|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$167.20 |
$167.20 |
$167.20 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$901.60 |
$901.60 |
$901.60 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$391.20 |
$391.20 |
$391.20 |
$491.50
|
|
Treatment of thigh fracture
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,772.97
|
|
Treatment of toe fracture 28510
|
$301.60 |
$301.60 |
$301.60 |
$369.70
|
|
Treat sternum fracture
|
$201.60 |
$201.60 |
$201.60 |
$423.00
|
|
Treat thigh fracture
|
$2,558.40 |
$2,558.40 |
$2,558.40 |
$1,893.86
|
|
Treat ulnar fracture
|
$1,693.60 |
$1,693.60 |
$1,693.60 |
$1,662.00
|
|
Treat wrist dislocation
|
$426.40 |
$426.40 |
$426.40 |
$656.25
|
|
Treponema pallidum antibody
|
$206.40 |
$206.40 |
$206.40 |
$70.40
|
|
Trg gene rearrangement anal
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$455.70
|
|
Triglycerides
|
$285.60 |
$285.60 |
$285.60 |
$58.05
|
|
Trnscath plc stnt ante carotid art
|
$5,724.80 |
$5,724.80 |
$5,724.80 |
$6,069.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,528.00 |
$4,528.00 |
$4,528.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,655.20 |
$2,655.20 |
$2,655.20 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,655.20 |
$2,655.20 |
$2,655.20 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,655.20 |
$2,655.20 |
$2,655.20 |
$3,866.70
|
|
Troponin quantitative
|
$317.60 |
$317.60 |
$317.60 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$20,607.20 |
$20,607.20 |
$20,607.20 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$540.00 |
$540.00 |
$540.00 |
$581.07
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$13,283.20 |
$13,283.20 |
$13,283.20 |
$4,468.55
|
|
Tympanometry & reflex thresh
|
$304.80 |
$304.80 |
$304.80 |
$170.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$969.60 |
$969.60 |
$969.60 |
$394.20
|
|
Ultrasound breast complete
|
$963.20 |
$963.20 |
$963.20 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$867.20 |
$867.20 |
$867.20 |
$449.35
|
|
Ultrasound chest
|
$756.00 |
$756.00 |
$756.00 |
$460.85
|
|
Ultrasound elastography parenchyma
|
$485.60 |
$485.60 |
$485.60 |
$307.00
|
|
Ultrasound exam k transpl w/doppler
|
$1,221.60 |
$1,221.60 |
$1,221.60 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$868.80 |
$868.80 |
$868.80 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$720.15
|
|
Ultrasound joint complete left
|
$1,564.80 |
$1,564.80 |
$1,564.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,144.80 |
$1,144.80 |
$1,144.80 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$687.20 |
$687.20 |
$687.20 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,544.00 |
$1,544.00 |
$1,544.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,241.60 |
$1,241.60 |
$1,241.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$868.80 |
$868.80 |
$868.80 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$754.40 |
$754.40 |
$754.40 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$1,099.20 |
$1,099.20 |
$1,099.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$1,207.20 |
$1,207.20 |
$1,207.20 |
$608.90
|
|
Ultrasound transabd ea addl gest
|
$1,128.80 |
$1,128.80 |
$1,128.80 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$1,081.60 |
$1,081.60 |
$1,081.60 |
$558.35
|
|
Ultraviolet therapy
|
$36.80 |
$36.80 |
$36.80 |
$39.76
|
|
Unlisted cytogenetic study
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$160.18
|
|
Unlisted maaa
|
$460.80 |
$460.80 |
$460.80 |
$235.20
|
|
Unlisted orl service/px
|
$200.00 |
$200.00 |
$200.00 |
$132.60
|
|
Unlisted procedure microbiology
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$523.50
|
|
Unlisted px ant segment eye
|
