|
Tyms gene com variants
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$192.29
|
|
Typhoid vaccine oral
|
$63.28 |
$63.28 |
$63.28 |
$63.28
|
|
U2af1 gene common variants
|
$324.80 |
$324.80 |
$324.80 |
$243.34
|
|
Ua w/micro/comp poc
|
$165.76 |
$165.76 |
$165.76 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$17,921.01 |
$17,921.01 |
$17,921.01 |
$20,945.01
|
|
Ue triple control harness
|
$327.60 |
$327.60 |
$327.60 |
$327.60
|
|
Ugt1a1 gene analy common variants
|
$34.82 |
$34.82 |
$537.60 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$427.95 |
$427.95 |
$901.60 |
$394.20
|
|
Ultrasound bone density measure
|
$442.40 |
$442.40 |
$442.40 |
$143.75
|
|
Ultrasound breast complete
|
$339.15 |
$339.15 |
$1,164.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$309.00 |
$309.00 |
$560.00 |
$449.35
|
|
Ultrasound chest
|
$343.05 |
$343.05 |
$980.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$397.60 |
$397.60 |
$397.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$296.80 |
$296.80 |
$296.80 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$219.52 |
$219.52 |
$219.52 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$425.60 |
$425.60 |
$425.60 |
$307.00
|
|
Ultrasound encephalogram
|
$266.55 |
$266.55 |
$862.40 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$542.85 |
$542.85 |
$1,388.80 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$252.90 |
$252.90 |
$1,030.40 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$362.55 |
$362.55 |
$1,008.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$627.00 |
$627.00 |
$1,349.60 |
$720.15
|
|
Ultrasound guide intraoperative
|
$321.75 |
$321.75 |
$476.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$655.20 |
$655.20 |
$655.20 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$49.20 |
$49.20 |
$610.40 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$610.40 |
$610.40 |
$610.40 |
$311.25
|
|
Ultrasound joint complete left
|
$403.80 |
$403.80 |
$868.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$318.90 |
$318.90 |
$767.20 |
$425.45
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$296.80 |
$296.80 |
$296.80 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$380.80 |
$380.80 |
$478.35 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$59.10 |
$59.10 |
$380.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$901.60 |
$901.60 |
$901.60 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$208.35 |
$208.35 |
$543.20 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$385.65 |
$385.65 |
$604.80 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$302.85 |
$302.85 |
$806.40 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$659.10 |
$659.10 |
$750.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$282.00 |
$282.00 |
$795.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$429.60 |
$429.60 |
$890.40 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$666.40 |
$666.40 |
$666.40 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$655.20 |
$655.20 |
$655.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$315.00 |
$315.00 |
$716.80 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$644.00 |
$644.00 |
$644.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$666.40 |
$666.40 |
$666.40 |
$348.00
|
|
Ultraviolet therapy
|
$39.76 |
$39.76 |
$39.76 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$145.60 |
$145.60 |
$145.60 |
$206.64
|
|
Umbilical cord occlud w/us
|
$1,624.00 |
$1,624.00 |
$1,624.00 |
$754.00
|
|
Umbilicoplasty 15847
|
$7,252.00 |
$7,252.00 |
$7,252.00 |
$4,172.97
|
|
Unit mobile power mpu
|
$14,359.52 |
$14,359.52 |
$14,359.52 |
$14,612.80
|
|
Unlistd noninvas vasc dx std
|
$202.35 |
$202.35 |
$291.20 |
$528.80
|
|
Unlisted all/immlg svc/px
|
$111.44 |
$111.44 |
$111.44 |
$28.98
|
|
