|
Tube trach disp innr can 5 xlt
|
$177.97 |
$177.97 |
$249.51 |
$460.58
|
|
Tube trach fen sz 6 uncuffed
|
$237.41 |
$237.41 |
$237.41 |
$132.40
|
|
Tx atrial fib pulm vein isol
|
$19,990.22 |
$19,990.22 |
$32,450.00 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$406.12 |
$406.12 |
$684.75 |
$786.00
|
|
Tx closed hip disl traumatic without anes
|
$665.66 |
$665.66 |
$1,065.90 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,043.32 |
$4,043.32 |
$5,231.05 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$632.78 |
$632.78 |
$632.78 |
$635.46
|
|
Tx contour defects >10.0 cc
|
$918.06 |
$918.06 |
$918.06 |
$755.08
|
|
Tx contour defects 1.1-5.0cc 11951
|
$642.78 |
$642.78 |
$642.78 |
$724.37
|
|
Tx l/r atrial fib addl
|
$851.24 |
$851.24 |
$14,300.00 |
$7,717.80
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$4,449.44 |
$4,449.44 |
$7,300.15 |
$4,449.44
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$5,505.50 |
$5,505.50 |
$16,467.00 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$5,067.70 |
$5,067.70 |
$5,067.70 |
$4,281.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$6,709.56 |
$6,709.56 |
$9,589.80 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$596.31 |
$596.31 |
$596.31 |
$469.20
|
|
Tympanic membrane repair
|
$257.40 |
$257.40 |
$3,233.23 |
$1,856.00
|
|
Tympanometry & reflex thresh
|
$27.72 |
$27.72 |
$258.12 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$943.25 |
$943.25 |
$1,142.57 |
$911.43
|
|
Ugt1a1 gene analy common variants
|
$495.55 |
$495.55 |
$887.70 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$209.00 |
$209.00 |
$209.00 |
$403.26
|
|
Ultrasound breast complete
|
$528.55 |
$528.55 |
$911.62 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$388.30 |
$388.30 |
$490.49 |
$449.35
|
|
Ultrasound chest
|
$382.25 |
$382.25 |
$749.32 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$368.22 |
$368.22 |
$368.22 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$105.60 |
$105.60 |
$338.20 |
$330.40
|
|
Ultrasound elastography ea l target les
|
$28.60 |
$28.60 |
$153.01 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$155.65 |
$155.65 |
$270.98 |
$284.25
|
|
Ultrasound encephalogram
|
$807.24 |
$807.24 |
$807.24 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$951.66 |
$951.66 |
$1,850.20 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$540.10 |
$540.10 |
$540.10 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$396.00 |
$396.00 |
$689.98 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$453.20 |
$453.20 |
$800.80 |
$701.35
|
|
Ultrasound guide intraoperative
|
$479.76 |
$479.76 |
$481.25 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$388.30 |
$388.30 |
$544.12 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$560.56 |
$560.56 |
$560.56 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$500.50 |
$500.50 |
$500.50 |
$321.35
|
|
Ultrasound joint complete left
|
$437.58 |
$437.58 |
$565.95 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$463.10 |
$463.10 |
$509.85 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$737.16 |
$737.16 |
$737.16 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$528.38 |
$528.38 |
$528.38 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$913.00 |
$913.00 |
$913.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$516.45 |
$516.45 |
$516.45 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$431.75 |
$431.75 |
$559.90 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$332.75 |
$332.75 |
$473.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$629.20 |
$629.20 |
$637.45 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$496.10 |
$496.10 |
$600.60 |
$498.00
|
|
Ultrasound scrotum and contents
|
$550.00 |
$550.00 |
$556.60 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$925.21 |
$925.21 |
