|
Treat clavicle dislocation 23545
|
$306.68 |
$306.68 |
$306.68 |
$705.60
|
|
Treat elbow dislocation
|
$1,784.73 |
$1,784.73 |
$1,784.73 |
$2,223.20
|
|
Treat elbow fracture
|
$1,742.50 |
$1,742.50 |
$1,742.50 |
$1,919.13
|
|
Treat finger fracture each
|
$793.76 |
$793.76 |
$793.76 |
$1,536.00
|
|
Treat foot dislocation
|
$139.40 |
$139.40 |
$139.40 |
$396.30
|
|
Treat foot dislocation
|
$306.68 |
$306.68 |
$306.68 |
$527.28
|
|
Treat foot dislocation
|
$84.87 |
$84.87 |
$84.87 |
$445.80
|
|
Treat fracture of radius
|
$793.76 |
$793.76 |
$793.76 |
$1,790.00
|
|
Treat fracture of radius
|
$874.53 |
$874.53 |
$874.53 |
$1,849.00
|
|
Treat fracture of ulna
|
$259.12 |
$259.12 |
$259.12 |
$726.05
|
|
Treat hip dislocation
|
$1,908.55 |
$1,908.55 |
$1,908.55 |
$2,192.80
|
|
Treat humerus fracture
|
$793.76 |
$793.76 |
$793.76 |
$1,771.43
|
|
Treat knee dislocation
|
$895.03 |
$895.03 |
$895.03 |
$2,220.89
|
|
Treat knee fracture 27530
|
$431.32 |
$431.32 |
$431.32 |
$550.00
|
|
Treat knuckle dislocation
|
$793.76 |
$793.76 |
$793.76 |
$1,523.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$27.47 |
$27.47 |
$27.47 |
$224.90
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$38.13 |
$38.13 |
$38.13 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$113.16 |
$113.16 |
$113.16 |
$520.80
|
|
Treatment of thigh fracture
|
$218.94 |
$218.94 |
$218.94 |
$548.90
|
|
Treatment of thigh fracture
|
$1,699.45 |
$1,699.45 |
$1,699.45 |
$1,772.97
|
|
Treat ulnar fracture
|
$793.76 |
$793.76 |
$793.76 |
$1,662.00
|
|
Treat vaginal bleeding
|
$220.17 |
$220.17 |
$220.17 |
$379.60
|
|
Treat wrist bone fracture
|
$793.76 |
$793.76 |
$793.76 |
$1,548.40
|
|
Treat wrist dislocation
|
$123.82 |
$123.82 |
$123.82 |
$656.25
|
|
Treponema pallidum antibody
|
$42.64 |
$42.64 |
$42.64 |
$70.40
|
|
Treprostinil injection
|
$13,039.89 |
$13,039.89 |
$13,039.89 |
$19,071.84
|
|
Trichomonas assay w/optic
|
$18.86 |
$18.86 |
$18.86 |
$55.50
|
|
Triglycerides
|
$66.83 |
$66.83 |
$66.83 |
$58.05
|
|
Trim nail(s)
|
$39.77 |
$39.77 |
$39.77 |
$79.00
|
|
Trim nondyst nails
|
$70.52 |
$70.52 |
$70.52 |
$113.40
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$8,144.24 |
$8,144.24 |
$8,144.24 |
$15,226.08
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,170.54 |
$2,170.54 |
$2,170.54 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,298.88 |
$1,298.88 |
$1,298.88 |
$2,406.77
|
|
Trnspl rej kdn mrna qpcr 139
|
$2,324.70 |
$2,324.70 |
$2,324.70 |
$3,232.32
|
|
Troponin quantitative
|
$85.28 |
$85.28 |
$85.28 |
$127.20
|
|
Tx closed distal humerus fx
|
$139.40 |
$139.40 |
$139.40 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$123.82 |
$123.82 |
$123.82 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,056.56 |
$2,056.56 |
$2,056.56 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$439.93 |
$439.93 |
$439.93 |
$535.60
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$3,959.78 |
$3,959.78 |
$3,959.78 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$3,656.38 |
$3,656.38 |
$3,656.38 |
$4,499.12
|
|
Ultrasound abdomen aorta screening study aaa
|
$164.00 |
$164.00 |
$164.00 |
$394.20
|
|
Ultrasound breast complete
|
$170.15 |
$170.15 |
$170.15 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$194.34 |
$194.34 |
$194.34 |
$449.35
|
|
Ultrasound chest
|
$279.21 |
$279.21 |
$279.21 |
$460.85
|
|
Ultrasound exam k transpl w/doppler
|
$363.67 |
$363.67 |
$363.67 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$256.25 |
$256.25 |
$256.25 |
$469.50
|
|
Ultrasound joint complete left
|
$199.67 |
$199.67 |
$199.67 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$256.25 |
$256.25 |
$256.25 |
$425.45
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$266.91 |
