|
Unlisted px small intestine
|
$3,857.33 |
$3,857.33 |
$3,857.33 |
|
|
Unlisted transfusion med px
|
$156.00 |
$512.27 |
$512.27 |
|
|
Unlisted ultrasound procedure
|
$74.09 |
$74.09 |
$313.30 |
|
|
Unsched dialysis esrd pt hos
|
$980.20 |
$1,280.50 |
$1,329.90 |
|
|
Upgrade pm system
|
$4,096.36 |
$4,096.36 |
$26,338.65 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,390.28 |
$2,889.25 |
$5,011.00 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$972.27 |
$972.27 |
$3,215.55 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$976.62 |
$2,037.75 |
$3,948.00 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$948.77 |
$2,637.15 |
$2,963.48 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$948.77 |
$2,990.38 |
$3,662.96 |
|
|
Uppr gi scope w/submuc inj
|
$4,112.87 |
$4,112.87 |
$4,112.87 |
|
|
Urea nitrogen
|
$20.44 |
$36.40 |
$63.00 |
|
|
Urea nitrogen 24 hour urine
|
$32.47 |
$37.70 |
$86.00 |
|
|
Urea nitrogen clearance
|
$47.73 |
$47.73 |
$47.73 |
|
|
Ureteral reflux study
|
$406.35 |
$406.35 |
$1,175.85 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$23.00 |
$257.15 |
$985.40 |
|
|
Urethrocystography void s&i
|
$88.00 |
$269.36 |
$690.00 |
|
|
Uric acid blood
|
$16.25 |
$25.25 |
$45.00 |
|
|
Uric acid urine
|
$23.59 |
$40.95 |
$76.05 |
|
|
Urinalysis microscopic only
|
$8.45 |
$22.57 |
$28.60 |
|
|
Urinalysis (with microscopy)
|
$11.05 |
$33.02 |
$59.80 |
|
|
Urinalysis (without microscopy)
|
$21.46 |
$39.65 |
$160.55 |
|
|
Urine Culture Test
|
$28.60 |
$47.82 |
$91.00 |
|
|
Urine pregnancy test
|
$26.00 |
$53.00 |
$205.40 |
|
|
Urography, antegrade
|
$297.67 |
$297.67 |
$702.65 |
|
|
Urography inf drip &/or bolus
|
$292.12 |
$292.12 |
$292.12 |
|
|
Use 1st target lesion
|
$114.33 |
$114.33 |
$252.85 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$133.50 |
$133.50 |
$16,296.36 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$89,537.92 |
$89,537.92 |
$111,850.54 |
|
|
Vaccine dtap < 7 years im
|
$51.45 |
$51.45 |
$142.69 |
|
|
Vaccine dtap-hep b-ipv im
|
$0.01 |
$128.52 |
$470.09 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$50.17 |
$50.17 |
$57.57 |
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$166.00 |
$166.00 |
$166.00 |
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$388.53 |
$388.53 |
$432.98 |
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$88.52 |
$88.52 |
$362.46 |
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$722.21 |
$722.21 |
$722.21 |
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.01 |
$35.61 |
$139.02 |
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,436.32 |
$1,436.32 |
$1,436.32 |
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$373.94 |
$373.94 |
$641.10 |
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$86.35 |
$86.35 |
$96.23 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$37.06 |
$37.06 |
$37.06 |
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,096.08 |
$1,096.08 |
$1,096.08 |
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$771.49 |
$771.49 |
$859.75 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$160.73 |
$160.73 |
$769.73 |
|
|
Vaccine mmr live subcutaneous
|
$115.29 |
$115.29 |
$466.73 |
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$150.79 |
$150.79 |
$878.11 |
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$270.03 |
$270.03 |
$270.03 |
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,346.83 |
$1,346.83 |
$2,309.10 |
|
|
Vaccine polio (ipv) subcutaneous/im
|
$54.70 |
$54.70 |
$205.87 |
|
|
Vaccine rabies im
|
