|
Unlisted px abdomen muscskel
|
$2,210.80 |
$2,210.80 |
$2,210.80 |
$1,848.60
|
|
Unlisted px foot/toes
|
$1,239.20 |
$1,239.20 |
$1,239.20 |
$1,225.50
|
|
Unlisted px med radj physics
|
$363.60 |
$363.60 |
$363.60 |
$462.35
|
|
Unlisted px small intestine
|
$2,210.40 |
$2,210.40 |
$2,210.40 |
$2,102.10
|
|
Unsched dialysis esrd pt hos
|
$774.00 |
$774.00 |
$774.00 |
$1,268.17
|
|
Upgrade pm system
|
$11,642.40 |
$11,642.40 |
$11,642.40 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,928.40 |
$1,928.40 |
$1,928.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,990.00 |
$1,990.00 |
$1,990.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,753.60 |
$1,753.60 |
$1,753.60 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$4,088.80 |
$4,088.80 |
$4,088.80 |
$1,751.66
|
|
Urea nitrogen
|
$11.20 |
$11.20 |
$11.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$11.60 |
$11.60 |
$11.60 |
$51.75
|
|
Urea nitrogen clearance
|
$16.00 |
$16.00 |
$16.00 |
$42.25
|
|
Ureteral reflux study
|
$1,249.20 |
$1,249.20 |
$1,249.20 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$382.40 |
$382.40 |
$382.40 |
$579.73
|
|
Urethrocystography void s&i
|
$714.40 |
$714.40 |
$714.40 |
$622.35
|
|
Uric acid blood
|
$11.60 |
$11.60 |
$11.60 |
$48.75
|
|
Uric acid urine
|
$12.00 |
$12.00 |
$12.00 |
$44.33
|
|
Urinalysis microscopic only
|
$8.40 |
$8.40 |
$8.40 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$5.60 |
$5.60 |
$5.60 |
$25.72
|
|
Urinalysis (with microscopy)
|
$9.20 |
$9.20 |
$9.20 |
$55.00
|
|
Urinalysis (without microscopy)
|
$5.60 |
$5.60 |
$5.60 |
$35.75
|
|
Urinary reflex study
|
$201.60 |
$201.60 |
$201.60 |
$216.05
|
|
Urine Culture Test
|
$20.40 |
$20.40 |
$20.40 |
$81.50
|
|
Urine flow measurement 51736
|
$210.00 |
$210.00 |
$210.00 |
$210.00
|
|
Urine pregnancy test
|
$11.60 |
$11.60 |
$11.60 |
$67.20
|
|
Urography, antegrade
|
$795.60 |
$795.60 |
$795.60 |
$622.35
|
|
Use 1st target lesion
|
$359.20 |
$359.20 |
$359.20 |
$332.00
|
|
User adjustable heel height
|
$1,111.60 |
$1,111.60 |
$1,111.60 |
$2,004.80
|
|
Vaccine dtap < 7 years im
|
$32.80 |
$32.80 |
$32.80 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$1.07 |
$1.07 |
$1.07 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$1.07 |
$1.07 |
$1.07 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$1.07 |
$1.07 |
$1.07 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$1.07 |
$1.07 |
$1.07 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$1.07 |
$1.07 |
$1.07 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$1.07 |
$1.07 |
$1.07 |
$43.12
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$1.07 |
$1.07 |
$1.07 |
$79.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$108.98 |
$108.98 |
$108.98 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$8.68 |
$8.68 |
$8.68 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1.07 |
$1.07 |
$1.07 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$53.20 |
$53.20 |
$53.20 |
$143.20
|
|
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
|
$26.70 |
$26.70 |
$26.70 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$54.00 |
$54.00 |
$54.00 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$20.80 |
$20.80 |
$20.80 |
$33.60
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$7.60 |
$7.60 |
$7.60 |
$76.50
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$2.80 |
$2.80 |
$2.80 |
$31.20
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1.07 |
$1.07 |
$1.07 |
$400.03
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1.07 |
$1.07 |
$1.07 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$148.40 |
$148.40 |
$148.40 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$13.59 |
$13.59 |
$13.59 |
$211.68
|
|
Vaccine mmrv live subcutaneous
|
$1.07 |
$1.07 |
$1.07 |
