|
Troponin quantitative
|
$178.20 |
$178.20 |
$178.20 |
$127.20
|
|
Tr retinal les preterm inf
|
$2,226.60 |
$2,226.60 |
$2,226.60 |
$1,794.00
|
|
Tte w or without contr, cont ecg
|
$1,873.20 |
$1,873.20 |
$1,873.20 |
$2,012.40
|
|
Tx atrial fib pulm vein isol
|
$37,600.80 |
$37,600.80 |
$37,600.80 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$442.80 |
$442.80 |
$442.80 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,655.20 |
$3,655.20 |
$3,655.20 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$293.40 |
$293.40 |
$293.40 |
$535.60
|
|
Tx l/r atrial fib addl
|
$21,592.80 |
$21,592.80 |
$21,592.80 |
$6,769.00
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,153.40 |
$8,153.40 |
$8,153.40 |
$4,468.55
|
|
Tympanometry & reflex thresh
|
$178.20 |
$178.20 |
$178.20 |
$170.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$587.40 |
$587.40 |
$587.40 |
$394.20
|
|
Ultrasound breast complete
|
$652.20 |
$652.20 |
$652.20 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$544.20 |
$544.20 |
$544.20 |
$449.35
|
|
Ultrasound chest
|
$174.00 |
$174.00 |
$174.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$587.40 |
$587.40 |
$587.40 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$406.80 |
$406.80 |
$406.80 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$164.40 |
$164.40 |
$164.40 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$203.40 |
$203.40 |
$203.40 |
$307.00
|
|
Ultrasound encephalogram
|
$729.00 |
$729.00 |
$729.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$729.00 |
$729.00 |
$729.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$622.80 |
$622.80 |
$622.80 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$742.20 |
$742.20 |
$742.20 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$248.40 |
$248.40 |
$248.40 |
$720.15
|
|
Ultrasound guide intraoperative
|
$1,384.80 |
$1,384.80 |
$1,384.80 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$950.40 |
$950.40 |
$950.40 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$592.80 |
$592.80 |
$592.80 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$631.80 |
$631.80 |
$631.80 |
$311.25
|
|
Ultrasound joint complete left
|
$835.80 |
$835.80 |
$835.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$835.80 |
$835.80 |
$835.80 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$909.60 |
$909.60 |
$909.60 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$614.40 |
$614.40 |
$614.40 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$582.60 |
$582.60 |
$582.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$655.20 |
$655.20 |
$655.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$499.20 |
$499.20 |
$499.20 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$631.20 |
$631.20 |
$631.20 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$587.40 |
$587.40 |
$587.40 |
$486.50
|
|
Ultrasound scrotum and contents
|
$779.40 |
$779.40 |
$779.40 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$674.40 |
$674.40 |
$674.40 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$1,051.80 |
$1,051.80 |
$1,051.80 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$787.20 |
$787.20 |
$787.20 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$618.00 |
$618.00 |
$618.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$308.40 |
$308.40 |
$308.40 |
$348.00
|
|
Ultraviolet therapy
|
$27.60 |
$27.60 |
$27.60 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$198.00 |
$198.00 |
$198.00 |
$206.64
|
|
Unlistd noninvas vasc dx std
|
$3,041.40 |
$3,041.40 |
$3,041.40 |
$528.80
|
|
Unlisted CT procedure
|
$1,756.80 |
$1,756.80 |
$1,756.80 |
$732.70
|
|
Unlisted cytogenetic study
|
$2,329.20 |
$2,329.20 |
$2,329.20 |
$160.18
|
|
Unlisted endocrine px dx nuc
|
$753.60 |
$753.60 |
$753.60 |
$569.91
|
|
Unlisted gi px dx nuc med
|
