|
Treat humerus fracture
|
$1,874.40 |
$1,874.40 |
$1,874.40 |
$1,790.00
|
|
Treat knee fracture 27530
|
$460.80 |
$460.80 |
$460.80 |
$550.73
|
|
Treat lower leg dislocation
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$532.60
|
|
Treatment of ankle fracture 27786
|
$448.00 |
$448.00 |
$448.00 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$386.40 |
$386.40 |
$386.40 |
$501.20
|
|
Treatment of heel fracture 28400
|
$404.80 |
$404.80 |
$404.80 |
$473.00
|
|
Treatment of toe fracture 28510
|
$342.40 |
$342.40 |
$342.40 |
$371.40
|
|
Treat metatarsal fracture
|
$6,875.20 |
$6,875.20 |
$6,875.20 |
$3,839.54
|
|
Treat metatarsal fracture
|
$8,840.80 |
$8,840.80 |
$8,840.80 |
$8,241.00
|
|
Treat midfoot fracture each
|
$2,836.80 |
$2,836.80 |
$2,836.80 |
$1,884.74
|
|
Treat wrist dislocation
|
$521.60 |
$521.60 |
$521.60 |
$656.25
|
|
Treponema pallidum antibody
|
$152.00 |
$152.00 |
$152.00 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$67.01 |
$67.01 |
$67.01 |
$43.09
|
|
Triglycerides
|
$85.60 |
$85.60 |
$85.60 |
$58.50
|
|
Trim nail(s)
|
$77.60 |
$77.60 |
$77.60 |
$79.00
|
|
Trim nondyst nails
|
$113.60 |
$113.60 |
$113.60 |
$113.88
|
|
Troponin quantitative
|
$212.80 |
$212.80 |
$212.80 |
$127.60
|
|
Tx closed hip disl traumatic without anes
|
$612.80 |
$612.80 |
$612.80 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$448.00 |
$448.00 |
$448.00 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$354.40 |
$354.40 |
$354.40 |
$419.04
|
|
Ultrasound breast unilateral limited (both sides)
|
$480.00 |
$480.00 |
$480.00 |
$452.40
|
|
Ultrasound exam k transpl w/doppler
|
$905.60 |
$905.60 |
$905.60 |
$578.40
|
|
Ultrasound Guidance for a Needle Procedure
|
$961.60 |
$961.60 |
$961.60 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$388.08
|
|
Ultrasound hips infant dynamic
|
$645.60 |
$645.60 |
$645.60 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$391.20 |
$391.20 |
$391.20 |
$311.25
|
|
Ultrasound joint complete left
|
$729.60 |
$729.60 |
$729.60 |
$557.99
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$580.80 |
$580.80 |
$580.80 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$812.00 |
$812.00 |
$812.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$641.60 |
$641.60 |
$641.60 |
$463.00
|
|
Unlisted px forearm/wrist
|
$3,908.80 |
$3,908.80 |
$3,908.80 |
$859.50
|
|
Unlisted px hands/fingers
|
$2,334.40 |
$2,334.40 |
$2,334.40 |
$354.20
|
|
Unlisted ultrasound procedure
|
$669.60 |
$669.60 |
$669.60 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$403.20 |
$403.20 |
$403.20 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,322.40 |
$4,322.40 |
$4,322.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,496.80 |
$3,496.80 |
$3,496.80 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,370.40 |
$3,370.40 |
$3,370.40 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$463.20 |
$463.20 |
$463.20 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$580.80 |
$580.80 |
$580.80 |
$381.60
|
|
Urea nitrogen
|
$85.60 |
$85.60 |
$85.60 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$48.80 |
$48.80 |
$48.80 |
$52.00
|
|
Uric acid blood
|
$74.40 |
$74.40 |
$74.40 |
$49.44
|
|
Uric acid urine
|
$72.00 |
$72.00 |
$72.00 |
$45.36
|
|
Urinalysis microscopic only
|
$76.00 |
$76.00 |
$76.00 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$50.40 |
$50.40 |
$50.40 |
$25.72
|
|
Urinalysis (with microscopy)
|
$82.40 |
$82.40 |
$82.40 |
$55.20
|
|
Urinalysis (without microscopy)
|
$39.20 |
$39.20 |
$39.20 |
$36.00
|
|
Urine Culture Test
|
$114.40 |
$114.40 |
$114.40 |
$83.00
|
|
Urine pregnancy test
|
$88.80 |
$88.80 |
$88.80 |
$68.78
|
|
Vaccine Administration (one shot)
|
$64.00 |
$64.00 |
