|
Ultrasound pregnant uterus transvaginal
|
$668.50 |
$668.50 |
$668.50 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,034.15 |
$1,034.15 |
$1,034.15 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$473.55 |
$473.55 |
$3,924.65 |
$498.00
|
|
Ultrasound scrotum and contents
|
$908.17 |
$908.17 |
$3,066.18 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,493.07 |
$1,493.07 |
$1,493.07 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$2,358.94 |
$2,358.94 |
$2,358.94 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$719.60 |
$719.60 |
$2,427.15 |
$567.44
|
|
Ultraviolet therapy
|
$25.52 |
$25.52 |
$25.52 |
$42.60
|
|
Umbilical artery cath newborn 36660
|
$47.57 |
$47.57 |
$47.57 |
$265.85
|
|
Unlistd noninvas vasc dx std
|
$250.05 |
$250.05 |
$250.05 |
$819.65
|
|
Unlisted CT procedure
|
$6,879.87 |
$6,879.87 |
$6,879.87 |
$1,043.00
|
|
Unlisted fluoroscopic px
|
$185.54 |
$185.54 |
$185.54 |
$324.85
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$978.71 |
$978.71 |
$978.71 |
$6,904.15
|
|
Unlisted procedure microbiology
|
$125.06 |
$125.06 |
$125.06 |
$487.50
|
|
Unlisted procedure rectum
|
$346.19 |
$346.19 |
$346.19 |
$1,278.72
|
|
Unlisted px casting/strpg
|
$69.62 |
$69.62 |
$69.62 |
$224.93
|
|
Unlisted px leg/ankle
|
$318.78 |
$318.78 |
$318.78 |
$811.00
|
|
Unlisted surgical path px
|
$14.81 |
$14.81 |
$14.81 |
$71.65
|
|
Unlisted ultrasound procedure
|
$105.00 |
$105.00 |
$105.00 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$1,125.25 |
$1,125.25 |
$1,125.25 |
$1,505.29
|
|
Upgrade pm system
|
$4,161.78 |
$4,161.78 |
$49,383.28 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,041.45 |
$4,041.45 |
$28,834.54 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,443.65 |
$3,443.65 |
$13,034.55 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,391.20 |
$2,391.20 |
$15,391.45 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,002.54 |
$1,002.54 |
$1,002.54 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,326.31 |
$1,326.31 |
$1,326.31 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$715.05 |
$715.05 |
$715.05 |
$1,773.85
|
|
Urea nitrogen
|
$30.10 |
$30.10 |
$830.64 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$40.32 |
$40.32 |
$629.13 |
$50.00
|
|
Ureteral reflux study
|
$826.25 |
$826.25 |
$826.25 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$567.88 |
$567.88 |
$567.88 |
$574.40
|
|
Urethrocystography void s&i
|
$467.78 |
$467.78 |
$3,761.20 |
$634.50
|
|
Uric acid blood
|
$126.06 |
$126.06 |
$833.72 |
$46.64
|
|
Uric acid urine
|
$19.22 |
$19.22 |
$19.22 |
$46.75
|
|
Urinalysis microscopic only
|
$11.55 |
$11.55 |
$301.50 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$54.18 |
$54.18 |
$54.18 |
$25.72
|
|
Urinalysis (with microscopy)
|
$141.86 |
$141.86 |
$713.74 |
$48.14
|
|
Urinalysis (without microscopy)
|
$64.40 |
$64.40 |
$64.40 |
$38.99
|
|
Urinary bldr retent nuc study
|
$572.67 |
$572.67 |
$572.67 |
$309.22
|
|
Urine Culture Test
|
$188.90 |
$188.90 |
$1,278.27 |
$84.81
|
|
Urine pregnancy test
|
$167.65 |
$167.65 |
$167.65 |
$66.40
|
|
Urography, antegrade
|
$1,772.40 |
$1,772.40 |
$5,338.18 |
$593.37
|
|
Urography inf drip &/or bolus
|
$3,258.20 |
$3,258.20 |
$3,258.20 |
$641.69
|
|
Vaccine dtap-ipv/hib im
|
$304.78 |
$304.78 |
$304.78 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$63.29 |
$63.29 |
$63.29 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$2,528.32 |
$2,528.32 |
$2,528.32 |
$178.07
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$512.36 |
$512.36 |
$512.36 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$356.05 |
$356.05 |
$356.05 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,028.74 |
$1,028.74 |
$1,028.74 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$1,070.93 |
$1,070.93 |
$1,070.93 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$176.77 |
