|
Ultrasound spinal canal and contents
|
$391.20 |
$391.20 |
$398.87 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$323.20 |
$323.20 |
$342.53 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$482.56 |
$488.00 |
$488.00 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$179.52 |
$461.20 |
$461.20 |
$206.64
|
|
Umbilical cord occlud w/us
|
$252.90 |
$252.90 |
$252.90 |
$754.00
|
|
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 cytogenetic study
|
$127.79 |
$127.79 |
$127.79 |
$160.18
|
|
Unlisted fluoroscopic px
|
$275.20 |
$275.20 |
$516.40 |
$305.76
|
|
Unlisted hematology&coagj px
|
$46.42 |
$46.42 |
$46.42 |
$39.52
|
|
Unlisted maaa
|
$280.00 |
$280.00 |
$280.00 |
$235.20
|
|
Unlisted mr procedure
|
$1,622.50 |
$6,891.60 |
$6,891.60 |
$1,163.00
|
|
Unlisted procedure esophagus
|
$800.96 |
$800.96 |
$800.96 |
$1,998.88
|
|
Unlisted procedure larynx
|
$2,210.40 |
$2,210.40 |
$2,210.40 |
$924.00
|
|
Unlisted procedure liver
|
$1,122.14 |
$1,122.14 |
$1,122.14 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$22.40 |
$22.40 |
$1,482.03 |
$523.50
|
|
Unlisted procedure rectum
|
$457.15 |
$457.15 |
$457.15 |
$1,220.35
|
|
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 hands/fingers
|
$198.62 |
$198.62 |
$198.62 |
$354.20
|
|
Unlisted px male genital sys
|
$249.26 |
$249.26 |
$249.26 |
$343.55
|
|
Unlisted px med radj physics
|
$363.60 |
$363.60 |
$680.86 |
$462.35
|
|
Unlisted px small intestine
|
$2,210.40 |
$2,210.40 |
$2,210.40 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$207.80 |
$207.80 |
$207.80 |
$282.50
|
|
Unlisted special svc px/rprt
|
$36.97 |
$36.97 |
$36.97 |
$90.00
|
|
Unlisted transfusion med px
|
$165.10 |
$165.10 |
$165.10 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$774.00 |
$774.00 |
$1,055.75 |
$1,268.17
|
|
Upgrade pm system
|
$5,213.00 |
$11,642.40 |
$11,642.40 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,928.40 |
$1,928.40 |
$3,488.70 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,990.00 |
$1,990.00 |
$2,302.54 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,753.60 |
$1,753.60 |
$2,267.66 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$671.52 |
$4,088.80 |
$4,088.80 |
$1,751.66
|
|
Urea nitrogen
|
$11.20 |
$11.20 |
$18.58 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$11.60 |
$11.60 |
$32.02 |
$51.75
|
|
Urea nitrogen clearance
|
$16.00 |
$16.00 |
$28.92 |
$42.25
|
|
Ureteral embolization/occl
|
$1,532.94 |
$1,532.94 |
$1,532.94 |
$2,181.40
|
|
Ureteral reflux study
|
$694.43 |
$1,249.20 |
$1,249.20 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$382.40 |
$382.40 |
$481.78 |
$579.73
|
|
Urethrocystography void s&i
|
$626.32 |
$714.40 |
$714.40 |
$622.35
|
|
Uric acid blood
|
$11.60 |
$11.60 |
$19.05 |
$48.75
|
|
Uric acid urine
|
$12.00 |
$12.00 |
$33.62 |
$44.33
|
|
Urinalysis microscopic only
|
$8.40 |
$8.40 |
$20.44 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$5.60 |
$5.60 |
$5.60 |
$25.72
|
|
Urinalysis (with microscopy)
|
$9.20 |
$9.20 |
$33.16 |
$55.00
|
|
Urinalysis (without microscopy)
|
$5.60 |
$5.60 |
$29.35 |
$35.75
|
|
Urinary bldr retent nuc study
|
$378.93 |
$378.93 |
$378.93 |
$350.66
|
|
Urinary reflex study
|
$201.60 |
$201.60 |
$201.60 |
$216.05
|
|
Urine Culture Test
|
$20.40 |
$20.40 |
$65.31 |
$81.50
|
|
Urine flow measurement 51736
|
$210.00 |
$210.00 |
$210.00 |
$210.00
|
|
Urine pregnancy test
|
$11.60 |
$11.60 |
$55.83 |
$67.20
|
|
Urography, antegrade
|
$461.30 |
$795.60 |
$795.60 |
$622.35
|
|
Use 1st target lesion
|
$178.16 |
$359.20 |
$359.20 |
$332.00
|
|
User adjustable heel height
|
$1,111.60 |
$1,111.60 |
$1,111.60 |
$2,004.80
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$33.61 |
$33.61 |
$12,475.55 |
$5,184.34
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$633.45 |
$633.45 |
$633.45 |
$51,633.07
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$192.17 |
$192.17 |
$192.17 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$123.31 |
$123.31 |
$123.31 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$92.09 |
$92.09 |
$92.09 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$32.80 |
$32.80 |
$43.11 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$1.07 |
$1.07 |
$33.36 |
$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 |
$47.24 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$1.07 |
$1.07 |
$7.94 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$1.07 |
$5.32 |
$98.14 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$68.55 |
$68.55 |
$139.50 |
$166.62
|
|
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
|
$177.36 |
$177.36 |
$177.94 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$8.59 |
$8.69 |
$88.68 |
$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 |
$120.60 |
$576.48
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$53.20 |
$53.20 |
$53.20 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$89.91 |
$89.91 |
$89.91 |
$109.50
|
|
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
|
$16.56 |
$20.00 |
$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 |
$89.18 |
$400.03
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1.07 |
$1.07 |
$65.82 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$148.40 |
$148.40 |
$268.59 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$13.64 |
$13.80 |
$169.91 |
$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 |
$217.37 |
$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 |
$514.35 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$1.07 |
$8.50 |
$78.47 |
$90.70
|
|
Vaccine rabies im
|
$548.06 |
$672.40 |
$696.36 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$217.52 |
$218.00 |
$810.21 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1.07 |
$218.00 |
$810.21 |
$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 |
$81.56 |
$86.78 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$54.98 |
$54.98 |
$95.64 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$1.07 |
$69.54 |
$196.11 |
$365.17
|
|
Vacuum drain bottle/tube kit
|
$349.20 |
$349.20 |
$587.76 |
$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
|
