|
Treat sternum fracture
|
$151.20 |
$151.20 |
$151.20 |
$423.00
|
|
Treat thigh fracture
|
$2,018.40 |
$2,018.40 |
$2,018.40 |
$1,893.86
|
|
Treat ulnar fracture
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,662.00
|
|
Treat wrist dislocation
|
$322.20 |
$322.20 |
$322.20 |
$656.25
|
|
Treponema pallidum antibody
|
$134.40 |
$134.40 |
$134.40 |
$70.40
|
|
Trg gene rearrangement anal
|
$766.80 |
$766.80 |
$766.80 |
$455.70
|
|
Triglycerides
|
$88.80 |
$88.80 |
$88.80 |
$58.05
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,657.00 |
$3,657.00 |
$3,657.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,143.80 |
$2,143.80 |
$2,143.80 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,143.80 |
$2,143.80 |
$2,143.80 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,143.80 |
$2,143.80 |
$2,143.80 |
$3,866.70
|
|
Troponin quantitative
|
$294.00 |
$294.00 |
$294.00 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$15,445.80 |
$15,445.80 |
$15,445.80 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$683.40 |
$683.40 |
$683.40 |
$581.07
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,996.60 |
$3,996.60 |
$3,996.60 |
$4,468.55
|
|
Ultrasound abdomen aorta screening study aaa
|
$852.00 |
$852.00 |
$852.00 |
$394.20
|
|
Ultrasound breast complete
|
$742.80 |
$742.80 |
$742.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$604.20 |
$604.20 |
$604.20 |
$449.35
|
|
Ultrasound chest
|
$543.60 |
$543.60 |
$543.60 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$488.40 |
$488.40 |
$488.40 |
$338.00
|
|
Ultrasound encephalogram
|
$543.60 |
$543.60 |
$543.60 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$742.80 |
$742.80 |
$742.80 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$742.80 |
$742.80 |
$742.80 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$781.20 |
$781.20 |
$781.20 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$652.20 |
$652.20 |
$652.20 |
$720.15
|
|
Ultrasound guide intraoperative
|
$958.20 |
$958.20 |
$958.20 |
$632.85
|
|
Ultrasound joint complete left
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$745.20 |
$745.20 |
$745.20 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$949.20 |
$949.20 |
$949.20 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$362.40 |
$362.40 |
$362.40 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$408.60 |
$408.60 |
$408.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$742.80 |
$742.80 |
$742.80 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$543.60 |
$543.60 |
$543.60 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$742.80 |
$742.80 |
$742.80 |
$486.50
|
|
Ultrasound scrotum and contents
|
$742.80 |
$742.80 |
$742.80 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$947.40 |
$947.40 |
$947.40 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$577.80 |
$577.80 |
$577.80 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$742.80 |
$742.80 |
$742.80 |
$558.35
|
|
Ultraviolet therapy
|
$27.60 |
$27.60 |
$27.60 |
$39.76
|
|
Unlisted CT procedure
|
$2,446.80 |
$2,446.80 |
$2,446.80 |
$732.70
|
|
Unlisted cytogenetic study
|
$1,547.40 |
$1,547.40 |
$1,547.40 |
$160.18
|
|
Unlisted fluoroscopic px
|
$561.60 |
$561.60 |
$561.60 |
$305.76
|
|
Unlisted maaa
|
$345.60 |
$345.60 |
$345.60 |
$235.20
|
|
Unlisted procedure microbiology
|
$1,692.60 |
$1,692.60 |
$1,692.60 |
$523.50
|
|
Unlisted px casting/strpg
|
$436.20 |
$436.20 |
$436.20 |
$219.70
|
|
Unlisted ultrasound procedure
|
$543.60 |
$543.60 |
$543.60 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,119.60 |
$4,119.60 |
$4,119.60 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,119.60 |
$4,119.60 |
$4,119.60 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,602.60 |