$176.77 |
$971.60 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,988.10 |
$1,988.10 |
$1,988.10 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$654.67 |
$654.67 |
$654.67 |
$385.45
|
|
Vaccine polio (ipv) subcutaneous/im
|
$246.30 |
$246.30 |
$246.30 |
$119.17
|
|
Vaccine rabies im
|
$210.95 |
$210.95 |
$210.95 |
$945.46
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$859.40 |
$859.40 |
$859.40 |
$624.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,406.99 |
$1,406.99 |
$1,406.99 |
$1,196.00
|
|
Vaccine tdap >=7 years im
|
$729.38 |
$729.38 |
$729.38 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$64.32 |
$64.32 |
$64.32 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$134.75 |
$134.75 |
$1,316.73 |
$115.00
|
|
Valvuloplasty mitral
|
$66,031.60 |
$66,031.60 |
$66,031.60 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$66,031.60 |
$66,031.60 |
$66,031.60 |
$11,945.20
|
|
Vancomycin hcl injection
|
$54.03 |
$54.03 |
$54.03 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$150.85 |
$150.85 |
$1,487.47 |
$126.79
|
|
Varicella zoster antibody igg
|
$58.91 |
$58.91 |
$935.25 |
$82.55
|
|
Varicella-zoster immue globin im
|
$7,485.65 |
$7,485.65 |
$7,485.65 |
$2,372.84
|
|
Veeg unmon 12-26 hrs
|
$2,414.99 |
$2,414.99 |
$2,414.99 |
$1,411.20
|
|
Vein x-ray adrenal gland
|
$316.58 |
$316.58 |
$316.58 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$1,340.33 |
$1,340.33 |
$19,132.28 |
$3,999.60
|
|
Vein x-ray eye socket
|
$316.58 |
$316.58 |
$10,405.98 |
$1,128.41
|
|
Vein x-ray kidney
|
$2,034.59 |
$2,034.59 |
$2,034.59 |
$2,716.20
|
|
Vein x-ray liver
|
$1,064.35 |
$1,064.35 |
$12,880.22 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$10,405.98 |
$10,405.98 |
$10,405.98 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$1,239.53 |
$1,239.53 |
$12,880.22 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$12,969.34 |
$12,969.34 |
$12,969.34 |
$2,489.25
|
|
Vein x-ray skull
|
$1,064.35 |
$1,064.35 |
$10,405.98 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$430.29 |
$430.29 |
$10,405.98 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$1,340.33 |
$1,340.33 |
$5,894.06 |
$3,450.30
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$29.93 |
$29.93 |
$29.93 |
$188.65
|
|
Venipuncture <3 yrs other vein
|
$73.71 |
$73.71 |
$73.71 |
$82.11
|
|
Venogram ext bil s&i
|
$899.50 |
$899.50 |
$899.50 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$719.42 |
$719.42 |
$719.42 |
$1,326.00
|
|
Venous mech thrombectomy
|
$2,031.75 |
$2,031.75 |
$2,031.75 |
$8,869.50
|
|
Venous m-thrombectomy add-on
|
$1,847.16 |
$1,847.16 |
$1,847.16 |
$5,352.00
|
|
Venous sampling s&i
|
$12,880.22 |
$12,880.22 |
$12,880.22 |
$4,416.78
|
|
Venous thrombosis imaging
|
$699.30 |
$699.30 |
$699.30 |
$636.97
|
|
Ven thrombosis images bilat
|
$1,361.75 |
$1,361.75 |
$8,646.96 |
$779.56
|
|
Ventilator each subsequent day
|
$1,458.80 |
$1,458.80 |
$2,959.03 |
$1,305.92
|
|
Ventilator initial day
|
$1,517.25 |
$1,517.25 |
$3,435.63 |
$1,540.80
|
|
Vinblastine 1 mg/ml intravenous solution
|
$1,367.58 |
$1,367.58 |
$1,367.58 |
$186.71
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$2,589.56 |
$2,589.56 |
$2,589.56 |
$245.36
|
|
Visit established high 40-54 minutes/level 5
|
$351.75 |
$351.75 |
$351.75 |
$179.40
|
|
Vital capacity test
|
$115.29 |
$115.29 |
$587.53 |
$173.33
|
|
Vitamin b-12
|
$70.93 |
$70.93 |
$1,329.05 |
$94.90
|
|
Vitamin D Test
|
$95.80 |
$95.80 |
$95.80 |
$132.00
|
|
Vkorc1 gene
|
$257.36 |
$257.36 |
$257.36 |
$176.80
|
|
Volume measurement urine timed
|
$18.20 |
$18.20 |
$106.14 |
$21.45
|
|
Warde 1003990 aldosterone
|
$123.80 |
$123.80 |
$2,807.28 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$103.95 |
$103.95 |
$838.34 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$27.72 |
$27.72 |
$155.42 |
$72.50
|
