|
Ultrasound chest
|
$105.03 |
$105.03 |
$501.90 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$61.92 |
$149.63 |
$179.46 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$224.55 |
$224.55 |
$436.63 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$186.84 |
$186.84 |
$1,155.88 |
$284.25
|
|
Ultrasound encephalogram
|
$403.38 |
$1,689.93 |
$1,689.93 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$452.79 |
$452.79 |
$820.40 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$161.91 |
$161.91 |
$1,337.18 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$300.96 |
$300.96 |
$585.20 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$629.64 |
$629.64 |
$1,224.30 |
$701.35
|
|
Ultrasound guide intraoperative
|
$381.33 |
$381.33 |
$741.48 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$552.96 |
$552.96 |
$3,252.55 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$162.72 |
$162.72 |
$405.65 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$93.33 |
$93.33 |
$517.65 |
$321.35
|
|
Ultrasound joint complete left
|
$362.25 |
$362.25 |
$704.38 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$316.35 |
$316.35 |
$615.13 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$297.99 |
$297.99 |
$642.95 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$224.55 |
$224.55 |
$436.63 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$588.69 |
$588.69 |
$1,513.58 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$322.92 |
$322.92 |
$627.90 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$236.52 |
$236.52 |
$985.43 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$256.05 |
$256.05 |
$1,175.65 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$331.29 |
$331.29 |
$644.18 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$433.26 |
$433.26 |
$550.73 |
$498.00
|
|
Ultrasound scrotum and contents
|
$532.53 |
$532.53 |
$1,035.48 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$169.56 |
$169.56 |
$550.73 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$410.40 |
$410.40 |
$858.73 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$265.68 |
$265.68 |
$516.60 |
$567.44
|
|
Unit mobile power mpu
|
$19,556.37 |
$19,556.37 |
$19,556.37 |
$17,052.34
|
|
Unlisted cytopathology px
|
$79.38 |
$79.38 |
$203.35 |
$71.65
|
|
Unlisted fluoroscopic px
|
$284.94 |
$284.94 |
$284.94 |
$324.85
|
|
Unlisted mr procedure
|
$1,108.80 |
$1,108.80 |
$2,376.50 |
$1,032.20
|
|
Unlisted neurological dx px
|
$573.65 |
$573.65 |
$573.65 |
$185.15
|
|
Unlisted procedure microbiology
|
$317.07 |
$317.07 |
$616.53 |
$487.50
|
|
Unlisted surgical path px
|
$104.58 |
$104.58 |
$170.10 |
$71.65
|
|
Unlisted transfusion med px
|
$101.34 |
$106.56 |
$471.98 |
$141.35
|
|
Unlisted ultrasound procedure
|
$114.57 |
$114.57 |
$222.78 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$351.72 |
$351.72 |
$1,217.13 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,556.09 |
$2,556.09 |
$4,970.18 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,603.71 |
$1,603.71 |
$3,542.70 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,271.34 |
$1,271.34 |
$2,472.05 |
$2,013.08
|
|
Urea nitrogen
|
$64.26 |
$64.26 |
$124.95 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$40.86 |
$40.86 |
$79.45 |
$50.00
|
|
Ureteral reflux study
|
$1,180.80 |
$1,180.80 |
$1,996.58 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$595.26 |
$595.26 |
$1,157.45 |
$574.40
|
|
Urethrocystography void s&i
|
$698.58 |
$698.58 |
$1,358.35 |
$634.50
|
|
Uric acid blood
|
$47.43 |
$47.43 |
$92.23 |
$46.64
|
|
Uric acid urine
|
$37.62 |
$41.76 |
$82.43 |
$46.75
|
|
Urinalysis microscopic only
|
$18.09 |
$18.09 |
$35.18 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$21.42 |
$21.42 |
$21.42 |
$25.72
|
|
Urinalysis (with microscopy)
|
$90.27 |
$90.27 |
$175.53 |
$48.14
|
|
Urinalysis (without microscopy)
|
$50.49 |
$50.49 |
