|
Transferrin
|
$123.84 |
$123.84 |
$123.84 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,512.72 |
$1,512.72 |
$1,512.72 |
$983.00
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$157.46 |
$157.46 |
$157.46 |
$7,540.20
|
|
Treat clavicle dislocation 23545
|
$518.40 |
$518.40 |
$518.40 |
$705.60
|
|
Treat finger fracture each
|
$7,008.48 |
$7,008.48 |
$7,008.48 |
$4,132.02
|
|
Treat fracture of radius
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,790.00
|
|
Treat fracture of radius
|
$4,217.04 |
$4,217.04 |
$4,217.04 |
$1,849.00
|
|
Treat fracture of ulna
|
$1,601.28 |
$1,601.28 |
$1,601.28 |
$726.05
|
|
Treat knee fracture 27530
|
$642.24 |
$642.24 |
$642.24 |
$550.00
|
|
Treat knuckle dislocation
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,523.90
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$15,430.32 |
$15,430.32 |
$15,430.32 |
$8,370.75
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$601.92 |
$601.92 |
$601.92 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$180.00 |
$180.00 |
$180.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$439.20 |
$439.20 |
$439.20 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$645.12 |
$645.12 |
$645.12 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$1,742.40 |
$1,742.40 |
$1,742.40 |
$491.50
|
|
Treatment of heel fracture 28400
|
$1,370.88 |
$1,370.88 |
$1,370.88 |
$473.00
|
|
Treatment of toe fracture 28510
|
$652.32 |
$652.32 |
$652.32 |
$369.70
|
|
Treat metacarpal fracture
|
$7,008.48 |
$7,008.48 |
$7,008.48 |
$3,977.49
|
|
Treat thigh fracture
|
$3,007.44 |
$3,007.44 |
$3,007.44 |
$2,032.10
|
|
Treponema pallidum antibody
|
$96.48 |
$96.48 |
$96.48 |
$70.40
|
|
Trg gene rearrangement anal
|
$888.48 |
$888.48 |
$888.48 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$8.09 |
$8.09 |
$8.09 |
$43.21
|
|
Trichomonas assay w/optic
|
$169.20 |
$169.20 |
$169.20 |
$55.50
|
|
Triglycerides
|
$95.04 |
$95.04 |
$95.04 |
$58.05
|
|
Trim nondyst nails
|
$133.20 |
$133.20 |
$133.20 |
$113.40
|
|
Troponin quantitative
|
$216.72 |
$216.72 |
$216.72 |
$127.20
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$7,564.32 |
$7,564.32 |
$7,564.32 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$1,166.40 |
$1,166.40 |
$1,166.40 |
$416.16
|
|
Ugt1a1 gene analy common variants
|
$295.20 |
$295.20 |
$295.20 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$815.76 |
$815.76 |
$815.76 |
$394.20
|
|
Ultrasound breast complete
|
$910.80 |
$910.80 |
$910.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$836.64 |
$836.64 |
$836.64 |
$449.35
|
|
Ultrasound chest
|
$852.48 |
$852.48 |
$852.48 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$398.16 |
$398.16 |
$398.16 |
$338.00
|
|
Ultrasound exam k transpl w/doppler
|
$1,135.44 |
$1,135.44 |
$1,135.44 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$945.36 |
$945.36 |
$945.36 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$159.84 |
$159.84 |
$159.84 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$201.60 |
$201.60 |
$201.60 |
$720.15
|
|
Ultrasound guide intraoperative
|
$544.32 |
$544.32 |
$544.32 |
$632.85
|
|
Ultrasound joint complete left
|
$647.28 |
$647.28 |
$647.28 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$465.84 |
$465.84 |
$465.84 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,211.04 |
$1,211.04 |
$1,211.04 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$381.60 |
$381.60 |
$381.60 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,018.08 |
$1,018.08 |
$1,018.08 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$601.20 |
$601.20 |
$601.20 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$544.32 |
$544.32 |
$544.32 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$398.16 |
$398.16 |
$398.16 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$945.36 |
$945.36 |
