|
Transcath occlusion cns
|
$16,460.60 |
$16,460.60 |
$16,460.60 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$28,294.50 |
$28,294.50 |
$28,294.50 |
$10,270.00
|
|
Trans cath replace aortic valve 33366
|
$55,231.15 |
$55,231.15 |
$55,231.15 |
$14,799.50
|
|
Transcath rmvl perm ldss pmkr rv
|
$8,503.30 |
$8,503.30 |
$8,503.30 |
$4,822.00
|
|
Transferrin
|
$98.80 |
$98.80 |
$98.80 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$787.80 |
$787.80 |
$787.80 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$974.35 |
$974.35 |
$974.35 |
$499.20
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$12,804.34 |
$12,804.34 |
$12,804.34 |
$7,540.20
|
|
Treat ankle dislocation
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$2,360.00
|
|
Treat elbow dislocation
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$2,272.50
|
|
Treat finger fracture each
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,592.00
|
|
Treat fracture of radius
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,790.00
|
|
Treat fracture of radius
|
$4,277.65 |
$4,277.65 |
$4,277.65 |
$1,849.00
|
|
Treat hip dislocation
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$2,211.05
|
|
Treat hip dislocation
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$2,641.60
|
|
Treat humerus fracture
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,790.00
|
|
Treat knuckle dislocation
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,726.01
|
|
Treat lower leg dislocation
|
$4,992.65 |
$4,992.65 |
$4,992.65 |
$3,908.80
|
|
Treatment mouth roof lesion
|
$8,214.70 |
$8,214.70 |
$8,214.70 |
$4,256.70
|
|
Treatment of ankle fracture
|
$13,759.20 |
$13,759.20 |
$13,759.20 |
$7,913.97
|
|
Treatment radiation delivery level 2
|
$830.70 |
$830.70 |
$830.70 |
$830.70
|
|
Treat spinal cord lesion
|
$2,237.95 |
$2,237.95 |
$2,237.95 |
$1,142.50
|
|
Treat spinal cord lesion
|
$3,214.25 |
$3,214.25 |
$3,214.25 |
$1,337.00
|
|
Treat toe dislocation
|
$2,715.70 |
$2,715.70 |
$2,715.70 |
$756.39
|
|
Treat trigeminal nerve
|
$2,431.65 |
$2,431.65 |
$2,431.65 |
$3,754.40
|
|
Treat ulnar fracture
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$1,677.20
|
|
Treat vaginal bleeding
|
$534.30 |
$534.30 |
$534.30 |
$379.60
|
|
Treat wrist dislocation
|
$760.50 |
$760.50 |
$760.50 |
$656.25
|
|
Treponema pallidum antibody
|
$66.95 |
$66.95 |
$66.95 |
$72.05
|
|
Trg gene rearrangement anal
|
$1,043.90 |
$1,043.90 |
$1,043.90 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$29.82 |
$29.82 |
$29.82 |
$43.09
|
|
Trichinella antibody
|
$150.80 |
$150.80 |
$150.80 |
$70.65
|
|
#tricyclicantidprssnt
|
$18.85 |
$18.85 |
$18.85 |
$50.54
|
|
Triglycerides
|
$329.55 |
$329.55 |
$329.55 |
$58.50
|
|
Trimethobenzamide hcl inj
|
$66.75 |
$66.75 |
$66.75 |
$117.49
|
|
Trim nondyst nails
|
$180.05 |
$180.05 |
$180.05 |
$113.88
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$37,070.80 |
$37,070.80 |
$37,070.80 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$674.70 |
$674.70 |
$674.70 |
$7,354.00
|
|
Trnscath plc stent crv crtd w/prtct
|
$7,865.65 |
$7,865.65 |
$7,865.65 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$10,648.30 |
$10,648.30 |
$10,648.30 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$10,648.30 |
$10,648.30 |
$10,648.30 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$20,982.00 |
$20,982.00 |
$20,982.00 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,591.95 |
$5,591.95 |
$5,591.95 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,036.50 |
$4,036.50 |
$4,036.50 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$7,009.60 |
$7,009.60 |
$7,009.60 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,009.60 |
$7,009.60 |
$7,009.60 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$3,627.65 |
$3,627.65 |
$3,627.65 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$5,554.90 |
$5,554.90 |
$5,554.90 |
$4,872.75
|
|
Troponin quantitative
|
$219.70 |
$219.70 |
$219.70 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$1,742.65 |