$424.32
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$137.20 |
$137.20 |
$137.20 |
$251.64
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$66.40 |
$66.40 |
$66.40 |
$397.11
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$430.80 |
$430.80 |
$430.80 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$490.40 |
$490.40 |
$490.40 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$1.07 |
$1.07 |
$1.07 |
$90.70
|
|
Vaccine rabies im
|
$548.06 |
$548.06 |
$548.06 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$215.29 |
$215.29 |
$215.29 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1.07 |
$1.07 |
$1.07 |
$997.44
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$1.07 |
$1.07 |
$1.07 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$1.07 |
$1.07 |
$1.07 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$30.40 |
$30.40 |
$30.40 |
$131.34
|
|
Vaccine varicella live subcutaneous
|
$1.07 |
$1.07 |
$1.07 |
$365.17
|
|
Vacuum drain bottle/tube kit
|
$349.20 |
$349.20 |
$349.20 |
$325.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$3,285.60 |
$3,285.60 |
$3,285.60 |
$2,002.00
|
|
Vad cable power module dc input
|
$638.00 |
$638.00 |
$638.00 |
$731.74
|
|
Vad univ batt charger hm 1440
|
$13,299.60 |
$13,299.60 |
$13,299.60 |
$14,827.28
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$0.70 |
$0.70 |
$0.70 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$34.00 |
$34.00 |
$34.00 |
$114.72
|
|
Valvuloplasty aortic
|
$11,805.20 |
$11,805.20 |
$11,805.20 |
$7,830.80
|
|
Valvuloplasty mitral
|
$13,244.40 |
$13,244.40 |
$13,244.40 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$13,396.00 |
$13,396.00 |
$13,396.00 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$1.24 |
$1.24 |
$1.24 |
$251.86
|
|
Vancomycin hcl injection
|
$16.90 |
$16.90 |
$16.90 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$34.00 |
$34.00 |
$34.00 |
$136.13
|
|
Varicella zoster antibody igg
|
$32.40 |
$32.40 |
$32.40 |
$86.80
|
|
Varus/valgus strap padded/li
|
$40.80 |
$40.80 |
$40.80 |
$115.53
|
|
Vasc emb/occ w/prs cath
|
$40,210.80 |
$40,210.80 |
$40,210.80 |
$21,009.00
|
|
Vasectomy
|
$1,371.20 |
$1,371.20 |
$1,371.20 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$30.81 |
$30.81 |
$30.81 |
$325.80
|
|
Veeg cont 2-12 hrs
|
$1,992.00 |
$1,992.00 |
$1,992.00 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$2,845.60 |
$2,845.60 |
$2,845.60 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$1,660.00 |
$1,660.00 |
$1,660.00 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$1,394.80 |
$1,394.80 |
$1,394.80 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$715.60 |
$715.60 |
$715.60 |
$826.15
|
|
Vein x-ray kidney
|
$3,942.40 |
$3,942.40 |
$3,942.40 |
$2,766.73
|
|
Vein x-ray liver w/hemodynam
|
$7,868.40 |
$7,868.40 |
$7,868.40 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$4,199.20 |
$4,199.20 |
$4,199.20 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$2,949.20 |
$2,949.20 |
$2,949.20 |
$2,452.80
|
|
Vein x-ray skull
|
$2,898.40 |
$2,898.40 |
$2,898.40 |
$2,141.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$7.20 |
$7.20 |
$7.20 |
$202.80
|
|
Venipuncture <3 yrs other vein
|
$32.40 |
$32.40 |
$32.40 |
$67.00
|
|
Venogram ext bil s&i
|
$2,550.40 |
$2,550.40 |
$2,550.40 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$2,020.40 |
$2,020.40 |
$2,020.40 |
$1,366.20
|
|
Venous mech thrombectomy
|
$4,083.20 |
$4,083.20 |
$4,083.20 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$4,083.20 |
$4,083.20 |
$4,083.20 |
$5,094.75
|
|
Venous sampling s&i
|
$4,193.20 |
$4,193.20 |
$4,193.20 |
$4,193.20
|
|
Ven thrombosis images bilat
|
$887.60 |
$887.60 |
$887.60 |
$796.50
|
|
Ventilator each subsequent day
|
$2,670.80 |
$2,670.80 |
$2,670.80 |
$1,204.00
|
