|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$605.00 |
$605.00 |
$605.00 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$505.00 |
$505.00 |
$505.00 |
$501.60
|
|
Trauma partial team response w/critical care services level 4
|
$5,455.00 |
$5,455.00 |
$5,455.00 |
$4,471.50
|
|
Treat elbow fracture
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,027.40
|
|
Treat finger fracture each
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,592.00
|
|
Treat fracture of radius
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,821.60
|
|
Treat fracture of radius
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,849.00
|
|
Treat fracture of ulna
|
$270.00 |
$270.00 |
$270.00 |
$726.05
|
|
Treat hip dislocation
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,211.05
|
|
Treat humerus fracture
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,790.00
|
|
Treatment incomplete abortion completed surgically any trimester
|
$2,765.00 |
$2,765.00 |
$2,765.00 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$185.00 |
$185.00 |
$185.00 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$90.00 |
$90.00 |
$90.00 |
$147.48
|
|
Treatment of thigh fracture
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,790.00
|
|
Treatment radiation delivery level 2
|
$735.00 |
$735.00 |
$735.00 |
$830.70
|
|
Treat thigh fracture
|
$2,040.00 |
$2,040.00 |
$2,040.00 |
$2,008.18
|
|
Treat vaginal bleeding
|
$447.50 |
$447.50 |
$447.50 |
$379.60
|
|
Treat wrist dislocation
|
$270.00 |
$270.00 |
$270.00 |
$656.25
|
|
Treponema pallidum antibody
|
$80.00 |
$80.00 |
$80.00 |
$72.05
|
|
Trg gene rearrangement anal
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$455.70
|
|
Triamcinolone a inj prs-free
|
$561.54 |
$561.54 |
$561.54 |
$223.56
|
|
Trichomonas assay w/optic
|
$70.00 |
$70.00 |
$70.00 |
$57.40
|
|
Triglycerides
|
$45.00 |
$45.00 |
$45.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$198.24 |
$198.24 |
$198.24 |
$117.49
|
|
Trim nondyst nails
|
$105.00 |
$105.00 |
$105.00 |
$114.48
|
|
Trnscath plc stent crv crtd without prtct
|
$17,160.00 |
$17,160.00 |
$17,160.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$15,320.00 |
$15,320.00 |
$15,320.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,730.00 |
$11,730.00 |
$11,730.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$11,630.00 |
$11,630.00 |
$11,630.00 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$12,785.00 |
$12,785.00 |
$12,785.00 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,115.00 |
$3,115.00 |
$3,115.00 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,190.00 |
$5,190.00 |
$5,190.00 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,795.00 |
$1,795.00 |
$1,795.00 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,605.00 |
$1,605.00 |
$1,605.00 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$2,527.20
|
|
Troponin quantitative
|
$125.00 |
$125.00 |
$125.00 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$29,195.00 |
$29,195.00 |
$29,195.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$270.00 |
$270.00 |
$270.00 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$3,977.49
|
|
Tx l/r atrial fib addl
|
$11,080.00 |
$11,080.00 |
$11,080.00 |
$6,986.85
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$3,320.00 |
$3,320.00 |
$3,320.00 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$4,529.60
|
|
Tyms gene com variants
|
$175.00 |
$175.00 |
$175.00 |
$192.29
|
|
Ugt1a1 gene analy common variants
|
$235.00 |
$235.00 |
$235.00 |
$438.75
|
|
Ultrasound breast complete
|
$585.00 |
$585.00 |
$585.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$470.00 |
$470.00 |
$470.00 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$355.00 |
$355.00 |
$355.00 |
$338.00
|
|
Ultrasound encephalogram
|
$520.00 |
$520.00 |
$520.00 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$515.00 |
$515.00 |
$515.00 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$565.00 |
$565.00 |
$565.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$417.50 |
$417.50 |
$417.50 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$307.50 |
$307.50 |
$307.50 |
$388.08
|
|
Ultrasound guide intraoperative
|
$375.00 |
$375.00 |
$375.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$590.00 |
$590.00 |
$590.00 |
$560.00
|
|
Ultrasound infant hips ltd without stress
|
$327.50 |
$327.50 |
$327.50 |
$311.25
|
|
Ultrasound joint complete left
|
$540.00 |
$540.00 |
$540.00 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$402.50 |
$402.50 |
$402.50 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$385.00 |
$385.00 |
$385.00 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$335.00 |
$335.00 |
$335.00 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$820.00 |
$820.00 |
$820.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$505.00 |
$505.00 |
$505.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$530.00 |
$530.00 |
$530.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$415.00 |
$415.00 |
$415.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$615.00 |
$615.00 |
$615.00 |
$421.00
|
|
Unlisted chemotherapy px
|
$150.00 |
$150.00 |
$150.00 |
$143.75
|
|
Unlisted CT procedure
|
$445.00 |
$445.00 |
$445.00 |
$732.70
|
|
Unlisted mr procedure
|
$150.00 |
$150.00 |
$150.00 |
$1,163.00
|
|
Unlisted procedure liver
|
$700.00 |
$700.00 |
$700.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$555.00 |
$555.00 |
$555.00 |
$530.00
|
|
Unlisted reprod med lab proc
|
$65.00 |
$65.00 |
$65.00 |
$70.00
|
|
Unlisted transfusion med px
|
$147.50 |
$147.50 |
$147.50 |
$147.50
|
|
Unlisted ultrasound procedure
|
$335.00 |
$335.00 |
$335.00 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$1,296.00
|
|
Upgrade pm system
|
$12,270.00 |
$12,270.00 |
$12,270.00 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$320.00 |
$320.00 |
$320.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,245.00 |
$1,245.00 |
$1,245.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,750.00 |
$2,750.00 |
$2,750.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,865.00 |
$1,865.00 |
$1,865.00 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,765.00 |
$1,765.00 |
$1,765.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$417.50 |
$417.50 |
$417.50 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$447.50 |
$447.50 |
$447.50 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$440.00 |
$440.00 |
$440.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$387.50 |
$387.50 |
$387.50 |
$607.20
|
|
Urea nitrogen
|
$37.50 |
$37.50 |
$37.50 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$37.50 |
$37.50 |
$37.50 |
$51.84
|
|
Urea nitrogen clearance
|
$65.00 |
$65.00 |
$65.00 |
$34.02
|
|
Ureteral embolization/occl
|
$3,665.00 |
$3,665.00 |
$3,665.00 |
$2,079.31
|
|
Ureteral reflux study
|
$1,165.00 |
$1,165.00 |
$1,165.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$510.00 |
$510.00 |
$510.00 |
$584.00
|
|
Urethrocystography void s&i
|
$695.00 |
$695.00 |
$695.00 |
$634.50
|
|
Uric acid blood
|
$45.00 |
$45.00 |
$45.00 |
$49.32
|
|
Uric acid urine
|
$62.50 |
$62.50 |
$62.50 |
$44.52
|
|
Urinalysis microscopic only
|
$37.50 |
$37.50 |
$37.50 |
$26.35
|
|
Urinalysis (with microscopy)
|
$35.00 |
$35.00 |
$35.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$32.50 |
$32.50 |
$32.50 |
$35.91
|
|
Urine Culture Test
|
$57.50 |
$57.50 |
$57.50 |
$82.32
|
