|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$2,406.77
|
|
Troponin quantitative
|
$307.80 |
$307.80 |
$307.80 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,952.60 |
$2,952.60 |
$2,952.60 |
$2,012.40
|
|
Tx atrial fib pulm vein isol
|
$15,455.40 |
$15,455.40 |
$15,455.40 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$2,739.60 |
$2,739.60 |
$2,739.60 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$550.80 |
$550.80 |
$550.80 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,531.80 |
$4,531.80 |
$4,531.80 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$541.20 |
$541.20 |
$541.20 |
$535.60
|
|
Tx l/r atrial fib addl
|
$12,295.20 |
$12,295.20 |
$12,295.20 |
$6,769.00
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$1,172.40 |
$1,172.40 |
$1,172.40 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$10,027.80 |
$10,027.80 |
$10,027.80 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$4,040.40 |
$4,040.40 |
$4,040.40 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$451.20 |
$451.20 |
$451.20 |
$416.16
|
|
Ultrasound abdomen aorta screening study aaa
|
$608.40 |
$608.40 |
$608.40 |
$394.20
|
|
Ultrasound breast complete
|
$376.20 |
$376.20 |
$376.20 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$376.20 |
$376.20 |
$376.20 |
$449.35
|
|
Ultrasound chest
|
$836.40 |
$836.40 |
$836.40 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$687.00 |
$687.00 |
$687.00 |
$338.00
|
|
Ultrasound encephalogram
|
$737.40 |
$737.40 |
$737.40 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$1,205.40 |
$1,205.40 |
$1,205.40 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$727.20 |
$727.20 |
$727.20 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$556.20 |
$556.20 |
$556.20 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,170.60 |
$1,170.60 |
$1,170.60 |
$720.15
|
|
Ultrasound guide intraoperative
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$264.00 |
$264.00 |
$264.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$319.80 |
$319.80 |
$319.80 |
$311.25
|
|
Ultrasound joint complete left
|
$1,414.80 |
$1,414.80 |
$1,414.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$865.20 |
$865.20 |
$865.20 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$599.40 |
$599.40 |
$599.40 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$523.20 |
$523.20 |
$523.20 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,011.60 |
$1,011.60 |
$1,011.60 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$786.60 |
$786.60 |
$786.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$347.40 |
$347.40 |
$347.40 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$650.40 |
$650.40 |
$650.40 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$1,205.40 |
$1,205.40 |
$1,205.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$841.20 |
$841.20 |
$841.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$955.80 |
$955.80 |
$955.80 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$963.60 |
$963.60 |
$963.60 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$556.20 |
$556.20 |
$556.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$801.00 |
$801.00 |
$801.00 |
$558.35
|
|
Ultraviolet therapy
|
$27.60 |
$27.60 |
$27.60 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$88.80 |
$88.80 |
$88.80 |
$206.64
|
|
Unlisted CT procedure
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$732.70
|
|
Unlisted cytogenetic study
|
$2,290.80 |
$2,290.80 |
$2,290.80 |
$160.18
|
|
Unlisted fluoroscopic px
|
$224.40 |
$224.40 |
$224.40 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$868.20 |
$868.20 |
$868.20 |
$995.00
|
|
Unlisted maaa
|
$399.00 |
$399.00 |
$399.00 |
$235.20
|
|
