|
Transcath closure of asd
|
$3,203.32 |
$3,203.32 |
$3,203.32 |
$18,772.00
|
|
Transcatheter bx s&i
|
$1,037.78 |
$1,037.78 |
$1,037.78 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$1,767.72 |
$1,767.72 |
$1,767.72 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$3,088.47 |
$3,088.47 |
$3,088.47 |
$17,106.18
|
|
Transcath occlusion cns
|
$4,794.32 |
$4,794.32 |
$4,794.32 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$1,534.17 |
$1,534.17 |
$1,534.17 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$3,197.99 |
$3,197.99 |
$3,197.99 |
$4,627.00
|
|
Transferrin
|
$29.90 |
$29.90 |
$29.90 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,220.41 |
$1,220.41 |
$1,220.41 |
$988.24
|
|
Transperi needle place pros
|
$5,102.16 |
$5,102.16 |
$5,102.16 |
$6,203.00
|
|
Transposition of vein valve
|
$5,361.45 |
$5,361.45 |
$5,361.45 |
$5,907.78
|
|
Trastuzumab 150 mg intravenous solution
|
$9,206.08 |
$9,206.08 |
$9,206.08 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$7,620.16 |
$7,620.16 |
$7,620.16 |
$7,191.23
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$5,212.75 |
$5,212.75 |
$5,212.75 |
$4,500.03
|
|
Tray bonemarrw oncontrol 102mm
|
$338.04 |
$338.04 |
$338.04 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$73.41 |
$73.41 |
$73.41 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$42.04 |
$42.04 |
$42.04 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$142.68 |
$142.68 |
$142.68 |
$210.00
|
|
Treatment radiation delivery level 2
|
$237.99 |
$237.99 |
$237.99 |
$735.00
|
|
Treponema pallidum antibody
|
$36.12 |
$36.12 |
$36.12 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$39.46 |
$39.46 |
$39.46 |
$55.80
|
|
Trichinella antibody
|
$49.44 |
$49.44 |
$49.44 |
$70.65
|
|
Triglycerides
|
$15.40 |
$15.40 |
$15.40 |
$54.60
|
|
Trnscath plc stent crv crtd without prtct
|
$1,389.13 |
$1,389.13 |
$1,389.13 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$1,389.13 |
$1,389.13 |
$1,389.13 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$784.40 |
$784.40 |
$784.40 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$737.64 |
$737.64 |
$737.64 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$12,291.40 |
$12,291.40 |
$12,291.40 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,225.22 |
$3,225.22 |
$3,225.22 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,375.22 |
$1,375.22 |
$1,375.22 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,375.22 |
$1,375.22 |
$1,375.22 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,375.22 |
$1,375.22 |
$1,375.22 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$1,375.22 |
$1,375.22 |
$1,375.22 |
$4,329.36
|
|
Troponin quantitative
|
$158.96 |
$158.96 |
$158.96 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$992.20 |
$992.20 |
$992.20 |
$1,582.75
|
|
Tx atrial fib pulm vein isol
|
$24,828.48 |
$24,828.48 |
$24,828.48 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$496.69 |
$496.69 |
$496.69 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$9.48 |
$9.48 |
$9.48 |
$24.45
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$22,431.23 |
$22,431.23 |
$22,431.23 |
$17,191.88
|
|
Ultrasound abdomen aorta screening study aaa
|
$230.29 |
$230.29 |
$230.29 |
$403.26
|
|
Ultrasound breast complete
|
$997.23 |
$997.23 |
$997.23 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$332.71 |
$332.71 |
$332.71 |
$449.35
|
|
Ultrasound chest
|
$260.48 |
$260.48 |
$260.48 |
$459.55
|
|
Ultrasound exam k transpl w/doppler
|
$337.74 |
$337.74 |
$337.74 |
$570.44
|
|
Ultrasound guidance for vascular access
|
$229.11 |
$229.11 |
$229.11 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$352.24 |
$352.24 |
$352.24 |
$701.35
|
|
Ultrasound guide intraoperative
|
$370.30 |
$370.30 |
$370.30 |
$632.90
|
|
Ultrasound joint/nonvascular extremity limited left
|
$195.36 |
$195.36 |
$195.36 |
$448.50
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$250.12 |
