|
Ultrasound guidance for vascular access
|
$302.25 |
$302.25 |
$302.25 |
$388.08
|
|
Ultrasound guide intraoperative
|
$945.10 |
$945.10 |
$945.10 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$1,087.45 |
$1,087.45 |
$1,087.45 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$494.00 |
$494.00 |
$494.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$494.00 |
$494.00 |
$494.00 |
$304.00
|
|
Ultrasound joint complete left
|
$854.10 |
$854.10 |
$854.10 |
$560.92
|
|
Ultrasound ob >=14wks ea addl gest
|
$832.65 |
$832.65 |
$832.65 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$815.10 |
$815.10 |
$815.10 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,849.25 |
$1,849.25 |
$1,849.25 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$839.80 |
$839.80 |
$839.80 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$776.10 |
$776.10 |
$776.10 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$890.50 |
$890.50 |
$890.50 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$994.50 |
$994.50 |
$994.50 |
$417.15
|
|
Ultrasound trgt dyn mbubb 1st les
|
$1,418.95 |
$1,418.95 |
$1,418.95 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$843.70 |
$843.70 |
$843.70 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$204.75 |
$204.75 |
$204.75 |
$223.80
|
|
Umbilicoplasty 15847
|
$3,788.20 |
$3,788.20 |
$3,788.20 |
$4,172.97
|
|
Unit mobile power mpu
|
$10,400.00 |
$10,400.00 |
$10,400.00 |
$14,359.52
|
|
Unlistd noninvas vasc dx std
|
$1,025.05 |
$1,025.05 |
$1,025.05 |
$564.60
|
|
Unlisted chemotherapy px
|
$88.40 |
$88.40 |
$88.40 |
$149.15
|
|
Unlisted cranfcl&maxlfcl px
|
$9,103.25 |
$9,103.25 |
$9,103.25 |
$571.20
|
|
Unlisted CT procedure
|
$8,697.00 |
$8,697.00 |
$8,697.00 |
$740.43
|
|
Unlisted dx gi procedure
|
$1,682.20 |
$1,682.20 |
$1,682.20 |
$649.22
|
|
Unlisted fluoroscopic px
|
$30,872.40 |
$30,872.40 |
$30,872.40 |
$305.76
|
|
Unlisted hystsc px uterus
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$16,602.30 |
$16,602.30 |
$16,602.30 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$7,044.05 |
$7,044.05 |
$7,044.05 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$8,637.20 |
$8,637.20 |
$8,637.20 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$9,700.60 |
$9,700.60 |
$9,700.60 |
$6,463.42
|
|
Unlisted laps px appendix
|
$3,513.25 |
$3,513.25 |
$3,513.25 |
$3,617.40
|
|
Unlisted laps px bladder
|
$10,743.20 |
$10,743.20 |
$10,743.20 |
$5,082.74
|
|
Unlisted laps px esoph
|
$11,668.80 |
$11,668.80 |
$11,668.80 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$4,560.40 |
$4,560.40 |
$4,560.40 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$4,290.00 |
$4,290.00 |
$4,290.00 |
$6,904.15
|
|
Unlisted laps px renal
|
$7,046.00 |
$7,046.00 |
$7,046.00 |
$5,110.00
|
|
Unlisted laps px ureter
|
$6,258.20 |
$6,258.20 |
$6,258.20 |
$6,376.26
|
|
Unlisted laps px uterus
|
$4,524.00 |
$4,524.00 |
$4,524.00 |
$4,627.00
|
|
Unlisted maaa
|
$231.40 |
$231.40 |
$231.40 |
$235.20
|
|
Unlisted misc path test
|
$69.55 |
$69.55 |
$69.55 |
$89.40
|
|
Unlisted mr procedure
|
$8,762.65 |
$8,762.65 |
$8,762.65 |
$1,165.00
|
|
Unlisted oph svc/procedure
|
$122.85 |
$122.85 |
$122.85 |
$40.26
|
|
Unlisted orl service/px
|
$207.35 |
$207.35 |
$207.35 |
$132.60
|
|
Unlisted procedure colon
|
$6,869.20 |
$6,869.20 |
$6,869.20 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$12,597.00 |
$12,597.00 |
$12,597.00 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$2,174.90 |
$2,174.90 |
$2,174.90 |
$2,174.90
|
|
Unlisted procedure larynx
|
$5,031.65 |
$5,031.65 |
$5,031.65 |
$924.00
|
|
Unlisted procedure liver
|
$4,366.70 |
$4,366.70 |
$4,366.70 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,011.10 |
$2,011.10 |
$2,011.10 |
$530.00
|
|
Unlisted procedure orbit
|
$576.55 |
$576.55 |
$576.55 |
$437.00
|
|
Unlisted procedure pancreas
|
$14,754.35 |
$14,754.35 |
$14,754.35 |
$4,810.00
|
|
Unlisted procedure rectum
