$716.95 |
$3,041.22
|
|
Urethrcystgrphy rtrgrde s&i
|
$697.45 |
$697.45 |
$697.45 |
$574.40
|
|
Urethrocystography void s&i
|
$697.45 |
$697.45 |
$697.45 |
$634.50
|
|
Uric acid blood
|
$11.05 |
$11.05 |
$11.05 |
$46.64
|
|
Uric acid urine
|
$27.95 |
$27.95 |
$27.95 |
$46.75
|
|
Urinalysis microscopic only
|
$7.80 |
$7.80 |
$7.80 |
$26.35
|
|
Urinalysis (with microscopy)
|
$20.15 |
$20.15 |
$20.15 |
$48.14
|
|
Urinalysis (without microscopy)
|
$22.10 |
$22.10 |
$22.10 |
$38.99
|
|
Urine Culture Test
|
$38.35 |
$38.35 |
$38.35 |
$84.81
|
|
Urine pregnancy test
|
$16.90 |
$16.90 |
$16.90 |
$66.40
|
|
Urography, antegrade
|
$1,032.85 |
$1,032.85 |
$1,032.85 |
$593.37
|
|
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
|
$92.72 |
$92.72 |
$92.72 |
$48.29
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$389.71 |
$389.71 |
$389.71 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$666.33 |
$666.33 |
$666.33 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$794.21 |
$794.21 |
$794.21 |
$715.41
|
|
Vaccine rabies im
|
$965.46 |
$965.46 |
$965.46 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$167.54 |
$167.54 |
$167.54 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$144.53 |
$144.53 |
$144.53 |
$131.77
|
|
Vaginal bx
|
$439.40 |
$439.40 |
$439.40 |
$441.75
|
|
Valproic acid total therapeutic drug level
|
$33.80 |
$33.80 |
$33.80 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$28.50 |
$28.50 |
$28.50 |
$204.01
|
|
Vancomycin hcl injection
|
$13.92 |
$13.92 |
$13.92 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$33.80 |
$33.80 |
$33.80 |
$126.79
|
|
Varicella zoster antibody igg
|
$59.80 |
$59.80 |
$59.80 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$59.08 |
$59.08 |
$59.08 |
$394.13
|
|
Veeg cont 2-12 hrs
|
$4,267.90 |
$4,267.90 |
$4,267.90 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$7,453.55 |
$7,453.55 |
$7,453.55 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$4,267.90 |
$4,267.90 |
$4,267.90 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$7,453.55 |
$7,453.55 |
$7,453.55 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$4,267.90 |
$4,267.90 |
$4,267.90 |
$704.79
|
|
Vein x-ray adrenal gland
|
$1,794.00 |
$1,794.00 |
$1,794.00 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$2,405.65 |
$2,405.65 |
$2,405.65 |
$3,999.60
|
|
Vein x-ray kidney
|
$5,296.85 |
$5,296.85 |
$5,296.85 |
$2,716.20
|
|
Vein x-ray liver
|
$3,310.45 |
$3,310.45 |
$3,310.45 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$7,324.20 |
$7,324.20 |
$7,324.20 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$7,083.70 |
$7,083.70 |
$7,083.70 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$5,003.05 |
$5,003.05 |
$5,003.05 |
$2,489.25
|
|
Vein x-ray skull
|
$3,721.90 |
$3,721.90 |
$3,721.90 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$2,120.95 |
$2,120.95 |
$2,120.95 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$4,824.95 |
$4,824.95 |
$4,824.95 |
$3,450.30
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$549.25 |
$549.25 |
$549.25 |
$188.65
|
|
Venogram ext bil s&i
|
$1,958.45 |
$1,958.45 |
$1,958.45 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,220.05 |
$1,220.05 |
$1,220.05 |
$1,326.00
|
|
Venous sampling s&i
|
$7,324.20 |
$7,324.20 |
$7,324.20 |
$4,416.78
|
|
Ventilator each subsequent day
|
$917.80 |
$917.80 |
$917.80 |
$1,305.92
|
|
Ventilator initial day
|
$917.80 |
$917.80 |
$917.80 |
$1,540.80
|
|
Version cephalic external
|
$1,043.90 |
$1,043.90 |
$1,043.90 |
$2,598.57
|
|
Very long chain fatty acids
|
$127.40 |
$127.40 |
$127.40 |
$140.40
|
|
Virus isolation addl studies ea
|
$91.00 |
$91.00 |
$91.00 |
$90.35
|
|
Visit established high 40-54 minutes/level 5
|
$204.75 |
$204.75 |
$204.75 |
$179.40
|
|
Vitamin b-12
|
$31.20 |
$31.20 |
$31.20 |
$94.90
|
|
Vitamin D Test
|
$72.80 |
$72.80 |
$72.80 |
$132.00
|
|
Volume measurement urine timed
|
$12.35 |
$12.35 |
$12.35 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$202.22 |
$202.22 |
$202.22 |
$224.40
|
|
Warde 1003990 aldosterone
|
$100.10 |
$100.10 |
$100.10 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$100.10 |
$100.10 |
$100.10 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$68.25 |
$68.25 |
$68.25 |
$72.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$62.40 |
$62.40 |
$62.40 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$38.35 |
$38.35 |
$38.35 |
$69.55
|
|
Warde 1015200 kappa light chain free
|
$367.90 |
$367.90 |
$367.90 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$24.05 |
$24.05 |
$24.05 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$72.80 |
$72.80 |
$72.80 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$78.00 |
$78.00 |
$78.00 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$65.65 |
$65.65 |
$65.65 |
$69.00
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$57.20 |
$57.20 |
$57.20 |
$55.25
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$27.30 |
$27.30 |
$27.30 |
$63.05
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$78.00 |
$78.00 |
$78.00 |
$78.57
|
|
Warde 3400852 arsenic
|
$46.80 |
$46.80 |
$46.80 |
$105.12
|
|
Warde 3708165 mercury urine
|
$39.65 |
$39.65 |
$39.65 |
$72.80
|
|
Warde actin (smooth muscle) antibody each
|
$191.10 |
$191.10 |
$191.10 |
$45.58
|
|
Warde adenosine deaminase pleural fluid
|
$261.95 |
$261.95 |
$261.95 |
$91.76
|
|
Warde adrenocorticotropic hormone (acth)
|
$95.55 |
$95.55 |
$95.55 |
$129.75
|
|
Warde aldolase
|
$24.05 |
$24.05 |
$24.05 |
$49.20
|