|
Ultrasound exam k transpl w/doppler
|
$398.49 |
$398.49 |
$398.49 |
$494.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$294.06 |
$294.06 |
$294.06 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$155.49 |
$155.49 |
$155.49 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$289.99 |
$289.99 |
$289.99 |
$629.64
|
|
Ultrasound guide intraoperative
|
$193.42 |
$193.42 |
$193.42 |
$628.80
|
|
Ultrasound hips infant dynamic
|
$175.75 |
$175.75 |
$175.75 |
$395.20
|
|
Ultrasound infant hips ltd without stress
|
$93.80 |
$93.80 |
$93.80 |
$311.25
|
|
Ultrasound joint complete left
|
$205.63 |
$205.63 |
$205.63 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$154.75 |
$154.75 |
$154.75 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$192.22 |
$192.22 |
$192.22 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$125.34 |
$125.34 |
$125.34 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$479.89 |
$479.89 |
$479.89 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$446.22 |
$446.22 |
$446.22 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$350.02 |
$350.02 |
$350.02 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$272.04 |
$272.04 |
$272.04 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$295.45 |
$295.45 |
$295.45 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$277.13 |
$277.13 |
$277.13 |
$469.58
|
|
Ultrasound scrotum and contents
|
$299.15 |
$299.15 |
$299.15 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$175.01 |
$175.01 |
$175.01 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$137.55 |
$137.55 |
$137.55 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$378.88 |
$378.88 |
$378.88 |
$523.20
|
|
Umbilical artery cath newborn 36660
|
$293.78 |
$293.78 |
$293.78 |
$204.75
|
|
Unlisted procedure microbiology
|
$234.58 |
$234.58 |
$234.58 |
$384.15
|
|
Unlisted px male genital sys
|
$5,358.53 |
$5,358.53 |
$5,358.53 |
$1,925.04
|
|
Unlisted px pelvis/hip joint
|
$2,108.82 |
$2,108.82 |
$2,108.82 |
$8,660.60
|
|
Unlisted transfusion med px
|
$512.27 |
$512.27 |
$512.27 |
$113.36
|
|
Unlisted ultrasound procedure
|
$74.09 |
$74.09 |
$74.09 |
$335.00
|
|
Upgrade pm system
|
$4,096.36 |
$4,096.36 |
$4,096.36 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,390.28 |
$1,390.28 |
$1,390.28 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$972.27 |
$972.27 |
$972.27 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$976.62 |
$976.62 |
$976.62 |
$1,794.00
|
|
Upper Endoscopy (EGD, diagnostic)
|
$948.77 |
$948.77 |
$948.77 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$948.77 |
$948.77 |
$948.77 |
$1,760.00
|
|
Urea nitrogen
|
$20.44 |
$20.44 |
$20.44 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$32.47 |
$32.47 |
$32.47 |
$42.90
|
|
Urea nitrogen clearance
|
$47.73 |
$47.73 |
$47.73 |
$33.57
|
|
Ureteral reflux study
|
$406.35 |
$406.35 |
$406.35 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$257.15 |
$257.15 |
$257.15 |
$554.28
|
|
Urethrocystography void s&i
|
$269.36 |
$269.36 |
$269.36 |
$586.50
|
|
Uric acid blood
|
$25.25 |
$25.25 |
$25.25 |
$44.00
|
|
Uric acid urine
|
$23.59 |
$23.59 |
$23.59 |
$43.20
|
|
Urinalysis microscopic only
|
$22.57 |
$22.57 |
$22.57 |
$25.72
|
|
Urinalysis (with microscopy)
|
$33.02 |
$33.02 |
$33.02 |
$37.39
|
|
Urinalysis (without microscopy)
|
$21.46 |
$21.46 |
$21.46 |
$33.00
|
|
Urine Culture Test
|
$47.82 |
$47.82 |
$47.82 |
$63.84
|
|
Urine pregnancy test
|
$27.01 |
$27.01 |
$27.01 |
$57.00
|
|
Urography, antegrade
|
$297.67 |
$297.67 |
$297.67 |
$593.37
|
|
Urography inf drip &/or bolus
|
$292.12 |
$292.12 |
$292.12 |
$599.82
|
|
Use 1st target lesion
|
$114.33 |
$114.33 |
$114.33 |
$252.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$133.50 |
$133.50 |
$133.50 |
$8,225.22
|
|
Vaccine dtap < 7 years im
|
$51.45 |
$51.45 |
