|
Treat humerus fracture
|
$750.24 |
$750.24 |
$750.24 |
$1,771.43
|
|
Treat knee dislocation
|
$503.76 |
$503.76 |
$503.76 |
$2,220.89
|
|
Treat knee fracture 27530
|
$68.88 |
$68.88 |
$68.88 |
$550.00
|
|
Treat knuckle dislocation
|
$439.68 |
$439.68 |
$439.68 |
$1,523.90
|
|
Treat lower leg dislocation
|
$59.52 |
$59.52 |
$59.52 |
$530.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$88.08 |
$88.08 |
$88.08 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$88.08 |
$88.08 |
$88.08 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$60.24 |
$60.24 |
$60.24 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$75.36 |
$75.36 |
$75.36 |
$520.80
|
|
Treatment of thigh fracture
|
$75.36 |
$75.36 |
$75.36 |
$548.90
|
|
Treatment of thigh fracture
|
$439.68 |
$439.68 |
$439.68 |
$1,772.97
|
|
Treat thigh fracture
|
$1,048.32 |
$1,048.32 |
$1,048.32 |
$2,032.10
|
|
Treat ulnar fracture
|
$439.68 |
$439.68 |
$439.68 |
$1,662.00
|
|
Treat vaginal bleeding
|
$129.60 |
$129.60 |
$129.60 |
$379.60
|
|
Treat wrist bone fracture
|
$439.68 |
$439.68 |
$439.68 |
$1,548.40
|
|
Treat wrist dislocation
|
$75.36 |
$75.36 |
$75.36 |
$656.25
|
|
Treponema pallidum antibody
|
$45.84 |
$45.84 |
$45.84 |
$70.40
|
|
Treprostinil injection
|
$7,633.11 |
$7,633.11 |
$7,633.11 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$151.92 |
$151.92 |
$151.92 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$103.25 |
$103.25 |
$103.25 |
$43.21
|
|
Trichinella antibody
|
$8.16 |
$8.16 |
$8.16 |
$70.20
|
|
Trichomonas assay w/optic
|
$11.04 |
$11.04 |
$11.04 |
$55.50
|
|
#tricyclicantidprssnt
|
$43.68 |
$43.68 |
$43.68 |
$50.86
|
|
Triglycerides
|
$38.88 |
$38.88 |
$38.88 |
$58.05
|
|
Trim nail(s)
|
$23.28 |
$23.28 |
$23.28 |
$79.00
|
|
Trim nondyst nails
|
$41.28 |
$41.28 |
$41.28 |
$113.40
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$4,767.36 |
$4,767.36 |
$4,767.36 |
$15,226.08
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,244.64 |
$1,244.64 |
$1,244.64 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$444.72 |
$444.72 |
$444.72 |
$2,406.77
|
|
Trnspl rej kdn mrna qpcr 139
|
$2,332.80 |
$2,332.80 |
$2,332.80 |
$3,232.32
|
|
Troponin quantitative
|
$89.04 |
$89.04 |
$89.04 |
$127.20
|
|
Tx closed distal humerus fx
|
$59.52 |
$59.52 |
$59.52 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$75.36 |
$75.36 |
$75.36 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,083.20 |
$2,083.20 |
$2,083.20 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$75.36 |
$75.36 |
$75.36 |
$535.60
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$2,317.92 |
$2,317.92 |
$2,317.92 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,083.92 |
$2,083.92 |
$2,083.92 |
$4,499.12
|
|
Ugt1a1 gene analy common variants
|
$342.00 |
$342.00 |
$342.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$58.56 |
$58.56 |
$58.56 |
$394.20
|
|
Ultrasound breast complete
|
$158.64 |
$158.64 |
$158.64 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$158.64 |
$158.64 |
$158.64 |
$449.35
|
|
Ultrasound chest
|
$124.08 |
$124.08 |
$124.08 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$62.64 |
$62.64 |
$62.64 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$94.32 |
$94.32 |
$94.32 |
$307.00
|
|
Ultrasound encephalogram
|
$142.80 |
$142.80 |
$142.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$212.88 |
$212.88 |
$212.88 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$296.64 |
$296.64 |
$296.64 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$111.60 |
$111.60 |
$111.60 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$214.80 |
$214.80 |
$214.80 |