|
$9,100.00 |
$9,100.00 |
$9,100.00 |
$1,278.72
|
|
Unlisted procedure spine
|
$13,436.80 |
$13,436.80 |
$13,436.80 |
$4,706.35
|
|
Unlisted procedure urinary 58750
|
$4,066.40 |
$4,066.40 |
$4,066.40 |
$926.40
|
|
Unlisted px abdomen muscskel
|
$2,067.00 |
$2,067.00 |
$2,067.00 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$6,248.45 |
$6,248.45 |
$6,248.45 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$2,478.45 |
$2,478.45 |
$2,478.45 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$4,087.20 |
$4,087.20 |
$4,087.20 |
$2,765.60
|
|
Unlisted px biliary tract
|
$34,425.95 |
$34,425.95 |
$34,425.95 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$199.55 |
$199.55 |
$199.55 |
$222.00
|
|
Unlisted px diaphragm
|
$28,316.60 |
$28,316.60 |
$28,316.60 |
$6,325.20
|
|
Unlisted px external ear
|
$2,056.60 |
$2,056.60 |
$2,056.60 |
$325.68
|
|
Unlisted px foot/toes
|
$3,881.80 |
$3,881.80 |
$3,881.80 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$3,192.15 |
$3,192.15 |
$3,192.15 |
$859.50
|
|
Unlisted px hands/fingers
|
$423.15 |
$423.15 |
$423.15 |
$349.70
|
|
Unlisted px leg/ankle
|
$1,931.80 |
$1,931.80 |
$1,931.80 |
$813.24
|
|
Unlisted px male genital sys
|
$10,795.85 |
$10,795.85 |
$10,795.85 |
$362.00
|
|
Unlisted px palate uvula
|
$3,053.05 |
$3,053.05 |
$3,053.05 |
$274.80
|
|
Unlisted px pelvis/hip joint
|
$10,826.40 |
$10,826.40 |
$10,826.40 |
$3,251.90
|
|
Unlisted px salivry glnd/dux
|
$1,607.45 |
$1,607.45 |
$1,607.45 |
$1,173.42
|
|
Unlisted px small intestine
|
$7,163.00 |
$7,163.00 |
$7,163.00 |
$2,118.35
|
|
Unlisted px ther rad tx plng
|
$228.80 |
$228.80 |
$228.80 |
$182.00
|
|
Unlisted px tongue flr mouth
|
$1,678.30 |
$1,678.30 |
$1,678.30 |
$282.50
|
|
Unlisted px vestibule mouth
|
$1,409.20 |
$1,409.20 |
$1,409.20 |
$456.96
|
|
Unlisted spec derm svc/px
|
$345.15 |
$345.15 |
$345.15 |
$223.08
|
|
Unlisted special svc px/rprt
|
$481.65 |
$481.65 |
$481.65 |
$90.00
|
|
Unlisted surgical path px
|
$1,422.20 |
$1,422.20 |
$1,422.20 |
$216.00
|
|
Unlisted ultrasound procedure
|
$462.15 |
$462.15 |
$462.15 |
$335.00
|
|
Unlisted vasc endoscopy px
|
$687.70 |
$687.70 |
$687.70 |
$1,523.20
|
|
Unlstd laps px sprmatic cord
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$2,274.35 |
$2,274.35 |
$2,274.35 |
$1,316.90
|
|
Upgrade pm system
|
$20,950.15 |
$20,950.15 |
$20,950.15 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$535.60 |
$535.60 |
$535.60 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,314.95 |
$1,314.95 |
$1,314.95 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$856.70 |
$856.70 |
$856.70 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,597.40 |
$2,597.40 |
$2,597.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,510.95 |
$2,510.95 |
$2,510.95 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,778.40 |
$1,778.40 |
$1,778.40 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$653.90 |
$653.90 |
$653.90 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$662.35 |
$662.35 |
$662.35 |
$380.82
|
|
Upper Endoscopy (EGD, diagnostic)
|
$3,504.15 |
$3,504.15 |
$3,504.15 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$3,504.15 |
$3,504.15 |
$3,504.15 |
$1,768.00
|
|
Upper ext fx orthosis rad/ul
|
$352.95 |
$352.95 |
$352.95 |
$619.49
|
|
Upper ext harvest for cabg1 seg 35600
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$627.20
|
|
Upper GI Barium X-ray (barium and gas)
|
$1,231.75 |
$1,231.75 |
$1,231.75 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$1,205.75 |
$1,205.75 |
$1,205.75 |
$603.20
|
|
Uppr gi scope w/submuc inj
|
$3,504.15 |
$3,504.15 |
$3,504.15 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$2,873.00 |
$2,873.00 |
$2,873.00 |
$6,082.67
|
|
Urea nitrogen
|
$52.00 |
$52.00 |
$52.00 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$85.15 |
$85.15 |
$85.15 |
$51.77
|
|
Ureteral embolization/occl
|
$1,047.80 |
$1,047.80 |
$1,047.80 |
$2,079.31
|