$925.21 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$925.21 |
$925.21 |
$925.21 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$522.50 |
$522.50 |
$576.40 |
$567.44
|
|
Ultrasound trgt dyn mbubb 1st les
|
$211.20 |
$211.20 |
$484.77 |
$479.72
|
|
Ultrasound trgt dyn mbubb ea addl
|
$48.40 |
$48.40 |
$48.40 |
$336.60
|
|
Umbilical artery cath newborn 36660
|
$260.26 |
$260.26 |
$260.26 |
$265.85
|
|
Unlisted dx gi procedure
|
$649.22 |
$649.22 |
$1,519.10 |
$482.90
|
|
Unlisted fetal invas px w/us
|
$1,910.48 |
$1,910.48 |
$1,910.48 |
$492.81
|
|
Unlisted mr procedure
|
$3,232.52 |
$3,232.52 |
$3,870.90 |
$1,032.20
|
|
Unlisted neurological dx px
|
$221.10 |
$221.10 |
$221.10 |
$185.15
|
|
Unlisted orl service/px
|
$68.96 |
$68.96 |
$68.96 |
$121.50
|
|
Unlisted procedure colon
|
$2,750.60 |
$2,750.60 |
$2,750.60 |
$1,580.44
|
|
Unlisted procedure microbiology
|
$1,957.45 |
$1,957.45 |
$1,957.45 |
$487.50
|
|
Unlisted procedure rectum
|
$1,109.68 |
$1,109.68 |
$1,109.68 |
$1,278.72
|
|
Unlisted procedure spine
|
$3,519.94 |
$3,519.94 |
$3,519.94 |
$4,706.35
|
|
Unlisted px ant segment eye
|
$2,934.95 |
$2,934.95 |
$2,934.95 |
$2,698.92
|
|
Unlisted px biliary tract
|
$3,297.58 |
$3,297.58 |
$3,297.58 |
$2,718.10
|
|
Unlisted px casting/strpg
|
$486.92 |
$486.92 |
$486.92 |
$224.93
|
|
Unlisted px external ear
|
$245.30 |
$245.30 |
$245.30 |
$354.00
|
|
Unlisted px extraocular musc
|
$310.72 |
$310.72 |
$310.72 |
$352.04
|
|
Unlisted px hands/fingers
|
$346.50 |
$346.50 |
$346.50 |
$379.44
|
|
Unlisted px lacrimal system
|
$3,506.25 |
$3,506.25 |
$3,506.25 |
$359.15
|
|
Unlisted px leg/ankle
|
$256.85 |
$256.85 |
$256.85 |
$811.00
|
|
Unlisted px med radj physics
|
$314.05 |
$314.05 |
$314.05 |
$376.03
|
|
Unlisted px pelvis/hip joint
|
$347.60 |
$347.60 |
$409.70 |
$2,108.82
|
|
Unlisted px small intestine
|
$3,379.80 |
$3,379.80 |
$3,379.80 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$249.54 |
$249.54 |
$302.50 |
$274.80
|
|
Unlisted surgical path px
|
$113.30 |
$113.30 |
$113.30 |
$71.65
|
|
Unlisted transfusion med px
|
$153.45 |
$153.45 |
$393.25 |
$141.35
|
|
Unlisted ultrasound procedure
|
$223.30 |
$223.30 |
$223.30 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$1,801.80 |
$1,801.80 |
$2,130.70 |
$1,469.76
|
|
Upgrade pm system
|
$11,911.35 |
$11,911.35 |
$24,352.29 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,472.80 |
$2,472.80 |
$3,181.75 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,935.45 |
$1,935.45 |
$2,445.30 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,398.10 |
$1,398.10 |
$1,410.75 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,179.20 |
$1,179.20 |
$1,179.20 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,361.25 |
$1,361.25 |
$1,361.25 |
$1,656.60
|
|
Urea nitrogen
|
$33.00 |
$33.00 |
$53.90 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$33.00 |
$33.00 |
$37.40 |
$50.00
|
|
Ureteral embolization/occl
|
$4,233.52 |
$4,233.52 |
$11,238.15 |
$3,041.22
|
|
Ureteral reflux study
|
$779.90 |
$779.90 |
$1,060.95 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$528.00 |
$528.00 |
$729.46 |
$574.40
|
|
Urethrocystography void s&i
|
$631.40 |
$631.40 |
$861.85 |
$634.50
|
|
Uric acid blood
|
$24.75 |
$24.75 |
$41.25 |
$46.64
|
|
Uric acid urine
|
$77.00 |
$77.00 |
$113.85 |
$46.75
|
|
Urinalysis microscopic only
|
$20.35 |
$20.35 |
$20.35 |
$26.35
|
|
Urinalysis (with microscopy)
|
$18.70 |
$18.70 |
$33.00 |
$48.14
|
|
Urinalysis (without microscopy)
|
$14.85 |
$14.85 |
$21.45 |
$38.99
|
|
Urinary bldr retent nuc study
|
$268.95 |
$268.95 |
$268.95 |
$309.22
|
|
Urine Culture Test
|
$38.50 |
$38.50 |
$52.25 |
$84.81
|
|
Urine flow measurement 51736
|
$26.40 |
$26.40 |
$203.06 |
$152.54
|
|
Urine pregnancy test
|
$38.50 |
$38.50 |
$78.65 |
$66.40
|
|
Urography, antegrade
|
$531.78 |
$531.78 |
$562.65 |
$593.37
|
