|
Unlisted ultrasound procedure
|
$93.90 |
$93.90 |
$93.90 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$166.80 |
$166.80 |
$166.80 |
$1,268.17
|
|
Upgrade pm system
|
$4,780.35 |
$4,780.35 |
$4,780.35 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$426.60 |
$426.60 |
$426.60 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$384.60 |
$384.60 |
$384.60 |
$1,768.00
|
|
Urea nitrogen
|
$6.90 |
$6.90 |
$6.90 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$7.95 |
$7.95 |
$7.95 |
$51.75
|
|
Ureteral reflux study
|
$182.70 |
$182.70 |
$182.70 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$119.55 |
$119.55 |
$119.55 |
$579.73
|
|
Urethrocystography void s&i
|
$119.55 |
$119.55 |
$119.55 |
$622.35
|
|
Uric acid blood
|
$7.95 |
$7.95 |
$7.95 |
$48.75
|
|
Uric acid urine
|
$8.40 |
$8.40 |
$8.40 |
$44.33
|
|
Urinalysis microscopic only
|
$5.40 |
$5.40 |
$5.40 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$3.75 |
$3.75 |
$3.75 |
$25.72
|
|
Urinalysis (with microscopy)
|
$5.70 |
$5.70 |
$5.70 |
$55.00
|
|
Urinalysis (without microscopy)
|
$3.90 |
$3.90 |
$3.90 |
$35.75
|
|
Urine Culture Test
|
$13.95 |
$13.95 |
$13.95 |
$81.50
|
|
Urine flow measurement 51736
|
$54.75 |
$54.75 |
$54.75 |
$210.00
|
|
Urine pregnancy test
|
$11.10 |
$11.10 |
$11.10 |
$67.20
|
|
Urography, antegrade
|
$119.55 |
$119.55 |
$119.55 |
$622.35
|
|
Urography inf drip &/or bolus
|
$119.55 |
$119.55 |
$119.55 |
$642.50
|
|
Use 1st target lesion
|
$152.10 |
$152.10 |
$152.10 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$6,582.93 |
$6,582.93 |
$6,582.93 |
$5,184.34
|
|
Vaccine dtap < 7 years im
|
$57.05 |
$57.05 |
$57.05 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$129.87 |
$129.87 |
$129.87 |
$164.63
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$29.35 |
$29.35 |
$29.35 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$136.12 |
$136.12 |
$136.12 |
$166.62
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$57.08 |
$57.08 |
$57.08 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$55.58 |
$55.58 |
$55.58 |
$75.39
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$23.12 |
$23.12 |
$24.23 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$290.32 |
$290.32 |
$290.32 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$207.95 |
$207.95 |
$207.95 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$155.02 |
$155.02 |
$159.55 |
$211.68
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$326.57 |
$326.57 |
$326.57 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$359.12 |
$359.12 |
$359.12 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$68.78 |
$68.78 |
$68.78 |
$90.70
|
|
Vaccine rabies im
|
$546.67 |
$546.67 |
$546.67 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$79.54 |
$79.54 |
$79.54 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$67.32 |
$67.32 |
$67.32 |
$112.10
|
|
Vaginal bx
|
$246.60 |
$246.60 |
$246.60 |
$455.94
|
|
Valproic acid total therapeutic drug level
|
$23.70 |
$23.70 |
$23.70 |
$114.72
|
|
Valvuloplasty aortic
|
$4,357.65 |
$4,357.65 |
$4,357.65 |
$7,830.80
|
|
Valvuloplasty mitral
|
$4,357.65 |
$4,357.65 |
$4,357.65 |
$10,877.90
|
|
Vancomycin 1,000 mg intravenous injection
|
$306.48 |
$306.48 |
$313.30 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$58.98 |
$58.98 |
$90.33 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$23.70 |
$23.70 |
$23.70 |
$136.13
|
|
Varicella zoster antibody igg
|
$22.50 |
$22.50 |
$22.50 |
$86.80
|
|
Vasc emb/occ w/prs cath
|
$7,261.35 |
$7,261.35 |
$7,261.35 |
$21,009.00
|