$1,742.65 |
$1,742.65 |
$1,632.80
|
|
Tx atrial fib pulm vein isol
|
$34,719.10 |
$34,719.10 |
$34,719.10 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$760.50 |
$760.50 |
$760.50 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$7,212.40 |
$7,212.40 |
$7,212.40 |
$3,977.49
|
|
Tx l/r atrial fib addl
|
$12,005.50 |
$12,005.50 |
$12,005.50 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$8,443.50 |
$8,443.50 |
$8,443.50 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,443.50 |
$8,443.50 |
$8,443.50 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$8,443.50 |
$8,443.50 |
$8,443.50 |
$4,637.36
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$6,044.73 |
$6,044.73 |
$6,044.73 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$465.40 |
$465.40 |
$465.40 |
$438.75
|
|
Ultrasound breast complete
|
$539.50 |
$539.50 |
$539.50 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$513.50 |
$513.50 |
$513.50 |
$452.40
|
|
Ultrasound elastography ea l target les
|
$561.60 |
$561.60 |
$561.60 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$362.05 |
$362.05 |
$362.05 |
$313.95
|
|
Ultrasound encephalogram
|
$839.80 |
$839.80 |
$839.80 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$442.65 |
$442.65 |
$442.65 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$657.15 |
$657.15 |
$657.15 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,933.75 |
$1,933.75 |
$1,933.75 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$83.85 |
$83.85 |
$83.85 |
$388.08
|
|
Ultrasound guide intraoperative
|
$875.55 |
$875.55 |
$875.55 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$925.60 |
$925.60 |
$925.60 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$552.50 |
$552.50 |
$552.50 |
$311.25
|
|
Ultrasound ob >=14wks ea addl gest
|
$733.85 |
$733.85 |
$733.85 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$362.05 |
$362.05 |
$362.05 |
$334.50
|
|
Ultrasound prostate/transrectal
|
$1,165.45 |
$1,165.45 |
$1,165.45 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$776.10 |
$776.10 |
$776.10 |
$463.00
|
|
Umbilical artery cath newborn 36660
|
$265.85 |
$265.85 |
$265.85 |
$223.80
|
|
Unlisted CT procedure
|
$430.30 |
$430.30 |
$430.30 |
$732.70
|
|
Unlisted cytogenetic study
|
$449.80 |
$449.80 |
$449.80 |
$160.00
|
|
Unlisted cytopathology px
|
$122.20 |
$122.20 |
$122.20 |
$132.08
|
|
Unlisted fluoroscopic px
|
$350.35 |
$350.35 |
$350.35 |
$305.76
|
|
Unlisted hematology&coagj px
|
$50.70 |
$50.70 |
$50.70 |
$39.52
|
|
Unlisted maaa
|
$301.60 |
$301.60 |
$301.60 |
$235.20
|
|
Unlisted maxlfcl prosth px
|
$325.65 |
$325.65 |
$325.65 |
$571.20
|
|
Unlisted misc path test
|
$5.20 |
$5.20 |
$5.20 |
$89.40
|
|
Unlisted procedure microbiology
|
$4,032.60 |
$4,032.60 |
$4,032.60 |
$530.00
|
|
Unlisted procedure pancreas
|
$1,695.85 |
$1,695.85 |
$1,695.85 |
$4,810.00
|
|
Unlisted procedure rectum
|
$2,397.20 |
$2,397.20 |
$2,397.20 |
$1,223.20
|
|
Unlisted px forearm/wrist
|
$724.75 |
$724.75 |
$724.75 |
$859.50
|
|
Unlisted px palate uvula
|
$664.30 |
$664.30 |
$664.30 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$623.35 |
$623.35 |
$623.35 |
$1,265.16
|
|
Unlisted px small intestine
|
$5,653.70 |
$5,653.70 |
$5,653.70 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$623.35 |
$623.35 |
$623.35 |
$282.50
|
|
Unlisted surgical path px
|
$2,258.10 |
$2,258.10 |
$2,258.10 |
$217.75
|
|
Unlisted transfusion med px
|
$243.75 |
$243.75 |
$243.75 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$1,480.70 |
$1,480.70 |
$1,480.70 |
$1,292.33
|
|
Upgrade pm system
|
$23,331.10 |
$23,331.10 |
$23,331.10 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$520.65 |
$520.65 |
$520.65 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,822.30 |
$2,822.30 |
$2,822.30 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,960.40 |
$1,960.40 |
$1,960.40 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,332.25 |
$4,332.25 |
$4,332.25 |
$2,998.00
|
