|
Unlisted transfusion med px
|
$39.60 |
$334.20 |
$2,944.20 |
$147.50
|
|
Unlisted ultrasound procedure
|
$78.60 |
$78.60 |
$78.60 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$684.60 |
$1,025.40 |
$1,704.60 |
$1,316.90
|
|
Upper Arm (Humerus) X-ray (left side)
|
$405.00 |
$456.60 |
$686.40 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,654.40 |
$3,054.00 |
$4,599.60 |
$1,680.60
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,740.00 |
$1,950.00 |
$2,937.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,810.40 |
$6,512.40 |
$9,808.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$4,621.20 |
$5,313.60 |
$8,004.00 |
$2,410.98
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,682.80 |
$4,125.00 |
$6,214.20 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$405.00 |
$456.60 |
$686.40 |
$322.50
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$405.00 |
$456.60 |
$686.40 |
$381.75
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,895.40 |
$2,978.40 |
$3,288.00 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,214.00 |
$3,973.20 |
$4,330.80 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$699.00 |
$903.60 |
$1,312.80 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$699.00 |
$903.60 |
$1,312.80 |
$612.00
|
|
Uppr gi scope w/submuc inj
|
$1,876.80 |
$2,978.40 |
$4,856.40 |
$1,872.00
|
|
Urea nitrogen
|
$33.60 |
$68.40 |
$173.40 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$39.60 |
$89.40 |
$322.80 |
$51.77
|
|
Urea nitrogen clearance
|
$60.60 |
$72.00 |
$214.80 |
$34.02
|
|
Ureteral embolization/occl
|
$6,966.60 |
$9,301.80 |
$10,911.00 |
$2,079.31
|
|
Ureteral reflux study
|
$2,370.00 |
$2,370.00 |
$2,370.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,868.40 |
$1,935.00 |
$2,813.40 |
$584.23
|
|
Urethrocystography void s&i
|
$437.40 |
$1,668.60 |
$2,813.40 |
$637.80
|
|
Uric acid blood
|
$33.00 |
$66.60 |
$147.00 |
$48.96
|
|
Uric acid urine
|
$21.60 |
$64.80 |
$375.00 |
$44.35
|
|
Urinalysis microscopic only
|
$52.80 |
$58.80 |
$666.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$378.00 |
$378.00 |
$378.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$52.80 |
$81.00 |
$468.60 |
$54.60
|
|
Urinalysis (without microscopy)
|
$34.80 |
$49.20 |
$71.40 |
$35.75
|
|
Urinary pouch on barr w/flng
|
$17.40 |
$165.00 |
$307.20 |
$9.89
|
|
Urinary suspensory
|
$32.40 |
$32.40 |
$52.20 |
$52.20
|
|
Urine Culture Test
|
$80.40 |
$173.40 |
$490.20 |
$81.27
|
|
Urine pregnancy test
|
$49.20 |
$83.40 |
$666.00 |
$67.80
|
|
Urography, antegrade
|
$1,624.80 |
$1,825.20 |
$2,813.40 |
$622.35
|
|
Use 1st target lesion
|
$945.00 |
$945.00 |
$945.00 |
$336.50
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$52.50 |
$55.80 |
$50,697.60 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$704.40 |
$704.40 |
$746.40 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$12.00 |
$12.00 |
$12.00 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$340.00 |
$340.20 |
$340.20 |
$227.04
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$193.20 |
$193.20 |
$193.20 |
$211.89
|
|
Vaccine dtap < 7 years im
|
$34.20 |
$34.20 |
$43.20 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$63.00 |
$63.00 |
$63.00 |
$165.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$31.20 |
$31.20 |
$31.20 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$81.00 |
$91.20 |
$108.00 |
$168.95
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$117.60 |
$117.60 |
$117.60 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$86.40 |
$86.40 |
$86.40 |
$80.28
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$64.80 |
$64.80 |
$86.40 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$126.60 |
$168.80 |
$881.40 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$49.80 |
$49.80 |
$49.80 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$186.00 |
$186.00 |
$186.00 |
$570.87
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$186.00 |