$944.40 |
$944.40 |
$944.40 |
$995.00
|
|
Unlisted maaa
|
$353.40 |
$353.40 |
$353.40 |
$235.20
|
|
Unlisted mr procedure
|
$2,423.40 |
$2,423.40 |
$2,423.40 |
$1,163.00
|
|
Unlisted orl service/px
|
$144.00 |
$144.00 |
$144.00 |
$132.60
|
|
Unlisted procedure esophagus
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$1,998.88
|
|
Unlisted procedure liver
|
$1,060.20 |
$1,060.20 |
$1,060.20 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$1,692.60 |
$1,692.60 |
$1,692.60 |
$523.50
|
|
Unlisted procedure pancreas
|
$548.40 |
$548.40 |
$548.40 |
$3,986.00
|
|
Unlisted procedure rectum
|
$574.20 |
$574.20 |
$574.20 |
$1,220.35
|
|
Unlisted procedure spine
|
$633.00 |
$633.00 |
$633.00 |
$4,659.85
|
|
Unlisted psychiatric service/proc 90899
|
$595.20 |
$595.20 |
$595.20 |
$277.76
|
|
Unlisted px abdomen muscskel
|
$151.20 |
$151.20 |
$151.20 |
$1,848.60
|
|
Unlisted px ant segment eye
|
$1,437.00 |
$1,437.00 |
$1,437.00 |
$2,698.92
|
|
Unlisted px biliary tract
|
$7,028.40 |
$7,028.40 |
$7,028.40 |
$2,718.10
|
|
Unlisted px leg/ankle
|
$1,566.60 |
$1,566.60 |
$1,566.60 |
$811.00
|
|
Unlisted px male genital sys
|
$402.60 |
$402.60 |
$402.60 |
$343.55
|
|
Unlisted px neck/thorax
|
$2,520.00 |
$2,520.00 |
$2,520.00 |
$571.20
|
|
Unlisted px salivry glnd/dux
|
$2,143.80 |
$2,143.80 |
$2,143.80 |
$1,265.16
|
|
Unlisted px small intestine
|
$1,915.80 |
$1,915.80 |
$1,915.80 |
$2,102.10
|
|
Unlisted resp px dx nuc med
|
$993.60 |
$993.60 |
$993.60 |
$670.60
|
|
Unlisted transfusion med px
|
$171.60 |
$171.60 |
$171.60 |
$147.50
|
|
Unlisted ultrasound procedure
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$321.20
|
|
Upgrade pm system
|
$17,812.80 |
$17,812.80 |
$17,812.80 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,592.20 |
$3,592.20 |
$3,592.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,346.80 |
$3,346.80 |
$3,346.80 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,871.00 |
$2,871.00 |
$2,871.00 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$927.00 |
$927.00 |
$927.00 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$927.00 |
$927.00 |
$927.00 |
$1,768.00
|
|
Urea nitrogen
|
$100.80 |
$100.80 |
$100.80 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$67.20 |
$67.20 |
$67.20 |
$51.75
|
|
Ureteral embolization/occl
|
$29,062.20 |
$29,062.20 |
$29,062.20 |
$2,181.40
|
|
Ureteral reflux study
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$952.50
|
|
Ureteroneocystostomy 50780
|
$3,606.00 |
$3,606.00 |
$3,606.00 |
$4,457.05
|
|
Urethrcystgrphy rtrgrde s&i
|
$430.20 |
$430.20 |
$430.20 |
$579.73
|
|
Urethrocystography void s&i
|
$419.40 |
$419.40 |
$419.40 |
$622.35
|
|
Uric acid blood
|
$79.80 |
$79.80 |
$79.80 |
$48.75
|
|
Uric acid urine
|
$124.80 |
$124.80 |
$124.80 |
$44.33
|
|
Urinalysis microscopic only
|
$73.20 |
$73.20 |
$73.20 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$69.00 |
$69.00 |
$69.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$31.80 |
$31.80 |
$31.80 |
$55.00
|
|
Urinalysis (without microscopy)
|
$171.00 |
$171.00 |
$171.00 |
$35.75
|
|
Urinary bldr retent nuc study
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$350.66
|
|
Urine Culture Test
|
$68.40 |
$68.40 |
$68.40 |
$81.50
|
|
Urine pregnancy test
|
$86.40 |
$86.40 |
$86.40 |
$67.20
|
|
Use 1st target lesion
|
$328.80 |
$328.80 |
$328.80 |
$332.00
|
|
Vaginal bx
|
$585.60 |
$585.60 |
$585.60 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,134.60 |
$1,134.60 |
$1,134.60 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$220.20 |
$220.20 |
$220.20 |
$114.72
|
|
Valvuloplasty aortic
|
$9,384.60 |
$9,384.60 |
$9,384.60 |
$7,830.80
|
|
Valvuloplasty mitral
|
$9,384.60 |
$9,384.60 |
$9,384.60 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$9,852.60 |
$9,852.60 |
$9,852.60 |
$11,945.20
|