$595.40 |
$595.40 |
$1,527.99 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,603.09 |
$2,603.09 |
$2,603.09 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$2,603.09 |
$2,603.09 |
$2,603.09 |
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$446.17 |
$446.17 |
$446.17 |
|
|
Vaccine tdap >=7 years im
|
$61.66 |
$213.61 |
$366.23 |
|
|
Vaccine td preservative free >= 7 years im
|
$53.22 |
$53.22 |
$216.51 |
|
|
Vaccine varicella live subcutaneous
|
$837.13 |
$932.91 |
$932.91 |
|
|
Vag hyst including t/o
|
$9,670.75 |
$9,670.75 |
$9,670.75 |
|
|
Vaginal bx
|
$4,554.76 |
$4,554.76 |
$6,009.00 |
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$21.87 |
$29.31 |
$32.66 |
|
|
Valproic acid total therapeutic drug level
|
$53.00 |
$72.80 |
$383.50 |
|
|
Valvuloplasty aortic
|
$7,020.01 |
$7,020.01 |
$7,020.01 |
|
|
Valvuloplasty mitral
|
$6,699.13 |
$6,699.13 |
$6,699.13 |
|
|
Vancomycin 1,000 mg intravenous injection
|
$46.48 |
$78.19 |
$2,187.25 |
|
|
Vancomycin 750 mg intravenous solution
|
$117.58 |
$187.24 |
$187.24 |
|
|
Vancomycin peak therapeutic drug level
|
$90.84 |
$117.00 |
$197.00 |
|
|
Varicella zoster antibody igg
|
$65.00 |
$128.11 |
$209.95 |
|
|
Varicella-zoster immue globin im
|
$3,936.48 |
$3,936.48 |
$3,936.48 |
|
|
Vasopressin 20 unit/ml intravenous solution
|
$459.78 |
$459.78 |
$788.29 |
|
|
Vedolizumab 300 mg intravenous solution
|
$50.88 |
$50.88 |
$36,962.83 |
|
|
Veeg intrmnt 2-12 hrs
|
$2,811.90 |
$2,811.90 |
$2,811.90 |
|
|
Veeg unmon 12-26 hrs
|
$2,645.50 |
$2,645.50 |
$2,645.50 |
|
|
Vein x-ray adrenal gland
|
$1,190.85 |
$1,190.85 |
$4,181.45 |
|
|
Vein x-ray adrenal glands
|
$4,171.01 |
$4,171.01 |
$4,171.01 |
|
|
Vein x-ray eye socket
|
$815.39 |
$815.39 |
$1,497.60 |
|
|
Vein x-ray kidney
|
$1,190.85 |
$1,190.85 |
$5,837.65 |
|
|
Vein x-ray liver
|
$1,396.01 |
$1,396.01 |
$1,852.50 |
|
|
Vein x-ray liver w/hemodynam
|
$1,213.60 |
$1,213.60 |
$1,946.75 |
|
|
Vein x-ray liver w/hemodynam
|
$1,274.28 |
$1,274.28 |
$3,466.45 |
|
|
Vein x-ray liver without hemodyn
|
$766.36 |
$766.36 |
$1,553.50 |
|
|
Vein x-ray skull
|
$348.82 |
$348.82 |
$2,117.05 |
|
|
Vein x-ray skull epidural
|
$1,249.95 |
$1,249.95 |
$1,249.95 |
|
|
Vein x-ray spleen/liver
|
$4,716.40 |
$4,716.40 |
$4,716.40 |
|
|
Vemp test i&r cervical
|
$399.10 |
$399.10 |
$399.10 |
|
|
Vemp test i&r ocular
|
$328.90 |
$328.90 |
$328.90 |
|
|
Vemp tst i&r cervical&ocular
|
$804.05 |
$804.05 |
$804.05 |
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$14.80 |
$14.80 |
$4,600.24 |
|
|
Venipuncture <3 yrs other vein
|
$13.65 |
$29.00 |
$97.50 |
|
|
Venogram ext bil s&i
|
$890.50 |
$1,257.75 |
$1,935.00 |
|
|
Venogram extremity supervision & interpretation unilateral
|
$610.50 |
$1,060.15 |
$1,631.00 |
|
|
Venous mech thrombectomy
|
$2,388.81 |
$2,388.81 |
$6,297.85 |
|
|
Venous m-thrombectomy add-on
|
$2,004.66 |
$2,004.66 |
$2,004.66 |
|
|
Venous sampling s&i
|
$4,171.01 |
$4,171.01 |
$7,471.10 |
|
|
Ventilator each subsequent day
|
$286.84 |
$558.35 |
$2,766.40 |
|
|
Ventilator initial day
|
$354.55 |
$1,005.55 |
$5,580.25 |
|
|
Ventricular puncture prev burr hole without inj 61020
|
$111.09 |
$111.09 |
$111.09 |
|
|
Version cephalic external
|
$1,642.06 |
$1,743.30 |
$3,357.25 |
|
|
Very long chain fatty acids
|
$111.15 |
$150.96 |
$207.00 |
|
|
V-exc/lip/w/pri linear closure 40520
|
$7,606.49 |
$7,606.49 |
$7,606.49 |
|
|
Vinblastine 1 mg/ml intravenous solution
|
$20.48 |
$20.48 |
$259.61 |
|
|
Vincristine 1 mg/ml intravenous solution
|
$36.41 |
$36.41 |
$171.94 |
|