$720.15
|
|
Ultrasound guide intraoperative
|
$148.80 |
$148.80 |
$148.80 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$101.52 |
$101.52 |
$101.52 |
$403.88
|
|
Ultrasound joint complete left
|
$184.56 |
$184.56 |
$184.56 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$125.52 |
$125.52 |
$125.52 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$253.44 |
$253.44 |
$253.44 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$88.08 |
$88.08 |
$88.08 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$488.64 |
$488.64 |
$488.64 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$174.24 |
$174.24 |
$174.24 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$239.28 |
$239.28 |
$239.28 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$88.08 |
$88.08 |
$88.08 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$120.24 |
$120.24 |
$120.24 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$175.20 |
$175.20 |
$175.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$130.56 |
$130.56 |
$130.56 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$117.36 |
$117.36 |
$117.36 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$142.80 |
$142.80 |
$142.80 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$267.36 |
$267.36 |
$267.36 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$206.64 |
$206.64 |
$206.64 |
$206.64
|
|
Unlisted chemotherapy px
|
$150.00 |
$150.00 |
$150.00 |
$150.00
|
|
Unlisted maaa
|
$190.80 |
$190.80 |
$190.80 |
$235.20
|
|
Unlisted procedure rectum
|
$259.44 |
$259.44 |
$259.44 |
$1,220.35
|
|
Unlisted px ant segment eye
|
$700.32 |
$700.32 |
$700.32 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$44.88 |
$44.88 |
$44.88 |
$219.70
|
|
Unlisted px leg/ankle
|
$59.52 |
$59.52 |
$59.52 |
$811.00
|
|
Unlisted px male genital sys
|
$83.04 |
$83.04 |
$83.04 |
$343.55
|
|
Unlisted px palate uvula
|
$154.80 |
$154.80 |
$154.80 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$686.88 |
$686.88 |
$686.88 |
$1,265.16
|
|
Unlisted px tongue flr mouth
|
$68.64 |
$68.64 |
$68.64 |
$282.50
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,445.04 |
$1,445.04 |
$1,445.04 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,427.28 |
$1,427.28 |
$1,427.28 |
$2,034.41
|
|
Urea nitrogen
|
$45.84 |
$45.84 |
$45.84 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$26.16 |
$26.16 |
$26.16 |
$51.75
|
|
Urea nitrogen clearance
|
$11.04 |
$11.04 |
$11.04 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$154.80 |
$154.80 |
$154.80 |
$579.73
|
|
Urethrocystography void s&i
|
$179.52 |
$179.52 |
$179.52 |
$622.35
|
|
Uric acid blood
|
$38.88 |
$38.88 |
$38.88 |
$48.75
|
|
Uric acid urine
|
$41.28 |
$41.28 |
$41.28 |
$44.33
|
|
Urinalysis glass test
|
$5.28 |
$5.28 |
$5.28 |
$11.20
|
|
Urinalysis microscopic only
|
$2.88 |
$2.88 |
$2.88 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$1.92 |
$1.92 |
$1.92 |
$25.72
|
|
Urinalysis (with microscopy)
|
$55.44 |
$55.44 |
$55.44 |
$55.00
|
|
Urinalysis (without microscopy)
|
$38.16 |
$38.16 |
$38.16 |
$35.75
|
|
Urine Culture Test
|
$77.04 |
$77.04 |
$77.04 |
$81.50
|
|
Urine pregnancy test
|
$64.80 |
$64.80 |
$64.80 |
$67.20
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$16.97 |
$16.97 |
$16.97 |
$143.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$4.40 |
$4.40 |
$4.40 |
$33.60
|
|
Vaginal bx
|
$46.08 |
$46.08 |
$46.08 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$1,882.80 |
$1,882.80 |
$1,882.80 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$56.16 |
$56.16 |
$56.16 |
$114.72
|
|
Valrubicin injection
|
$981.04 |
$981.04 |
$981.04 |
$2,813.49
|
