|
Transcath occlusion non-cns
|
$17,152.59 |
$17,152.59 |
$17,152.59 |
$12,427.79
|
|
Trans cath replace aortic valve 33366
|
$69,210.85 |
$69,210.85 |
$69,210.85 |
$17,848.35
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,872.42 |
$4,872.42 |
$4,872.42 |
$4,627.00
|
|
Transferrin
|
$67.47 |
$67.47 |
$67.47 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,032.06 |
$1,032.06 |
$1,032.06 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$3,437.63 |
$3,437.63 |
$3,437.63 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$220.42 |
$220.42 |
$220.42 |
$7,191.23
|
|
Tray bonemarrw oncontrol 102mm
|
$784.86 |
$784.86 |
$784.86 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$325.48 |
$325.48 |
$325.48 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$109.70 |
$109.70 |
$109.70 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$262.65 |
$262.65 |
$262.65 |
$210.00
|
|
Treatment radiation delivery level 2
|
$608.22 |
$608.22 |
$608.22 |
$735.00
|
|
Treat metatarsal fracture
|
$748.81 |
$748.81 |
$748.81 |
$3,839.54
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$48,204.00 |
$48,204.00 |
$48,204.00 |
$101,032.80
|
|
Treponema pallidum antibody
|
$29.87 |
$29.87 |
$29.87 |
$72.80
|
|
Treprostinil injection
|
$146.26 |
$146.26 |
$146.26 |
$841.84
|
|
Trg gene rearrangement anal
|
$154.50 |
$154.50 |
$154.50 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$55.46 |
$55.46 |
$55.46 |
$55.80
|
|
Trichinella antibody
|
$24.85 |
$24.85 |
$24.85 |
$70.65
|
|
Triglycerides
|
$97.85 |
$97.85 |
$97.85 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$32.45 |
$32.45 |
$32.45 |
$128.00
|
|
Trim nondyst nails
|
$106.09 |
$106.09 |
$106.09 |
$124.22
|
|
Trnscath plc stent crv crtd without prtct
|
$17,077.92 |
$17,077.92 |
$17,077.92 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$17,077.92 |
$17,077.92 |
$17,077.92 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$8,790.54 |
$8,790.54 |
$8,790.54 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,790.54 |
$8,790.54 |
$8,790.54 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$18,176.41 |
$18,176.41 |
$18,176.41 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,698.35 |
$4,698.35 |
$4,698.35 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,786.80 |
$3,786.80 |
$3,786.80 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$3,956.23 |
$3,956.23 |
$3,956.23 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,260.85 |
$2,260.85 |
$2,260.85 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$5,651.61 |
$5,651.61 |
$5,651.61 |
$4,329.36
|
|
Troponin quantitative
|
$213.21 |
$213.21 |
$213.21 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$3,264.59 |
$3,264.59 |
$3,264.59 |
$1,876.20
|
|
Tte w or without fol w/con,stres
|
$2,566.76 |
$2,566.76 |
$2,566.76 |
$1,582.75
|
|
Tx atrial fib pulm vein isol
|
$25,202.56 |
$25,202.56 |
$25,202.56 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$366.68 |
$366.68 |
$366.68 |
$786.00
|
|
Tx l/r atrial fib addl
|
$9,325.11 |
$9,325.11 |
$9,325.11 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$1.55 |
$1.55 |
$1.55 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$224.54 |
$224.54 |
$224.54 |
$403.26
|
|
Ultrasound chest
|
$330.12 |
$330.12 |
$330.12 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$202.91 |
$202.91 |
$202.91 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$185.92 |
$185.92 |
$185.92 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$229.69 |
$229.69 |
$229.69 |
$284.25
|
|
Ultrasound encephalogram
|
$1,285.44 |
$1,285.44 |
$1,285.44 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$2,137.25 |
$2,137.25 |
$2,137.25 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$781.77 |
$781.77 |
$781.77 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$552.60 |
$552.60 |
$552.60 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$854.39 |
$854.39 |
$854.39 |
$701.35
|
|
Ultrasound guide intraoperative
|
$681.86 |
