|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,890.44 |
$1,890.44 |
$1,890.44 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,957.73 |
$3,957.73 |
$16,274.44 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,853.47 |
$1,853.47 |
$13,820.69 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,034.41 |
$2,034.41 |
$12,061.10 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$312.80 |
$312.80 |
$312.80 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$395.95 |
$395.95 |
$395.95 |
$381.60
|
|
Upper ext fx orthosis rad/ul
|
$619.49 |
$619.49 |
$619.49 |
$619.49
|
|
Upper GI Barium X-ray (barium and gas)
|
$657.77 |
$657.77 |
$657.77 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$555.04 |
$555.04 |
$3,654.31 |
$607.20
|
|
Urea nitrogen
|
$63.28 |
$63.28 |
$799.39 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$71.51 |
$71.51 |
$801.04 |
$51.84
|
|
Urea nitrogen clearance
|
$20.07 |
$20.07 |
$20.07 |
$34.02
|
|
Ureteral embolization/occl
|
$3,689.40 |
$3,689.40 |
$3,689.40 |
$2,079.31
|
|
Ureteral reflux study
|
$432.89 |
$432.89 |
$432.89 |
$952.50
|
|
Ureter endoscopy & biopsy
|
$5,696.72 |
$5,696.72 |
$5,696.72 |
$5,696.72
|
|
Ureteroureterostomy 50760
|
$2,999.40 |
$2,999.40 |
$2,999.40 |
$2,773.01
|
|
Urethrcystgrphy rtrgrde s&i
|
$615.08 |
$615.08 |
$615.08 |
$584.00
|
|
Urethrocystography void s&i
|
$702.97 |
$702.97 |
$702.97 |
$634.50
|
|
Uric acid blood
|
$70.34 |
$70.34 |
$903.88 |
$49.32
|
|
Uric acid urine
|
$69.30 |
$69.30 |
$69.30 |
$44.52
|
|
Urinalysis microscopic only
|
$31.75 |
$31.75 |
$477.64 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$46.86 |
$46.86 |
$461.05 |
$25.72
|
|
Urinalysis (with microscopy)
|
$77.87 |
$77.87 |
$766.23 |
$55.20
|
|
Urinalysis (without microscopy)
|
$96.30 |
$96.30 |
$96.30 |
$35.91
|
|
Urinary bldr retent nuc study
|
$309.22 |
$309.22 |
$309.22 |
$350.66
|
|
Urine Culture Test
|
$129.30 |
$129.30 |
$1,507.55 |
$82.32
|
|
Urine pregnancy test
|
$97.30 |
$97.30 |
$97.30 |
$68.21
|
|
Urography, antegrade
|
$593.37 |
$593.37 |
$593.37 |
$622.35
|
|
Urography inf drip &/or bolus
|
$690.85 |
$690.85 |
$690.85 |
$642.50
|
|
Use 1st target lesion
|
$355.91 |
$355.91 |
$355.91 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,644.13 |
$3,644.13 |
$3,644.13 |
$5,205.00
|
|
Vaccine Administration (one shot)
|
$77.72 |
$77.72 |
$186.60 |
$67.74
|
|
Vaccine dtap < 7 years im
|
$101.02 |
$101.02 |
$111.29 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$1,082.39 |
$1,082.39 |
$1,082.39 |
$164.63
|
|
Vaccine dtap-ipv/hib im
|
$280.15 |
$280.15 |
$359.83 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$396.35 |
$396.35 |
$396.35 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$46.99 |
$46.99 |
$46.99 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$225.31 |
$225.31 |
$225.31 |
$166.62
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$179.89 |
$179.89 |
$179.89 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$402.20 |
$402.20 |
$402.20 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$103.22 |
$103.22 |
$114.26 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$81.00 |
$81.00 |
$293.71 |
$149.21
|
|
Vaccine influenza inactivated adjuvant im
|
$81.00 |
$81.00 |
$81.00 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$27.00 |
$27.00 |
$73.15 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$90.86 |
$90.86 |
$90.86 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$605.69 |
$605.69 |
$605.69 |
$394.26
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$599.27 |
$599.27 |
$599.27 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$426.43 |
$426.43 |
$426.43 |
$327.37
|
|
Vaccine mmr live subcutaneous
|
$254.57 |
$254.57 |
$486.39 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,119.48 |
$1,119.48 |
$1,119.48 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,448.43 |
$1,448.43 |
$1,448.43 |
$393.25
