|
Trnscath tx thromblytc art/ven sbsq day
|
$5,624.15 |
$11,836.73 |
$11,836.73 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,108.24 |
$18,710.40 |
$18,710.40 |
|
|
Trnscath tx thromblytc vein ini day
|
$5,507.73 |
$22,194.66 |
$22,194.66 |
|
|
Troponin quantitative
|
$8.63 |
$249.45 |
$1,948.25 |
|
|
Truskin, per sq centimeter
|
$1.00 |
$1.00 |
$1.00 |
|
|
Tte w or without contr, cont ecg
|
$653.45 |
$653.45 |
$739.33 |
|
|
Tte w or without fol w/con,stres
|
$430.15 |
$4,515.64 |
$10,218.15 |
|
|
Tte w or without fol w/cont, com
|
$472.50 |
$841.43 |
$9,327.00 |
|
|
Tte w or without fol w/cont, f/u
|
$362.25 |
$648.32 |
$9,327.00 |
|
|
Tubal Ligation (Laparoscopic)
|
$15,191.33 |
$15,191.33 |
$15,191.33 |
|
|
Tx atrial fib pulm vein isol
|
$10,926.93 |
$57,603.19 |
$222,291.00 |
|
|
Tx closed distal humerus fx
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
|
|
Tx closed hip disl traumatic without anes
|
$290.73 |
$1,241.93 |
$1,241.93 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Tx closed tib shaft fx without manip
|
$499.98 |
$1,241.93 |
$1,241.93 |
|
|
Tx contour defects >10.0 cc
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
|
|
Tx contour defects 1.1-5.0cc 11951
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
|
|
Tx l/r atrial fib addl
|
$2,298.48 |
$21,079.53 |
$35,206.00 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$10,807.53 |
$10,807.53 |
$10,807.53 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Tx tarsal bone fx without manip 28450
|
$198.68 |
$4,652.29 |
$4,652.29 |
|
|
Typhoid vaccine oral
|
$62.91 |
$62.91 |
$62.91 |
|
|
Ua w/micro/comp poc
|
$130.34 |
$130.34 |
$922.00 |
|
|
Ugt1a1 gene analy common variants
|
$97.58 |
$345.46 |
$2,013.00 |
|
|
Ultrasound breast complete
|
$298.07 |
$2,063.28 |
$2,063.28 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$231.71 |
$1,923.06 |
$1,923.06 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$142.12 |
$1,466.50 |
$1,784.75 |
|
|
Ultrasound dx ophth b-scan
|
$3,525.59 |
$3,525.59 |
$3,525.59 |
|
|
Ultrasound elastography ea l target les
|
$107.84 |
$387.41 |
$387.41 |
|
|
Ultrasound elastography parenchyma
|
$221.75 |
$387.41 |
$5,902.60 |
|
|
Ultrasound encephalogram
|
$191.89 |
$1,602.55 |
$2,995.75 |
|
|
Ultrasound exam k transpl w/doppler
|
$249.40 |
$1,842.92 |
$2,658.00 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$275.39 |
$1,892.81 |
$3,174.51 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$222.86 |
$2,189.40 |
$2,189.40 |
|
|
Ultrasound guidance for vascular access
|
$190.23 |
$2,027.10 |
$2,739.00 |
|
|
Ultrasound guide intraoperative
|
$144.27 |
$1,602.55 |
$1,602.55 |
|
|
Ultrasound guide tissue ablation
|
$594.48 |
$1,462.27 |
$4,563.71 |
|
|
Ultrasound hips infant dynamic
|
$197.97 |
$961.51 |
$3,562.90 |
|
|
Ultrasound infant hips ltd without stress
|
$140.46 |
$961.51 |
$1,707.25 |
|
|
Ultrasound joint complete left
|
$275.39 |
$2,437.49 |
$2,437.49 |
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$355.67 |
$355.67 |
$355.67 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$167.01 |
$1,538.43 |
$1,538.43 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$114.47 |
$1,095.52 |
$1,095.52 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$354.43 |
$1,602.55 |
$4,618.00 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$203.50 |
$1,114.50 |
$1,602.55 |
|
|
Ultrasound prostate/transrectal
|
$341.37 |
$1,602.55 |
$4,836.47 |
|
|
Ultrasound spinal canal and contents
|
$231.18 |
$961.51 |
$2,977.00 |
|
|
Ultrasound transabd ea addl gest
|
$390.42 |
$1,560.03 |
$3,290.00 |
|
|
