|
Trurl dstrj prst8 tiss rf wv
|
$4,385.60 |
$4,385.60 |
$4,385.60 |
$4,228.00
|
|
Tte w or without contr, cont ecg
|
$1,430.30 |
$1,430.30 |
$1,430.30 |
$2,196.00
|
|
Tte w or without fol w/con,stres
|
$1,720.64 |
$1,720.64 |
$1,720.64 |
$1,643.14
|
|
Tte w or without fol w/cont, com
|
$1,720.64 |
$1,720.64 |
$1,720.64 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$1,720.64 |
$1,720.64 |
$1,720.64 |
$1,178.00
|
|
Tubal Ligation (Laparoscopic)
|
$920.80 |
$920.80 |
$920.80 |
$4,323.20
|
|
Tubing (oxygen) per foot
|
$0.40 |
$0.40 |
$0.40 |
$0.40
|
|
Tvh >250 gms 58290
|
$2,885.60 |
$2,885.60 |
$2,885.60 |
$6,872.92
|
|
Tvh w/mmk 58267
|
$2,665.60 |
$2,665.60 |
$2,665.60 |
$1,747.20
|
|
Tx atrial fib pulm vein isol
|
$28,245.40 |
$28,245.40 |
$28,245.40 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$237.88 |
$237.88 |
$237.88 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$905.60 |
$905.60 |
$905.60 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,735.51 |
$3,735.51 |
$3,735.51 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$535.60
|
|
Tx contour defects >10.0 cc
|
$388.80 |
$388.80 |
$388.80 |
$918.06
|
|
Tx contour defects 1.1-5.0cc 11951
|
$262.40 |
$262.40 |
$262.40 |
$849.50
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$2,277.60 |
$2,277.60 |
$2,277.60 |
$2,277.60
|
|
Tx ectopic pregnancy ntrstl prtl rescj uter 59136
|
$2,159.20 |
$2,159.20 |
$2,159.20 |
$2,159.20
|
|
Tx l/r atrial fib addl
|
$17,216.46 |
$17,216.46 |
$17,216.46 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,907.58 |
$3,907.58 |
$3,907.58 |
$4,537.59
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,342.40 |
$1,342.40 |
$1,342.40 |
$4,595.50
|
|
Tx open nsl fx uncomp
|
$1,072.80 |
$1,072.80 |
$1,072.80 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$1,567.20 |
$1,567.20 |
$1,567.20 |
$4,308.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,463.20 |
$1,463.20 |
$1,463.20 |
$4,529.60
|
|
Tx septic abortion surgical 59830
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$523.20 |
$523.20 |
$523.20 |
$423.15
|
|
Tympanic membrane repair
|
$1,856.00 |
$1,856.00 |
$1,856.00 |
$2,133.48
|
|
Tympanolysis transcanal 69450
|
$2,659.20 |
$2,659.20 |
$2,659.20 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$49.60 |
$49.60 |
$49.60 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$966.40 |
$966.40 |
$966.40 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$6,740.80 |
$6,740.80 |
$6,740.80 |
$6,740.80
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$6,043.20 |
$6,043.20 |
$6,043.20 |
$7,000.36
|
|
Tyms gene com variants
|
$350.40 |
$350.40 |
$350.40 |
$192.29
|
|
Typhoid vaccine oral
|
$100.00 |
$100.00 |
$100.00 |
$63.28
|
|
Ua w/micro/comp poc
|
$25.72 |
$25.72 |
$25.72 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$111.87 |
$111.87 |
$111.87 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$468.00 |
$468.00 |
$468.00 |
$438.75
|
|
Ultrasound bone density measure
|
$29.60 |
$29.60 |
$29.60 |
$143.75
|
|
Ultrasound breast complete
|
$385.60 |
$385.60 |
$385.60 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$316.80 |
$316.80 |
$316.80 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$198.83 |
$198.83 |
$198.83 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$158.40 |
$158.40 |
$158.40 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$108.00 |
$108.00 |
$108.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$189.60 |
$189.60 |
$189.60 |
$307.00
|
|
Ultrasound encephalogram
|
$384.62 |
$384.62 |
$384.62 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$283.20 |
$283.20 |
$283.20 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$736.32 |
$736.32 |
$736.32 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$441.60 |
$441.60 |
$441.60 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$229.67 |
