|
Ultrasound prostate/transrectal
|
$741.47 |
$741.47 |
$741.47 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$453.15 |
$453.15 |
$453.15 |
$498.00
|
|
Ultrasound scrotum and contents
|
$579.82 |
$579.82 |
$579.82 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$701.19 |
$701.19 |
$701.19 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$440.96 |
$440.96 |
$440.96 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$520.99 |
$520.99 |
$520.99 |
$567.44
|
|
Ultraviolet therapy
|
$22.26 |
$22.26 |
$22.26 |
$42.60
|
|
Unlisted cytogenetic study
|
$137.27 |
$137.27 |
$137.27 |
$132.48
|
|
Unlisted transfusion med px
|
$283.02 |
$283.02 |
$283.02 |
$141.35
|
|
Unlisted ultrasound procedure
|
$155.29 |
$155.29 |
$155.29 |
$321.20
|
|
Upgrade pm system
|
$14,269.19 |
$14,269.19 |
$14,269.19 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,271.69 |
$3,271.69 |
$3,271.69 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,121.06 |
$2,121.06 |
$2,121.06 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,100.39 |
$2,100.39 |
$2,100.39 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,184.66 |
$2,184.66 |
$2,184.66 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,318.75 |
$2,318.75 |
$2,318.75 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$770.62 |
$770.62 |
$770.62 |
$1,773.85
|
|
Urea nitrogen
|
$39.75 |
$39.75 |
$39.75 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$39.22 |
$39.22 |
$39.22 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$404.39 |
$404.39 |
$404.39 |
$574.40
|
|
Urethrocystography void s&i
|
$437.25 |
$437.25 |
$437.25 |
$634.50
|
|
Uric acid blood
|
$46.64 |
$46.64 |
$46.64 |
$46.64
|
|
Uric acid urine
|
$49.29 |
$49.29 |
$49.29 |
$46.75
|
|
Urinalysis microscopic only
|
$25.44 |
$25.44 |
$25.44 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$18.02 |
$18.02 |
$18.02 |
$25.72
|
|
Urinalysis (with microscopy)
|
$25.44 |
$25.44 |
$25.44 |
$48.14
|
|
Urinalysis (without microscopy)
|
$16.96 |
$16.96 |
$16.96 |
$38.99
|
|
Urinary bldr retent nuc study
|
$130.38 |
$130.38 |
$130.38 |
$309.22
|
|
Urinary reflex study
|
$464.81 |
$464.81 |
$464.81 |
$152.00
|
|
Urine Culture Test
|
$64.66 |
$64.66 |
$64.66 |
$84.81
|
|
Urine flow measurement 51736
|
$50.88 |
$50.88 |
$50.88 |
$152.54
|
|
Urine pregnancy test
|
$59.89 |
$59.89 |
$59.89 |
$66.40
|
|
Urine screen for bacteria
|
$9.01 |
$9.01 |
$9.01 |
$32.98
|
|
Urography, antegrade
|
$488.66 |
$488.66 |
$488.66 |
$593.37
|
|
Urokinase 5000 iu injection
|
$8.48 |
$8.48 |
$8.48 |
$199.82
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$10.17 |
$10.17 |
$10.17 |
$5,521.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$210.94 |
$210.94 |
$210.94 |
$56,553.85
|
|
Vaccine dtap < 7 years im
|
$39.22 |
$39.22 |
$39.22 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$106.53 |
$106.53 |
$106.53 |
$193.83
|
|
Vaccine dtap-ipv 4-6 years im
|
$64.13 |
$64.13 |
$64.13 |
$126.84
|
|
Vaccine dtap-ipv-hib-hepb im
|
$140.45 |
$140.45 |
$140.45 |
$158.30
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$41.34 |
$41.34 |
$41.34 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$39.75 |
$39.75 |
$39.75 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$87.98 |
$87.98 |
$87.98 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$133.56 |
$133.56 |
$133.56 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$63.60 |
$63.60 |
$63.60 |
$84.38
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im
|
$63.60 |
$63.60 |
$63.60 |
$48.10
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$112.36 |
$112.36 |
$112.36 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$163.53 |
$163.53 |
$163.53 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$64.13 |
$64.13 |
$64.13 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$204.58 |
$204.58 |
$204.58 |
$686.67
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$204.58 |