$1,602.60 |
$1,602.60 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,602.60 |
$1,602.60 |
$1,602.60 |
$1,768.00
|
|
Urea nitrogen
|
$69.00 |
$69.00 |
$69.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$82.20 |
$82.20 |
$82.20 |
$51.75
|
|
Ureteral reflux study
|
$1,757.40 |
$1,757.40 |
$1,757.40 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$579.73
|
|
Urethrocystography void s&i
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$622.35
|
|
Uric acid blood
|
$82.20 |
$82.20 |
$82.20 |
$48.75
|
|
Uric acid urine
|
$82.20 |
$82.20 |
$82.20 |
$44.33
|
|
Urinalysis microscopic only
|
$91.80 |
$91.80 |
$91.80 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$91.80 |
$91.80 |
$91.80 |
$25.72
|
|
Urinalysis (with microscopy)
|
$88.80 |
$88.80 |
$88.80 |
$55.00
|
|
Urinalysis (without microscopy)
|
$75.00 |
$75.00 |
$75.00 |
$35.75
|
|
Urine Culture Test
|
$68.40 |
$68.40 |
$68.40 |
$81.50
|
|
Urine pregnancy test
|
$140.40 |
$140.40 |
$140.40 |
$67.20
|
|
Urography, antegrade
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$622.35
|
|
Vad battery clip set hmii 14-v li-ion
|
$3,481.20 |
$3,481.20 |
$3,481.20 |
$2,002.00
|
|
Valproic acid total therapeutic drug level
|
$172.20 |
$172.20 |
$172.20 |
$114.72
|
|
Vancomycin peak therapeutic drug level
|
$233.40 |
$233.40 |
$233.40 |
$136.13
|
|
Varicella zoster antibody igg
|
$184.80 |
$184.80 |
$184.80 |
$86.80
|
|
Vein x-ray liver w/hemodynam
|
$1,959.60 |
$1,959.60 |
$1,959.60 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$2,712.00 |
$2,712.00 |
$2,712.00 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$1,959.60 |
$1,959.60 |
$1,959.60 |
$2,452.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$99.00 |
$99.00 |
$99.00 |
$202.80
|
|
Venogram ext bil s&i
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,297.80 |
$1,297.80 |
$1,297.80 |
$1,366.20
|
|
Venous mech thrombectomy
|
$7,551.00 |
$7,551.00 |
$7,551.00 |
$7,965.00
|
|
Ventilator each subsequent day
|
$765.00 |
$765.00 |
$765.00 |
$1,204.00
|
|
Ventilator initial day
|
$943.80 |
$943.80 |
$943.80 |
$1,431.43
|
|
Version cephalic external
|
$2,346.60 |
$2,346.60 |
$2,346.60 |
$2,361.75
|
|
Very long chain fatty acids
|
$612.00 |
$612.00 |
$612.00 |
$139.88
|
|
Vest large holster
|
$1,838.40 |
$1,838.40 |
$1,838.40 |
$1,078.25
|
|
Virus isolation addl studies ea
|
$190.80 |
$190.80 |
$190.80 |
$77.50
|
|
Vital capacity test
|
$98.40 |
$98.40 |
$98.40 |
$170.00
|
|
Vitamin b-12
|
$105.00 |
$105.00 |
$105.00 |
$100.00
|
|
Vitamin D Test
|
$127.80 |
$127.80 |
$127.80 |
$132.00
|
|
Volume measurement urine timed
|
$45.00 |
$45.00 |
$45.00 |
$21.45
|
|
Warde 1003990 aldosterone
|
$294.60 |
$294.60 |
$294.60 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$223.80 |
$223.80 |
$223.80 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$174.00 |
$174.00 |
$174.00 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$226.20 |
$226.20 |
$226.20 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$157.80 |
$157.80 |
$157.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$118.20 |
$118.20 |
$118.20 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$268.20 |
$268.20 |
$268.20 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$210.60 |
$210.60 |
$210.60 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$355.20 |
$355.20 |
$355.20 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$303.60 |
$303.60 |
$303.60 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$184.80 |
$184.80 |
$184.80 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$142.20 |
$142.20 |
$142.20 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$114.60 |
$114.60 |
$114.60 |
$72.50
|
|
Warde 3400852 arsenic
|
$585.60 |
$585.60 |
$585.60 |
$100.88
|