$64.00 |
$67.70
|
|
Vaccine dtap < 7 years im
|
$76.58 |
$76.58 |
$76.58 |
$71.17
|
|
Vaccine dtap-ipv-hib-hepb im
|
$247.92 |
$247.92 |
$247.92 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$109.34 |
$109.34 |
$109.34 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$77.13 |
$77.13 |
$77.13 |
$70.53
|
|
Vaccine hepatitis a (hepa) adult im
|
$93.75 |
$93.75 |
$93.75 |
$166.62
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$79.15 |
$79.15 |
$79.15 |
$78.25
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$218.79 |
$218.79 |
$218.79 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$68.33 |
$68.33 |
$68.33 |
$75.39
|
|
Vaccine mmr live subcutaneous
|
$104.84 |
$104.84 |
$104.84 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$219.46 |
$219.46 |
$219.46 |
$252.87
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$370.80 |
$370.80 |
$370.80 |
$414.46
|
|
Vaccine polio (ipv) subcutaneous/im
|
$77.67 |
$77.67 |
$77.67 |
$90.70
|
|
Vaccine rabies im
|
$564.60 |
$564.60 |
$564.60 |
$858.95
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$108.43 |
$108.43 |
$108.43 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$85.60 |
$85.60 |
$85.60 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$75.64 |
$75.64 |
$75.64 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$120.17 |
$120.17 |
$120.17 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$100.80 |
$100.80 |
$100.80 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$73.00 |
$73.00 |
$73.00 |
$259.05
|
|
Vancomycin peak therapeutic drug level
|
$168.00 |
$168.00 |
$168.00 |
$136.13
|
|
Varicella zoster antibody igg
|
$54.40 |
$54.40 |
$54.40 |
$86.80
|
|
Vasectomy
|
$3,714.40 |
$3,714.40 |
$3,714.40 |
$2,424.12
|
|
Virus isolation addl studies ea
|
$136.00 |
$136.00 |
$136.00 |
$79.34
|
|
Vitamin b-12
|
$79.20 |
$79.20 |
$79.20 |
$100.28
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$132.00
|
|
Volume measurement urine timed
|
$44.80 |
$44.80 |
$44.80 |
$21.64
|
|
Walking (Gait) Training (each 15 minutes)
|
$118.40 |
$118.40 |
$118.40 |
$87.50
|
|
Warde 1003990 aldosterone
|
$383.20 |
$383.20 |
$383.20 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$122.40 |
$122.40 |
$122.40 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$47.20 |
$47.20 |
$47.20 |
$64.08
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$92.00 |
$92.00 |
$92.00 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$48.80 |
$48.80 |
$48.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$112.80 |
$112.80 |
$112.80 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$254.40 |
$254.40 |
$254.40 |
$39.36
|
|
Warde 3016000 west nile virus antibody
|
$152.00 |
$152.00 |
$152.00 |
$71.60
|
|
Warde 3016000 west nile virus antibody igg
|
$152.00 |
$152.00 |
$152.00 |
$70.74
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$112.80 |
$112.80 |
$112.80 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$104.80 |
$104.80 |
$104.80 |
$73.60
|
|
Warde 3400852 arsenic
|
$231.20 |
$231.20 |
$231.20 |
$101.00
|
|
Warde 3708165 mercury urine
|
$231.20 |
$231.20 |
$231.20 |
$71.60
|
|
Warde actin (smooth muscle) antibody each
|
$52.80 |
$52.80 |
$52.80 |
$42.00
|
|
Warde adrenocorticotropic hormone (acth)
|
$112.00 |
$112.00 |
$112.00 |
$156.40
|
|
Warde aldolase
|
$118.40 |
$118.40 |
$118.40 |
$54.05
|
|
Warde analysis gene hfe common variants
|
$159.20 |
$159.20 |
$159.20 |
$269.50
|
|
Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative
|
$400.00 |
$400.00 |
$400.00 |
$368.00
|
|
Warde anti-mullerian hormone
|
$94.40 |
$94.40 |
$94.40 |
$82.50
|
|
Warde apolipoprotein b
|
$57.60 |
$57.60 |
$57.60 |
$61.82
|
|
Warde bile acids
|
$52.00 |
$52.00 |
$52.00 |
$64.28
|
