|
Trauma partial team response w/critical care services level 4
|
$1,602.60 |
$1,602.60 |
$1,602.60 |
$4,063.80
|
|
Treat fracture of radius
|
$909.00 |
$909.00 |
$909.00 |
$1,790.00
|
|
Treat kneecap dislocation
|
$2,569.20 |
$2,569.20 |
$2,569.20 |
$1,098.60
|
|
Treat knee fracture
|
$1,675.80 |
$1,675.80 |
$1,675.80 |
$3,486.60
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$1,314.60 |
$1,314.60 |
$1,314.60 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$1,179.60 |
$1,179.60 |
$1,179.60 |
$8,370.75
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$150.00 |
$150.00 |
$150.00 |
$203.49
|
|
Treatment of ankle fracture
|
$1,146.60 |
$1,146.60 |
$1,146.60 |
$8,412.89
|
|
Treponema pallidum antibody
|
$174.60 |
$174.60 |
$174.60 |
$70.40
|
|
Trg gene rearrangement anal
|
$581.40 |
$581.40 |
$581.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$39.00 |
$39.00 |
$39.00 |
$43.09
|
|
Triglycerides
|
$93.00 |
$93.00 |
$93.00 |
$57.85
|
|
Trim nondyst nails
|
$126.00 |
$126.00 |
$126.00 |
$115.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$4,872.75
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$498.60 |
$498.60 |
$498.60 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$983.40 |
$983.40 |
$983.40 |
$2,371.50
|
|
Troponin quantitative
|
$169.20 |
$169.20 |
$169.20 |
$127.20
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$301.80 |
$301.80 |
$301.80 |
$911.43
|
|
Ua w/micro/comp poc
|
$58.20 |
$58.20 |
$58.20 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$464.40 |
$464.40 |
$464.40 |
$394.20
|
|
Ultrasound breast complete
|
$1,033.20 |
$1,033.20 |
$1,033.20 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$518.40 |
$518.40 |
$518.40 |
$452.00
|
|
Ultrasound chest
|
$792.00 |
$792.00 |
$792.00 |
$460.85
|
|
Ultrasound exam k transpl w/doppler
|
$289.20 |
$289.20 |
$289.20 |
$585.15
|
|
Ultrasound guidance for vascular access
|
$453.00 |
$453.00 |
$453.00 |
$388.08
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,108.80 |
$1,108.80 |
$1,108.80 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$753.60 |
$753.60 |
$753.60 |
$403.88
|
|
Ultrasound joint complete left
|
$261.00 |
$261.00 |
$261.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$339.00 |
$339.00 |
$339.00 |
$424.00
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$744.00 |
$744.00 |
$744.00 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$934.20 |
$934.20 |
$934.20 |
$490.00
|
|
Ultrasound retroperitoneal limited
|
$289.20 |
$289.20 |
$289.20 |
$479.60
|
|
Ultrasound scrotum and contents
|
$1,164.60 |
$1,164.60 |
$1,164.60 |
$612.55
|
|
Ultrasound transabd ea addl gest
|
$934.20 |
$934.20 |
$934.20 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$863.40 |
$863.40 |
$863.40 |
$558.35
|
|
Unlisted chemotherapy px
|
$61.80 |
$61.80 |
$61.80 |
$150.00
|
|
Unlisted laparoscopic procedure 49659
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$6,838.32
|
|
Unlisted spec derm svc/px
|
$227.40 |
$227.40 |
$227.40 |
$223.08
|
|
Unsched dialysis esrd pt hos
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,808.60 |
$5,808.60 |
$5,808.60 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,819.60 |
$3,819.60 |
$3,819.60 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,892.80 |
$3,892.80 |
$3,892.80 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$623.40 |
$623.40 |
$623.40 |
$1,794.22
|
|
Upper Endoscopy (EGD, with biopsy)
|
$589.80 |
$589.80 |
$589.80 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$692.40 |
$692.40 |
$692.40 |
$1,774.00
|
|
Urea nitrogen
|
$75.00 |
$75.00 |
$75.00 |
$40.95
|
|
Urea nitrogen 24 hour urine
|
$84.60 |
$84.60 |
$84.60 |
$52.00
|
|
Uric acid blood
|
$67.20 |
$67.20 |
$67.20 |
$49.44
|
|
Uric acid urine
|
$67.20 |
$67.20 |
$67.20 |
$44.22
|
|
Urinalysis microscopic only
|
$55.20 |
$55.20 |
