|
Urinalysis (with microscopy)
|
$10.00 |
$27.60 |
$468.60 |
|
|
Urinalysis (without microscopy)
|
$10.00 |
$17.40 |
$80.40 |
|
|
Urinary bldr retent nuc study
|
$4.83 |
$221.40 |
$1,801.60 |
|
|
Urinary pouch on barr w/flng
|
$12.60 |
$165.00 |
$307.20 |
|
|
Urinary reflex study
|
$36.11 |
$36.11 |
$40.82 |
|
|
Urinary suspensory
|
$21.00 |
$23.40 |
$52.20 |
|
|
Urine Culture Test
|
$25.00 |
$54.60 |
$490.20 |
|
|
Urine flow measurement 51736
|
$5.29 |
$5.98 |
$154.00 |
|
|
Urine pregnancy test
|
$19.50 |
$63.00 |
$666.00 |
|
|
Urine screen for bacteria
|
$20.70 |
$20.70 |
$23.40 |
|
|
Urine shunt to intestine
|
$788.90 |
$788.90 |
$891.80 |
|
|
Urine specimen collect mult
|
$6.44 |
$6.44 |
$7.28 |
|
|
Urography, antegrade
|
$449.40 |
$896.40 |
$2,813.40 |
|
|
Urography inf drip &/or bolus
|
$64.80 |
$427.80 |
$716.10 |
|
|
Use 1st target lesion
|
$18.17 |
$20.54 |
$945.00 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$46.20 |
$67.20 |
$50,697.60 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$57.00 |
$16,705.20 |
$16,705.20 |
|
|
Vaccine Administration (one shot)
|
$12.00 |
$25.60 |
$205.60 |
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$131.50 |
$340.00 |
$340.20 |
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$113.00 |
$193.20 |
$209.40 |
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$59.80 |
$59.80 |
$228.00 |
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$45.00 |
$45.00 |
$45.00 |
|
|
Vaccine dtap < 7 years im
|
$14.22 |
$32.40 |
$75.60 |
|
|
Vaccine dtap-hep b-ipv im
|
$37.80 |
$63.00 |
$412.80 |
|
|
Vaccine dtap-ipv 4-6 years im
|
$31.20 |
$57.50 |
$543.60 |
|
|
Vaccine dtap-ipv/hib im
|
$65.40 |
$66.00 |
$282.00 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$28.00 |
$31.20 |
$31.20 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$6.58 |
$31.20 |
$51.00 |
|
|
Vaccine hepatitis a (hepa) adult im
|
$46.80 |
$81.00 |
$734.00 |
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$95.50 |
$156.80 |
$265.20 |
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$32.50 |
$43.80 |
$170.40 |
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$46.50 |
$46.50 |
$46.50 |
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$32.89 |
$86.40 |
$834.80 |
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$71.64 |
$168.80 |
$881.40 |
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$14.82 |
$63.20 |
$268.80 |
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$157.80 |
$186.00 |
$492.00 |
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$109.20 |
$186.00 |
$282.50 |
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$25.80 |
$30.00 |
$145.04 |
|
|
Vaccine influenza inactivated adjuvant im
|
$73.00 |
$167.20 |
$643.00 |
|
|
Vaccine influenza nos 0.5ml dose im
|
$12.00 |
$16.50 |
$32.56 |
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$13.20 |
$37.60 |
$144.60 |
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$12.00 |
$12.60 |
$13.20 |
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$69.00 |
$69.00 |
$69.00 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$12.00 |
$12.00 |
$12.60 |
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$12.00 |
$12.00 |
$14.40 |
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$10.00 |
$15.00 |
$15.00 |
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$25.80 |
$65.50 |
$76.20 |
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$18.00 |
$24.00 |
$76.23 |
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$10.00 |
$10.00 |
$16.28 |
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$82.20 |
$109.60 |
$385.20 |
