|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,254.90 |
$4,254.90 |
$4,254.90 |
$9,418.42
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$14,143.35 |
$14,143.35 |
$14,143.35 |
$9,565.92
|
|
Trnscath plc vas stent w/s&i ini vein
|
$37,805.40 |
$37,805.40 |
$37,805.40 |
$15,873.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$12,669.21 |
$12,669.21 |
$12,669.21 |
$5,555.55
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,817.10 |
$2,817.10 |
$2,817.10 |
$6,354.94
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,390.05 |
$2,390.05 |
$2,390.05 |
$4,770.98
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,252.25 |
$2,252.25 |
$2,252.25 |
$5,324.40
|
|
Trnscath tx thromblytc vein ini day
|
$2,287.35 |
$2,287.35 |
$2,287.35 |
$4,201.80
|
|
Troponin quantitative
|
$135.85 |
$135.85 |
$135.85 |
$112.80
|
|
Tte w or without contr, cont ecg
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$1,613.95
|
|
Tte w or without fol w/con,stres
|
$2,728.70 |
$2,728.70 |
$2,728.70 |
$1,108.76
|
|
Tvh >250 gms 58290
|
$22,259.52 |
$22,259.52 |
$22,259.52 |
$6,872.92
|
|
Tx atrial fib pulm vein isol
|
$34,519.55 |
$34,519.55 |
$34,519.55 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$7,837.05 |
$7,837.05 |
$7,837.05 |
$6,986.85
|
|
Tympanic membrane repair
|
$5,622.59 |
$5,622.59 |
$5,622.59 |
$1,856.00
|
|
Tympanolysis transcanal 69450
|
$14,075.85 |
$14,075.85 |
$14,075.85 |
$3,589.62
|
|
Ua w/micro/comp poc
|
$44.20 |
$44.20 |
$44.20 |
$25.72
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$25,772.31 |
$25,772.31 |
$25,772.31 |
$71.90
|
|
Ugt1a1 gene analy common variants
|
$1,182.35 |
$1,182.35 |
$1,182.35 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$274.30 |
$274.30 |
$274.30 |
$394.20
|
|
Ultrasound breast complete
|
$1,007.50 |
$1,007.50 |
$1,007.50 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$809.25 |
$809.25 |
$809.25 |
$427.00
|
|
Ultrasound chest
|
$529.75 |
$529.75 |
$529.75 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$241.80 |
$241.80 |
$241.80 |
$340.03
|
|
Ultrasound dx ophth b-scan
|
$395.85 |
$395.85 |
$395.85 |
$335.68
|
|
Ultrasound elastography ea l target les
|
$321.75 |
$321.75 |
$321.75 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$377.00 |
$377.00 |
$377.00 |
$275.98
|
|
Ultrasound encephalogram
|
$571.35 |
$571.35 |
$571.35 |
$463.50
|
|
Ultrasound exam k transpl w/doppler
|
$475.80 |
$475.80 |
$475.80 |
$494.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$584.35 |
$584.35 |
$584.35 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$286.65 |
$286.65 |
$286.65 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$871.00 |
$871.00 |
$871.00 |
$629.64
|
|
Ultrasound guide intraoperative
|
$1,076.40 |
$1,076.40 |
$1,076.40 |
$628.80
|
|
Ultrasound guide tissue ablation
|
$1,037.40 |
$1,037.40 |
$1,037.40 |
$463.50
|
|
Ultrasound hips infant dynamic
|
$538.20 |
$538.20 |
$538.20 |
$395.20
|
|
Ultrasound infant hips ltd without stress
|
$258.70 |
$258.70 |
$258.70 |
$311.25
|
|
Ultrasound joint complete left
|
$776.75 |
$776.75 |
$776.75 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$955.50 |
$955.50 |
$955.50 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$369.85 |
$369.85 |
$369.85 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$285.35 |
$285.35 |
$285.35 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$552.50 |
$552.50 |
$552.50 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$347.10 |
$347.10 |
$347.10 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$433.55 |
$433.55 |
$433.55 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$590.85 |
$590.85 |
$590.85 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$395.20 |
$395.20 |
$395.20 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$365.30 |
$365.30 |
$365.30 |
$469.58
|
|
Ultrasound scrotum and contents
|
$867.75 |
$867.75 |
$867.75 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$412.10 |
$412.10 |
$412.10 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$513.50 |