$55.20 |
$26.46
|
|
Urinalysis (with microscopy)
|
$55.20 |
$55.20 |
$55.20 |
$55.44
|
|
Urinalysis (without microscopy)
|
$33.60 |
$33.60 |
$33.60 |
$36.00
|
|
Urine Culture Test
|
$124.20 |
$124.20 |
$124.20 |
$81.27
|
|
Urine pregnancy test
|
$52.80 |
$52.80 |
$52.80 |
$67.80
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$589.50 |
$589.50 |
$589.50 |
$239.85
|
|
Vaccine influenza inactivated adjuvant im
|
$250.80 |
$250.80 |
$250.80 |
$106.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$54.90 |
$54.90 |
$54.90 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$69.00 |
$69.00 |
$69.00 |
$33.60
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$991.20 |
$991.20 |
$991.20 |
$563.36
|
|
Vaccine rabies im
|
$1,326.00 |
$1,326.00 |
$1,326.00 |
$858.95
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$499.62
|
|
Vaccine tdap >=7 years im
|
$185.40 |
$185.40 |
$185.40 |
$132.88
|
|
Vaccine td preservative free >= 7 years im
|
$147.00 |
$147.00 |
$147.00 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$27.60 |
$27.60 |
$27.60 |
$114.48
|
|
Vancomycin 1,000 mg intravenous injection
|
$94.20 |
$94.20 |
$94.20 |
$246.70
|
|
Vancomycin 750 mg intravenous solution
|
$93.60 |
$93.60 |
$93.60 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$137.40 |
$137.40 |
$137.40 |
$132.72
|
|
Varicella zoster antibody igg
|
$289.20 |
$289.20 |
$289.20 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$325.80 |
$325.80 |
$325.80 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$20,329.80 |
$20,329.80 |
$20,329.80 |
$18,719.82
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$1,759.20 |
$1,759.20 |
$1,759.20 |
$197.04
|
|
Ventilator each subsequent day
|
$460.80 |
$460.80 |
$460.80 |
$1,184.00
|
|
Ventilator initial day
|
$897.60 |
$897.60 |
$897.60 |
$1,416.96
|
|
Vital capacity test
|
$199.80 |
$199.80 |
$199.80 |
$170.00
|
|
Vitamin b-12
|
$217.20 |
$217.20 |
$217.20 |
$100.00
|
|
Vitamin D Test
|
$232.20 |
$232.20 |
$232.20 |
$132.00
|
|
Warde 1003990 aldosterone
|
$87.00 |
$87.00 |
$87.00 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$345.60 |
$345.60 |
$345.60 |
$96.00
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$49.80 |
$49.80 |
$49.80 |
$65.40
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$98.40 |
$98.40 |
$98.40 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$211.80 |
$211.80 |
$211.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$101.40 |
$101.40 |
$101.40 |
$64.28
|
|
Warde 3004000 immunoglobulin subclass 1
|
$31.80 |
$31.80 |
$31.80 |
$39.60
|
|
Warde 3016000 west nile virus antibody
|
$86.40 |
$86.40 |
$86.40 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$86.40 |
$86.40 |
$86.40 |
$69.12
|
|
Warde 3016300 saccharomyces cerevisiae iga antibody
|
$67.20 |
$67.20 |
$67.20 |
$60.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$120.00 |
$120.00 |
$120.00 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$76.80 |
$76.80 |
$76.80 |
$70.85
|
|
Warde 3400852 arsenic
|
$243.60 |
$243.60 |
$243.60 |
$100.88
|
|
Warde 3708165 mercury urine
|
$118.20 |
$118.20 |
$118.20 |
$71.50
|
|
Warde actin (smooth muscle) antibody each
|
$15.00 |
$15.00 |
$15.00 |
$44.16
|
|
Warde adenosine deaminase pleural fluid
|
$238.20 |
$238.20 |
$238.20 |
$87.60
|
|
Warde adrenocorticotropic hormone (acth)
|
$586.20 |
$586.20 |
$586.20 |
$151.20
|
|
Warde aldolase
|
$124.20 |
$124.20 |
$124.20 |
$53.30
|
|
Warde amiodarone therapeutic drug level
|
$550.80 |
$550.80 |
$550.80 |
$53.95
|
|
Warde analysis gene hfe common variants
|
$399.00 |
$399.00 |
$399.00 |
$266.40
|
|
Warde anti-mullerian hormone
|
$73.20 |
$73.20 |
$73.20 |
$80.08
|
|
Warde apolipoprotein b
|
$150.60 |
$150.60 |
$150.60 |
$61.82
|
|
Warde bile acids
|
$118.80 |
$118.80 |
$118.80 |
$63.70
|
|
Warde cadmium blood
|
$229.20 |
$229.20 |
$229.20 |
$76.50
|