$1,916.00 |
$1,916.00 |
$1,916.00 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$577.60 |
$577.60 |
$577.60 |
$219.70
|
|
Unlisted ultrasound procedure
|
$754.40 |
$754.40 |
$754.40 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,080.80 |
$5,080.80 |
$5,080.80 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$4,444.00 |
$4,444.00 |
$4,444.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,608.80 |
$3,608.80 |
$3,608.80 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$3,616.80 |
$3,616.80 |
$3,616.80 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$4,154.40 |
$4,154.40 |
$4,154.40 |
$1,768.00
|
|
Urea nitrogen
|
$108.00 |
$108.00 |
$108.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$234.40 |
$234.40 |
$234.40 |
$51.75
|
|
Ureteral reflux study
|
$946.40 |
$946.40 |
$946.40 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$579.73
|
|
Urethrocystography void s&i
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$622.35
|
|
Uric acid blood
|
$127.20 |
$127.20 |
$127.20 |
$48.75
|
|
Uric acid urine
|
$235.20 |
$235.20 |
$235.20 |
$44.33
|
|
Urinalysis microscopic only
|
$120.00 |
$120.00 |
$120.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$112.80 |
$112.80 |
$112.80 |
$25.72
|
|
Urinalysis (with microscopy)
|
$120.00 |
$120.00 |
$120.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$86.40 |
$86.40 |
$86.40 |
$35.75
|
|
Urine Culture Test
|
$91.20 |
$91.20 |
$91.20 |
$81.50
|
|
Urine pregnancy test
|
$208.00 |
$208.00 |
$208.00 |
$67.20
|
|
Urography, antegrade
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
$622.35
|
|
Vad battery clip set hmii 14-v li-ion
|
$4,641.60 |
$4,641.60 |
$4,641.60 |
$2,002.00
|
|
Valproic acid total therapeutic drug level
|
$258.40 |
$258.40 |
$258.40 |
$114.72
|
|
Vancomycin peak therapeutic drug level
|
$303.20 |
$303.20 |
$303.20 |
$136.13
|
|
Varicella zoster antibody igg
|
$313.60 |
$313.60 |
$313.60 |
$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)
|
$140.00 |
$140.00 |
$140.00 |
$202.80
|
|
Venogram extremity supervision & interpretation unilateral
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$1,366.20
|
|
Venous mech thrombectomy
|
$9,350.40 |
$9,350.40 |
$9,350.40 |
$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
|
|
Very long chain fatty acids
|
$839.20 |
$839.20 |
$839.20 |
$139.88
|
|
Vest large holster
|
$2,451.20 |
$2,451.20 |
$2,451.20 |
$1,078.25
|
|
Virus isolation addl studies ea
|
$122.40 |
$122.40 |
$122.40 |
$77.50
|
|
Visual audiometry (vra)
|
$280.00 |
$280.00 |
$280.00 |
$215.25
|
|
Vital capacity test
|
$131.20 |
$131.20 |
$131.20 |
$170.00
|
|
Vitamin b-12
|
$140.00 |
$140.00 |
$140.00 |
$100.00
|
|
Vitamin D Test
|
$170.40 |
$170.40 |
$170.40 |
$132.00
|
|
Volume measurement urine timed
|
$72.80 |
$72.80 |
$72.80 |
$21.45
|
|
Warde 1003990 aldosterone
|
$404.80 |
$404.80 |
$404.80 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$335.20 |
$335.20 |
$335.20 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$235.20 |
$235.20 |
$235.20 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$309.60 |
$309.60 |
$309.60 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$219.20 |
$219.20 |
$219.20 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$148.00 |
$148.00 |
$148.00 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$364.00 |
$364.00 |
$364.00 |
$39.00
|
|
Warde 3008005 oligoclonal bands
|
$298.40 |
$298.40 |
$298.40 |
$107.97
|
|
Warde 3016000 west nile virus antibody
|
$546.40 |
$546.40 |
$546.40 |
$69.60
|
|
Warde 3016000 west nile virus antibody igg
|
$467.20 |
$467.20 |
$467.20 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$283.20 |
$283.20 |
$283.20 |
$60.50
|
