|
Tx phalangeal shaft fx open prox/middle ea
|
$148.75 |
$148.75 |
$148.75 |
$4,499.12
|
|
Tx septic abortion surgical 59830
|
$108.99 |
$108.99 |
$108.99 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$54.88 |
$54.88 |
$54.88 |
$416.16
|
|
Tympanic membrane repair
|
$94.01 |
$94.01 |
$94.01 |
$2,638.87
|
|
Tympanolysis transcanal 69450
|
$134.96 |
$134.96 |
$134.96 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$5.46 |
$5.46 |
$5.46 |
$170.00
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$75.60 |
$75.60 |
$75.60 |
$911.43
|
|
Ua w/micro/comp poc
|
$8.26 |
$8.26 |
$8.26 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$16.25 |
$16.25 |
$16.25 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$126.63 |
$126.63 |
$126.63 |
$394.20
|
|
Ultrasound breast complete
|
$159.46 |
$159.46 |
$159.46 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$239.19 |
$239.19 |
$239.19 |
$449.35
|
|
Ultrasound chest
|
$194.95 |
$194.95 |
$194.95 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$178.22 |
$178.22 |
$178.22 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$13.65 |
$13.65 |
$13.65 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$67.55 |
$67.55 |
$67.55 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$134.96 |
$134.96 |
$134.96 |
$307.00
|
|
Ultrasound encephalogram
|
$192.15 |
$192.15 |
$192.15 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$199.15 |
$199.15 |
$199.15 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$270.55 |
$270.55 |
$270.55 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$81.27 |
$81.27 |
$81.27 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$267.96 |
$267.96 |
$267.96 |
$720.15
|
|
Ultrasound guide intraoperative
|
$131.81 |
$131.81 |
$131.81 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$26.95 |
$26.95 |
$26.95 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$200.13 |
$200.13 |
$200.13 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$159.46 |
$159.46 |
$159.46 |
$311.25
|
|
Ultrasound joint complete left
|
$192.15 |
$192.15 |
$192.15 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$233.31 |
$233.31 |
$233.31 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$89.81 |
$89.81 |
$89.81 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$79.80 |
$79.80 |
$79.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$142.66 |
$142.66 |
$142.66 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$95.27 |
$95.27 |
$95.27 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$147.77 |
$147.77 |
$147.77 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$134.05 |
$134.05 |
$134.05 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$57.61 |
$57.61 |
$57.61 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$133.56 |
$133.56 |
$133.56 |
$486.50
|
|
Ultrasound scrotum and contents
|
$199.99 |
$199.99 |
$199.99 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$267.68 |
$267.68 |
$267.68 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$23.38 |
$23.38 |
$23.38 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$132.51 |
$132.51 |
$132.51 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$16.10 |
$16.10 |
$16.10 |
$206.64
|
|
Umbilicoplasty 15847
|
$151.06 |
$151.06 |
$151.06 |
$4,172.97
|
|
Unlistd noninvas vasc dx std
|
$3.29 |
$3.29 |
$3.29 |
$528.80
|
|
Unlisted dx gi procedure
|
$124.60 |
$124.60 |
$124.60 |
$649.22
|
|
Unlisted hematology&coagj px
|
$3.08 |
$3.08 |
$3.08 |
$39.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$257.39 |
$257.39 |
$257.39 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$75.04 |
$75.04 |
$75.04 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$298.41 |
$298.41 |