$229.67 |
$229.67 |
$388.08
|
|
Ultrasound guide intraoperative
|
$491.27 |
$491.27 |
$491.27 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$401.60 |
$401.60 |
$401.60 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$384.62 |
$384.62 |
$384.62 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$384.62 |
$384.62 |
$384.62 |
$304.00
|
|
Ultrasound joint complete left
|
$376.77 |
$376.77 |
$376.77 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$191.20 |
$191.20 |
$191.20 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$382.29 |
$382.29 |
$382.29 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$355.81 |
$355.81 |
$355.81 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$497.12 |
$497.12 |
$497.12 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$372.81 |
$372.81 |
$372.81 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$373.60 |
$373.60 |
$373.60 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$384.62 |
$384.62 |
$384.62 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$424.80 |
$424.80 |
$424.80 |
$417.15
|
|
Ultrasound trgt dyn mbubb 1st les
|
$516.00 |
$516.00 |
$516.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$348.00 |
$348.00 |
$348.00 |
$348.00
|
|
Ultraviolet therapy
|
$15.20 |
$15.20 |
$15.20 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$176.80 |
$176.80 |
$176.80 |
$223.80
|
|
Umbilical cord occlud w/us
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
$754.00
|
|
Umbilicoplasty 15847
|
$834.40 |
$834.40 |
$834.40 |
$4,172.97
|
|
Unlistd noninvas vasc dx std
|
$44.80 |
$44.80 |
$44.80 |
$564.60
|
|
Unlisted endocrine px dx nuc
|
$478.37 |
$478.37 |
$478.37 |
$653.31
|
|
Unlisted hematology&coagj px
|
$33.57 |
$33.57 |
$33.57 |
$39.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$1,218.40 |
$1,218.40 |
$1,218.40 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$1,755.20 |
$1,755.20 |
$1,755.20 |
$5,419.00
|
|
Unlisted laps px bladder
|
$1,531.20 |
$1,531.20 |
$1,531.20 |
$5,082.74
|
|
Unlisted laps px ovidct ovry
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$6,904.15
|
|
Unlisted laps px uterus
|
$768.00 |
$768.00 |
$768.00 |
$4,627.00
|
|
Unlisted maaa
|
$127.86 |
$127.86 |
$127.86 |
$235.20
|
|
Unlisted procedure microbiology
|
$38.58 |
$38.58 |
$38.58 |
$530.00
|
|
Unlisted procedure pancreas
|
$1,849.60 |
$1,849.60 |
$1,849.60 |
$4,810.00
|
|
Unlisted procedure rectum
|
$1,002.62 |
$1,002.62 |
$1,002.62 |
$1,278.72
|
|
Unlisted px arthroscopy
|
$2,765.60 |
$2,765.60 |
$2,765.60 |
$2,765.60
|
|
Unlisted px casting/strpg
|
$78.40 |
$78.40 |
$78.40 |
$222.00
|
|
Unlisted px foot/toes
|
$1,740.80 |
$1,740.80 |
$1,740.80 |
$1,225.50
|
|
Unlisted px pelvis/hip joint
|
$1,415.20 |
$1,415.20 |
$1,415.20 |
$3,251.90
|
|
Unlisted px small intestine
|
$2,636.80 |
$2,636.80 |
$2,636.80 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$208.00 |
$208.00 |
$208.00 |
$282.50
|
|
Unlisted reprod med lab proc
|
$70.00 |
$70.00 |
$70.00 |
$70.00
|
|
Unlisted special svc px/rprt
|
$25.60 |
$25.60 |
$25.60 |
$90.00
|
|
Unlisted transfusion med px
|
$57.14 |
$57.14 |
$57.14 |
$147.50
|
|
Unlisted ultrasound procedure
|
$384.62 |
$384.62 |
$384.62 |
$335.00
|
|
Unlisted urinalysis px
|
$25.72 |
$25.72 |
$25.72 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$934.16 |
$934.16 |
$934.16 |
$1,316.90
|
|
Upgrade pm system
|
$22,204.42 |
$22,204.42 |
$22,204.42 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$234.44 |
$234.44 |
$234.44 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,714.26 |
$2,714.26 |
$2,714.26 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,396.27 |
$2,396.27 |
$2,396.27 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,477.34 |
$4,477.34 |
$4,477.34 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,888.77 |
$3,888.77 |
$3,888.77 |
$2,364.35
|
