|
Triglycerides
|
$31.35 |
$31.35 |
$31.35 |
$54.60
|
|
Trim nail(s)
|
$134.20 |
$134.20 |
$134.20 |
$70.29
|
|
Trim nondyst nails
|
$198.55 |
$198.55 |
$198.55 |
$124.22
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$10,293.25 |
$10,293.25 |
$10,293.25 |
$15,111.95
|
|
Trml dstrj ios bvn ea addl
|
$5,179.90 |
$5,179.90 |
$5,179.90 |
$9,781.50
|
|
Trmt of fracture (femoral shaft) 27500
|
$432.30 |
$432.30 |
$432.30 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$8,933.65 |
$8,933.65 |
$8,933.65 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$9,678.35 |
$9,678.35 |
$9,678.35 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$9,118.45 |
$9,118.45 |
$9,118.45 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,945.05 |
$4,945.05 |
$4,945.05 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$6,145.15 |
$6,145.15 |
$6,145.15 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$9,503.45 |
$9,503.45 |
$9,503.45 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,371.50 |
$3,371.50 |
$3,371.50 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,786.75 |
$3,786.75 |
$3,786.75 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,680.15 |
$2,680.15 |
$2,680.15 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,680.15 |
$2,680.15 |
$2,680.15 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,307.80 |
$2,307.80 |
$2,307.80 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,198.35 |
$2,198.35 |
$2,198.35 |
$2,986.34
|
|
Troponin quantitative
|
$83.60 |
$83.60 |
$83.60 |
$123.75
|
|
Trurl dstrj prst8 tiss rf wv
|
$1,068.53 |
$1,068.53 |
$1,068.53 |
$4,385.60
|
|
Tte w or without fol w/con,stres
|
$3,959.45 |
$3,959.45 |
$3,959.45 |
$1,582.75
|
|
Tube trach disp innr can 5 xlt
|
$150.77 |
$150.77 |
$150.77 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$15,991.25 |
$15,991.25 |
$15,991.25 |
$32,426.20
|
|
Tx closed hip disl traumatic without anes
|
$636.35 |
$636.35 |
$636.35 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,726.90 |
$2,726.90 |
$2,726.90 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$454.30 |
$454.30 |
$454.30 |
$635.46
|
|
Tx l/r atrial fib addl
|
$1,609.30 |
$1,609.30 |
$1,609.30 |
$7,717.80
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$4,369.20 |
$4,369.20 |
$4,369.20 |
$4,449.44
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$7,676.90 |
$7,676.90 |
$7,676.90 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$4,673.90 |
$4,673.90 |
$4,673.90 |
$4,281.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$4,379.10 |
$4,379.10 |
$4,379.10 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$479.60 |
$479.60 |
$479.60 |
$469.20
|
|
Ugt1a1 gene analy common variants
|
$463.65 |
$463.65 |
$463.65 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$212.30 |
$212.30 |
$212.30 |
$403.26
|
|
Ultrasound breast complete
|
$814.00 |
$814.00 |
$814.00 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$518.10 |
$518.10 |
$518.10 |
$449.35
|
|
Ultrasound chest
|
$402.05 |
$402.05 |
$402.05 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$326.15 |
$326.15 |
$326.15 |
$340.14
|
|
Ultrasound elastography ea l target les
|
$114.95 |
$114.95 |
$114.95 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$318.45 |
$318.45 |
$318.45 |
$284.25
|
|
Ultrasound encephalogram
|
$446.60 |
$446.60 |
$446.60 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$523.05 |
$523.05 |
$523.05 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$391.60 |
$391.60 |
$391.60 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$318.45 |
$318.45 |
$318.45 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$728.20 |
$728.20 |
$728.20 |
$701.35
|
|
Ultrasound guide intraoperative
|
$890.45 |
$890.45 |
$890.45 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$424.60 |
$424.60 |
$424.60 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$532.95 |
$532.95 |