$513.50 |
$513.50 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$671.45 |
$671.45 |
$671.45 |
$523.20
|
|
Umbilical artery cath newborn 36660
|
$722.80 |
$722.80 |
$722.80 |
$204.75
|
|
Unit mobile power mpu
|
$13,936.00 |
$13,936.00 |
$13,936.00 |
$18,857.25
|
|
Unlisted fluoroscopic px
|
$672.10 |
$672.10 |
$672.10 |
$256.00
|
|
Unlisted laparoscopic liver biopy 47379
|
$18,767.15 |
$18,767.15 |
$18,767.15 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$17,828.15 |
$17,828.15 |
$17,828.15 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$19,318.29 |
$19,318.29 |
$19,318.29 |
$4,981.62
|
|
Unlisted laps px appendix
|
$24,780.58 |
$24,780.58 |
$24,780.58 |
$3,617.40
|
|
Unlisted laps px bladder
|
$12,516.97 |
$12,516.97 |
$12,516.97 |
$5,082.74
|
|
Unlisted laps px ovidct ovry
|
$11,574.02 |
$11,574.02 |
$11,574.02 |
$4,713.11
|
|
Unlisted laps px spleen
|
$15,988.84 |
$15,988.84 |
$15,988.84 |
$6,457.82
|
|
Unlisted mr procedure
|
$1,298.70 |
$1,298.70 |
$1,298.70 |
$1,249.50
|
|
Unlisted muscskel px head
|
$2,893.15 |
$2,893.15 |
$2,893.15 |
$257.26
|
|
Unlisted procedure colon
|
$604.50 |
$604.50 |
$604.50 |
$1,640.00
|
|
Unlisted procedure esophagus
|
$2,558.07 |
$2,558.07 |
$2,558.07 |
$1,247.13
|
|
Unlisted procedure eyelids
|
$7,699.37 |
$7,699.37 |
$7,699.37 |
$479.62
|
|
Unlisted procedure larynx
|
$12,554.16 |
$12,554.16 |
$12,554.16 |
$4,960.50
|
|
Unlisted procedure liver
|
$37,043.77 |
$37,043.77 |
$37,043.77 |
$2,802.00
|
|
Unlisted procedure rectum
|
$19,937.54 |
$19,937.54 |
$19,937.54 |
$1,395.50
|
|
Unlisted procedure spine
|
$5,073.90 |
$5,073.90 |
$5,073.90 |
$5,007.60
|
|
Unlisted px ant segment eye
|
$2,641.60 |
$2,641.60 |
$2,641.60 |
$2,561.65
|
|
Unlisted px arthroscopy
|
$26,600.12 |
$26,600.12 |
$26,600.12 |
$11,433.76
|
|
Unlisted px biliary tract
|
$4,666.35 |
$4,666.35 |
$4,666.35 |
$3,598.64
|
|
Unlisted px foot/toes
|
$2,849.60 |
$2,849.60 |
$2,849.60 |
$3,105.70
|
|
Unlisted px lacrimal system
|
$6,222.57 |
$6,222.57 |
$6,222.57 |
$436.44
|
|
Unlisted px leg/ankle
|
$759.20 |
$759.20 |
$759.20 |
$811.00
|
|
Unlisted px middle ear
|
$25,468.01 |
$25,468.01 |
$25,468.01 |
$1,975.05
|
|
Unlisted px neck/thorax
|
$12,435.80 |
$12,435.80 |
$12,435.80 |
$2,680.22
|
|
Unlisted px pelvis/hip joint
|
$8,160.10 |
$8,160.10 |
$8,160.10 |
$8,660.60
|
|
Unlisted px posterior segmnt
|
$16,151.39 |
$16,151.39 |
$16,151.39 |
$3,997.80
|
|
Unlisted px salivry glnd/dux
|
$24,442.12 |
$24,442.12 |
$24,442.12 |
$1,607.45
|
|
Unlisted transfusion med px
|
$100.75 |
$100.75 |
$100.75 |
$113.36
|
|
Unlisted ultrasound procedure
|
$212.55 |
$212.55 |
$212.55 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$980.20
|
|
Upgrade pm system
|
$29,010.89 |
$29,010.89 |
$29,010.89 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,141.45 |
$3,141.45 |
$3,141.45 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,948.70 |
$1,948.70 |
$1,948.70 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,665.95 |
$1,665.95 |
$1,665.95 |
$1,794.00
|
|
Upper Endoscopy (EGD, diagnostic)
|
$3,311.93 |
$3,311.93 |
$3,311.93 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$4,107.16 |
$4,107.16 |
$4,107.16 |
$1,760.00
|
|
Uppr gi scope w/submuc inj
|
$5,055.67 |
$5,055.67 |
$5,055.67 |
$1,247.13
|
|
Urachal cyst/sinus excision 51500
|
$10,702.50 |
$10,702.50 |
$10,702.50 |
$6,082.67
|
|
Urea nitrogen
|
$48.10 |
$48.10 |
$48.10 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$55.90 |
$55.90 |
$55.90 |
$42.90
|
|
Ureteral reflux study
|
$832.65 |
$832.65 |
$832.65 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$663.00 |
$663.00 |
$663.00 |
$554.28
|
|
Urethrocystography void s&i
|
$949.65 |
$949.65 |
$949.65 |
$586.50
|
|
Uric acid blood
|
$42.90 |
$42.90 |
$42.90 |
$44.00
|
|
Uric acid urine
|
$61.10 |
$61.10 |
$61.10 |
$43.20
|
|
Urinalysis microscopic only
|
$64.35 |
$64.35 |
$64.35 |
$25.72
|
|
Urinalysis (with microscopy)
|
$91.65 |
$91.65 |
$91.65 |
$37.39
|