$298.41 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$24.36 |
$24.36 |
$24.36 |
$6,463.42
|
|
Unlisted laps px bladder
|
$394.31 |
$394.31 |
$394.31 |
$5,082.74
|
|
Unlisted laps px ovidct ovry
|
$63.84 |
$63.84 |
$63.84 |
$6,904.15
|
|
Unlisted laps px renal
|
$181.30 |
$181.30 |
$181.30 |
$5,110.00
|
|
Unlisted laps px spleen
|
$316.47 |
$316.47 |
$316.47 |
$4,627.00
|
|
Unlisted laps px uterus
|
$140.14 |
$140.14 |
$140.14 |
$4,627.00
|
|
Unlisted misc path test
|
$0.65 |
$0.65 |
$0.65 |
$89.40
|
|
Unlisted oph svc/procedure
|
$4.27 |
$4.27 |
$4.27 |
$40.26
|
|
Unlisted procedure microbiology
|
$31.01 |
$31.01 |
$31.01 |
$523.50
|
|
Unlisted procedure rectum
|
$84.14 |
$84.14 |
$84.14 |
$1,220.35
|
|
Unlisted procedure urinary 58750
|
$216.16 |
$216.16 |
$216.16 |
$1,181.29
|
|
Unlisted px abdomen muscskel
|
$148.47 |
$148.47 |
$148.47 |
$1,848.60
|
|
Unlisted px accessory sinus
|
$30.73 |
$30.73 |
$30.73 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$44.10 |
$44.10 |
$44.10 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$172.06 |
$172.06 |
$172.06 |
$2,765.60
|
|
Unlisted px casting/strpg
|
$60.76 |
$60.76 |
$60.76 |
$219.70
|
|
Unlisted px conjunctiva
|
$18.13 |
$18.13 |
$18.13 |
$479.62
|
|
Unlisted px external ear
|
$18.13 |
$18.13 |
$18.13 |
$325.68
|
|
Unlisted px foot/toes
|
$382.62 |
$382.62 |
$382.62 |
$1,225.50
|
|
Unlisted px leg/ankle
|
$205.87 |
$205.87 |
$205.87 |
$811.00
|
|
Unlisted px male genital sys
|
$67.55 |
$67.55 |
$67.55 |
$343.55
|
|
Unlisted px middle ear
|
$22.12 |
$22.12 |
$22.12 |
$343.50
|
|
Unlisted px neck/thorax
|
$30.87 |
$30.87 |
$30.87 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$18.13 |
$18.13 |
$18.13 |
$3,118.44
|
|
Unlisted px small intestine
|
$384.16 |
$384.16 |
$384.16 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$19.18 |
$19.18 |
$19.18 |
$282.50
|
|
Unlisted special svc px/rprt
|
$15.61 |
$15.61 |
$15.61 |
$90.00
|
|
Unlisted transfusion med px
|
$4.55 |
$4.55 |
$4.55 |
$147.50
|
|
Unlisted ultrasound procedure
|
$68.11 |
$68.11 |
$68.11 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$255.78 |
$255.78 |
$255.78 |
$1,268.17
|
|
Upgrade pm system
|
$110.88 |
$110.88 |
$110.88 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$934.92 |
$934.92 |
$934.92 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$860.72 |
$860.72 |
$860.72 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$846.79 |
$846.79 |
$846.79 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$108.22 |
$108.22 |
$108.22 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$108.22 |
$108.22 |
$108.22 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$32.76 |
$32.76 |
$32.76 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$154.00 |
$154.00 |
$154.00 |
$6,082.67
|
|
Urea nitrogen
|
$49.07 |
$49.07 |
$49.07 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$23.87 |
$23.87 |
$23.87 |
$51.75
|
|
Urea nitrogen clearance
|
$0.41 |
$0.41 |
$0.41 |
$42.25
|
|
Ureteral embolization/occl
|
$482.86 |
$482.86 |
$482.86 |
$2,181.40
|
|
Ureteral reflux study
|
$7.42 |
$7.42 |
$7.42 |
$952.50
|
|
Ureter endoscopy & treatment
|
$74.20 |
$74.20 |
$74.20 |
$5,631.74
|
|
Ureteroneocystostomy 50780
|
$264.39 |
$264.39 |
$264.39 |
$4,457.05
|
|
Ureteroureterostomy 50760
|
$267.47 |
$267.47 |
$267.47 |
$2,999.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$141.40 |
$141.40 |
$141.40 |
$579.73
|
|
Urethrlys transvag with scope
|
$178.78 |
$178.78 |
$178.78 |
$4,081.37
|
|
Urethrocystography void s&i
|
$273.49 |
$273.49 |
$273.49 |
$622.35
|
|
Uric acid blood
|
$25.20 |
$25.20 |
$25.20 |
$48.75
|
|
Uric acid urine
|
$0.36 |
$0.36 |
$0.36 |
$44.33
|
|
Urinalysis microscopic only
|
$0.21 |
$0.21 |
$0.21 |
$26.35
|
