|
Unlisted transfusion med px
|
$18.20 |
$18.20 |
$18.20 |
$147.50
|
|
Unlisted ultrasound procedure
|
$164.68 |
$164.68 |
$2,861.95 |
$335.00
|
|
Unlisted vasc endoscopy px
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$1,523.20
|
|
Unlstd laps px sprmatic cord
|
$4,608.50 |
$4,608.50 |
$4,608.50 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$1,748.01 |
$1,748.01 |
$1,748.01 |
$1,316.90
|
|
Upgrade pm system
|
$2,254.70 |
$2,254.70 |
$16,584.26 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$353.69 |
$353.69 |
$353.69 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$524.30 |
$524.30 |
$2,041.20 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$468.13 |
$468.13 |
$1,768.19 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,250.03 |
$1,250.03 |
$3,855.61 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$910.53 |
$910.53 |
$2,039.85 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$827.75 |
$827.75 |
$2,143.16 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$403.23 |
$403.23 |
$403.23 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$450.25 |
$450.25 |
$450.25 |
$380.82
|
|
Upper Endoscopy (EGD, diagnostic)
|
$393.75 |
$393.75 |
$393.75 |
$1,824.75
|
|
Upper ext fx orthosis rad/ul
|
$327.60 |
$327.60 |
$327.60 |
$619.49
|
|
Upper GI Barium X-ray (barium and gas)
|
$492.10 |
$492.10 |
$704.42 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$287.53 |
$287.53 |
$771.95 |
$603.20
|
|
Urachal cyst/sinus excision 51500
|
$6,620.59 |
$6,620.59 |
$6,620.59 |
$6,082.67
|
|
Urea nitrogen
|
$16.10 |
$16.10 |
$63.50 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$25.90 |
$25.90 |
$86.29 |
$51.77
|
|
Urea nitrogen clearance
|
$20.07 |
$20.07 |
$20.07 |
$34.02
|
|
Ureteral embolization/occl
|
$1,591.37 |
$1,591.37 |
$1,591.37 |
$2,079.31
|
|
Ureteral reflux study
|
$351.05 |
$351.05 |
$1,298.73 |
$952.50
|
|
Ureter endoscopy
|
$949.04 |
$949.04 |
$949.04 |
$3,326.40
|
|
Ureter endoscopy & biopsy
|
$5,080.40 |
$5,080.40 |
$5,080.40 |
$5,696.72
|
|
Ureter endoscopy & catheter
|
$1,579.40 |
$1,579.40 |
$1,579.40 |
$3,326.40
|
|
Ureter endoscopy & treatment
|
$4,407.52 |
$4,407.52 |
$4,407.52 |
$5,631.74
|
|
Ureter endoscopy & treatment
|
$3,935.24 |
$3,935.24 |
$3,935.24 |
$5,631.74
|
|
Ureteroureterostomy 50760
|
$2,773.01 |
$2,773.01 |
$2,773.01 |
$2,773.01
|
|
Urethrcystgrphy rtrgrde s&i
|
$364.88 |
$364.88 |
$690.54 |
$592.80
|
|
Urethrlys transvag with scope
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$4,081.37
|
|
Urethrocystography void s&i
|
$364.88 |
$364.88 |
$706.96 |
$631.75
|
|
Uric acid blood
|
$39.03 |
$39.03 |
$48.44 |
$48.96
|
|
Uric acid urine
|
$19.43 |
$19.43 |
$63.21 |
$44.14
|
|
Urinalysis microscopic only
|
$6.83 |
$6.83 |
$36.01 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$46.86 |
$46.86 |
$46.86 |
$25.72
|
|
Urinalysis (with microscopy)
|
$58.28 |
$58.28 |
$77.87 |
$54.60
|
|
Urinalysis (without microscopy)
|
$96.30 |
$96.30 |
$96.30 |
$35.15
|
|
Urinary bldr retent nuc study
|
$350.66 |
$350.66 |
$350.66 |
$350.66
|
|
Urinary reflex study
|
$52.33 |
$52.33 |
$316.14 |
$216.05
|
|
Urine Culture Test
|
$31.85 |
$31.85 |
$86.92 |
$81.00
|
|
Urine flow measurement 51736
|
$4.55 |
$4.55 |
$230.92 |
$210.00
|
|
Urine pregnancy test
|
$7.69 |
$7.69 |
$76.13 |
$66.87
|
|
Urography, antegrade
|
$383.95 |
$383.95 |
$701.49 |
$622.35
|
|
Urography inf drip &/or bolus
|
$191.98 |
$191.98 |
$709.58 |
$642.50
|
|
Use 1st target lesion
|
$352.21 |
$352.21 |
$352.21 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$307.82 |
$307.82 |
$3,644.13 |
$5,205.00
|
|
Vaccine Administration (one shot)
|
$30.45 |
$30.45 |
$67.70 |
$67.74
|
|
Vaccine dtap < 7 years im
|
$6.13 |
$6.13 |
$101.02 |
$68.19
|
|
Vaccine dtap-ipv/hib im
|
$280.15 |
$280.15 |
$280.15 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$6.83 |