$945.36 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$902.16 |
$902.16 |
$902.16 |
$486.50
|
|
Ultrasound scrotum and contents
|
$945.36 |
$945.36 |
$945.36 |
$608.90
|
|
Ultrasound transabd ea addl gest
|
$745.20 |
$745.20 |
$745.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$714.24 |
$714.24 |
$714.24 |
$558.35
|
|
Unlisted hematology&coagj px
|
$52.56 |
$52.56 |
$52.56 |
$39.52
|
|
Unlisted px casting/strpg
|
$340.56 |
$340.56 |
$340.56 |
$219.70
|
|
Unlisted transfusion med px
|
$67.68 |
$67.68 |
$67.68 |
$147.50
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,185.36 |
$4,185.36 |
$4,185.36 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,700.08 |
$3,700.08 |
$3,700.08 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,098.16 |
$3,098.16 |
$3,098.16 |
$2,034.41
|
|
Urea nitrogen
|
$95.04 |
$95.04 |
$95.04 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$123.84 |
$123.84 |
$123.84 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$550.80 |
$550.80 |
$550.80 |
$579.73
|
|
Urethrocystography void s&i
|
$749.52 |
$749.52 |
$749.52 |
$622.35
|
|
Uric acid blood
|
$120.96 |
$120.96 |
$120.96 |
$48.75
|
|
Uric acid urine
|
$64.80 |
$64.80 |
$64.80 |
$44.33
|
|
Urinalysis qual/semiquant excpt ia
|
$39.60 |
$39.60 |
$39.60 |
$25.72
|
|
Urinalysis (with microscopy)
|
$82.80 |
$82.80 |
$82.80 |
$55.00
|
|
Urinalysis (without microscopy)
|
$31.68 |
$31.68 |
$31.68 |
$35.75
|
|
Urine Culture Test
|
$104.40 |
$104.40 |
$104.40 |
$81.50
|
|
Urine pregnancy test
|
$126.00 |
$126.00 |
$126.00 |
$67.20
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$100.69 |
$100.69 |
$100.69 |
$75.39
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$71.75 |
$71.75 |
$71.75 |
$47.88
|
|
Vaccine mmr live subcutaneous
|
$337.39 |
$337.39 |
$337.39 |
$211.68
|
|
Vaccine rabies im
|
$1,502.03 |
$1,502.03 |
$1,502.03 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$167.18 |
$167.18 |
$167.18 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$174.24 |
$174.24 |
$174.24 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$0.74 |
$0.74 |
$0.74 |
$251.86
|
|
Vancomycin peak therapeutic drug level
|
$209.52 |
$209.52 |
$209.52 |
$136.13
|
|
Varicella zoster antibody igg
|
$109.44 |
$109.44 |
$109.44 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$18.17 |
$18.17 |
$18.17 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$107.83 |
$107.83 |
$107.83 |
$18,732.33
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$258.48 |
$258.48 |
$258.48 |
$202.80
|
|
Vitamin b-12
|
$70.56 |
$70.56 |
$70.56 |
$100.00
|
|
Vitamin D Test
|
$210.96 |
$210.96 |
$210.96 |
$132.00
|
|
Volume measurement urine timed
|
$23.04 |
$23.04 |
$23.04 |
$21.45
|
|
Warde 1003990 aldosterone
|
$211.68 |
$211.68 |
$211.68 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$38.16 |
$38.16 |
$38.16 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$38.88 |
$38.88 |
$38.88 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$56.16 |
$56.16 |
$56.16 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$38.88 |
$38.88 |
$38.88 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$173.52 |
$173.52 |
$173.52 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$22.32 |
$22.32 |
$22.32 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$185.04 |
$185.04 |
$185.04 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$38.16 |
$38.16 |
$38.16 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$38.16 |
$38.16 |
$38.16 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$174.24 |
$174.24 |
$174.24 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$84.96 |
$84.96 |
$84.96 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$74.16 |
$74.16 |
$74.16 |
$72.50
|
|
Warde 3400683 amplification rna markers infectious disease bacterial vaginosis
|
$317.52 |
$317.52 |
$317.52 |
$218.40
|
|
Warde 3400852 arsenic
|
$20.88 |
$20.88 |
$20.88 |
$100.88
|
