|
Trg gene rearrangement anal
|
$88.20 |
$88.20 |
$171.30 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$19.11 |
$19.11 |
$19.11 |
$55.80
|
|
Trichinella antibody
|
$14.19 |
$14.19 |
$27.56 |
$70.65
|
|
Triglycerides
|
$108.49 |
$108.49 |
$193.16 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$37.12 |
$37.12 |
$37.12 |
$128.00
|
|
Trnscath plc stent crv crtd without prtct
|
$9,589.11 |
$9,589.11 |
$9,589.11 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$14,101.71 |
$14,101.71 |
$14,101.71 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$14,101.71 |
$14,101.71 |
$14,101.71 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,185.39 |
$4,185.39 |
$4,185.39 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$5,744.18 |
$5,744.18 |
$5,744.18 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,488.64 |
$11,488.64 |
$11,488.64 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,493.69 |
$5,493.69 |
$5,493.69 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$8,426.93 |
$8,426.93 |
$8,426.93 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,249.37 |
$5,249.37 |
$5,249.37 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,900.90 |
$2,900.90 |
$2,900.90 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$7,390.87 |
$7,390.87 |
$7,390.87 |
$4,329.36
|
|
Troponin quantitative
|
$173.02 |
$173.02 |
$352.80 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$1,763.42 |
$1,763.42 |
$1,763.42 |
$1,876.20
|
|
Tte w or without fol w/con,stres
|
$1,385.63 |
$1,385.63 |
$1,385.63 |
$1,582.75
|
|
Tx atrial fib pulm vein isol
|
$19,486.91 |
$19,486.91 |
$19,486.91 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$333.11 |
$333.11 |
$333.11 |
$786.00
|
|
Tx l/r atrial fib addl
|
$7,989.75 |
$7,989.75 |
$7,989.75 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$254.90 |
$254.90 |
$254.90 |
$403.26
|
|
Ultrasound chest
|
$900.82 |
$900.82 |
$900.82 |
$459.55
|
|
Ultrasound dx ophth b-scan
|
$158.47 |
$158.47 |
$158.47 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$137.01 |
$137.01 |
$137.01 |
$284.25
|
|
Ultrasound encephalogram
|
$1,365.05 |
$1,365.05 |
$1,365.05 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$502.16 |
$502.16 |
$502.16 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$837.61 |
$837.61 |
$837.61 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$326.34 |
$326.34 |
$326.34 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$2,483.42 |
$2,483.42 |
$2,483.42 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,398.27 |
$1,398.27 |
$1,398.27 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$105.26 |
$105.26 |
$105.26 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$1,758.71 |
$1,758.71 |
$1,758.71 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$277.83 |
$277.83 |
$277.83 |
$321.35
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,190.41 |
$1,190.41 |
$1,190.41 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$819.68 |
$819.68 |
$819.68 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,219.81 |
$1,219.81 |
$1,219.81 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,180.71 |
$1,180.71 |
$1,180.71 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$955.21 |
$955.21 |
$955.21 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$396.32 |
$396.32 |
$396.32 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,180.41 |
$1,180.41 |
$1,180.41 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,519.10 |
$1,519.10 |
$1,519.10 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$528.32 |
$528.32 |
$528.32 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$878.18 |
$878.18 |
$878.18 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,665.51 |
$1,665.51 |
$1,665.51 |
$567.44
|
|
Unlistd noninvas vasc dx std
|
$87.03 |
$87.03 |
$87.03 |
$819.65
|
|
Unlisted muscskel px head
|
$174.05 |
$174.05 |
$174.05 |
$274.80
|