$6.83 |
$6.83 |
$72.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$6.48 |
$6.48 |
$46.99 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$10.85 |
$10.85 |
$225.31 |
$169.35
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$10.85 |
$10.85 |
$10.85 |
$80.28
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$9.63 |
$9.63 |
$179.89 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$0.01 |
$0.01 |
$402.20 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$5.78 |
$5.78 |
$103.22 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$81.00 |
$81.00 |
$81.00 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$8.65 |
$8.65 |
$81.00 |
$96.84
|
|
Vaccine influenza nos 0.5ml dose im
|
$2.80 |
$2.80 |
$2.80 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$2.98 |
$2.98 |
$27.00 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$5.08 |
$5.08 |
$5.08 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$63.88 |
$63.88 |
$63.88 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$5.08 |
$5.08 |
$5.08 |
$28.77
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$25.55 |
$25.55 |
$25.55 |
$33.21
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$5.08 |
$5.08 |
$5.08 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$7.00 |
$7.00 |
$7.00 |
$37.05
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$34.65 |
$34.65 |
$605.69 |
$387.95
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$30.63 |
$30.63 |
$30.63 |
$406.05
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$16.95 |
$16.95 |
$426.43 |
$323.39
|
|
Vaccine mmr live subcutaneous
|
$8.93 |
$8.93 |
$254.57 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$9.80 |
$9.80 |
$9.80 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$20.30 |
$20.30 |
$20.30 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$284.73 |
$284.73 |
$729.93 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$5.25 |
$5.25 |
$1,134.58 |
$90.70
|
|
Vaccine rabies im
|
$54.87 |
$54.87 |
$1,174.89 |
$858.95
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$12.25 |
$12.25 |
$12.25 |
$200.70
|
|
Vaccine tdap >=7 years im
|
$7.02 |
$7.02 |
$167.69 |
$131.22
|
|
Vaccine td preservative free >= 7 years im
|
$6.13 |
$6.13 |
$131.77 |
$110.19
|
|
Vaccine typhoid vicps im
|
$8.58 |
$8.58 |
$8.58 |
$253.50
|
|
Vaccine varicella live subcutaneous
|
$495.68 |
$495.68 |
$1,544.20 |
$364.16
|
|
Vaccine yellow fever live subcutaneous
|
$10.50 |
$10.50 |
$10.50 |
$418.46
|
|
Vacuum drain bottle/tube kit
|
$374.85 |
$374.85 |
$1,617.00 |
$325.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$3,055.80 |
$3,055.80 |
$3,055.80 |
$1,932.00
|
|
Vad cable power module dc input
|
$5,556.00 |
$5,556.00 |
$5,556.00 |
$731.74
|
|
Vad univ batt charger hm 1440
|
$16,675.20 |
$16,675.20 |
$16,675.20 |
$14,814.14
|
|
Vag hys/<250g/rmv tube/rpr entero 58263
|
$5,345.59 |
$5,345.59 |
$5,345.59 |
$5,345.59
|
|
Vag hyst incl t/o complex
|
$7,785.35 |
$7,785.35 |
$7,785.35 |
$5,813.46
|
|
Vag hyst including t/o
|
$4,827.18 |
$4,827.18 |
$4,827.18 |
$5,110.00
|
|
Vag hyst t/o & repair compl
|
$6,037.58 |
$6,037.58 |
$6,037.58 |
$8,081.64
|
|
Vag hyst w/enterocele compl 58294
|
$5,232.57 |
$5,232.57 |
$5,232.57 |
$5,468.70
|
|
Vag hyst w/enterocele repair
|
$5,355.90 |
$5,355.90 |
$5,355.90 |
$5,463.96
|
|
Vaginal bx
|
$3,859.51 |
$3,859.51 |
$3,859.51 |
$471.12
|
|
Vaginal delivery after cesarean delivery 59612
|
$3,866.47 |
$3,866.47 |
$3,866.47 |
$3,866.47
|
|
Vaginal Delivery (full care)
|
$2,680.40 |
$2,680.40 |
$2,680.40 |
$4,184.00
|
|
Vaginal hysterectomy
|
$6,072.38 |
$6,072.38 |
$6,072.38 |
$5,766.00
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$24.12 |
$24.12 |
$24.12 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$58.10 |
$58.10 |
$126.17 |
$114.48
|
|
Valvuloplasty aortic
|
$1,569.93 |
$1,569.93 |
$13,324.96 |
$7,830.80
|