$98.18 |
$38.99
|
|
Urine Culture Test
|
$48.06 |
$48.06 |
$103.60 |
$84.81
|
|
Urine flow measurement 51736
|
$158.73 |
$158.73 |
$158.73 |
$152.54
|
|
Urine pregnancy test
|
$50.49 |
$50.49 |
$98.18 |
$66.40
|
|
Urography, antegrade
|
$686.97 |
$686.97 |
$1,239.35 |
$593.37
|
|
Use 1st target lesion
|
$186.84 |
$186.84 |
$1,155.88 |
$245.30
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$29,976.57 |
$29,976.57 |
$58,287.78 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$107.10 |
$107.10 |
$208.25 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$98.37 |
$183.06 |
$191.28 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$52.11 |
$52.11 |
$101.33 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$63.54 |
$63.54 |
$123.55 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$31.68 |
$31.68 |
$61.60 |
$157.41
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$56.97 |
$56.97 |
$110.78 |
$42.90
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$24.57 |
$24.57 |
$47.78 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$56.97 |
$56.97 |
$110.78 |
$40.01
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$173.25 |
$173.25 |
$173.25 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$33.21 |
$64.58 |
$107.10 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$150.39 |
$150.39 |
$292.43 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$110.97 |
$110.97 |
$215.78 |
$715.41
|
|
Vaccine rabies im
|
$445.59 |
$445.59 |
$866.43 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$106.11 |
$106.11 |
$206.33 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$51.03 |
$51.03 |
$99.23 |
$131.77
|
|
Vad battery clip set hmii 14-v li-ion
|
$1,234.62 |
$1,234.62 |
$1,409.10 |
$1,683.99
|
|
Vad cable power module dc input
|
$358.02 |
$358.02 |
$358.02 |
$601.65
|
|
Vad univ batt charger hm 1440
|
$4,654.30 |
$15,610.77 |
$15,610.77 |
$14,929.92
|
|
Valproic acid total therapeutic drug level
|
$151.11 |
$151.11 |
$293.83 |
$115.00
|
|
Valvuloplasty aortic
|
$4,466.07 |
$4,466.07 |
$4,962.13 |
$7,324.85
|
|
Valvuloplasty mitral
|
$10,525.38 |
$23,787.00 |
$23,787.00 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$7,052.33 |
$23,787.00 |
$23,787.00 |
$11,945.20
|
|
Vancomycin hcl injection
|
$27.81 |
$27.81 |
$27.81 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$155.25 |
$155.25 |
$301.88 |
$126.79
|
|
Varicella zoster antibody igg
|
$84.51 |
$93.87 |
$298.73 |
$82.55
|
|
Vedolizumab 300 mg intravenous solution
|
$7,401.69 |
$7,401.69 |
$14,392.18 |
$23,003.79
|
|
Veeg cont 2-12 hrs
|
$1,139.40 |
$1,139.40 |
$1,343.48 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$2,132.64 |
$2,132.64 |
$2,514.40 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$593.91 |
$593.91 |
$700.18 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$1,139.40 |
$1,139.40 |
$1,343.48 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$593.91 |
$593.91 |
$700.18 |
$704.79
|
|
Vein x-ray adrenal gland
|
$2,363.58 |
$2,363.58 |
$2,363.58 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$2,363.58 |
$2,363.58 |
$2,363.58 |
$3,999.60
|
|
Vein x-ray eye socket
|
$1,313.91 |
$1,313.91 |
$1,906.10 |
$1,128.41
|
|
Vein x-ray kidney
|
$2,108.25 |
$2,108.25 |
$2,695.88 |
$2,716.20
|
|
Vein x-ray liver
|
$3,757.05 |
$3,757.05 |
$4,050.73 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$4,064.76 |
$4,064.76 |
$5,897.33 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$4,064.76 |
$4,064.76 |
$5,897.33 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$1,313.91 |
$1,313.91 |
$1,906.10 |
$2,489.25
|
|
Vein x-ray skull
|
$535.50 |
$535.50 |
$776.65 |
$2,301.09
|
|
Vein x-ray spleen/liver
|
$4,064.76 |
$4,064.76 |
$5,897.33 |
$3,450.30
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$2,277.99 |
$2,277.99 |
$4,429.43 |
$2,277.99
|
|
Venogram ext bil s&i
|
$993.78 |
$993.78 |
$1,932.35 |
$1,838.28
|
