|
Treat ulnar fracture
|
$4,853.25 |
$4,853.25 |
$4,853.25 |
$1,662.00
|
|
Treat ulnar fracture
|
$11,544.00 |
$11,544.00 |
$11,544.00 |
$5,926.25
|
|
Treat vaginal bleeding
|
$577.50 |
$577.50 |
$577.50 |
$379.60
|
|
Treat wrist bone fracture
|
$4,853.25 |
$4,853.25 |
$4,853.25 |
$1,548.40
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$89,429.91 |
$89,429.91 |
$89,429.91 |
$73,346.25
|
|
Treponema pallidum ag if
|
$72.75 |
$72.75 |
$72.75 |
$33.60
|
|
Treponema pallidum antibody
|
$82.50 |
$82.50 |
$82.50 |
$70.40
|
|
Treprostinil injection
|
$27,507.47 |
$27,507.47 |
$27,507.47 |
$19,071.84
|
|
Trh stimulation panel
|
$409.50 |
$409.50 |
$409.50 |
$117.75
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$11.16 |
$11.16 |
$11.16 |
$43.21
|
|
Triamcinolone a inj prs-free
|
$293.91 |
$293.91 |
$293.91 |
$223.56
|
|
Triamcinolone hexacetonl inj
|
$28.62 |
$28.62 |
$28.62 |
$21.36
|
|
Trichinella antibody
|
$78.75 |
$78.75 |
$78.75 |
$70.20
|
|
Trichomonas assay w/optic
|
$75.00 |
$75.00 |
$75.00 |
$55.50
|
|
#tricyclicantidprssnt
|
$350.25 |
$350.25 |
$350.25 |
$50.86
|
|
Triglycerides
|
$39.75 |
$39.75 |
$39.75 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$96.51 |
$96.51 |
$96.51 |
$117.49
|
|
Triptorelin pamoate
|
$12,862.89 |
$12,862.89 |
$12,862.89 |
$4,619.39
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$5,333.25 |
$5,333.25 |
$5,333.25 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$5,428.50 |
$5,428.50 |
$5,428.50 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,343.75 |
$11,343.75 |
$11,343.75 |
$15,330.11
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$8,955.75 |
$8,955.75 |
$8,955.75 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,116.50 |
$2,116.50 |
$2,116.50 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,116.50 |
$2,116.50 |
$2,116.50 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,116.50 |
$2,116.50 |
$2,116.50 |
$3,866.70
|
|
Troponin quantitative
|
$145.50 |
$145.50 |
$145.50 |
$127.20
|
|
Tube trach fen sz 6 uncuffed
|
$248.94 |
$248.94 |
$248.94 |
$155.98
|
|
Tubular dressing
|
$2.25 |
$2.25 |
$2.25 |
$28.46
|
|
Tx atrial fib pulm vein isol
|
$22,800.00 |
$22,800.00 |
$22,800.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$772.50 |
$772.50 |
$772.50 |
$581.07
|
|
Tx l/r atrial fib addl
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$6,769.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,148.75 |
$2,148.75 |
$2,148.75 |
$4,499.12
|
|
Tympanometry & reflex thresh
|
$529.50 |
$529.50 |
$529.50 |
$170.00
|
|
Typhoid vaccine oral
|
$83.10 |
$83.10 |
$83.10 |
$63.28
|
|
Ua w/micro/comp poc
|
$12.75 |
$12.75 |
$12.75 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$24,001.35 |
$24,001.35 |
$24,001.35 |
$20,945.01
|
|
Ultrasound abdomen aorta screening study aaa
|
$292.50 |
$292.50 |
$292.50 |
$394.20
|
|
Ultrasound bone density measure
|
$336.00 |
$336.00 |
$336.00 |
$143.75
|
|
Ultrasound breast complete
|
$840.00 |
$840.00 |
$840.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$435.00 |
$435.00 |
$435.00 |
$449.35
|
|
Ultrasound chest
|
$405.00 |
$405.00 |
$405.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$327.00 |
$327.00 |
$327.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$305.25 |
$305.25 |
$305.25 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$363.75 |
$363.75 |
$363.75 |
$307.00
|
|
Ultrasound encephalogram
|
$502.50 |
$502.50 |
$502.50 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$412.50 |
$412.50 |
$412.50 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$479.25 |
$479.25 |
$479.25 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$312.00 |
$312.00 |
$312.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$318.75 |
$318.75 |
$318.75 |
$720.15