$204.58 |
$204.58 |
$226.20
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$133.15 |
$133.15 |
$133.15 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$51.94 |
$51.94 |
$51.94 |
$110.25
|
|
Vaccine influenza nos 0.5ml dose im
|
$19.61 |
$19.61 |
$19.61 |
$36.80
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$46.48 |
$46.48 |
$46.48 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$21.20 |
$21.20 |
$21.20 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$19.61 |
$19.61 |
$19.61 |
$40.01
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$31.80 |
$31.80 |
$31.80 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$44.52 |
$44.52 |
$44.52 |
$72.00
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$325.64 |
$325.64 |
$325.64 |
$499.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$159.53 |
$159.53 |
$159.53 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$121.37 |
$121.37 |
$121.37 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$137.80 |
$137.80 |
$137.80 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$160.67 |
$160.67 |
$160.67 |
$224.04
|
|
Vaccine mmrv live subcutaneous
|
$195.04 |
$195.04 |
$195.04 |
$474.24
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$94.34 |
$94.34 |
$94.34 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$234.26 |
$234.26 |
$234.26 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$517.97 |
$517.97 |
$517.97 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$41.34 |
$41.34 |
$41.34 |
$119.17
|
|
Vaccine rabies im
|
$695.08 |
$695.08 |
$695.08 |
$945.46
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$308.80 |
$308.80 |
$308.80 |
$624.00
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$129.85 |
$129.85 |
$129.85 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$109.71 |
$109.71 |
$109.71 |
$108.00
|
|
Vaccine tdap >=7 years im
|
$36.57 |
$36.57 |
$36.57 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$36.57 |
$36.57 |
$36.57 |
$131.77
|
|
Vaccine typhoid vicps im
|
$113.95 |
$113.95 |
$113.95 |
$205.22
|
|
Vaccine varicella live subcutaneous
|
$292.01 |
$292.01 |
$292.01 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$105.47 |
$105.47 |
$105.47 |
$115.00
|
|
Valrubicin injection
|
$2,550.44 |
$2,550.44 |
$2,550.44 |
$2,813.49
|
|
Valvuloplasty aortic
|
$12,848.79 |
$12,848.79 |
$12,848.79 |
$7,324.85
|
|
Valvuloplasty mitral
|
$18,230.41 |
$18,230.41 |
$18,230.41 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$32,118.00 |
$32,118.00 |
$32,118.00 |
$11,945.20
|
|
Vancomycin hcl injection
|
$145.42 |
$145.42 |
$145.42 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$108.65 |
$108.65 |
$108.65 |
$126.79
|
|
Vantas implant
|
$5,225.80 |
$5,225.80 |
$5,225.80 |
$13,843.70
|
|
Variable concentration mask
|
$1.06 |
$1.06 |
$1.06 |
$1.26
|
|
Varicella zoster antibody igg
|
$47.17 |
$47.17 |
$47.17 |
$82.55
|
|
Varicella-zoster immue globin im
|
$2,072.30 |
$2,072.30 |
$2,072.30 |
$2,372.84
|
|
Vasectomy
|
$411.28 |
$411.28 |
$411.28 |
$2,424.12
|
|
Vasopressin 20 unit/ml intravenous solution
|
$364.96 |
$364.96 |
$364.96 |
$362.93
|
|
Veeg cont 2-12 hrs
|
$1,188.26 |
$1,188.26 |
$1,188.26 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$1,883.09 |
$1,883.09 |
$1,883.09 |
$3,332.45
|
|
Veeg unmon 12-26 hrs
|
$1,671.09 |
$1,671.09 |
$1,671.09 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$976.26 |
$976.26 |
$976.26 |
$704.79
|
|
Vein x-ray kidney
|
$1,675.33 |
$1,675.33 |
$1,675.33 |
$2,716.20
|
|
Vein x-ray liver w/hemodynam
|
$1,674.80 |
$1,674.80 |
$1,674.80 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$1,674.80 |
$1,674.80 |
$1,674.80 |
$3,439.84
|
|
Velaglucerase alfa 400 unit intravenous solution
|
$590.09 |
$590.09 |
$590.09 |
$2,978.05
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$1,160.17 |
$1,160.17 |
$1,160.17 |
$188.65
|
