|
Treatment of heel fracture 28400
|
$473.00 |
$473.00 |
$473.00 |
$473.00
|
|
Treatment of thigh fracture
|
$1,592.00 |
$1,592.00 |
$1,592.00 |
$1,749.06
|
|
Treatment of thigh fracture
|
$1,058.00 |
$1,058.00 |
$1,058.00 |
$549.00
|
|
Treatment of thigh fracture
|
$1,592.00 |
$1,592.00 |
$1,592.00 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$362.00 |
$362.00 |
$362.00 |
$371.40
|
|
Treat metacarpal fracture
|
$7,401.00 |
$7,401.00 |
$7,401.00 |
$5,857.86
|
|
Treat thigh fracture
|
$476.00 |
$476.00 |
$476.00 |
$618.80
|
|
Treat ulnar fracture
|
$1,592.00 |
$1,592.00 |
$1,592.00 |
$1,677.20
|
|
Treat wrist dislocation
|
$461.00 |
$461.00 |
$461.00 |
$656.25
|
|
Treponema pallidum antibody
|
$118.00 |
$118.00 |
$118.00 |
$72.05
|
|
Trichomonas assay w/optic
|
$66.00 |
$66.00 |
$66.00 |
$57.40
|
|
Triglycerides
|
$23.00 |
$23.00 |
$23.00 |
$58.50
|
|
Trim nondyst nails
|
$201.00 |
$201.00 |
$201.00 |
$113.88
|
|
Trnscath plc stent crv crtd without prtct
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$1,457.00 |
$1,457.00 |
$1,457.00 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$19,562.00 |
$19,562.00 |
$19,562.00 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$9,052.00 |
$9,052.00 |
$9,052.00 |
$4,766.40
|
|
Trnscath tx thromblytc vein ini day
|
$3,508.00 |
$3,508.00 |
$3,508.00 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$4,667.00 |
$4,667.00 |
$4,667.00 |
$4,872.75
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$6,536.00 |
$6,536.00 |
$6,536.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$6,628.00 |
$6,628.00 |
$6,628.00 |
$3,186.00
|
|
Troponin quantitative
|
$40.00 |
$40.00 |
$40.00 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$2,362.00 |
$2,362.00 |
$2,362.00 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$1,697.00 |
$1,697.00 |
$1,697.00 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$1,309.00 |
$1,309.00 |
$1,309.00 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$52,578.00 |
$52,578.00 |
$52,578.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$316.00 |
$316.00 |
$316.00 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,237.00 |
$3,237.00 |
$3,237.00 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$573.00 |
$573.00 |
$573.00 |
$535.60
|
|
Tx l/r atrial fib addl
|
$4,150.00 |
$4,150.00 |
$4,150.00 |
$6,986.85
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$6,743.00 |
$6,743.00 |
$6,743.00 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$414.00 |
$414.00 |
$414.00 |
$419.04
|
|
Tympanometry & reflex thresh
|
$170.00 |
$170.00 |
$170.00 |
$173.18
|
|
Ua w/micro/comp poc
|
$23.00 |
$23.00 |
$23.00 |
$23.00
|
|
Ultrasound breast complete
|
$1,641.00 |
$1,641.00 |
$1,641.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,230.00 |
$1,230.00 |
$1,230.00 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$603.00 |
$603.00 |
$603.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$623.00 |
$623.00 |
$623.00 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$1,078.00 |
$1,078.00 |
$1,078.00 |
$313.95
|
|
Ultrasound encephalogram
|
$855.00 |
$855.00 |
$855.00 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$980.00 |
$980.00 |
$980.00 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$820.00 |
$820.00 |
$820.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,238.00 |
$1,238.00 |
$1,238.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$221.00 |
$221.00 |
$221.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$1,318.00 |
$1,318.00 |
$1,318.00 |
$632.85
|
|
Ultrasound infant hips ltd without stress
|
$1,040.00 |
$1,040.00 |
$1,040.00 |
$311.25
|
|
Ultrasound joint complete left
|
$904.00 |
$904.00 |
$904.00 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$714.00 |
$714.00 |
