|
Transcath closure of asd
|
$12,314.77 |
$12,314.77 |
$17,878.48 |
$17,088.00
|
|
Transcath closure of vsd
|
$4,096.42 |
$4,096.42 |
$7,516.03 |
$17,115.04
|
|
Transcatheter bx s&i
|
$468.90 |
$468.90 |
$481.40 |
$1,950.85
|
|
Transcath mv repair addl prosthesis
|
$3,041.21 |
$3,041.21 |
$4,415.21 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$10,328.80 |
$10,328.80 |
$14,995.26 |
$13,093.20
|
|
Transcath occlusion cns
|
$2,606.70 |
$2,606.70 |
$3,784.39 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$2,007.39 |
$2,007.39 |
$2,914.31 |
$10,270.00
|
|
Trans cath replace aortic valve 33366
|
$5,668.24 |
$5,668.24 |
$8,229.10 |
$14,593.50
|
|
Transcath rmvl perm ldss pmkr rv
|
$9,120.74 |
$9,120.74 |
$13,241.40 |
$4,822.00
|
|
Transferrin
|
$12.17 |
$12.17 |
$12.64 |
$82.00
|
|
Transperi needle place pros
|
$4,064.15 |
$4,064.15 |
$4,064.15 |
$6,015.75
|
|
Transplj hematopoietic boost
|
$1,322.32 |
$1,322.32 |
$1,322.32 |
$2,667.20
|
|
Transplt allo lymphocytes
|
$1,322.32 |
$1,322.32 |
$1,322.32 |
$2,751.65
|
|
Transplt autol hct/donor
|
$2,993.21 |
$2,993.21 |
$2,993.21 |
$3,986.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$173.66 |
$173.66 |
$205.79 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$173.66 |
$173.66 |
$205.79 |
$501.60
|
|
Trauma partial team response w/critical care services level 4
|
$1,772.00 |
$1,772.00 |
$2,945.84 |
$4,471.50
|
|
Tray bonemarrw oncontrol 102mm
|
$120.58 |
$120.58 |
$125.33 |
$940.80
|
|
Treatment radiation delivery level 2
|
$219.60 |
$219.60 |
$219.60 |
$830.70
|
|
Treat spinal cord lesion
|
$489.69 |
$489.69 |
$489.69 |
$1,337.00
|
|
Treponema pallidum antibody
|
$10.06 |
$10.06 |
$15.91 |
$72.05
|
|
Trg gene rearrangement anal
|
$141.42 |
$141.42 |
$200.96 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$0.06 |
$0.06 |
$0.06 |
$43.00
|
|
Trichinella antibody
|
$9.38 |
$9.38 |
$14.83 |
$70.65
|
|
#tricyclicantidprssnt
|
$13.57 |
$13.57 |
$14.09 |
$50.54
|
|
Triglycerides
|
$18.72 |
$18.72 |
$19.44 |
$58.05
|
|
Trnscath plc stent crv crtd without prtct
|
$2,595.81 |
$2,595.81 |
$3,768.58 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$4,924.82 |
$4,924.82 |
$7,149.81 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$6,279.90 |
$6,279.90 |
$9,117.10 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,261.26 |
$4,261.26 |
$6,186.45 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$4,170.51 |
$4,170.51 |
$6,054.70 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$8,340.29 |
$8,340.29 |
$12,108.35 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,236.51 |
$3,236.51 |
$4,698.73 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,484.74 |
$2,484.74 |
$3,607.32 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,576.87 |
$1,576.87 |
$2,289.29 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,028.74 |
$1,028.74 |
$1,493.52 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$1,713.72 |
$1,713.72 |
$2,487.97 |
$3,866.70
|
|
Troponin quantitative
|
$28.70 |
$28.70 |
$29.81 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$671.84 |
$671.84 |
$920.55 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$523.95 |
$523.95 |
$717.92 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$555.15 |
$555.15 |
$760.66 |
$1,254.50
|
|
Tte w or without fol w/cont, f/u
|
$261.04 |
$261.04 |
$357.67 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$4,645.60 |
$4,645.60 |
$33,586.93 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$1,765.30 |
$1,765.30 |
$3,968.14 |
$6,986.85
|
|
Tympanometry & reflex thresh
|
$66.85 |
$66.85 |
$66.85 |
$173.18
|
|
Ugt1a1 gene analy common variants
|
$164.16 |
$164.16 |
$233.28 |
$438.75
|
|
Ultrasound breast complete
|
$187.15 |
$187.15 |
$221.78 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$131.51 |
$131.51 |
$155.84 |
$452.40
|
|
Ultrasound dx ophth b-scan
|
$98.07 |
$98.07 |
