|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,653.25 |
$4,653.25 |
$4,653.25 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$4,373.60 |
$4,373.60 |
$4,373.60 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$4,619.65 |
$4,619.65 |
$4,619.65 |
$4,805.85
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$1,128.75 |
$1,128.75 |
$1,128.75 |
$2,343.60
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,247.00 |
$2,247.00 |
$2,247.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$2,247.00 |
$2,247.00 |
$2,247.00 |
$3,322.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,247.00 |
$2,247.00 |
$2,247.00 |
$2,355.65
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,480.50 |
$1,480.50 |
$1,480.50 |
$2,190.24
|
|
Troponin quantitative
|
$89.60 |
$89.60 |
$89.60 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$1,028.65 |
$1,028.65 |
$1,028.65 |
$1,876.20
|
|
Tte w or without fol w/con,stres
|
$1,586.90 |
$1,586.90 |
$1,586.90 |
$1,582.75
|
|
Tube trach disp innr can 5 xlt
|
$375.95 |
$375.95 |
$375.95 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$25,848.20 |
$25,848.20 |
$25,848.20 |
$32,426.20
|
|
Tx closed hip disl traumatic without anes
|
$275.80 |
$275.80 |
$275.80 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$438.20 |
$438.20 |
$438.20 |
$635.46
|
|
Tx l/r atrial fib addl
|
$7,334.95 |
$7,334.95 |
$7,334.95 |
$7,717.80
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$4,449.44
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$4,281.00
|
|
Tx open nsl fx uncomp
|
$1,699.95 |
$1,699.95 |
$1,699.95 |
$4,007.22
|
|
Tx open nsl sptl fx
|
$2,377.90 |
$2,377.90 |
$2,377.90 |
$4,289.04
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,447.20 |
$2,447.20 |
$2,447.20 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$242.20 |
$242.20 |
$242.20 |
$469.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$680.40 |
$680.40 |
$680.40 |
$403.26
|
|
Ultrasound breast complete
|
$232.40 |
$232.40 |
$232.40 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$173.95 |
$173.95 |
$173.95 |
$449.35
|
|
Ultrasound chest
|
$232.40 |
$232.40 |
$232.40 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$129.15 |
$129.15 |
$129.15 |
$340.14
|
|
Ultrasound elastography ea l target les
|
$78.40 |
$78.40 |
$78.40 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$156.45 |
$156.45 |
$156.45 |
$284.25
|
|
Ultrasound encephalogram
|
$924.00 |
$924.00 |
$924.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$743.05 |
$743.05 |
$743.05 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$629.30 |
$629.30 |
$629.30 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$494.55 |
$494.55 |
$494.55 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$474.25 |
$474.25 |
$474.25 |
$701.35
|
|
Ultrasound guide intraoperative
|
$437.85 |
$437.85 |
$437.85 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$672.35 |
$672.35 |
$672.35 |
$403.00
|
|
Ultrasound joint complete left
|
$540.40 |
$540.40 |
$540.40 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$405.65 |
$405.65 |
$405.65 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$390.25 |
$390.25 |
$390.25 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$390.25 |
$390.25 |
$390.25 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$390.25 |
$390.25 |
$390.25 |
$690.48
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$246.75 |
$246.75 |
$246.75 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$464.45 |
$464.45 |
$464.45 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$686.35 |
$686.35 |
$686.35 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$680.40 |
$680.40 |
$680.40 |
$498.00
|
|
Ultrasound scrotum and contents
|
$732.20 |
$732.20 |
$732.20 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$232.40 |
$232.40 |
$232.40 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$464.45 |
