|
Treat humerus fracture
|
$2,061.60 |
$2,061.60 |
$2,061.60 |
$1,771.43
|
|
Treat knee dislocation
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$2,220.89
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$398.40 |
$398.40 |
$398.40 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$148.00 |
$148.00 |
$148.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$116.00 |
$116.00 |
$116.00 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$1,166.40 |
$1,166.40 |
$1,166.40 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$1,166.40 |
$1,166.40 |
$1,166.40 |
$491.50
|
|
Treatment of thigh fracture
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,772.97
|
|
Treatment of toe fracture 28510
|
$376.00 |
$376.00 |
$376.00 |
$369.70
|
|
Treat sternum fracture
|
$556.00 |
$556.00 |
$556.00 |
$423.00
|
|
Treat thigh fracture
|
$2,077.60 |
$2,077.60 |
$2,077.60 |
$1,893.86
|
|
Treat ulnar fracture
|
$2,144.80 |
$2,144.80 |
$2,144.80 |
$1,662.00
|
|
Treat wrist dislocation
|
$334.40 |
$334.40 |
$334.40 |
$656.25
|
|
Treponema pallidum antibody
|
$176.00 |
$176.00 |
$176.00 |
$70.40
|
|
Triglycerides
|
$131.20 |
$131.20 |
$131.20 |
$58.05
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,654.40 |
$4,654.40 |
$4,654.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,728.00 |
$2,728.00 |
$2,728.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,728.00 |
$2,728.00 |
$2,728.00 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,728.00 |
$2,728.00 |
$2,728.00 |
$3,866.70
|
|
Troponin quantitative
|
$176.00 |
$176.00 |
$176.00 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$19,847.20 |
$19,847.20 |
$19,847.20 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$469.60 |
$469.60 |
$469.60 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$639.20 |
$639.20 |
$639.20 |
$535.60
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$585.60 |
$585.60 |
$585.60 |
$911.43
|
|
Ua w/micro/comp poc
|
$122.40 |
$122.40 |
$122.40 |
$23.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$666.40 |
$666.40 |
$666.40 |
$394.20
|
|
Ultrasound breast complete
|
$796.80 |
$796.80 |
$796.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,200.80 |
$1,200.80 |
$1,200.80 |
$449.35
|
|
Ultrasound chest
|
$612.80 |
$612.80 |
$612.80 |
$460.85
|
|
Ultrasound encephalogram
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$488.80
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$797.60 |
$797.60 |
$797.60 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$268.00 |
$268.00 |
$268.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$459.20 |
$459.20 |
$459.20 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$489.60 |
$489.60 |
$489.60 |
$311.25
|
|
Ultrasound joint complete left
|
$676.80 |
$676.80 |
$676.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$967.20 |
$967.20 |
$967.20 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$503.20 |
$503.20 |
$503.20 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$279.20 |
$279.20 |
$279.20 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$871.20 |
$871.20 |
$871.20 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$275.20 |
$275.20 |
$275.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$924.80 |
$924.80 |
$924.80 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$969.60 |
$969.60 |
$969.60 |
$486.50
|
|
Ultrasound scrotum and contents
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$832.00 |
$832.00 |
$832.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$279.20 |
$279.20 |
$279.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$924.80 |
$924.80 |
$924.80 |
$558.35
|
|
Ultraviolet therapy
|
$36.80 |
$36.80 |
$36.80 |
$39.76
|
|
Unlisted cytogenetic study
|
$2,134.40 |
$2,134.40 |
$2,134.40 |
$160.18
|
|