$186.00 |
$248.00 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$30.00 |
$30.00 |
$30.00 |
$143.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$13.20 |
$13.20 |
$13.20 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$12.00 |
$12.00 |
$13.20 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$12.00 |
$12.00 |
$12.60 |
$33.21
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$15.00 |
$15.00 |
$15.00 |
$20.80
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$57.00 |
$57.00 |
$57.00 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$18.00 |
$18.00 |
$24.00 |
$82.71
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$82.20 |
$82.20 |
$109.60 |
$400.03
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$73.20 |
$73.20 |
$73.20 |
$406.05
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$82.20 |
$97.80 |
$97.80 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$91.80 |
$91.80 |
$108.80 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$48.60 |
$48.60 |
$64.80 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$75.00 |
$75.00 |
$75.00 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$144.00 |
$144.00 |
$152.40 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$144.00 |
$144.00 |
$192.00 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.20 |
$40.20 |
$51.20 |
$90.70
|
|
Vaccine rabies im
|
$600.00 |
$600.00 |
$800.00 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$504.00 |
$504.00 |
$504.00 |
$521.74
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,195.80 |
$1,195.80 |
$1,196.00 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$980.10
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$440.40 |
$440.40 |
$440.40 |
$407.74
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$57.60 |
$57.60 |
$57.60 |
$126.50
|
|
Vaccine tdap >=7 years im
|
$31.80 |
$31.80 |
$42.40 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$55.80 |
$55.80 |
$74.40 |
$110.19
|
|
Vaccine typhoid vicps im
|
$46.80 |
$46.80 |
$46.80 |
$253.50
|
|
Vaccine varicella live subcutaneous
|
$82.20 |
$82.20 |
$82.20 |
$364.16
|
|
Vacuum drain bottle/tube kit
|
$158.40 |
$250.20 |
$2,748.00 |
$325.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$6,913.80 |
$6,913.80 |
$6,913.80 |
$1,932.00
|
|
Vad univ batt charger hm 1440
|
$43,092.60 |
$43,092.60 |
$43,092.60 |
$14,814.14
|
|
Vaginal bx
|
$112.80 |
$112.80 |
$112.80 |
$471.12
|
|
Vaginal Delivery (full care)
|
$4,748.40 |
$4,748.40 |
$4,748.40 |
$4,184.00
|
|
Valproic acid total therapeutic drug level
|
$86.40 |
$205.80 |
$490.80 |
$115.00
|
|
Valvuloplasty aortic
|
$6,420.60 |
$6,420.60 |
$9,243.60 |
$8,052.60
|
|
Valvuloplasty mitral
|
$17,108.40 |
$17,108.40 |
$17,108.40 |
$10,851.48
|
|
Valvuloplasty pulmonary
|
$14,880.00 |
$14,880.00 |
$14,880.00 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$0.60 |
$1.20 |
$8.40 |
$251.86
|
|
Vancomycin hcl injection
|
$25.80 |
$74.40 |
$280.20 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$93.60 |
$159.00 |
$1,366.20 |
$135.00
|
|
Varicella zoster antibody igg
|
$76.80 |
$128.40 |
$2,145.60 |
$86.80
|
|
Varicella-zoster immue globin im
|
$2,109.00 |
$2,109.00 |
$3,055.80 |
$3,816.19
|
|
Vasopressin 20 unit/ml intravenous solution
|
$7.95 |
$7.95 |
$8.00 |
$325.80
|
|
Vbac delivery 59610
|
$4,748.40 |
$4,748.40 |
$4,748.40 |
$4,492.00
|
|
Vedolizumab 300 mg intravenous solution
|
$73.80 |
$74.20 |
$22,174.80 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$1,062.60 |
$1,126.20 |
$1,502.40 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$2,109.60 |
$2,109.60 |
$2,811.60 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$553.80 |
$586.80 |
$783.60 |
$983.38
|
|
Veeg unmon 12-26 hrs
|
$1,126.20 |
$1,194.00 |
$1,502.40 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$553.80 |
$586.80 |
$783.60 |
$833.90
|
|
Vein x-ray adrenal gland
|
$8,292.00 |
$8,292.00 |
$8,292.00 |
$2,870.00
|