|
|
Ultrasound guide intraoperative
|
$194.25 |
$194.25 |
$194.25 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$490.50 |
$490.50 |
$490.50 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$571.50 |
$571.50 |
$571.50 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$357.75 |
$357.75 |
$357.75 |
$311.25
|
|
Ultrasound joint complete left
|
$342.75 |
$342.75 |
$342.75 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$300.00 |
$300.00 |
$300.00 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$283.50 |
$283.50 |
$283.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$258.75 |
$258.75 |
$258.75 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$748.50 |
$748.50 |
$748.50 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$507.00 |
$507.00 |
$507.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$305.25 |
$305.25 |
$305.25 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$532.50 |
$532.50 |
$532.50 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$501.75 |
$501.75 |
$501.75 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$480.00 |
$480.00 |
$480.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$457.50 |
$457.50 |
$457.50 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$720.00 |
$720.00 |
$720.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$811.50 |
$811.50 |
$811.50 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$559.50 |
$559.50 |
$559.50 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$1,012.50 |
$1,012.50 |
$1,012.50 |
$568.32
|
|
Ultraviolet therapy
|
$21.75 |
$21.75 |
$21.75 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$239.25 |
$239.25 |
$239.25 |
$206.64
|
|
Unit mobile power mpu
|
$9.00 |
$9.00 |
$9.00 |
$14,612.80
|
|
Unlisted CT procedure
|
$367.50 |
$367.50 |
$367.50 |
$732.70
|
|
Unlisted fluoroscopic px
|
$272.25 |
$272.25 |
$272.25 |
$305.76
|
|
Unlisted mr procedure
|
$435.00 |
$435.00 |
$435.00 |
$1,163.00
|
|
Unlisted procedure liver
|
$2,059.50 |
$2,059.50 |
$2,059.50 |
$2,287.20
|
|
Unlisted px casting/strpg
|
$153.75 |
$153.75 |
$153.75 |
$219.70
|
|
Unlisted px small intestine
|
$2,568.75 |
$2,568.75 |
$2,568.75 |
$2,102.10
|
|
Unlisted reprod med lab proc
|
$138.75 |
$138.75 |
$138.75 |
$70.00
|
|
Unsched dialysis esrd pt hos
|
$825.00 |
$825.00 |
$825.00 |
$1,268.17
|
|
Upgrade pm system
|
$11,747.25 |
$11,747.25 |
$11,747.25 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,325.00 |
$2,325.00 |
$2,325.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,257.50 |
$2,257.50 |
$2,257.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,983.75 |
$1,983.75 |
$1,983.75 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,476.00 |
$1,476.00 |
$1,476.00 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$1,462.50 |
$1,462.50 |
$1,462.50 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$10,242.75 |
$10,242.75 |
$10,242.75 |
$6,082.67
|
|
Urea nitrogen
|
$32.25 |
$32.25 |
$32.25 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$30.00 |
$30.00 |
$30.00 |
$51.75
|
|
Urea nitrogen clearance
|
$41.25 |
$41.25 |
$41.25 |
$42.25
|
|
Urea nitrogen semi-quant
|
$24.75 |
$24.75 |
$24.75 |
$10.40
|
|
Ureteral reflux study
|
$997.50 |
$997.50 |
$997.50 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$654.75 |
$654.75 |
$654.75 |
$579.73
|
|
Urethrocystography void s&i
|
$654.75 |
$654.75 |
$654.75 |
$622.35
|
|
Uric acid blood
|
$37.50 |
$37.50 |
$37.50 |
$48.75
|
|
Uric acid urine
|
$31.50 |
$31.50 |
$31.50 |
$44.33
|
|
Urinalysis glass test
|
$17.25 |
$17.25 |
$17.25 |
$11.20
|
|
Urinalysis microscopic only
|
$25.50 |
$25.50 |
$25.50 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$10.50 |
$10.50 |
$10.50 |
$25.72
|
|
Urinalysis (with microscopy)
|
$33.75 |
$33.75 |
$33.75 |
$55.00
|