|
Unlisted surgical path px
|
$21.17 |
$21.17 |
$21.17 |
$71.65
|
|
Unsched dialysis esrd pt hos
|
$1,467.65 |
$1,467.65 |
$1,467.65 |
$1,469.76
|
|
Upgrade pm system
|
$7,163.02 |
$7,163.02 |
$7,163.02 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$8,076.48 |
$8,076.48 |
$8,076.48 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$7,026.60 |
$7,026.60 |
$7,026.60 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,846.01 |
$4,846.01 |
$4,846.01 |
$2,013.08
|
|
Urea nitrogen
|
$140.24 |
$140.24 |
$157.03 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$129.07 |
$129.07 |
$264.95 |
$50.00
|
|
Ureteral embolization/occl
|
$826.14 |
$826.14 |
$826.14 |
$3,041.22
|
|
Ureteral reflux study
|
$280.77 |
$280.77 |
$280.77 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$252.55 |
$252.55 |
$252.55 |
$574.40
|
|
Urethrocystography void s&i
|
$1,262.73 |
$1,262.73 |
$1,262.73 |
$634.50
|
|
Uric acid blood
|
$40.55 |
$40.55 |
$140.24 |
$46.64
|
|
Uric acid urine
|
$160.82 |
$160.82 |
$272.94 |
$46.75
|
|
Urinalysis microscopic only
|
$37.05 |
$37.05 |
$71.95 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$21.76 |
$21.76 |
$41.69 |
$25.72
|
|
Urinalysis (with microscopy)
|
$161.41 |
$161.41 |
$201.57 |
$48.14
|
|
Urinalysis (without microscopy)
|
$47.34 |
$47.34 |
$65.10 |
$38.99
|
|
Urine Culture Test
|
$123.78 |
$123.78 |
$194.14 |
$84.81
|
|
Urine pregnancy test
|
$106.43 |
$106.43 |
$201.57 |
$66.40
|
|
Urography inf drip &/or bolus
|
$1,013.13 |
$1,013.13 |
$1,013.13 |
$641.69
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$1,834.56 |
$1,834.56 |
$1,834.56 |
$5,521.54
|
|
Vaccine dtap < 7 years im
|
$30.58 |
$30.58 |
$30.58 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$205.22 |
$205.22 |
$205.22 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$29.99 |
$29.99 |
$54.82 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$84.68 |
$84.68 |
$84.68 |
$178.07
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$39.99 |
$39.99 |
$39.99 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$71.15 |
$71.15 |
$71.15 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$29.11 |
$29.11 |
$53.11 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$84.38 |
$84.38 |
$84.38 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$23.52 |
$23.52 |
$42.83 |
$48.29
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$219.92 |
$219.92 |
$219.92 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$169.64 |
$169.64 |
$308.92 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$94.38 |
$94.38 |
$94.38 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$244.96 |
$244.96 |
$244.96 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$471.65 |
$471.65 |
$471.65 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$309.29 |
$309.29 |
$309.29 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.28 |
$40.28 |
$40.28 |
$119.17
|
|
Vaccine rabies im
|
$434.83 |
$434.83 |
$434.83 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$51.16 |
$51.16 |
$93.08 |
$150.76
|
|
Vaccine typhoid vicps im
|
$220.41 |
$220.41 |
$220.41 |
$205.22
|
|
Valproic acid total therapeutic drug level
|
$363.39 |
$363.39 |
$435.11 |
$115.00
|
|
Valvuloplasty aortic
|
$6,070.52 |
$6,070.52 |
$6,070.52 |
$7,324.85
|
|
Vancomycin hcl injection
|
$276.66 |
$276.66 |
$276.66 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$123.91 |
$123.91 |
$271.95 |
$126.79
|
|
Varicella zoster antibody igg
|
$35.41 |
$35.41 |
$97.32 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$243.73 |
$243.73 |
$243.73 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$7,201.24 |
$7,201.24 |
$7,201.24 |
$20,730.98
|
|
Veeg cont 2-12 hrs
|
$371.33 |
$371.33 |
$821.10 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$694.73 |
$694.73 |
$1,536.57 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$193.46 |
$193.46 |
$428.25 |
$904.90
|