$116.22 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$103.97 |
$103.97 |
$123.21 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$189.39 |
$189.39 |
$224.44 |
$313.95
|
|
Ultrasound encephalogram
|
$184.15 |
$184.15 |
$184.15 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$146.40 |
$146.40 |
$173.49 |
$575.40
|
|
Ultrasound Guidance for a Needle Procedure
|
$271.73 |
$271.73 |
$322.01 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$56.20 |
$56.20 |
$66.60 |
$388.08
|
|
Ultrasound guide intraoperative
|
$221.45 |
$221.45 |
$221.45 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$170.85 |
$170.85 |
$202.46 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$147.85 |
$147.85 |
$147.85 |
$311.25
|
|
Ultrasound joint complete left
|
$155.67 |
$155.67 |
$184.48 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$151.18 |
$151.18 |
$179.15 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$103.13 |
$103.13 |
$122.21 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$270.06 |
$270.06 |
$270.06 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$204.85 |
$204.85 |
$242.76 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$115.49 |
$115.49 |
$136.86 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$251.42 |
$251.42 |
$251.42 |
$463.00
|
|
Umbilical artery cath newborn 36660
|
$806.22 |
$806.22 |
$806.22 |
$223.80
|
|
Unlisted chemotherapy px
|
$50.50 |
$50.50 |
$50.50 |
$143.75
|
|
Unlisted CT procedure
|
$525.59 |
$525.59 |
$525.59 |
$732.70
|
|
Unlisted dialysis procedure
|
$252.51 |
$252.51 |
$890.43 |
$1,144.00
|
|
Unlisted dx gi procedure
|
$119.51 |
$119.51 |
$119.51 |
$649.22
|
|
Unlisted hematology&coagj px
|
$7.41 |
$7.41 |
$7.81 |
$39.52
|
|
Unlisted mr procedure
|
$638.79 |
$638.79 |
$747.96 |
$1,163.00
|
|
Unlisted procedure liver
|
$3,275.71 |
$3,275.71 |
$3,275.71 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$736.87 |
$736.87 |
$736.87 |
$530.00
|
|
Unlisted px accessory sinus
|
$747.42 |
$747.42 |
$747.42 |
$3,335.28
|
|
Unlisted px biliary tract
|
$2,914.89 |
$2,914.89 |
$2,914.89 |
$3,055.00
|
|
Unlisted px mediastinum
|
$646.50 |
$646.50 |
$646.50 |
$397.60
|
|
Unlisted px neck/thorax
|
$3,313.83 |
$3,313.83 |
$3,313.83 |
$571.20
|
|
Unlisted spec derm svc/px
|
$216.20 |
$216.20 |
$216.20 |
$223.08
|
|
Unlisted transfusion med px
|
$47.44 |
$47.44 |
$54.94 |
$147.50
|
|
Unlisted ultrasound procedure
|
$134.86 |
$134.86 |
$134.86 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$346.50 |
$346.50 |
$471.24 |
$1,296.00
|
|
Upgrade pm system
|
$9,648.90 |
$9,648.90 |
$14,008.19 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$139.80 |
$139.80 |
$143.53 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$354.58 |
$354.58 |
$362.96 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$283.59 |
$283.59 |
$290.29 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$519.78 |
$519.78 |
$679.13 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$433.19 |
$433.19 |
$566.00 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$346.47 |
$346.47 |
$452.69 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$109.20 |
$109.20 |
$112.11 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$135.60 |
$135.60 |
$139.22 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$184.20 |
$184.20 |
$189.11 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$161.40 |
$161.40 |
$165.70 |
$607.20
|
|
Urea nitrogen
|
$21.37 |
$21.37 |
$22.19 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$8.11 |
$8.11 |
$8.42 |
$51.84
|
|
Ureteral embolization/occl
|
$1,355.44 |
$1,355.44 |
$1,967.82 |
$2,079.31
|
|
Urethrcystgrphy rtrgrde s&i
|
$161.70 |
$161.70 |
$166.01 |
$584.00
|
|
Urethrocystography void s&i
|
$215.70 |
$215.70 |
$221.45 |
$634.50
|
|
Uric acid blood
|
$15.91 |
$15.91 |
$16.52 |
$49.32
|
|
Uric acid urine
|
$11.23 |
$11.23 |
$11.66 |
$44.52
|
