|
Ultrasound encephalogram
|
$107.94 |
$447.38 |
$468.14 |
|
|
Ultrasound exam k transpl w/doppler
|
$281.40 |
$281.40 |
$281.40 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$162.54 |
$653.70 |
$704.46 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$475.42 |
$489.62 |
$512.34 |
|
|
Ultrasound guidance for vascular access
|
$146.58 |
$251.94 |
$271.50 |
|
|
Ultrasound guide intraoperative
|
$439.74 |
$439.74 |
$439.74 |
|
|
Ultrasound guide tissue ablation
|
$281.40 |
$281.40 |
$281.40 |
|
|
Ultrasound hips infant dynamic
|
$107.94 |
$107.94 |
$107.94 |
|
|
Ultrasound infant hips ltd without stress
|
$78.96 |
$248.26 |
$259.78 |
|
|
Ultrasound joint complete left
|
$282.66 |
$760.83 |
$819.92 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$126.84 |
$344.84 |
$371.62 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$86.94 |
$236.03 |
$254.36 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$265.02 |
$265.02 |
$522.29 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$129.78 |
$454.49 |
$489.79 |
|
|
Ultrasound prostate/transrectal
|
$269.64 |
$269.64 |
$542.10 |
|
|
Ultrasound spinal canal and contents
|
$166.74 |
$166.74 |
$367.11 |
|
|
Ultrasound transabd ea addl gest
|
$296.52 |
$584.23 |
$629.60 |
|
|
Unlisted CT procedure
|
$3,239.64 |
$3,239.64 |
$3,239.64 |
|
|
Unlisted hematology&coagj px
|
$23.94 |
$36.25 |
$39.16 |
|
|
Unlisted mr procedure
|
$1,249.50 |
$1,249.50 |
$1,249.50 |
|
|
Unlisted procedure microbiology
|
$359.52 |
$359.52 |
$359.52 |
|
|
Unlisted transfusion med px
|
$112.56 |
$175.00 |
$205.82 |
|
|
Unsched dialysis esrd pt hos
|
$831.60 |
$831.60 |
$831.60 |
|
|
Upgrade pm system
|
$8,276.94 |
$8,276.94 |
$8,276.94 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$78.96 |
$301.31 |
$327.85 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$809.34 |
$2,362.80 |
$2,705.41 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$647.22 |
$1,890.00 |
$2,164.05 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,194.48 |
$1,736.87 |
$1,841.03 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$995.40 |
$1,447.39 |
$1,534.19 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$796.32 |
$1,157.91 |
$1,227.35 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$78.96 |
$347.07 |
$377.64 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$84.00 |
$359.74 |
$391.43 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$229.32 |
$622.34 |
$677.14 |
|
|
Upper GI Barium X-ray (barium only)
|
$200.76 |
$468.86 |
$510.16 |
|
|
Urea nitrogen
|
$5.04 |
$26.44 |
$28.60 |
|
|
Urea nitrogen 24 hour urine
|
$21.84 |
$31.98 |
$34.58 |
|
|
Ureteral embolization/occl
|
$1,504.44 |
$1,504.44 |
$1,504.44 |
|
|
Ureteral reflux study
|
$253.26 |
$535.31 |
$616.23 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$206.22 |
$500.54 |
$544.63 |
|
|
Urethrocystography void s&i
|
$220.08 |
$566.72 |
$616.63 |
|
|
Uric acid blood
|
$5.88 |
$8.61 |
$9.31 |
|
|
Uric acid urine
|
$30.24 |
$44.28 |
$47.88 |
|
|
Urinalysis microscopic only
|
$4.20 |
$5.93 |
$6.64 |
|
|
Urinalysis qual/semiquant excpt ia
|
$2.94 |
$4.15 |
$4.65 |
|
|
Urinalysis (with microscopy)
|
$4.20 |
$32.61 |
$36.52 |
|
|
Urinalysis (without microscopy)
|
$4.15 |
$4.44 |
$22.26 |
|
|
Urine Culture Test
|
$10.50 |
$15.72 |
$17.70 |
|
|
Urine pregnancy test
|
$24.36 |
$34.39 |
$38.51 |
|
|
Urography, antegrade
|
$278.46 |
$278.46 |
$499.14 |