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$995.28 |
$995.28 |
$995.28 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$729.93 |
$729.93 |
$1,373.14 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$134.48 |
$134.48 |
$1,134.58 |
$90.70
|
|
Vaccine rabies im
|
$1,174.89 |
$1,174.89 |
$1,174.89 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$2,093.16 |
$2,093.16 |
$2,093.16 |
$1,105.21
|
|
Vaccine tdap >=7 years im
|
$167.69 |
$167.69 |
$224.13 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$131.77 |
$131.77 |
$435.96 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$495.68 |
$495.68 |
$903.98 |
$365.17
|
|
Vacuum drain bottle/tube kit
|
$1,617.00 |
$1,617.00 |
$1,617.00 |
$325.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$2,541.00 |
$2,541.00 |
$2,541.00 |
$1,932.00
|
|
Vad cable power module dc input
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$731.74
|
|
Vad univ batt charger hm 1440
|
$15,793.12 |
$15,793.12 |
$15,793.12 |
$14,814.14
|
|
Vaginal bx
|
$3,859.51 |
$3,859.51 |
$3,859.51 |
$459.42
|
|
Vaginal delivery after cesarean delivery 59612
|
$4,170.07 |
$4,170.07 |
$4,170.07 |
$3,866.47
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$24.12 |
$24.12 |
$29.57 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$173.37 |
$173.37 |
$1,439.54 |
$115.00
|
|
Valvuloplasty aortic
|
$16,030.65 |
$16,030.65 |
$16,030.65 |
$7,944.16
|
|
Valvuloplasty mitral
|
$17,175.83 |
$17,175.83 |
$17,175.83 |
$10,845.00
|
|
Valvuloplasty pulmonary
|
$12,700.66 |
$12,700.66 |
$12,700.66 |
$11,945.20
|
|
Valvuloplasty/tv without ring insert 33463
|
$15,523.12 |
$15,523.12 |
$15,523.12 |
$7,556.80
|
|
Vancomycin 1,000 mg intravenous injection
|
$246.70 |
$246.70 |
$246.70 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$89.83 |
$89.83 |
$89.83 |
$90.33
|
|
Vancomycin hcl injection
|
$589.52 |
$589.52 |
$589.52 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$182.61 |
$182.61 |
$1,155.97 |
$135.60
|
|
Vanomycin dna amp probe
|
$174.24 |
$174.24 |
$174.24 |
$78.40
|
|
Varicella zoster antibody igg
|
$108.99 |
$108.99 |
$108.99 |
$86.80
|
|
Varus/valgus strap padded/li
|
$136.41 |
$136.41 |
$136.41 |
$114.24
|
|
Vasc emb/occ w/prs cath
|
$16,060.54 |
$16,060.54 |
$16,060.54 |
$21,009.00
|
|
Vasopressin 20 unit/ml intravenous solution
|
$835.13 |
$835.13 |
$1,458.00 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$15,599.84 |
$15,599.84 |
$15,599.84 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$1,868.14 |
$1,868.14 |
$1,868.14 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$4,212.17 |
$4,212.17 |
$4,212.17 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$2,338.10 |
$2,338.10 |
$2,338.10 |
$994.91
|
|
Veeg unmon 12-26 hrs
|
$2,826.33 |
$2,826.33 |
$2,826.33 |
$1,737.12
|
|
Veeg unmon 2-12 hrs
|
$1,889.94 |
$1,889.94 |
$1,889.94 |
$826.15
|
|
Vein x-ray adrenal gland
|
$2,833.34 |
$2,833.34 |
$2,833.34 |
$2,833.34
|
|
Vein x-ray adrenal glands
|
$3,353.84 |
$3,353.84 |
$3,353.84 |
$3,480.10
|
|
Vein x-ray eye socket
|
$1,128.41 |
$1,128.41 |
$1,128.41 |
$1,438.32
|
|
Vein x-ray kidney
|
$2,571.95 |
$2,571.95 |
$2,571.95 |
$2,870.00
|
|
Vein x-ray liver
|
$2,563.49 |
$2,563.49 |
$5,848.74 |
$3,312.00
|
|
Vein x-ray liver w/hemodynam
|
$2,376.74 |
$2,376.74 |
$15,660.18 |
$3,619.84
|
|
Vein x-ray liver w/hemodynam
|
$3,368.95 |
$3,368.95 |
$5,951.02 |
$3,683.90
|
|
Vein x-ray liver without hemodyn
|
$1,869.20 |
$1,869.20 |
$1,869.20 |
$2,452.80
|
|
Vein x-ray skull
|
$2,122.85 |
$2,122.85 |
$2,122.85 |
$2,236.50
|
|
Vein x-ray skull epidural
|
$1,006.40 |
$1,006.40 |
$1,006.40 |
$1,596.00
|
|
Vein x-ray spleen/liver
|
$2,320.33 |
$2,320.33 |
$2,320.33 |
$3,434.00
|
|
Vemp test i&r cervical
|
$167.46 |
$167.46 |
$167.46 |
$343.72
|
|
Vemp test i&r ocular
|
$167.46 |
$167.46 |
$167.46 |
$257.50
|
|
Vemp tst i&r cervical&ocular
|
$317.34 |
$317.34 |
$317.34 |
$591.50
|
