|
Trnscath tx thromblytc artery non-intracrn ini day
|
$17,616.37 |
$17,616.37 |
$17,616.37 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$14,598.70 |
$14,598.70 |
$14,598.70 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$14,266.70 |
$14,266.70 |
$14,266.70 |
$4,793.13
|
|
Troponin quantitative
|
$92.33 |
$92.33 |
$92.33 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$59,073.41 |
$59,073.41 |
$59,073.41 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$19,768.30 |
$19,768.30 |
$19,768.30 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$29.54 |
$29.54 |
$29.54 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$1,562.65 |
$1,562.65 |
$1,562.65 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,371.43 |
$1,371.43 |
$1,371.43 |
$403.26
|
|
Ultrasound breast complete
|
$1,510.41 |
$1,510.41 |
$1,510.41 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,224.83 |
$1,224.83 |
$1,224.83 |
$449.35
|
|
Ultrasound chest
|
$1,824.31 |
$1,824.31 |
$1,824.31 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,570.44 |
$1,570.44 |
$1,570.44 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$2,645.60 |
$2,645.60 |
$2,645.60 |
$284.25
|
|
Ultrasound encephalogram
|
$1,425.47 |
$1,425.47 |
$1,425.47 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$4,523.85 |
$4,523.85 |
$4,523.85 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$2,475.49 |
$2,475.49 |
$2,475.49 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$1,021.52 |
$1,021.52 |
$1,021.52 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$3,020.82 |
$3,020.82 |
$3,020.82 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,278.84 |
$1,278.84 |
$1,278.84 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$4,696.65 |
$4,696.65 |
$4,696.65 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$1,810.77 |
$1,810.77 |
$1,810.77 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$1,482.10 |
$1,482.10 |
$1,482.10 |
$321.35
|
|
Ultrasound joint complete left
|
$2,703.23 |
$2,703.23 |
$2,703.23 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,539.95 |
$1,539.95 |
$1,539.95 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,682.75 |
$2,682.75 |
$2,682.75 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$330.75 |
$330.75 |
$330.75 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$646.65 |
$646.65 |
$646.65 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,655.67 |
$1,655.67 |
$1,655.67 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,249.45 |
$1,249.45 |
$1,249.45 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,735.68 |
$1,735.68 |
$1,735.68 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$2,645.60 |
$2,645.60 |
$2,645.60 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,863.70 |
$1,863.70 |
$1,863.70 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,926.03 |
$2,926.03 |
$2,926.03 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,943.72 |
$1,943.72 |
$1,943.72 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$457.80 |
$457.80 |
$457.80 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$2,090.20 |
$2,090.20 |
$2,090.20 |
$567.44
|
|
Umbilical artery cath newborn 36660
|
$942.15 |
$942.15 |
$942.15 |
$265.85
|
|
Unlisted fluoroscopic px
|
$360.61 |
$360.61 |
$360.61 |
$324.85
|
|
Unlisted procedure microbiology
|
$8.90 |
$8.90 |
$8.90 |
$487.50
|
|
Unlisted px foot/toes
|
$1,230.98 |
$1,230.98 |
$1,230.98 |
$3,105.70
|
|
Unlisted transfusion med px
|
$85.72 |
$85.72 |
$85.72 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$5,485.24 |
$5,485.24 |
$5,485.24 |
$1,480.70
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$12,170.68 |
$12,170.68 |
$12,170.68 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$9,467.45 |
$9,467.45 |
$9,467.45 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$8,731.33 |
$8,731.33 |
$8,731.33 |
$2,013.08
|
|
Urea nitrogen
|
$29.54 |
$29.54 |
$29.54 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$36.73 |
$36.73 |
$36.73 |
$50.00
|
|
Ureteral reflux study
|
$1,678.40 |
$1,678.40 |