Unlistd noninvas vasc dx std
|
$1,285.41 |
$1,285.41 |
$1,285.41 |
|
|
Unlisted cytogenetic study
|
$604.27 |
$604.27 |
$604.27 |
|
|
Unlisted dialysis procedure
|
$2,714.13 |
$2,714.13 |
$2,714.13 |
|
|
Unlisted fluoroscopic px
|
$1,846.05 |
$1,846.05 |
$1,846.05 |
|
|
Unlisted hematology&coagj px
|
$5.81 |
$16.07 |
$35.51 |
|
|
Unlisted mr procedure
|
$4,973.03 |
$4,973.03 |
$17,159.75 |
|
|
Unlisted procedure microbiology
|
$75.63 |
$75.63 |
$238.82 |
|
|
Unlisted px casting/strpg
|
$760.39 |
$760.39 |
$760.39 |
|
|
Unlisted px foot/toes
|
$206.07 |
$206.07 |
$206.07 |
|
|
Unlisted px med radj physics
|
$411.96 |
$411.96 |
$411.96 |
|
|
Unlisted px pelvis/hip joint
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
|
|
Unlisted transfusion med px
|
$103.45 |
$691.17 |
$691.17 |
|
|
Unsched dialysis esrd pt hos
|
$342.54 |
$4,957.94 |
$14,230.81 |
|
|
Upgrade pm system
|
$7,764.56 |
$23,405.67 |
$23,405.67 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$59.84 |
$1,096.90 |
$1,096.90 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$476.62 |
$6,039.22 |
$8,021.50 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$381.09 |
$5,800.95 |
$5,800.95 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$445.30 |
$7,305.32 |
$24,552.00 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$371.23 |
$6,115.59 |
$23,489.95 |
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$296.87 |
$5,468.12 |
$19,355.60 |
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$56.67 |
$859.50 |
$1,308.04 |
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$69.70 |
$940.25 |
$1,569.62 |
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,937.06 |
$1,937.06 |
$1,937.06 |
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,937.06 |
$1,937.06 |
$1,937.06 |
|
|
Upper GI Barium X-ray (barium and gas)
|
$145.73 |
$2,105.18 |
$8,644.36 |
|
|
Upper GI Barium X-ray (barium only)
|
$127.42 |
$1,887.98 |
$5,525.85 |
|
|
Uppr gi scope w/submuc inj
|
$1,937.06 |
$1,937.06 |
$1,937.06 |
|
|
Urea nitrogen
|
$2.72 |
$104.41 |
$143.50 |
|
|
Urea nitrogen 24 hour urine
|
$11.80 |
$134.53 |
$1,393.04 |
|
|
Urea nitrogen clearance
|
$627.14 |
$814.84 |
$845.13 |
|
|
Ureteral embolization/occl
|
$19,429.87 |
$19,429.87 |
$19,429.87 |
|
|
Ureteral reflux study
|
$335.51 |
$2,219.56 |
$12,688.30 |
|
|
Urethrcystgrphy rtrgrde s&i
|
$228.45 |
$2,406.42 |
$8,210.49 |
|
|
Urethrocystography void s&i
|
$182.69 |
$1,581.00 |
$2,502.25 |
|
|
Uric acid blood
|
$3.18 |
$105.95 |
$1,448.11 |
|
|
Uric acid urine
|
$16.00 |
$130.24 |
$626.40 |
|
|
Urinalysis microscopic only
|
$1.28 |
$101.72 |
$552.38 |
|
|
Urinalysis qual/semiquant excpt ia
|
$0.90 |
$153.47 |
$355.15 |
|
|
Urinalysis (with microscopy)
|
$1.28 |
$222.81 |
$1,127.81 |
|
|
Urinalysis (without microscopy)
|
$3.85 |
$130.13 |
$130.13 |
|
|
Urine Culture Test
|
$3.62 |
$183.25 |
$1,906.00 |
|
|
Urine pregnancy test
|
$7.42 |
$101.35 |
$719.00 |
|
|
Urography, antegrade
|
$315.39 |
$2,818.38 |
$3,128.61 |
|
|
Urography inf drip &/or bolus
|
$389.66 |
$389.66 |
$389.66 |
|
|
Use 1st target lesion
|
$190.23 |
$202.54 |
$513.25 |
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$9,928.80 |
$35,061.00 |
$35,061.00 |
|
|
Vaccine Administration (one shot)
|
$16.40 |
$207.42 |
$207.42 |
|
|
Vaccine dtap < 7 years im
|
$105.00 |
$218.97 |
$838.98 |
|
|
Vaccine dtap-hep b-ipv im
|
$1,241.87 |
$1,241.87 |
$1,241.87 |
|
|
Vaccine dtap-ipv 4-6 years im
|
$183.00 |
$183.00 |
$279.25 |
|
|
Vaccine dtap-ipv/hib im
|
$306.88 |
$364.75 |
$1,253.10 |
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$197.01 |
$197.01 |
$518.71 |
|