|
|
Urography inf drip &/or bolus
|
$464.94 |
$464.94 |
$464.94 |
|
|
Use 1st target lesion
|
$217.62 |
$217.62 |
$234.52 |
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$39.96 |
$39.96 |
$39.96 |
|
|
Vaccine Administration (one shot)
|
$27.11 |
$44.93 |
$55.02 |
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$38.21 |
$38.21 |
$38.21 |
|
|
Valproic acid total therapeutic drug level
|
$27.72 |
$32.59 |
$43.89 |
|
|
Valvuloplasty aortic
|
$4,814.46 |
$4,814.46 |
$4,814.46 |
|
|
Valvuloplasty mitral
|
$4,950.96 |
$4,950.96 |
$4,950.96 |
|
|
Valvuloplasty pulmonary
|
$4,521.30 |
$4,521.30 |
$4,521.30 |
|
|
Vancomycin peak therapeutic drug level
|
$17.22 |
$25.22 |
$27.26 |
|
|
Varicella zoster antibody igg
|
$22.26 |
$27.14 |
$46.14 |
|
|
Veeg cont 2-12 hrs
|
$971.04 |
$971.04 |
$971.04 |
|
|
Veeg ea 12-26hr cont mntr
|
$1,359.54 |
$1,359.54 |
$1,359.54 |
|
|
Veeg intrmnt 2-12 hrs
|
$893.34 |
$893.34 |
$893.34 |
|
|
Veeg unmon 12-26 hrs
|
$1,165.08 |
$1,165.08 |
$1,165.08 |
|
|
Veeg unmon 2-12 hrs
|
$776.58 |
$776.58 |
$776.58 |
|
|
Vein x-ray adrenal gland
|
$2,441.88 |
$2,441.88 |
$2,441.88 |
|
|
Vein x-ray adrenal glands
|
$2,865.24 |
$2,865.24 |
$2,865.24 |
|
|
Vein x-ray eye socket
|
$2,291.94 |
$2,291.94 |
$2,291.94 |
|
|
Vein x-ray kidney
|
$2,168.46 |
$2,168.46 |
$2,168.46 |
|
|
Vein x-ray liver
|
$1,954.68 |
$1,954.68 |
$1,954.68 |
|
|
Vein x-ray liver w/hemodynam
|
$2,669.10 |
$2,669.10 |
$2,669.10 |
|
|
Vein x-ray liver w/hemodynam
|
$2,171.82 |
$2,171.82 |
$2,171.82 |
|
|
Vein x-ray liver without hemodyn
|
$2,639.28 |
$2,639.28 |
$2,639.28 |
|
|
Vein x-ray skull
|
$1,575.84 |
$1,575.84 |
$1,575.84 |
|
|
Vein x-ray skull epidural
|
$2,441.88 |
$2,441.88 |
$2,441.88 |
|
|
Vein x-ray spleen/liver
|
$1,648.50 |
$1,648.50 |
$1,648.50 |
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$25.97 |
$29.80 |
$33.50 |
|
|
Venipuncture <3 yrs other vein
|
$24.16 |
$24.16 |
$24.16 |
|
|
Venogram ext bil s&i
|
$555.46 |
$597.27 |
$1,171.38 |
|
|
Venogram extremity supervision & interpretation unilateral
|
$475.20 |
$510.98 |
$1,020.60 |
|
|
Venous mech thrombectomy
|
$6,023.64 |
$6,023.64 |
$6,023.64 |
|
|
Venous m-thrombectomy add-on
|
$3,082.38 |
$3,082.38 |
$3,082.38 |
|
|
Venous sampling s&i
|
$2,852.22 |
$2,852.22 |
$2,852.22 |
|
|
Ventilator each subsequent day
|
$563.67 |
$564.65 |
$967.26 |
|
|
Ventilator Management (first day)
|
$698.56 |
$699.78 |
$1,343.16 |
|
|
Version cephalic external
|
$266.70 |
$559.77 |
$665.88 |
|
|
Very long chain fatty acids
|
$86.10 |
$126.08 |
$136.33 |
|
|
Video Swallow Study (Modified Barium Swallow)
|
$181.44 |
$432.96 |
$471.09 |
|
|
Virus isolation addl studies ea
|
$27.30 |
$40.88 |
$46.02 |
|
|
Vital capacity test
|
$56.55 |
$56.55 |
$79.38 |
|
|
Vitamin b-12
|
$22.68 |
$33.21 |
$35.91 |
|
|
Vitamin D Test
|
$37.38 |
$99.02 |
$107.07 |
|
|
Vkorc1 gene
|
$111.30 |
$159.79 |
$284.61 |
|
|
Volume measurement urine timed
|
$4.62 |
$4.62 |
$4.62 |
|
|
Walking (Gait) Training (each 15 minutes)
|
$36.12 |
$59.05 |
$65.94 |
|
|
Warde 1003990 aldosterone
|
$51.66 |
$166.05 |
$179.55 |
|
|
Warde 1005020 citrate 24 hour urine
|
$73.08 |
$107.01 |
$115.71 |
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$25.62 |
$37.52 |
$40.57 |
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$31.92 |
$46.74 |
$50.54 |
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$34.44 |
$50.43 |
$54.53 |
|