$51.45 |
$66.69
|
|
Vaccine dtap-hep b-ipv im
|
$128.52 |
$128.52 |
$128.52 |
$169.85
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$50.17 |
$50.17 |
$50.17 |
$39.78
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$166.00 |
$166.00 |
$166.00 |
$201.80
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$88.52 |
$88.52 |
$88.52 |
$162.07
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$35.61 |
$35.61 |
$35.61 |
$75.39
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$37.06 |
$37.06 |
$37.06 |
$29.60
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$160.73 |
$160.73 |
$160.73 |
$321.80
|
|
Vaccine mmr live subcutaneous
|
$115.29 |
$115.29 |
$115.29 |
$222.36
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$150.79 |
$150.79 |
$150.79 |
$195.69
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$270.03 |
$270.03 |
$270.03 |
$393.25
|
|
Vaccine polio (ipv) subcutaneous/im
|
$54.70 |
$54.70 |
$54.70 |
$100.00
|
|
Vaccine rabies im
|
$595.40 |
$595.40 |
$595.40 |
$800.00
|
|
Vaccine tdap >=7 years im
|
$61.66 |
$61.66 |
$61.66 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$53.22 |
$53.22 |
$53.22 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$53.00 |
$53.00 |
$53.00 |
$100.80
|
|
Valvuloplasty aortic
|
$7,020.01 |
$7,020.01 |
$7,020.01 |
$7,826.12
|
|
Valvuloplasty mitral
|
$6,699.13 |
$6,699.13 |
$6,699.13 |
$10,435.39
|
|
Vancomycin peak therapeutic drug level
|
$90.84 |
$90.84 |
$90.84 |
$116.00
|
|
Varicella zoster antibody igg
|
$128.11 |
$128.11 |
$128.11 |
$90.35
|
|
Vedolizumab 300 mg intravenous solution
|
$50.88 |
$50.88 |
$50.88 |
$22,019.50
|
|
Vein x-ray adrenal gland
|
$1,190.85 |
$1,190.85 |
$1,190.85 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$4,171.01 |
$4,171.01 |
$4,171.01 |
$3,353.84
|
|
Vein x-ray eye socket
|
$815.39 |
$815.39 |
$815.39 |
$1,128.41
|
|
Vein x-ray kidney
|
$1,190.85 |
$1,190.85 |
$1,190.85 |
$2,600.00
|
|
Vein x-ray liver
|
$1,396.01 |
$1,396.01 |
$1,396.01 |
$2,740.00
|
|
Vein x-ray liver w/hemodynam
|
$1,213.60 |
$1,213.60 |
$1,213.60 |
$2,669.10
|
|
Vein x-ray liver w/hemodynam
|
$1,274.28 |
$1,274.28 |
$1,274.28 |
$3,368.95
|
|
Vein x-ray liver without hemodyn
|
$766.36 |
$766.36 |
$766.36 |
$2,015.91
|
|
Vein x-ray skull
|
$348.82 |
$348.82 |
$348.82 |
$2,122.85
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$14.80 |
$14.80 |
$14.80 |
$123.00
|
|
Venogram ext bil s&i
|
$890.50 |
$890.50 |
$890.50 |
$1,697.72
|
|
Venogram extremity supervision & interpretation unilateral
|
$610.50 |
$610.50 |
$610.50 |
$1,270.23
|
|
Venous mech thrombectomy
|
$2,388.81 |
$2,388.81 |
$2,388.81 |
$9,059.31
|
|
Venous m-thrombectomy add-on
|
$2,004.66 |
$2,004.66 |
$2,004.66 |
$5,452.00
|
|
Venous sampling s&i
|
$4,171.01 |
$4,171.01 |
$4,171.01 |
$3,800.23
|
|
Ventilator each subsequent day
|
$286.84 |
$286.84 |
$286.84 |
$1,138.50
|
|
Ventilator initial day
|
$354.55 |
$354.55 |
$354.55 |
$1,331.00
|
|
Ventricular puncture prev burr hole without inj 61020
|
$111.09 |
$111.09 |
$111.09 |
$1,018.50
|
|
Version cephalic external
|
$1,642.06 |
$1,642.06 |
$1,642.06 |
$2,361.75
|
|
Very long chain fatty acids
|
$150.96 |
$150.96 |
$150.96 |
$157.30
|
|
Vinblastine 1 mg/ml intravenous solution
|
$20.48 |
$20.48 |
$20.48 |
$159.60
|
|
Vincristine 1 mg/ml intravenous solution
|
$36.41 |
$36.41 |
$36.41 |
$52.02
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$54.06 |
$54.06 |
$54.06 |
$177.04
|
|
Vital capacity test
|
$84.92 |
$84.92 |
$84.92 |
$170.00
|
|
Vitamin b-12
|
$49.67 |
$49.67 |
$49.67 |
$89.70
|
|
Vitamin D Test
|
$131.17 |
$131.17 |
$131.17 |
$132.60
|
|
Vkorc1 gene
|
$318.85 |
$318.85 |
$318.85 |
$176.80
|
|
Volume measurement urine timed
|
$11.38 |
$11.38 |
$11.38 |
$17.40
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$59.11 |
$59.11 |
$59.11 |
$59.11
|