|
Vasectomy
|
$898.95 |
$898.95 |
$898.95 |
$2,424.12
|
|
Vedolizumab 300 mg intravenous solution
|
$8,544.72 |
$8,544.72 |
$8,544.72 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$505.35 |
$505.35 |
$505.35 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$945.90 |
$945.90 |
$945.90 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$289.80 |
$289.80 |
$289.80 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$505.35 |
$505.35 |
$505.35 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$263.55 |
$263.55 |
$263.55 |
$826.15
|
|
Vein x-ray adrenal gland
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$2,845.80
|
|
Vein x-ray adrenal glands
|
$2,036.70 |
$2,036.70 |
$2,036.70 |
$3,935.00
|
|
Vein x-ray eye socket
|
$429.15 |
$429.15 |
$429.15 |
$1,438.32
|
|
Vein x-ray kidney
|
$1,293.15 |
$1,293.15 |
$1,293.15 |
$2,766.73
|
|
Vein x-ray liver
|
$1,293.15 |
$1,293.15 |
$1,293.15 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$452.10 |
$452.10 |
$452.10 |
$2,452.80
|
|
Vein x-ray skull
|
$492.60 |
$492.60 |
$492.60 |
$2,141.00
|
|
Vein x-ray skull epidural
|
$376.95 |
$376.95 |
$376.95 |
$1,746.50
|
|
Vein x-ray spleen/liver
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,427.50
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$496.20 |
$496.20 |
$496.20 |
$202.80
|
|
Venogram ext bil s&i
|
$450.60 |
$450.60 |
$450.60 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$429.15 |
$429.15 |
$429.15 |
$1,366.20
|
|
Venous mech thrombectomy
|
$2,004.00 |
$2,004.00 |
$2,004.00 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$1,564.20 |
$1,564.20 |
$1,564.20 |
$5,094.75
|
|
Venous sampling s&i
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$4,193.20
|
|
Ventilator each subsequent day
|
$405.60 |
$405.60 |
$405.60 |
$1,204.00
|
|
Ventilator initial day
|
$198.90 |
$198.90 |
$198.90 |
$1,431.43
|
|
Ventricular puncture prev burr hole without inj 61020
|
$384.45 |
$384.45 |
$384.45 |
$1,314.30
|
|
Version cephalic external
|
$863.40 |
$863.40 |
$863.40 |
$2,361.75
|
|
Vincristine 1 mg/ml intravenous solution
|
$65.19 |
$65.19 |
$65.19 |
$87.15
|
|
Viper venom prothrombin time
|
$16.65 |
$16.65 |
$16.65 |
$85.80
|
|
Virus isolation addl studies ea
|
$34.20 |
$34.20 |
$34.20 |
$77.50
|
|
Visit established high 40-54 minutes/level 5
|
$65.55 |
$65.55 |
$65.55 |
$227.50
|
|
Visual audiometry (vra)
|
$30.00 |
$30.00 |
$30.00 |
$215.25
|
|
Vital capacity test
|
$28.35 |
$28.35 |
$28.35 |
$170.00
|
|
Vitamin b-12
|
$26.40 |
$26.40 |
$26.40 |
$100.00
|
|
Vitamin D Test
|
$52.05 |
$52.05 |
$52.05 |
$132.00
|
|
Vkorc1 gene
|
$115.50 |
$115.50 |
$115.50 |
$176.80
|
|
Voiding pressure study/intra-abd 51797
|
$31.50 |
$31.50 |
$31.50 |
$433.20
|
|
Vol reduction of blood/prod
|
$47.40 |
$47.40 |
$47.40 |
$172.78
|
|
Volume measurement urine timed
|
$5.40 |
$5.40 |
$5.40 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$216.25 |
$216.25 |
$216.25 |
$165.81
|
|
Warde 1003990 aldosterone
|
$68.70 |
$68.70 |
$68.70 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$48.60 |
$48.60 |
$48.60 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$22.65 |
$22.65 |
$22.65 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$44.10 |
$44.10 |
$44.10 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$27.15 |
$27.15 |
$27.15 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$38.40 |
$38.40 |
$38.40 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$13.95 |
$13.95 |
$13.95 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$35.25 |
$35.25 |
$35.25 |
$107.97
|