$266.91 |
$266.91 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$266.09 |
$266.09 |
$266.09 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$271.01 |
$271.01 |
$271.01 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$291.51 |
$291.51 |
$291.51 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$320.62 |
$320.62 |
$320.62 |
$486.50
|
|
Ultrasound scrotum and contents
|
$278.80 |
$278.80 |
$278.80 |
$608.90
|
|
Ultrasound transvaginal non obstetric
|
$287.00 |
$287.00 |
$287.00 |
$558.35
|
|
Unlisted procedure rectum
|
$464.53 |
$464.53 |
$464.53 |
$1,220.35
|
|
Unlisted px ant segment eye
|
$1,263.62 |
$1,263.62 |
$1,263.62 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$73.80 |
$73.80 |
$73.80 |
$219.70
|
|
Unlisted px leg/ankle
|
$139.40 |
$139.40 |
$139.40 |
$811.00
|
|
Unlisted px male genital sys
|
$150.47 |
$150.47 |
$150.47 |
$343.55
|
|
Unlisted px palate uvula
|
$263.22 |
$263.22 |
$263.22 |
$274.80
|
|
Unlisted px salivry glnd/dux
|
$1,173.42 |
$1,173.42 |
$1,173.42 |
$1,265.16
|
|
Unlisted px tongue flr mouth
|
$123.00 |
$123.00 |
$123.00 |
$282.50
|
|
Unsched dialysis esrd pt hos
|
$96.76 |
$96.76 |
$96.76 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,475.58 |
$2,475.58 |
$2,475.58 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,227.13 |
$1,227.13 |
$1,227.13 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,117.66 |
$1,117.66 |
$1,117.66 |
$2,034.41
|
|
Urea nitrogen
|
$23.37 |
$23.37 |
$23.37 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$66.83 |
$66.83 |
$66.83 |
$51.75
|
|
Uric acid blood
|
$23.37 |
$23.37 |
$23.37 |
$48.75
|
|
Uric acid urine
|
$24.60 |
$24.60 |
$24.60 |
$44.33
|
|
Urinalysis microscopic only
|
$40.18 |
$40.18 |
$40.18 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$3.28 |
$3.28 |
$3.28 |
$25.72
|
|
Urinalysis (with microscopy)
|
$25.83 |
$25.83 |
$25.83 |
$55.00
|
|
Urinalysis (without microscopy)
|
$39.36 |
$39.36 |
$39.36 |
$35.75
|
|
Urine Culture Test
|
$37.72 |
$37.72 |
$37.72 |
$81.50
|
|
Urine pregnancy test
|
$12.71 |
$12.71 |
$12.71 |
$67.20
|
|
Vaginal bx
|
$105.78 |
$105.78 |
$105.78 |
$455.94
|
|
Vaginal delivery after cesarean delivery 59612
|
$3,212.76 |
$3,212.76 |
$3,212.76 |
$3,843.60
|
|
Valproic acid total therapeutic drug level
|
$76.67 |
$76.67 |
$76.67 |
$114.72
|
|
Valrubicin injection
|
$1,675.94 |
$1,675.94 |
$1,675.94 |
$2,813.49
|
|
Vancomycin peak therapeutic drug level
|
$70.11 |
$70.11 |
$70.11 |
$136.13
|
|
Varicella zoster antibody igg
|
$78.31 |
$78.31 |
$78.31 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,958.56 |
$1,958.56 |
$1,958.56 |
$325.80
|
|
Ventilator each subsequent day
|
$370.23 |
$370.23 |
$370.23 |
$1,204.00
|
|
Ventilator initial day
|
$370.23 |
$370.23 |
$370.23 |
$1,431.43
|
|
Version cephalic external
|
$2,734.70 |
$2,734.70 |
$2,734.70 |
$2,361.75
|
|
Very long chain fatty acids
|
$24.19 |
$24.19 |
$24.19 |
$139.88
|
|
Vital capacity test
|
$67.24 |
$67.24 |
$67.24 |
$170.00
|
|
Vitamin b-12
|
$73.39 |
$73.39 |
$73.39 |
$100.00
|
|
Vitamin D Test
|
$138.17 |
$138.17 |
$138.17 |
$132.00
|
|
Volume measurement urine timed
|
$12.71 |
$12.71 |
$12.71 |
$21.45
|
|
Warde 1003990 aldosterone
|
$194.75 |
$194.75 |
$194.75 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$50.84 |
$50.84 |
$50.84 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$66.83 |
$66.83 |
$66.83 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$200.49 |
$200.49 |
$200.49 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$75.44 |
$75.44 |
$75.44 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$51.25 |
$51.25 |
$51.25 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$53.71 |
$53.71 |
$53.71 |
$39.00
|