$464.45 |
$464.45 |
$567.44
|
|
Ultrasound trgt dyn mbubb 1st les
|
$1,296.05 |
$1,296.05 |
$1,296.05 |
$479.72
|
|
Umbilical artery cath newborn 36660
|
$658.00 |
$658.00 |
$658.00 |
$265.85
|
|
Unlisted mr procedure
|
$99.40 |
$99.40 |
$99.40 |
$1,032.20
|
|
Unlisted neurological dx px
|
$200.20 |
$200.20 |
$200.20 |
$185.15
|
|
Unlisted procedure rectum
|
$236.25 |
$236.25 |
$236.25 |
$1,278.72
|
|
Unlisted px hands/fingers
|
$250.25 |
$250.25 |
$250.25 |
$379.44
|
|
Unlisted px salivry glnd/dux
|
$242.20 |
$242.20 |
$242.20 |
$486.72
|
|
Unlisted px small intestine
|
$679.70 |
$679.70 |
$679.70 |
$2,118.35
|
|
Unlisted ultrasound procedure
|
$103.60 |
$103.60 |
$103.60 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$2,197.30 |
$2,197.30 |
$2,197.30 |
$1,469.76
|
|
Upgrade pm system
|
$8,510.25 |
$8,510.25 |
$8,510.25 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,599.45 |
$2,599.45 |
$2,599.45 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,350.95 |
$2,350.95 |
$2,350.95 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,178.75 |
$2,178.75 |
$2,178.75 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$508.20 |
$508.20 |
$508.20 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$508.20 |
$508.20 |
$508.20 |
$1,656.60
|
|
Urea nitrogen
|
$90.65 |
$90.65 |
$90.65 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$107.10 |
$107.10 |
$107.10 |
$50.00
|
|
Ureteral reflux study
|
$814.10 |
$814.10 |
$814.10 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$300.30 |
$300.30 |
$300.30 |
$574.40
|
|
Urethrocystography void s&i
|
$423.85 |
$423.85 |
$423.85 |
$634.50
|
|
Uric acid blood
|
$90.65 |
$90.65 |
$90.65 |
$46.64
|
|
Uric acid urine
|
$107.10 |
$107.10 |
$107.10 |
$46.75
|
|
Urinalysis microscopic only
|
$41.65 |
$41.65 |
$41.65 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$30.80 |
$30.80 |
$30.80 |
$25.72
|
|
Urinalysis (with microscopy)
|
$69.30 |
$69.30 |
$69.30 |
$48.14
|
|
Urinalysis (without microscopy)
|
$45.50 |
$45.50 |
$45.50 |
$38.99
|
|
Urine Culture Test
|
$329.00 |
$329.00 |
$329.00 |
$84.81
|
|
Urine pregnancy test
|
$111.30 |
$111.30 |
$111.30 |
$66.40
|
|
Urography, antegrade
|
$1,067.50 |
$1,067.50 |
$1,067.50 |
$593.37
|
|
Use 1st target lesion
|
$156.45 |
$156.45 |
$156.45 |
$245.30
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$84.58 |
$84.58 |
$84.58 |
$239.85
|
|
Vaccine dtap < 7 years im
|
$110.58 |
$110.58 |
$110.58 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$258.72 |
$258.72 |
$258.72 |
$193.83
|
|
Vaccine dtap-ipv/hib im
|
$242.38 |
$242.38 |
$242.38 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$49.68 |
$49.68 |
$49.68 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$270.95 |
$270.95 |
$270.95 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$148.85 |
$148.85 |
$148.85 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$79.04 |
$79.04 |
$79.04 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$249.17 |
$249.17 |
$249.17 |
$110.25
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$99.80 |
$99.80 |
$99.80 |
$103.88
|
|
Vaccine mmr live subcutaneous
|
$350.71 |
$350.71 |
$350.71 |
$224.04
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$834.65 |
$834.65 |
$834.65 |
$715.41
|
|
Vaccine rabies im
|
$1,167.44 |
$1,167.44 |
$1,167.44 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,759.01 |
$1,759.01 |
$1,759.01 |
$1,196.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,759.01 |
$1,759.01 |
$1,759.01 |
$1,159.00
|
|
Vaccine tdap >=7 years im
|
$140.35 |
$140.35 |
$140.35 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$159.09 |
$159.09 |
$159.09 |
$131.77
|
|
Vad battery clip set hmii 14-v li-ion
|
$1,008.32 |
$1,008.32 |
$1,008.32 |
$1,683.99
|
|
Vad univ batt charger hm 1440
|
$11,376.29 |
$11,376.29 |
$11,376.29 |
$14,893.34
|
