|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,272.02 |
$2,272.02 |
$2,272.02 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,411.22 |
$1,411.22 |
$1,411.22 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$776.13 |
$776.13 |
$776.13 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$1,975.79 |
$1,975.79 |
$1,975.79 |
$4,329.36
|
|
Troponin quantitative
|
$241.08 |
$241.08 |
$241.08 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$20,418.82 |
$20,418.82 |
$20,418.82 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$7,555.07 |
$7,555.07 |
$7,555.07 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$101.48 |
$101.48 |
$101.48 |
$403.26
|
|
Ultrasound breast complete
|
$194.75 |
$194.75 |
$194.75 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$194.75 |
$194.75 |
$194.75 |
$449.35
|
|
Ultrasound chest
|
$213.82 |
$213.82 |
$213.82 |
$459.55
|
|
Ultrasound encephalogram
|
$217.92 |
$217.92 |
$217.92 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$281.47 |
$281.47 |
$281.47 |
$570.44
|
|
Ultrasound guidance for vascular access
|
$619.51 |
$619.51 |
$619.51 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$785.15 |
$785.15 |
$785.15 |
$701.35
|
|
Ultrasound guide intraoperative
|
$443.21 |
$443.21 |
$443.21 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$261.99 |
$261.99 |
$261.99 |
$403.00
|
|
Ultrasound joint complete left
|
$486.47 |
$486.47 |
$486.47 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$150.88 |
$150.88 |
$150.88 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$313.86 |
$313.86 |
$313.86 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$218.94 |
$218.94 |
$218.94 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$198.24 |
$198.24 |
$198.24 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$917.99 |
$917.99 |
$917.99 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$676.91 |
$676.91 |
$676.91 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$777.98 |
$777.98 |
$777.98 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$245.80 |
$245.80 |
$245.80 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$375.15 |
$375.15 |
$375.15 |
$498.00
|
|
Ultrasound scrotum and contents
|
$728.57 |
$728.57 |
$728.57 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$144.94 |
$144.94 |
$144.94 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$47.56 |
$47.56 |
$47.56 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$437.47 |
$437.47 |
$437.47 |
$567.44
|
|
Unlistd noninvas vasc dx std
|
$94.10 |
$94.10 |
$94.10 |
$819.65
|
|
Unlisted hematology&coagj px
|
$12.30 |
$12.30 |
$12.30 |
$35.51
|
|
Unlisted misc path test
|
$27.47 |
$27.47 |
$27.47 |
$89.40
|
|
Unlisted procedure microbiology
|
$236.78 |
$236.78 |
$236.78 |
$487.50
|
|
Unlisted px abdomen muscskel
|
$902.41 |
$902.41 |
$902.41 |
$2,633.80
|
|
Unlisted surgical path px
|
$11.07 |
$11.07 |
$11.07 |
$71.65
|
|
Unlisted transfusion med px
|
$1,614.38 |
$1,614.38 |
$1,614.38 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$677.12 |
$677.12 |
$677.12 |
$1,469.76
|
|
Upgrade pm system
|
$8,630.91 |
$8,630.91 |
$8,630.91 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,203.96 |
$2,203.96 |
$2,203.96 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,939.51 |
$1,939.51 |
$1,939.51 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,300.32 |
$1,300.32 |
$1,300.32 |
$2,013.08
|
|
Urea nitrogen
|
$83.64 |
$83.64 |
$83.64 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$56.38 |
$56.38 |
$56.38 |
$50.00
|
|
Ureteral reflux study
|
$560.06 |
$560.06 |
$560.06 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$415.54 |
$415.54 |
$415.54 |