$1,678.40 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$2,000.06 |
$2,000.06 |
$2,000.06 |
$574.40
|
|
Urethrocystography void s&i
|
$1,133.73 |
$1,133.73 |
$1,133.73 |
$634.50
|
|
Uric acid blood
|
$33.24 |
$33.24 |
$33.24 |
$46.64
|
|
Uric acid urine
|
$33.39 |
$33.39 |
$33.39 |
$46.75
|
|
Urinalysis microscopic only
|
$70.00 |
$70.00 |
$70.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$23.39 |
$23.39 |
$23.39 |
$48.14
|
|
Urinalysis (without microscopy)
|
$17.23 |
$17.23 |
$17.23 |
$38.99
|
|
Urine Culture Test
|
$59.08 |
$59.08 |
$59.08 |
$84.81
|
|
Urine pregnancy test
|
$64.02 |
$64.02 |
$64.02 |
$66.40
|
|
Urography, antegrade
|
$1,909.85 |
$1,909.85 |
$1,909.85 |
$593.37
|
|
Urography inf drip &/or bolus
|
$794.68 |
$794.68 |
$794.68 |
$641.69
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$569.55 |
$569.55 |
$569.55 |
$85.00
|
|
Vaccine hepatitis a (hepa) adult im
|
$687.34 |
$687.34 |
$687.34 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$1,996.89 |
$1,996.89 |
$1,996.89 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$959.77 |
$959.77 |
$959.77 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$408.90 |
$408.90 |
$408.90 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$5,298.75 |
$5,298.75 |
$5,298.75 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,414.90 |
$1,414.90 |
$1,414.90 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$1,064.73 |
$1,064.73 |
$1,064.73 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$412.05 |
$412.05 |
$412.05 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$294.68 |
$294.68 |
$294.68 |
$40.01
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$476.10 |
$476.10 |
$476.10 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$2,895.49 |
$2,895.49 |
$2,895.49 |
$499.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$2,787.72 |
$2,787.72 |
$2,787.72 |
$426.80
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$2,910.46 |
$2,910.46 |
$2,910.46 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$2,008.84 |
$2,008.84 |
$2,008.84 |
$274.95
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$3,356.03 |
$3,356.03 |
$3,356.03 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$4,015.16 |
$4,015.16 |
$4,015.16 |
$715.41
|
|
Vaccine tdap >=7 years im
|
$957.02 |
$957.02 |
$957.02 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$823.04 |
$823.04 |
$823.04 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$99.71 |
$99.71 |
$99.71 |
$115.00
|
|
Valvuloplasty aortic
|
$15,937.87 |
$15,937.87 |
$15,937.87 |
$7,324.85
|
|
Valvuloplasty mitral
|
$27,347.80 |
$27,347.80 |
$27,347.80 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$27,347.80 |
$27,347.80 |
$27,347.80 |
$11,945.20
|
|
Vancomycin 1,000 mg intravenous injection
|
$823.16 |
$823.16 |
$823.16 |
$246.70
|
|
Vancomycin hcl injection
|
$385.37 |
$385.37 |
$385.37 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$99.71 |
$99.71 |
$99.71 |
$126.79
|
|
Varicella zoster antibody igg
|
$94.78 |
$94.78 |
$94.78 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$470.04 |
$470.04 |
$470.04 |
$362.93
|
|
Veeg ea 12-26hr cont mntr
|
$4,152.67 |
$4,152.67 |
$4,152.67 |
$3,332.45
|
|
Vein x-ray kidney
|
$12,921.93 |
$12,921.93 |
$12,921.93 |
$2,716.20
|
|
Vein x-ray liver
|
$12,740.51 |
$12,740.51 |
$12,740.51 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$16,139.61 |
$16,139.61 |
$16,139.61 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$12,920.80 |
$12,920.80 |
$12,920.80 |
$3,439.84
|
|
Vein x-ray skull
|
$21,237.15 |
$21,237.15 |
$21,237.15 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$2,410.76 |
$2,410.76 |
$2,410.76 |
$1,344.60
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$2,836.36 |
$2,836.36 |
$2,836.36 |
$188.65
|
|
Venogram ext bil s&i
|
$9,748.91 |
$9,748.91 |
$9,748.91 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$4,874.46 |
$4,874.46 |
$4,874.46 |
$1,326.00
|
|
Venous mech thrombectomy
|
$26,722.24 |
$26,722.24 |
$26,722.24 |
$8,869.50
|
|
Venous sampling s&i
|
$21,237.15 |
$21,237.15 |
$21,237.15 |
$4,416.78
|