|
Tx atrial fib pulm vein isol
|
$10,636.20 |
$10,636.20 |
$10,636.20 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$47.12 |
$47.12 |
$47.12 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$59.66 |
$59.66 |
$59.66 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,649.20 |
$1,649.20 |
$1,649.20 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$59.66 |
$59.66 |
$59.66 |
$535.60
|
|
Tx l/r atrial fib addl
|
$2,816.75 |
$2,816.75 |
$2,816.75 |
$6,769.00
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,835.02 |
$1,835.02 |
$1,835.02 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,704.68 |
$1,704.68 |
$1,704.68 |
$4,499.12
|
|
Ua w/micro/comp poc
|
$2.28 |
$2.28 |
$2.28 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$270.75 |
$270.75 |
$270.75 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$45.22 |
$45.22 |
$45.22 |
$394.20
|
|
Ultrasound breast complete
|
$75.62 |
$75.62 |
$75.62 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$75.62 |
$75.62 |
$75.62 |
$449.35
|
|
Ultrasound chest
|
$75.62 |
$75.62 |
$75.62 |
$460.85
|
|
Ultrasound elastography parenchyma
|
$74.67 |
$74.67 |
$74.67 |
$307.00
|
|
Ultrasound encephalogram
|
$185.63 |
$185.63 |
$185.63 |
$488.80
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$70.30 |
$70.30 |
$70.30 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$92.72 |
$92.72 |
$92.72 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$148.77 |
$148.77 |
$148.77 |
$720.15
|
|
Ultrasound guide intraoperative
|
$117.80 |
$117.80 |
$117.80 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$85.12 |
$85.12 |
$85.12 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$112.48 |
$112.48 |
$112.48 |
$311.25
|
|
Ultrasound joint complete left
|
$146.11 |
$146.11 |
$146.11 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$106.78 |
$106.78 |
$106.78 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$249.85 |
$249.85 |
$249.85 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$206.15 |
$206.15 |
$206.15 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$119.70 |
$119.70 |
$119.70 |
$707.20
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$124.26 |
$124.26 |
$124.26 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$125.21 |
$125.21 |
$125.21 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$66.50 |
$66.50 |
$66.50 |
$486.50
|
|
Ultrasound scrotum and contents
|
$249.85 |
$249.85 |
$249.85 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$77.14 |
$77.14 |
$77.14 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$80.37 |
$80.37 |
$80.37 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$180.88 |
$180.88 |
$180.88 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$90.25 |
$90.25 |
$90.25 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$45.22 |
$45.22 |
$45.22 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$293.55 |
$293.55 |
$293.55 |
$206.64
|
|
Unlisted gu px dx nuc med
|
$132.62 |
$132.62 |
$132.62 |
$805.62
|
|
Unlisted mr procedure
|
$314.83 |
$314.83 |
$314.83 |
$1,163.00
|
|
Unlisted procedure liver
|
$1,977.90 |
$1,977.90 |
$1,977.90 |
$2,287.20
|
|
Unlisted procedure rectum
|
$211.66 |
$211.66 |
$211.66 |
$1,220.35
|
|
Unlisted procedure spine
|
$147.25 |
$147.25 |
$147.25 |
$4,659.85
|
|
Unlisted px ant segment eye
|
$578.74 |
$578.74 |
$578.74 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$35.53 |
$35.53 |
$35.53 |
$219.70
|
|
Unlisted px leg/ankle
|
$47.12 |
$47.12 |
$47.12 |
$811.00
|
|
Unlisted px male genital sys
|
$68.40 |
$68.40 |
$68.40 |
$343.55
|
|
Unlisted px med radj physics
|
$45.22 |
$45.22 |
$45.22 |
$462.35
|
|
Unlisted px palate uvula
|
$122.55 |
$122.55 |
$122.55 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$543.78 |