$714.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$301.00 |
$301.00 |
$301.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$530.00 |
$530.00 |
$530.00 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,896.00 |
$1,896.00 |
$1,896.00 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$621.00 |
$621.00 |
$621.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$514.00 |
$514.00 |
$514.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$723.00 |
$723.00 |
$723.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$702.00 |
$702.00 |
$702.00 |
$419.50
|
|
Umbilical artery cath newborn 36660
|
$177.00 |
$177.00 |
$177.00 |
$223.80
|
|
Unlisted chemotherapy px
|
$361.00 |
$361.00 |
$361.00 |
$149.15
|
|
Unlisted CT procedure
|
$175.00 |
$175.00 |
$175.00 |
$732.70
|
|
Unlisted dialysis procedure
|
$1,007.00 |
$1,007.00 |
$1,007.00 |
$1,144.00
|
|
Unlisted fluoroscopic px
|
$441.00 |
$441.00 |
$441.00 |
$305.76
|
|
Unlisted mr procedure
|
$3,737.00 |
$3,737.00 |
$3,737.00 |
$1,165.00
|
|
Unlisted procedure colon
|
$8,350.00 |
$8,350.00 |
$8,350.00 |
$1,839.55
|
|
Unlisted procedure liver
|
$5,372.00 |
$5,372.00 |
$5,372.00 |
$2,287.20
|
|
Unlisted px abdomen muscskel
|
$7,272.00 |
$7,272.00 |
$7,272.00 |
$1,956.50
|
|
Unlisted px external ear
|
$354.00 |
$354.00 |
$354.00 |
$325.68
|
|
Unlisted px med radj physics
|
$709.00 |
$709.00 |
$709.00 |
$462.35
|
|
Unlisted px pelvis/hip joint
|
$15,881.00 |
$15,881.00 |
$15,881.00 |
$3,251.90
|
|
Unlisted px small intestine
|
$980.00 |
$980.00 |
$980.00 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$1,376.00 |
$1,376.00 |
$1,376.00 |
$282.50
|
|
Unsched dialysis esrd pt hos
|
$1,043.00 |
$1,043.00 |
$1,043.00 |
$1,292.33
|
|
Upgrade pm system
|
$11,122.00 |
$11,122.00 |
$11,122.00 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$615.00 |
$615.00 |
$615.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,786.00 |
$1,786.00 |
$1,786.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,151.00 |
$1,151.00 |
$1,151.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,520.00 |
$3,520.00 |
$3,520.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,949.00 |
$2,949.00 |
$2,949.00 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,902.00 |
$1,902.00 |
$1,902.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$225.00 |
$225.00 |
$225.00 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$288.00 |
$288.00 |
$288.00 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$866.79 |
$866.79 |
$866.79 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$866.79 |
$866.79 |
$866.79 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$297.00 |
$297.00 |
$297.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$514.00 |
$514.00 |
$514.00 |
$607.20
|
|
Urea nitrogen
|
$17.00 |
$17.00 |
$17.00 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$18.00 |
$18.00 |
$18.00 |
$52.00
|
|
Urea nitrogen clearance
|
$22.00 |
$22.00 |
$22.00 |
$38.35
|
|
Ureteral embolization/occl
|
$1,460.00 |
$1,460.00 |
$1,460.00 |
$2,079.31
|
|
Urethrcystgrphy rtrgrde s&i
|
$437.00 |
$437.00 |
$437.00 |
$584.00
|
|
Urethrocystography void s&i
|
$893.00 |
$893.00 |
$893.00 |
$631.40
|
|
Uric acid blood
|
$18.00 |
$18.00 |
$18.00 |
$49.44
|
|
Uric acid urine
|
$19.00 |
$19.00 |
$19.00 |
$45.36
|
|
Urinalysis (with microscopy)
|
$22.00 |
$22.00 |
$22.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$15.00 |
$15.00 |
$15.00 |
$36.00
|
|
Urinary reflex study
|
$169.00 |
$169.00 |
$169.00 |
$216.05
|
|
Urine Culture Test
|
$55.00 |
$55.00 |
$55.00 |
$83.00
|
|
Urine pregnancy test
|
$23.00 |
$23.00 |
$23.00 |
$68.78
|
|
Urography, antegrade
|
$607.00 |
$607.00 |
$607.00 |
$622.35
|
|
Vaccine Administration (one shot)
|
$148.00 |
$148.00 |
$148.00 |
$67.70
|
|
Vaginal bx
|
$6,797.00 |
$6,797.00 |
$6,797.00 |
$455.94
|
