|
Ugt1a1 gene analy common variants
|
$282.00 |
$282.00 |
$282.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$359.20 |
$359.20 |
$359.20 |
$394.20
|
|
Ultrasound breast complete
|
$347.20 |
$347.20 |
$347.20 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$255.60 |
$255.60 |
$255.60 |
$449.35
|
|
Ultrasound chest
|
$353.60 |
$353.60 |
$353.60 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$300.00 |
$300.00 |
$300.00 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$327.20 |
$327.20 |
$327.20 |
$307.00
|
|
Ultrasound encephalogram
|
$359.20 |
$359.20 |
$359.20 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$464.40 |
$464.40 |
$464.40 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$359.20 |
$359.20 |
$359.20 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$84.40 |
$84.40 |
$84.40 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$579.20 |
$579.20 |
$579.20 |
$720.15
|
|
Ultrasound guide intraoperative
|
$339.60 |
$339.60 |
$339.60 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$335.60 |
$335.60 |
$335.60 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$305.60 |
$305.60 |
$305.60 |
$403.88
|
|
Ultrasound joint complete left
|
$407.20 |
$407.20 |
$407.20 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$304.40 |
$304.40 |
$304.40 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$407.20 |
$407.20 |
$407.20 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$266.00 |
$266.00 |
$266.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$707.20 |
$707.20 |
$707.20 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$346.00 |
$346.00 |
$346.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$355.60 |
$355.60 |
$355.60 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$399.20 |
$399.20 |
$399.20 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$435.20 |
$435.20 |
$435.20 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$359.20 |
$359.20 |
$359.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$426.00 |
$426.00 |
$426.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$391.20 |
$391.20 |
$391.20 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$323.20 |
$323.20 |
$323.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$488.00 |
$488.00 |
$488.00 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$461.20 |
$461.20 |
$461.20 |
$206.64
|
|
Unit mobile power mpu
|
$14,612.80 |
$14,612.80 |
$14,612.80 |
$14,612.80
|
|
Unlisted chemotherapy px
|
$108.40 |
$108.40 |
$108.40 |
$150.00
|
|
Unlisted fluoroscopic px
|
$275.20 |
$275.20 |
$275.20 |
$305.76
|
|
Unlisted maaa
|
$280.00 |
$280.00 |
$280.00 |
$235.20
|
|
Unlisted mr procedure
|
$6,891.60 |
$6,891.60 |
$6,891.60 |
$1,163.00
|
|
Unlisted procedure larynx
|
$2,210.40 |
$2,210.40 |
$2,210.40 |
$924.00
|
|
Unlisted procedure microbiology
|
$22.40 |
$22.40 |
$22.40 |
$523.50
|
|
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
|
$8.83 |
$8.83 |
$8.83 |
$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
|
$13.80 |
$13.80 |
$13.80 |
$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
|
$218.00 |
$218.00 |
$218.00 |
$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
|