$543.78 |
$543.78 |
$1,265.16
|
|
Unlisted px tongue flr mouth
|
$56.24 |
$56.24 |
$56.24 |
$282.50
|
|
Unsched dialysis esrd pt hos
|
$211.85 |
$211.85 |
$211.85 |
$1,268.17
|
|
Upgrade pm system
|
$8,455.76 |
$8,455.76 |
$8,455.76 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,730.52 |
$1,730.52 |
$1,730.52 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,018.21 |
$1,018.21 |
$1,018.21 |
$2,034.41
|
|
Urea nitrogen
|
$7.60 |
$7.60 |
$7.60 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$6.65 |
$6.65 |
$6.65 |
$51.75
|
|
Ureteral embolization/occl
|
$356.25 |
$356.25 |
$356.25 |
$2,181.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$169.10 |
$169.10 |
$169.10 |
$579.73
|
|
Urethrocystography void s&i
|
$175.56 |
$175.56 |
$175.56 |
$622.35
|
|
Uric acid blood
|
$9.50 |
$9.50 |
$9.50 |
$48.75
|
|
Uric acid urine
|
$47.69 |
$47.69 |
$47.69 |
$44.33
|
|
Urinalysis qual/semiquant excpt ia
|
$1.52 |
$1.52 |
$1.52 |
$25.72
|
|
Urinalysis (with microscopy)
|
$35.91 |
$35.91 |
$35.91 |
$55.00
|
|
Urinalysis (without microscopy)
|
$35.91 |
$35.91 |
$35.91 |
$35.75
|
|
Urine Culture Test
|
$11.59 |
$11.59 |
$11.59 |
$81.50
|
|
Urine pregnancy test
|
$62.13 |
$62.13 |
$62.13 |
$67.20
|
|
Urography, antegrade
|
$230.47 |
$230.47 |
$230.47 |
$622.35
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$13.62 |
$13.62 |
$13.62 |
$143.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$3.48 |
$3.48 |
$3.48 |
$33.60
|
|
Vaginal bx
|
$36.48 |
$36.48 |
$36.48 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,510.50 |
$1,510.50 |
$1,510.50 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$78.66 |
$78.66 |
$78.66 |
$114.72
|
|
Valrubicin injection
|
$1,294.42 |
$1,294.42 |
$1,294.42 |
$2,813.49
|
|
Valvuloplasty aortic
|
$4,300.84 |
$4,300.84 |
$4,300.84 |
$7,830.80
|
|
Vancomycin hcl injection
|
$572.60 |
$572.60 |
$572.60 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$57.00 |
$57.00 |
$57.00 |
$136.13
|
|
Varicella zoster antibody igg
|
$68.78 |
$68.78 |
$68.78 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,815.25 |
$1,815.25 |
$1,815.25 |
$325.80
|
|
Vein x-ray kidney
|
$1,160.14 |
$1,160.14 |
$1,160.14 |
$2,766.73
|
|
Vein x-ray liver
|
$1,160.33 |
$1,160.33 |
$1,160.33 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$1,160.14 |
$1,160.14 |
$1,160.14 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$1,160.33 |
$1,160.33 |
$1,160.33 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$347.51 |
$347.51 |
$347.51 |
$2,452.80
|
|
Vein x-ray skull
|
$316.73 |
$316.73 |
$316.73 |
$2,141.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$155.99 |
$155.99 |
$155.99 |
$202.80
|
|
Venogram ext bil s&i
|
$433.96 |
$433.96 |
$433.96 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$400.52 |
$400.52 |
$400.52 |
$1,366.20
|
|
Venous mech thrombectomy
|
$1,859.72 |
$1,859.72 |
$1,859.72 |
$7,965.00
|
|
Venous m-thrombectomy add-on
|
$1,859.72 |
$1,859.72 |
$1,859.72 |
$5,094.75
|
|
Venous sampling s&i
|
$1,241.46 |
$1,241.46 |
$1,241.46 |
$4,193.20
|
|
Ventilator each subsequent day
|
$335.35 |
$335.35 |
$335.35 |
$1,204.00
|
|
Ventilator initial day
|
$342.38 |
$342.38 |
$342.38 |
$1,431.43
|
|
Version cephalic external
|
$858.42 |
$858.42 |
$858.42 |
$2,361.75
|
|
Very long chain fatty acids
|
$219.07 |
$219.07 |
$219.07 |
$139.88
|
|
Vinblastine 1 mg/ml intravenous solution
|
$46.77 |
$46.77 |
$46.77 |
$165.00
|
|
Vincristine 1 mg/ml intravenous solution
|
$19.00 |
$19.00 |
$19.00 |
$87.15
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$335.52 |
$335.52 |
$335.52 |
$223.55
|
|
Visit established high 40-54 minutes/level 5
|
$24.32 |
$24.32 |
$24.32 |
$227.50
|
|
Vitamin b-12
|
$25.46 |
$25.46 |
$25.46 |
$100.00
|