$681.86 |
$681.86 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$202.91 |
$202.91 |
$202.91 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$1,725.25 |
$1,725.25 |
$1,725.25 |
$403.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$494.92 |
$494.92 |
$494.92 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$347.11 |
$347.11 |
$347.11 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$193.64 |
$193.64 |
$193.64 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,635.64 |
$1,635.64 |
$1,635.64 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,265.87 |
$1,265.87 |
$1,265.87 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,422.43 |
$1,422.43 |
$1,422.43 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$796.71 |
$796.71 |
$796.71 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$704.01 |
$704.01 |
$704.01 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,751.00 |
$1,751.00 |
$1,751.00 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,168.02 |
$1,168.02 |
$1,168.02 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$1,961.64 |
$1,961.64 |
$1,961.64 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,183.47 |
$1,183.47 |
$1,183.47 |
$567.44
|
|
Unlistd noninvas vasc dx std
|
$158.11 |
$158.11 |
$158.11 |
$819.65
|
|
Unlisted CT procedure
|
$117.94 |
$117.94 |
$117.94 |
$1,043.00
|
|
Unsched dialysis esrd pt hos
|
$1,339.52 |
$1,339.52 |
$1,339.52 |
$1,480.70
|
|
Upgrade pm system
|
$19,709.57 |
$19,709.57 |
$19,709.57 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$7,098.76 |
$7,098.76 |
$7,098.76 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$6,175.88 |
$6,175.88 |
$6,175.88 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,413.81 |
$2,413.81 |
$2,413.81 |
$2,013.08
|
|
Urea nitrogen
|
$144.20 |
$144.20 |
$144.20 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$210.12 |
$210.12 |
$210.12 |
$50.00
|
|
Ureteral reflux study
|
$573.20 |
$573.20 |
$573.20 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$877.05 |
$877.05 |
$877.05 |
$574.40
|
|
Urethrocystography void s&i
|
$877.05 |
$877.05 |
$877.05 |
$634.50
|
|
Uric acid blood
|
$49.44 |
$49.44 |
$49.44 |
$46.64
|
|
Uric acid urine
|
$226.60 |
$226.60 |
$226.60 |
$46.75
|
|
Urinalysis microscopic only
|
$69.53 |
$69.53 |
$69.53 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$40.69 |
$40.69 |
$40.69 |
$25.72
|
|
Urinalysis (with microscopy)
|
$184.89 |
$184.89 |
$184.89 |
$48.14
|
|
Urinalysis (without microscopy)
|
$84.98 |
$84.98 |
$84.98 |
$38.99
|
|
Urine Culture Test
|
$179.22 |
$179.22 |
$179.22 |
$84.81
|
|
Urine pregnancy test
|
$184.89 |
$184.89 |
$184.89 |
$66.40
|
|
Urography inf drip &/or bolus
|
$641.69 |
$641.69 |
$641.69 |
$641.69
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,856.32 |
$3,856.32 |
$3,856.32 |
$5,521.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$27,198.18 |
$27,198.18 |
$27,198.18 |
$56,553.85
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$329.60 |
$329.60 |
$329.60 |
$239.85
|
|
Vaccine dtap < 7 years im
|
$64.38 |
$64.38 |
$64.38 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$4.64 |
$4.64 |
$4.64 |
$193.83
|
|
Vaccine dtap-ipv 4-6 years im
|
$4.64 |
$4.64 |
$4.64 |
$126.84
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$70.26 |
$70.26 |
$70.26 |
$85.00
|
|
Vaccine hepatitis a (hepa) adult im
|
$177.68 |
$177.68 |
$177.68 |
$178.07
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$10.51 |
$10.51 |
$10.51 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$149.35 |
$149.35 |
$149.35 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$120.00 |
$120.00 |
$120.00 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$73.33 |
$73.33 |
$73.33 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$104.55 |
$104.55 |
$104.55 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$104.55 |
$104.55 |
$104.55 |
$110.25
|
|
Vaccine influenza nos 0.5ml dose im
|
$104.55 |
$104.55 |
$104.55 |
$36.80
|