Unlisted maaa
|
$431.20 |
$431.20 |
$431.20 |
$235.20
|
|
Unlisted procedure microbiology
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$523.50
|
|
Unlisted px casting/strpg
|
$133.60 |
$133.60 |
$133.60 |
$219.70
|
|
Unlisted ultrasound procedure
|
$559.20 |
$559.20 |
$559.20 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,398.40 |
$4,398.40 |
$4,398.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,702.40 |
$3,702.40 |
$3,702.40 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,401.60 |
$3,401.60 |
$3,401.60 |
$2,034.41
|
|
Urea nitrogen
|
$100.00 |
$100.00 |
$100.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$136.00 |
$136.00 |
$136.00 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$628.00 |
$628.00 |
$628.00 |
$579.73
|
|
Urethrocystography void s&i
|
$720.00 |
$720.00 |
$720.00 |
$622.35
|
|
Uric acid blood
|
$97.60 |
$97.60 |
$97.60 |
$48.75
|
|
Uric acid urine
|
$141.60 |
$141.60 |
$141.60 |
$44.33
|
|
Urinalysis microscopic only
|
$66.40 |
$66.40 |
$66.40 |
$26.35
|
|
Urinalysis (with microscopy)
|
$92.80 |
$92.80 |
$92.80 |
$55.00
|
|
Urinalysis (without microscopy)
|
$69.60 |
$69.60 |
$69.60 |
$35.75
|
|
Urine Culture Test
|
$77.60 |
$77.60 |
$77.60 |
$81.50
|
|
Urine pregnancy test
|
$144.00 |
$144.00 |
$144.00 |
$67.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$4,641.60 |
$4,641.60 |
$4,641.60 |
$2,002.00
|
|
Vaginal bx
|
$719.20 |
$719.20 |
$719.20 |
$455.94
|
|
Valproic acid total therapeutic drug level
|
$228.80 |
$228.80 |
$228.80 |
$114.72
|
|
Vancomycin peak therapeutic drug level
|
$162.40 |
$162.40 |
$162.40 |
$136.13
|
|
Varicella zoster antibody igg
|
$308.80 |
$308.80 |
$308.80 |
$86.80
|
|
Vein x-ray liver w/hemodynam
|
$2,644.00 |
$2,644.00 |
$2,644.00 |
$3,486.86
|
|
Vein x-ray liver without hemodyn
|
$2,644.00 |
$2,644.00 |
$2,644.00 |
$2,452.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$30.40 |
$30.40 |
$30.40 |
$202.80
|
|
Venogram ext bil s&i
|
$2,580.80 |
$2,580.80 |
$2,580.80 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,304.80 |
$1,304.80 |
$1,304.80 |
$1,366.20
|
|
Venous mech thrombectomy
|
$9,609.60 |
$9,609.60 |
$9,609.60 |
$7,965.00
|
|
Ventilator each subsequent day
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$1,204.00
|
|
Ventilator initial day
|
$1,258.40 |
$1,258.40 |
$1,258.40 |
$1,431.43
|
|
Vest large holster
|
$2,451.20 |
$2,451.20 |
$2,451.20 |
$1,078.25
|
|
Vital capacity test
|
$126.40 |
$126.40 |
$126.40 |
$170.00
|
|
Vitamin b-12
|
$119.20 |
$119.20 |
$119.20 |
$100.00
|
|
Vitamin D Test
|
$144.80 |
$144.80 |
$144.80 |
$132.00
|
|
Volume measurement urine timed
|
$53.60 |
$53.60 |
$53.60 |
$21.45
|
|
Warde 1003990 aldosterone
|
$318.40 |
$318.40 |
$318.40 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$615.20 |
$615.20 |
$615.20 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$246.40 |
$246.40 |
$246.40 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$293.60 |
$293.60 |
$293.60 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$182.40 |
$182.40 |
$182.40 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$150.40 |
$150.40 |
$150.40 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$381.60 |
$381.60 |
$381.60 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$292.80 |
$292.80 |
$292.80 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$448.00 |
$448.00 |
$448.00 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$384.00 |
$384.00 |
$384.00 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$240.00 |
$240.00 |
$240.00 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$130.40 |
$130.40 |
$130.40 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$131.20 |
$131.20 |
$131.20 |
$72.50
|
|
Warde 3400852 arsenic
|
$831.20 |
$831.20 |
$831.20 |
$100.88
|