$250.12 |
$250.12 |
$326.54
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$153.63 |
$153.63 |
$153.63 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$255.75 |
$255.75 |
$255.75 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$289.20 |
$289.20 |
$289.20 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$253.38 |
$253.38 |
$253.38 |
$498.00
|
|
Ultrasound scrotum and contents
|
$488.11 |
$488.11 |
$488.11 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$319.68 |
$319.68 |
$319.68 |
$567.44
|
|
Unlisted orl service/px
|
$22.80 |
$22.80 |
$22.80 |
$121.50
|
|
Unlisted procedure microbiology
|
$773.45 |
$773.45 |
$773.45 |
$487.50
|
|
Unlisted px small intestine
|
$918.49 |
$918.49 |
$918.49 |
$2,118.35
|
|
Upgrade pm system
|
$1,254.16 |
$1,254.16 |
$1,254.16 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,177.08 |
$2,177.08 |
$2,177.08 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,567.62 |
$1,567.62 |
$1,567.62 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,415.18 |
$1,415.18 |
$1,415.18 |
$2,013.08
|
|
Urea nitrogen
|
$58.32 |
$58.32 |
$58.32 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$15.40 |
$15.40 |
$15.40 |
$50.00
|
|
Urea nitrogen clearance
|
$65.42 |
$65.42 |
$65.42 |
$33.57
|
|
Urethrcystgrphy rtrgrde s&i
|
$249.53 |
$249.53 |
$249.53 |
$574.40
|
|
Urethrocystography void s&i
|
$317.02 |
$317.02 |
$317.02 |
$634.50
|
|
Uric acid blood
|
$75.78 |
$75.78 |
$75.78 |
$46.64
|
|
Uric acid urine
|
$8.29 |
$8.29 |
$8.29 |
$46.75
|
|
Urinalysis microscopic only
|
$26.35 |
$26.35 |
$26.35 |
$26.35
|
|
Urinalysis (with microscopy)
|
$10.07 |
$10.07 |
$10.07 |
$48.14
|
|
Urinalysis (without microscopy)
|
$7.70 |
$7.70 |
$7.70 |
$38.99
|
|
Urine Culture Test
|
$13.32 |
$13.32 |
$13.32 |
$84.81
|
|
Urine pregnancy test
|
$26.35 |
$26.35 |
$26.35 |
$66.40
|
|
Urography, antegrade
|
$300.44 |
$300.44 |
$300.44 |
$593.37
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$29.87 |
$29.87 |
$29.87 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$98.28 |
$98.28 |
$98.28 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$61.66 |
$61.66 |
$61.66 |
$173.98
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$0.08 |
$0.08 |
$0.08 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$48.03 |
$48.03 |
$48.03 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$24.93 |
$24.93 |
$24.93 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$78.38 |
$78.38 |
$78.38 |
$104.63
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$71.70 |
$71.70 |
$71.70 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$210.06 |
$210.06 |
$210.06 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$144.23 |
$144.23 |
$144.23 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$114.68 |
$114.68 |
$114.68 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$126.36 |
$126.36 |
$126.36 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$244.91 |
$244.91 |
$244.91 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$296.23 |
$296.23 |
$296.23 |
$715.41
|
|
Vaccine rabies im
|
$423.47 |
$423.47 |
$423.47 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$60.63 |
$60.63 |
$60.63 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$50.48 |
$50.48 |
$50.48 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$157.77 |
$157.77 |
$157.77 |
$115.00
|
|
Valrubicin injection
|
$3,839.12 |
$3,839.12 |
$3,839.12 |
$2,813.49
|
|
Valvuloplasty aortic
|
$9,894.69 |
$9,894.69 |
$9,894.69 |
$7,324.85
|
|
Vancomycin 1,000 mg intravenous injection
|
$259.05 |
$259.05 |
$259.05 |
$246.70
|
|
Vancomycin peak therapeutic drug level
|
$33.45 |
$33.45 |
$33.45 |
$126.79
|
|
Varicella zoster antibody igg
|
$22.50 |
$22.50 |
$22.50 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$170.99 |
$170.99 |
$170.99 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$18,581.08 |
$18,581.08 |
$18,581.08 |
$20,730.98
|