Unlisted mr procedure
|
$3,091.80 |
$3,091.80 |
$3,091.80 |
$1,163.00
|
|
Unlisted procedure larynx
|
$174.60 |
$174.60 |
$174.60 |
$924.00
|
|
Unlisted procedure microbiology
|
$1,725.60 |
$1,725.60 |
$1,725.60 |
$523.50
|
|
Unlisted procedure rectum
|
$574.20 |
$574.20 |
$574.20 |
$1,220.35
|
|
Unlisted px abdomen muscskel
|
$3,800.40 |
$3,800.40 |
$3,800.40 |
$1,848.60
|
|
Unlisted px casting/strpg
|
$425.40 |
$425.40 |
$425.40 |
$219.70
|
|
Unlisted px foot/toes
|
$834.60 |
$834.60 |
$834.60 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$4,369.20 |
$4,369.20 |
$4,369.20 |
$593.60
|
|
Unlisted px hands/fingers
|
$737.40 |
$737.40 |
$737.40 |
$354.20
|
|
Unlisted px leg/ankle
|
$3,787.80 |
$3,787.80 |
$3,787.80 |
$811.00
|
|
Unlisted px male genital sys
|
$250.20 |
$250.20 |
$250.20 |
$343.55
|
|
Unlisted px middle ear
|
$353.40 |
$353.40 |
$353.40 |
$343.50
|
|
Unlisted px pelvis/hip joint
|
$2,727.00 |
$2,727.00 |
$2,727.00 |
$3,118.44
|
|
Unlisted px small intestine
|
$2,598.00 |
$2,598.00 |
$2,598.00 |
$2,102.10
|
|
Unlisted resp px dx nuc med
|
$897.00 |
$897.00 |
$897.00 |
$670.60
|
|
Unlisted ultrasound procedure
|
$556.20 |
$556.20 |
$556.20 |
$321.20
|
|
Upgrade pm system
|
$17,573.40 |
$17,573.40 |
$17,573.40 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,525.00 |
$3,525.00 |
$3,525.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,343.80 |
$3,343.80 |
$3,343.80 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,091.80 |
$3,091.80 |
$3,091.80 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,768.00
|
|
Upper ext harvest for cabg1 seg 35600
|
$506.40 |
$506.40 |
$506.40 |
$627.20
|
|
Urea nitrogen
|
$83.40 |
$83.40 |
$83.40 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$88.20 |
$88.20 |
$88.20 |
$51.75
|
|
Ureteral reflux study
|
$1,470.60 |
$1,470.60 |
$1,470.60 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$898.20 |
$898.20 |
$898.20 |
$579.73
|
|
Urethrocystography void s&i
|
$887.40 |
$887.40 |
$887.40 |
$622.35
|
|
Uric acid blood
|
$88.20 |
$88.20 |
$88.20 |
$48.75
|
|
Uric acid urine
|
$88.20 |
$88.20 |
$88.20 |
$44.33
|
|
Urinalysis microscopic only
|
$99.00 |
$99.00 |
$99.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$99.00 |
$99.00 |
$99.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$89.40 |
$89.40 |
$89.40 |
$55.00
|
|
Urinalysis (without microscopy)
|
$75.60 |
$75.60 |
$75.60 |
$35.75
|
|
Urinary bldr retent nuc study
|
$452.40 |
$452.40 |
$452.40 |
$350.66
|
|
Urine Culture Test
|
$80.40 |
$80.40 |
$80.40 |
$81.50
|
|
Urine pregnancy test
|
$155.40 |
$155.40 |
$155.40 |
$67.20
|
|
Urography, antegrade
|
$886.80 |
$886.80 |
$886.80 |
$622.35
|
|
Vad battery clip set hmii 14-v li-ion
|
$3,481.20 |
$3,481.20 |
$3,481.20 |
$2,002.00
|
|
Vaginal bx
|
$631.20 |
$631.20 |
$631.20 |
$455.94
|
|
Valproic acid total therapeutic drug level
|
$230.40 |
$230.40 |
$230.40 |
$114.72
|
|
Valvuloplasty aortic
|
$10,845.00 |
$10,845.00 |
$10,845.00 |
$7,830.80
|
|
Valvuloplasty aortic valve
|
$4,471.80 |
$4,471.80 |
$4,471.80 |
$5,068.00
|
|
Valvuloplasty aortic valve
|
$4,471.80 |
$4,471.80 |
$4,471.80 |
$6,624.80
|
|
Valvuloplasty mitral
|
$10,845.00 |
$10,845.00 |
$10,845.00 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$10,845.00 |
$10,845.00 |
$10,845.00 |
$11,945.20
|
|
Valvuloplasty/tv without ring insert 33463
|
$6,056.40 |
$6,056.40 |
$6,056.40 |
$7,556.80
|
|
Valvuloplasty/tv w/ring insertion 33464
|
$4,794.60 |
$4,794.60 |
$4,794.60 |
$5,965.60
|
|
Vancomycin peak therapeutic drug level
|
$238.80 |
$238.80 |
$238.80 |
$136.13
|
|
Varicella zoster antibody igg
|
$195.00 |
$195.00 |
$195.00 |
$86.80
|
|
Veeg cont 2-12 hrs
|
$3,805.80 |
$3,805.80 |
$3,805.80 |
$1,540.00
|
