|
Unlisted px foot/toes
|
$1,225.50 |
$1,225.50 |
$1,225.50 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$396.00 |
$396.00 |
$396.00 |
$593.60
|
|
Unlisted px hands/fingers
|
$149.50 |
$149.50 |
$21,182.83 |
$354.20
|
|
Unlisted px lacrimal system
|
$318.00 |
$318.00 |
$318.00 |
$416.50
|
|
Unlisted px leg/ankle
|
$452.50 |
$452.50 |
$452.50 |
$811.00
|
|
Unlisted px male genital sys
|
$244.00 |
$244.00 |
$244.00 |
$343.55
|
|
Unlisted px middle ear
|
$343.50 |
$343.50 |
$343.50 |
$343.50
|
|
Unlisted px neck/thorax
|
$339.50 |
$339.50 |
$339.50 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$396.00 |
$396.00 |
$396.00 |
$3,118.44
|
|
Unlisted px salivry glnd/dux
|
$3,260.00 |
$3,260.00 |
$3,260.00 |
$1,265.16
|
|
Unlisted px small intestine
|
$1,369.00 |
$1,369.00 |
$1,369.00 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$282.50 |
$282.50 |
$289.20 |
$282.50
|
|
Unlisted surgical path px
|
$286.00 |
$286.00 |
$286.00 |
$217.75
|
|
Unlisted ultrasound procedure
|
$119.00 |
$119.00 |
$181.20 |
$321.20
|
|
Unlisted urinalysis px
|
$7.50 |
$7.50 |
$7.50 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$505.20 |
$505.20 |
$1,065.00 |
$1,268.17
|
|
Upgrade pm system
|
$13,822.00 |
$13,822.00 |
$13,822.00 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,315.50 |
$3,315.50 |
$5,152.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,644.00 |
$2,644.00 |
$4,172.40 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,000.00 |
$2,000.00 |
$3,602.40 |
$2,034.41
|
|
Upper ext fx orthosis rad/ul
|
$232.88 |
$232.88 |
$232.88 |
$619.49
|
|
Urea nitrogen
|
$52.20 |
$52.20 |
$65.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$106.00 |
$106.00 |
$106.00 |
$51.75
|
|
Urea nitrogen clearance
|
$106.00 |
$106.00 |
$106.00 |
$42.25
|
|
Ureteral embolization/occl
|
$1,514.00 |
$1,514.00 |
$1,514.00 |
$2,181.40
|
|
Ureteral reflux study
|
$854.00 |
$854.00 |
$854.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$513.50 |
$513.50 |
$665.40 |
$579.73
|
|
Urethrocystography void s&i
|
$513.50 |
$513.50 |
$513.50 |
$622.35
|
|
Uric acid blood
|
$70.20 |
$70.20 |
$79.50 |
$48.75
|
|
Uric acid urine
|
$28.20 |
$28.20 |
$86.00 |
$44.33
|
|
Urinalysis microscopic only
|
$22.00 |
$22.00 |
$43.20 |
$26.35
|
|
Urinalysis (with microscopy)
|
$68.40 |
$68.40 |
$89.50 |
$55.00
|
|
Urinalysis (without microscopy)
|
$40.80 |
$40.80 |
$53.50 |
$35.75
|
|
Urinary pouch w/barrier
|
$5.70 |
$5.70 |
$5.70 |
$5.70
|
|
Urine Culture Test
|
$75.60 |
$75.60 |
$112.50 |
$81.50
|
|
Urine pregnancy test
|
$91.80 |
$91.80 |
$142.50 |
$67.20
|
|
Urography, antegrade
|
$518.00 |
$518.00 |
$640.20 |
$622.35
|
|
Use 1st target lesion
|
$332.00 |
$332.00 |
$332.00 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$15,897.38 |
$15,897.38 |
$15,897.38 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$54,659.03 |
$54,659.03 |
$54,659.03 |
$51,633.07
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$76.61 |
$76.61 |
$76.61 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$76.61 |
$76.61 |
$76.61 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$68.83 |
$68.83 |
$68.83 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$46.08 |
$46.08 |
$46.08 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$34.32 |
$34.32 |
$34.32 |
$80.15
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$66.36 |
$66.36 |
$66.36 |
$43.12
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.01 |
$0.01 |
$0.01 |
$75.39
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$58.78 |
$58.78 |
$58.78 |
$76.50