Unlisted chemotherapy px
|
$109.35 |
$109.35 |
$256.48 |
$150.00
|
|
Unlisted cranfcl&maxlfcl px
|
$571.20 |
$571.20 |
$571.20 |
$571.20
|
|
Unlisted CT procedure
|
$281.70 |
$281.70 |
$571.20 |
$732.70
|
|
Unlisted cv px dx nuc med
|
$2,536.80 |
$2,536.80 |
$2,536.80 |
$1,200.00
|
|
Unlisted cytogenetic study
|
$91.84 |
$91.84 |
$91.84 |
$160.18
|
|
Unlisted cytopathology px
|
$199.92 |
$199.92 |
$199.92 |
$132.08
|
|
Unlisted dialysis procedure
|
$1,461.60 |
$1,461.60 |
$1,461.60 |
$1,144.00
|
|
Unlisted dx gi procedure
|
$666.40 |
$666.40 |
$666.40 |
$649.22
|
|
Unlisted endocrine px dx nuc
|
$1,400.00 |
$1,400.00 |
$1,400.00 |
$569.91
|
|
Unlisted fetal invas px w/us
|
$498.40 |
$498.40 |
$498.40 |
$498.40
|
|
Unlisted fluoroscopic px
|
$305.76 |
$305.76 |
$305.76 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$2,536.80 |
$2,536.80 |
$2,536.80 |
$995.00
|
|
Unlisted gu px dx nuc med
|
$2,536.80 |
$2,536.80 |
$2,536.80 |
$805.62
|
|
Unlisted hematology&coagj px
|
$19.60 |
$19.60 |
$19.60 |
$39.52
|
|
Unlisted hystsc px uterus
|
$498.40 |
$498.40 |
$498.40 |
$2,803.60
|
|
Unlisted laparoscopic liver biopy 47379
|
$103,852.00 |
$103,852.00 |
$103,852.00 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$93.81 |
$93.81 |
$98,823.20 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$98,823.20 |
$98,823.20 |
$98,823.20 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$6,463.42
|
|
Unlisted laps px appendix
|
$487.20 |
$487.20 |
$487.20 |
$3,617.40
|
|
Unlisted laps px bladder
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$5,082.74
|
|
Unlisted laps px endoc sys
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$5,855.00
|
|
Unlisted laps px esoph
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$9,553.60 |
$9,553.60 |
$9,553.60 |
$6,904.15
|
|
Unlisted laps px renal
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$5,110.00
|
|
Unlisted laps px spleen
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$4,627.00
|
|
Unlisted laps px testis
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$5,628.67
|
|
Unlisted laps px ureter
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$6,212.70
|
|
Unlisted laps px uterus
|
$3,600.80 |
$3,600.80 |
$3,600.80 |
$4,627.00
|
|
Unlisted maaa
|
$19.04 |
$19.04 |
$19.04 |
$235.20
|
|
Unlisted maxlfcl prosth px
|
$571.20 |
$571.20 |
$571.20 |
$571.20
|
|
Unlisted misc path test
|
$1.40 |
$1.40 |
$173.60 |
$89.40
|
|
Unlisted mr procedure
|
$367.92 |
$367.92 |
$367.92 |
$1,163.00
|
|
Unlisted muscskel px dx nuc
|
$1,110.00 |
$1,110.00 |
$2,536.80 |
$1,279.98
|
|
Unlisted muscskel px head
|
$1,657.60 |
$1,657.60 |
$1,657.60 |
$478.46
|
|
Unlisted neurological dx px
|
$464.80 |
$464.80 |
$464.80 |
$242.50
|
|
Unlisted nrvs sys px dx nuc
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$891.41
|
|
Unlisted oph svc/procedure
|
$182.56 |
$182.56 |
$182.56 |
$40.26
|
|
Unlisted orl service/px
|
$324.80 |
$324.80 |
$324.80 |
$132.60
|
|
Unlisted procedure colon
|
$2,251.20 |
$2,251.20 |
$2,251.20 |
$1,702.50
|
|
Unlisted procedure esophagus
|
$3,018.40 |
$3,018.40 |
$3,018.40 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$2,385.60 |
$2,385.60 |
$2,385.60 |
$833.00
|
|
Unlisted procedure larynx
|
$924.00 |
$924.00 |
$924.00 |
$924.00
|
|
Unlisted procedure liver
|
$5,264.00 |
$5,264.00 |
$5,264.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$17.92 |
$17.92 |
$66.45 |
$523.50
|
|
Unlisted procedure orbit
|
$739.20 |
$739.20 |
$739.20 |
$436.44
|
|
Unlisted procedure pancreas
|
$5,874.40 |
$5,874.40 |
$5,874.40 |
$3,986.00
|
|
Unlisted procedure rectum
|
$9,979.20 |
$9,979.20 |
$9,979.20 |
$1,220.35
|
|
Unlisted procedure spine
|
$6,064.80 |
$6,064.80 |
$6,064.80 |
$4,659.85
|
|
Unlisted psychiatric service/proc 90899
|
$55.35 |
$55.35 |
$277.76 |
$277.76
|