$532.95 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$532.95 |
$532.95 |
$532.95 |
$321.35
|
|
Ultrasound joint complete left
|
$436.70 |
$436.70 |
$436.70 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$229.90 |
$229.90 |
$229.90 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$363.00 |
$363.00 |
$363.00 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$323.40 |
$323.40 |
$323.40 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$698.50 |
$698.50 |
$698.50 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$361.35 |
$361.35 |
$361.35 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$271.70 |
$271.70 |
$271.70 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$401.50 |
$401.50 |
$401.50 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$590.70 |
$590.70 |
$590.70 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$471.35 |
$471.35 |
$471.35 |
$498.00
|
|
Ultrasound scrotum and contents
|
$632.50 |
$632.50 |
$632.50 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$496.65 |
$496.65 |
$496.65 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$468.60 |
$468.60 |
$468.60 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$457.60 |
$457.60 |
$457.60 |
$567.44
|
|
Ultrasound trgt dyn mbubb 1st les
|
$438.90 |
$438.90 |
$438.90 |
$479.72
|
|
Ultrasound trgt dyn mbubb ea addl
|
$336.60 |
$336.60 |
$336.60 |
$336.60
|
|
Umbilical artery cath newborn 36660
|
$186.45 |
$186.45 |
$186.45 |
$265.85
|
|
Unlistd noninvas vasc dx std
|
$1,207.80 |
$1,207.80 |
$1,207.80 |
$819.65
|
|
Unlisted CT procedure
|
$407.55 |
$407.55 |
$407.55 |
$1,043.00
|
|
Unlisted dx gi procedure
|
$482.90 |
$482.90 |
$482.90 |
$482.90
|
|
Unlisted fetal invas px w/us
|
$1,418.45 |
$1,418.45 |
$1,418.45 |
$492.81
|
|
Unlisted mr procedure
|
$627.00 |
$627.00 |
$627.00 |
$1,032.20
|
|
Unlisted procedure liver
|
$855.25 |
$855.25 |
$855.25 |
$2,694.00
|
|
Unlisted procedure microbiology
|
$2,830.30 |
$2,830.30 |
$2,830.30 |
$487.50
|
|
Unlisted procedure pancreas
|
$723.25 |
$723.25 |
$723.25 |
$2,967.75
|
|
Unlisted procedure rectum
|
$1,058.75 |
$1,058.75 |
$1,058.75 |
$1,278.72
|
|
Unlisted px abdomen muscskel
|
$442.75 |
$442.75 |
$442.75 |
$2,633.80
|
|
Unlisted px biliary tract
|
$2,718.10 |
$2,718.10 |
$2,718.10 |
$2,718.10
|
|
Unlisted px casting/strpg
|
$407.55 |
$407.55 |
$407.55 |
$224.93
|
|
Unlisted px extraocular musc
|
$291.50 |
$291.50 |
$291.50 |
$352.04
|
|
Unlisted px hands/fingers
|
$209.55 |
$209.55 |
$209.55 |
$379.44
|
|
Unlisted px lacrimal system
|
$359.15 |
$359.15 |
$359.15 |
$359.15
|
|
Unlisted px male genital sys
|
$247.50 |
$247.50 |
$247.50 |
$897.95
|
|
Unlisted px med radj physics
|
$199.10 |
$199.10 |
$199.10 |
$376.03
|
|
Unlisted px pelvis/hip joint
|
$304.70 |
$304.70 |
$304.70 |
$2,108.82
|
|
Unlisted px small intestine
|
$2,471.15 |
$2,471.15 |
$2,471.15 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$183.70 |
$183.70 |
$183.70 |
$274.80
|
|
Unlisted surgical path px
|
$29.70 |
$29.70 |
$29.70 |
$71.65
|
|
Unlisted transfusion med px
|
$141.35 |
$141.35 |
$141.35 |
$141.35
|
|
Unlisted ultrasound procedure
|
$321.20 |
$321.20 |
$321.20 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$1,872.75 |
$1,872.75 |
$1,872.75 |
$1,469.76
|
|
Upgrade pm system
|
$16,727.15 |
$16,727.15 |
$16,727.15 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,560.80 |
$2,560.80 |
$2,560.80 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,705.00 |
$1,705.00 |
$1,705.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,298.00 |
$1,298.00 |
$1,298.00 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,370.05 |
$1,370.05 |
$1,370.05 |
$1,656.60
|
|
Urea nitrogen
|
$45.10 |
$45.10 |
$45.10 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$31.35 |
$31.35 |
$31.35 |
$50.00
|
|
Ureteral embolization/occl
|
$3,489.20 |
$3,489.20 |
$3,489.20 |
$3,041.22
|
|
Urethrcystgrphy rtrgrde s&i
|
$570.90 |
$570.90 |
$570.90 |
$574.40
|