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$73.20 |
$170.00 |
$818.40 |
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$82.20 |
$97.80 |
$413.60 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$91.80 |
$108.80 |
$384.60 |
|
|
Vaccine mmr live subcutaneous
|
$42.76 |
$64.80 |
$347.60 |
|
|
Vaccine mmrv live subcutaneous
|
$106.80 |
$136.80 |
$593.40 |
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$53.86 |
$75.00 |
$183.00 |
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$144.00 |
$144.00 |
$207.00 |
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$190.25 |
$190.25 |
$190.25 |
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$129.93 |
$192.00 |
$1,898.00 |
|
|
Vaccine polio (ipv) subcutaneous/im
|
$38.40 |
$40.20 |
$105.60 |
|
|
Vaccine rabies im
|
$199.92 |
$800.00 |
$1,368.40 |
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$177.00 |
$504.00 |
$672.00 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$750.80 |
$1,195.80 |
$1,196.00 |
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$289.19 |
$885.00 |
$1,195.80 |
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$228.00 |
$228.00 |
$440.40 |
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$63.00 |
$63.00 |
$373.20 |
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$57.60 |
$60.60 |
$126.60 |
|
|
Vaccine tdap >=7 years im
|
$31.80 |
$42.40 |
$466.60 |
|
|
Vaccine td preservative free >= 7 years im
|
$18.74 |
$55.80 |
$103.80 |
|
|
Vaccine typhoid vicps im
|
$39.00 |
$46.80 |
$192.60 |
|
|
Vaccine varicella live subcutaneous
|
$82.20 |
$228.60 |
$1,154.40 |
|
|
Vaccine yellow fever live subcutaneous
|
$205.50 |
$205.50 |
$205.50 |
|
|
Vacuum drain bottle/tube kit
|
$71.40 |
$211.80 |
$2,748.00 |
|
|
Vad battery clip set hmii 14-v li-ion
|
$6,913.80 |
$6,913.80 |
$6,913.80 |
|
|
Vad univ batt charger hm 1440
|
$43,092.60 |
$43,092.60 |
$43,092.60 |
|
|
Vag hys/<250g/rmv tube/rpr entero 58263
|
$643.08 |
$643.08 |
$726.96 |
|
|
Vag hyst incl t/o complex
|
$802.47 |
$802.47 |
$907.14 |
|
|
Vag hyst including t/o
|
$599.15 |
$677.30 |
$6,479.76 |
|
|
Vag hyst t/o & repair compl
|
$845.25 |
$845.25 |
$955.50 |
|
|
Vag hyst w/enterocele compl 58294
|
$785.45 |
$785.45 |
$887.90 |
|
|
Vag hyst w/enterocele repair
|
$577.76 |
$577.76 |
$653.12 |
|
|
Vaginal bx
|
$83.40 |
$114.60 |
$1,315.00 |
|
|
Vaginal delivery after cesarean delivery 59612
|
$584.20 |
$1,896.00 |
$7,823.28 |
|
|
Vaginal Delivery (full care)
|
$1,556.64 |
$1,759.68 |
$4,748.40 |
|
|
Vaginal hysterectomy
|
$541.88 |
$612.56 |
$2,015.67 |
|
|
Vaginectomy partial w/nodes
|
$1,120.56 |
$1,120.56 |
$1,266.72 |
|
|
Vagnc compl rmvl paravag tis
|
$1,120.56 |
$1,120.56 |
$1,266.72 |
|
|
Vagnc compl rmvl vag wall
|
$582.82 |
$582.82 |
$658.84 |
|
|
Vagotomy pfrmd w/prtl dstl gstrct 43635
|
$72.22 |
$72.22 |
$81.64 |
|
|
Vagotomy & pylorus repair
|
$780.39 |
$780.39 |
$882.18 |
|
|
Vagotomy & pylorus repair 43640
|
$771.88 |
$771.88 |
$872.56 |
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$4.13 |
$4.13 |
$4.13 |
|
|
Valproic acid total therapeutic drug level
|
$51.00 |
$97.20 |
$490.80 |
|
|
Valrubicin injection
|
$168.60 |
$168.60 |
$3,066.00 |
|
|
Valvuloplasty aortic
|
$839.27 |
$12,208.80 |
$16,032.84 |
|
|
Valvuloplasty aortic valve
|
$1,223.14 |
$1,223.14 |
$1,382.68 |
|
|
Valvuloplasty aortic valve
|
$1,449.46 |
$1,449.46 |
$1,638.52 |
|
|
Valvuloplasty mitral
|
$865.49 |
$23,686.20 |
$23,686.20 |
|
|
Valvuloplasty pulmonary
|
$692.53 |
$15,019.80 |
$15,019.80 |
|
|
Valvuloplasty/tv without ring insert 33463
|
$1,950.40 |
$1,950.40 |
$2,204.80 |
|
