|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$692.00 |
$692.00 |
$692.00 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$583.58 |
$583.58 |
$583.58 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,232.29 |
$2,232.29 |
$2,232.29 |
$4,523.04
|
|
Treat ankle dislocation
|
$835.13 |
$835.13 |
$835.13 |
$2,360.00
|
|
Treat elbow dislocation
|
$802.01 |
$802.01 |
$802.01 |
$2,272.50
|
|
Treat eyelid lesion 67850
|
$183.96 |
$183.96 |
$183.96 |
$1,146.13
|
|
Treat finger fracture each
|
$377.93 |
$377.93 |
$377.93 |
$1,592.00
|
|
Treat foot dislocation
|
$207.97 |
$207.97 |
$207.97 |
$445.80
|
|
Treat fracture of radius
|
$777.03 |
$777.03 |
$777.03 |
$1,790.00
|
|
Treat fracture of ulna
|
$766.72 |
$766.72 |
$766.72 |
$731.04
|
|
Treat hip dislocation
|
$1,283.11 |
$1,283.11 |
$1,283.11 |
$2,211.05
|
|
Treat hip socket fracture
|
$1,653.98 |
$1,653.98 |
$1,653.98 |
$1,392.00
|
|
Treat humerus fracture
|
$961.11 |
$961.11 |
$961.11 |
$1,790.00
|
|
Treat kneecap dislocation
|
$823.73 |
$823.73 |
$823.73 |
$1,068.06
|
|
Treat knee dislocation
|
$1,066.45 |
$1,066.45 |
$1,066.45 |
$2,220.89
|
|
Treat knee fracture 27530
|
$479.47 |
$479.47 |
$479.47 |
$550.73
|
|
Treat lower leg dislocation
|
$604.90 |
$604.90 |
$604.90 |
$532.60
|
|
Treat lower leg dislocation
|
$684.18 |
$684.18 |
$684.18 |
$3,908.80
|
|
Treatment incomplete abortion completed surgically any trimester
|
$344.80 |
$344.80 |
$344.80 |
$3,928.20
|
|
Treatment of ankle fracture 27786
|
$485.44 |
$485.44 |
$485.44 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$475.13 |
$475.13 |
$475.13 |
$501.20
|
|
Treatment of heel fracture 28400
|
$385.53 |
$385.53 |
$385.53 |
$473.00
|
|
Treatment of thigh fracture
|
$1,154.96 |
$1,154.96 |
$1,154.96 |
$1,790.00
|
|
Treatment of thigh fracture
|
$1,645.83 |
$1,645.83 |
$1,645.83 |
$3,796.00
|
|
Treat midfoot fracture each
|
$290.50 |
$290.50 |
$290.50 |
$1,884.74
|
|
Treat thigh fracture
|
$804.73 |
$804.73 |
$804.73 |
$661.00
|
|
Treat thigh fx growth plate
|
$813.41 |
$813.41 |
$813.41 |
$478.40
|
|
Treat ulnar fracture
|
$705.36 |
$705.36 |
$705.36 |
$1,677.20
|
|
Treponema pallidum antibody
|
$56.83 |
$56.83 |
$56.83 |
$72.05
|
|
Trg gene rearrangement anal
|
$445.88 |
$445.88 |
$445.88 |
$455.70
|
|
Trichinella antibody
|
$52.99 |
$52.99 |
$52.99 |
$70.65
|
|
#tricyclicantidprssnt
|
$53.33 |
$53.33 |
$53.33 |
$50.54
|
|
Triglycerides
|
$33.10 |
$33.10 |
$33.10 |
$58.50
|
|
Trim nondyst nails
|
$33.52 |
$33.52 |
$33.52 |
$113.88
|
|
Troponin quantitative
|
$84.59 |
$84.59 |
$84.59 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$1,083.26 |
$1,083.26 |
$1,083.26 |
$1,632.80
|
|
Tx closed hip disl traumatic without anes
|
$313.85 |
$313.85 |
$313.85 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$539.74 |
$539.74 |
$539.74 |
$535.60
|
|
Tx open nsl fx uncomp
|
$488.16 |
$488.16 |
$488.16 |
$3,926.40
|
|
Tx tarsal bone fx without manip 28450
|
$214.49 |
$214.49 |
$214.49 |
$419.04
|
|
Tympanic membrane repair
|
$403.64 |
$403.64 |
$403.64 |
$2,638.87
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$182.16 |
$182.16 |
$182.16 |
$911.43
|
|
Ugt1a1 gene analy common variants
|
$517.37 |
$517.37 |
$517.37 |
$438.75
|
|
Ultrasound breast complete
|
$899.51 |
$899.51 |
$899.51 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$738.58 |
$738.58 |
$738.58 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$253.25 |
$253.25 |
$253.25 |
$338.00
|
|
Ultrasound encephalogram
|
$439.59 |
$439.59 |
$439.59 |
$494.92
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$661.51 |
$661.51 |
$661.51 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$481.10 |
$481.10 |
$481.10 |
$720.15
|
|
Ultrasound joint complete left