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,173.77 |
$1,173.77 |
$1,173.77 |
$400.03
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$825.41 |
$825.41 |
$825.41 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$485.05 |
$485.05 |
$485.05 |
$211.68
|
|
Vaccine rabies im
|
$2,151.32 |
$2,151.32 |
$2,151.32 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$241.30 |
$241.30 |
$241.30 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$209.12 |
$209.12 |
$209.12 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$950.97 |
$950.97 |
$950.97 |
$365.17
|
|
Vad battery clip set hmii 14-v li-ion
|
$1,270.46 |
$1,270.46 |
$1,270.46 |
$2,002.00
|
|
Vad cable power module dc input
|
$235.98 |
$235.98 |
$235.98 |
$731.74
|
|
Vad univ batt charger hm 1440
|
$8,314.68 |
$8,314.68 |
$26,333.70 |
$14,827.28
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$44.94 |
$44.94 |
$44.94 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$147.00 |
$147.00 |
$187.00 |
$114.72
|
|
Valvuloplasty aortic
|
$6,018.50 |
$6,018.50 |
$6,018.50 |
$7,830.80
|
|
Valvuloplasty mitral
|
$6,931.50 |
$6,931.50 |
$6,931.50 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$9,716.50 |
$9,716.50 |
$9,716.50 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$385.20 |
$385.20 |
$385.20 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$129.04 |
$129.04 |
$129.04 |
$90.33
|
|
Vancomycin hcl injection
|
$475.08 |
$475.08 |
$475.08 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$142.80 |
$142.80 |
$151.00 |
$136.13
|
|
Varicella zoster antibody igg
|
$68.00 |
$68.00 |
$101.40 |
$86.80
|
|
Varus/valgus strap padded/li
|
$187.31 |
$187.31 |
$187.31 |
$115.53
|
|
Vasopressin 20 unit/ml intravenous solution
|
$321.00 |
$321.00 |
$321.00 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$35,099.66 |
$35,099.66 |
$35,099.66 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$826.15
|
|
Vein x-ray adrenal gland
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$2,845.80
|
|
Vein x-ray adrenal glands
|
$4,898.50 |
$4,898.50 |
$4,898.50 |
$3,935.00
|
|
Vein x-ray eye socket
|
$2,427.50 |
$2,427.50 |
$2,427.50 |
$1,438.32
|
|
Vein x-ray kidney
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$2,766.73
|
|
Vein x-ray liver
|
$2,939.00 |
$2,939.00 |
$2,939.00 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$1,619.50 |
$1,619.50 |
$1,619.50 |
$2,452.80
|
|
Vein x-ray skull
|
$1,619.50 |
$1,619.50 |
$1,619.50 |
$2,141.00
|
|
Vein x-ray spleen/liver
|
$2,798.50 |
$2,798.50 |
$2,798.50 |
$3,427.50
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$183.50 |
$183.50 |
$231.60 |
$202.80
|
|
Venogram ext bil s&i
|
$2,079.50 |
$2,079.50 |
$2,079.50 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$1,366.20
|
|
Venous mech thrombectomy
|
$7,074.00 |
$7,074.00 |
$7,074.00 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$7,074.00 |
$7,074.00 |
$7,074.00 |
$5,094.75
|
|
Venous sampling s&i
|
$3,919.00 |
$3,919.00 |
$3,919.00 |
$4,193.20
|
|
Venous thrombosis imaging
|
$796.50 |
$796.50 |
$796.50 |
$697.20
|
|
Ven thrombosis images bilat
|
$796.50 |
$796.50 |
$796.50 |
$796.50
|
|
Ventilator each subsequent day
|
$507.00 |
$507.00 |
$1,450.00 |
$1,204.00
|
|
Ventilator initial day
|
$1,130.40 |
$1,130.40 |
$1,650.00 |
$1,431.43
|
|
Version cephalic external
|
$1,687.00 |
$1,687.00 |
$1,687.00 |
$2,361.75
|
|
Vest large holster
|
$459.54 |
$459.54 |
$1,942.65 |
$1,078.25
|
|
Vinblastine 1 mg/ml intravenous solution
|
$211.28 |
$211.28 |
$211.28 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$87.15
|