|
$769.92 |
$769.92 |
$769.92 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$348.96 |
$348.96 |
$348.96 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$238.85 |
$238.85 |
$238.85 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$528.53 |
$528.53 |
$528.53 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$459.92 |
$459.92 |
$459.92 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$509.05 |
$509.05 |
$509.05 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$344.73 |
$344.73 |
$344.73 |
$463.00
|
|
Unlisted hematology&coagj px
|
$34.31 |
$34.31 |
$34.31 |
$39.52
|
|
Unlisted transfusion med px
|
$175.00 |
$175.00 |
$175.00 |
$147.50
|
|
Upper Arm (Humerus) X-ray (left side)
|
$307.30 |
$307.30 |
$307.30 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,512.44 |
$2,512.44 |
$2,512.44 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,009.70 |
$2,009.70 |
$2,009.70 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,716.04 |
$1,716.04 |
$1,716.04 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,430.03 |
$1,430.03 |
$1,430.03 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,144.02 |
$1,144.02 |
$1,144.02 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$353.97 |
$353.97 |
$353.97 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$366.90 |
$366.90 |
$366.90 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$634.71 |
$634.71 |
$634.71 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$478.19 |
$478.19 |
$478.19 |
$607.20
|
|
Urea nitrogen
|
$26.36 |
$26.36 |
$26.36 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$31.88 |
$31.88 |
$31.88 |
$52.00
|
|
Ureteral reflux study
|
$537.83 |
$537.83 |
$537.83 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$510.50 |
$510.50 |
$510.50 |
$584.00
|
|
Urethrocystography void s&i
|
$577.99 |
$577.99 |
$577.99 |
$631.40
|
|
Uric acid blood
|
$8.58 |
$8.58 |
$8.58 |
$49.44
|
|
Uric acid urine
|
$44.14 |
$44.14 |
$44.14 |
$45.36
|
|
Urinalysis microscopic only
|
$6.52 |
$6.52 |
$6.52 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$4.56 |
$4.56 |
$4.56 |
$25.72
|
|
Urinalysis (with microscopy)
|
$35.86 |
$35.86 |
$35.86 |
$55.20
|
|
Urinalysis (without microscopy)
|
$4.56 |
$4.56 |
$4.56 |
$36.00
|
|
Urine Culture Test
|
$17.18 |
$17.18 |
$17.18 |
$83.00
|
|
Urine pregnancy test
|
$37.82 |
$37.82 |
$37.82 |
$68.78
|
|
Vaccine Administration (one shot)
|
$38.34 |
$38.34 |
$38.34 |
$67.70
|
|
Vaccine tdap >=7 years im
|
$48.70 |
$48.70 |
$48.70 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$32.49 |
$32.49 |
$32.49 |
$115.00
|
|
Vancomycin peak therapeutic drug level
|
$25.13 |
$25.13 |
$25.13 |
$136.13
|
|
Varicella zoster antibody igg
|
$29.95 |
$29.95 |
$29.95 |
$86.80
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$25.37 |
$25.37 |
$25.37 |
$188.83
|
|
Venipuncture <3 yrs other vein
|
$23.60 |
$23.60 |
$23.60 |
$67.00
|
|
Ven thrombosis images bilat
|
$604.19 |
$604.19 |
$604.19 |
$796.50
|
|
Ventilator each subsequent day
|
$555.81 |
$555.81 |
$555.81 |
$1,184.00
|
|
Ventilator Management (first day)
|
$688.82 |
$688.82 |
$688.82 |
$1,434.60
|
|
Version cephalic external
|
$543.57 |
$543.57 |
$543.57 |
$2,361.75
|
|
Very long chain fatty acids
|
$125.66 |
$125.66 |
$125.66 |
$139.88
|
|
Virus isolation addl studies ea
|
$44.66 |
$44.66 |
$44.66 |
$79.34
|
|
Vital capacity test
|
$54.90 |
$54.90 |
$54.90 |
$173.18
|
|
Vitamin b-12
|
$33.10 |
$33.10 |
$33.10 |
$100.28
|
|
Vitamin D Test
|
$98.69 |
$98.69 |
$98.69 |
$132.00
|
|
Vkorc1 gene
|
$195.30 |
$195.30 |
$195.30 |
$182.79
|
|
Volume measurement urine timed
|
$7.17 |
$7.17 |
$7.17 |
$21.64
|
|
Walking (Gait) Training (each 15 minutes)
|
$53.34 |
$53.34 |
$53.34 |
$87.50
|