$574.40
|
|
Urethrocystography void s&i
|
$415.54 |
$415.54 |
$415.54 |
$634.50
|
|
Uric acid blood
|
$106.81 |
$106.81 |
$106.81 |
$46.64
|
|
Uric acid urine
|
$50.23 |
$50.23 |
$50.23 |
$46.75
|
|
Urinalysis microscopic only
|
$3.28 |
$3.28 |
$3.28 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$28.29 |
$28.29 |
$28.29 |
$25.72
|
|
Urinalysis (with microscopy)
|
$96.15 |
$96.15 |
$96.15 |
$48.14
|
|
Urinalysis (without microscopy)
|
$99.63 |
$99.63 |
$99.63 |
$38.99
|
|
Urine Culture Test
|
$215.46 |
$215.46 |
$215.46 |
$84.81
|
|
Urine pregnancy test
|
$74.21 |
$74.21 |
$74.21 |
$66.40
|
|
Urography, antegrade
|
$527.06 |
$527.06 |
$527.06 |
$593.37
|
|
Vaccine dtap < 7 years im
|
$29.52 |
$29.52 |
$29.52 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$98.81 |
$98.81 |
$98.81 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$12.71 |
$12.71 |
$12.71 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$81.39 |
$81.39 |
$81.39 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$57.20 |
$57.20 |
$57.20 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$29.11 |
$29.11 |
$29.11 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$80.98 |
$80.98 |
$80.98 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$21.73 |
$21.73 |
$21.73 |
$48.29
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$261.99 |
$261.99 |
$261.99 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$163.39 |
$163.39 |
$163.39 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$86.51 |
$86.51 |
$86.51 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$129.36 |
$129.36 |
$129.36 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$274.91 |
$274.91 |
$274.91 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$40.80 |
$40.80 |
$40.80 |
$119.17
|
|
Vaccine rabies im
|
$418.82 |
$418.82 |
$418.82 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$49.20 |
$49.20 |
$49.20 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$30.14 |
$30.14 |
$30.14 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$86.51 |
$86.51 |
$86.51 |
$115.00
|
|
Valvuloplasty aortic
|
$5,166.82 |
$5,166.82 |
$5,166.82 |
$7,324.85
|
|
Valvuloplasty mitral
|
$7,708.00 |
$7,708.00 |
$7,708.00 |
$10,435.39
|
|
Valvuloplasty pulmonary
|
$3,251.10 |
$3,251.10 |
$3,251.10 |
$11,945.20
|
|
Vancomycin hcl injection
|
$42.85 |
$42.85 |
$42.85 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$148.01 |
$148.01 |
$148.01 |
$126.79
|
|
Vanomycin dna amp probe
|
$27.68 |
$27.68 |
$27.68 |
$87.20
|
|
Varicella zoster antibody igg
|
$45.31 |
$45.31 |
$45.31 |
$82.55
|
|
Varus/valgus strap padded/li
|
$108.65 |
$108.65 |
$108.65 |
$130.32
|
|
Vasc emb/occ w/prs cath
|
$10,800.02 |
$10,800.02 |
$10,800.02 |
$21,009.00
|
|
Vasopressin 20 unit/ml intravenous solution
|
$234.73 |
$234.73 |
$234.73 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$2,482.55 |
$2,482.55 |
$2,482.55 |
$20,730.98
|
|
Veeg cont 2-12 hrs
|
$306.68 |
$306.68 |
$306.68 |
$1,485.05
|
|
Veeg ea 12-26hr cont mntr
|
$573.39 |
$573.39 |
$573.39 |
$3,332.45
|
|
Veeg intrmnt 2-12 hrs
|
$159.49 |
$159.49 |
$159.49 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$306.68 |
$306.68 |
$306.68 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$159.49 |
$159.49 |
$159.49 |
$704.79
|
|
Vein x-ray adrenal gland
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
$3,999.60
|
|
Vein x-ray kidney
|
$1,301.96 |
$1,301.96 |
$1,301.96 |
$2,716.20
|
|
Vein x-ray liver w/hemodynam
|
$1,146.77 |
$1,146.77 |
$1,146.77 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$2,096.54 |
$2,096.54 |
$2,096.54 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$1,327.79 |
$1,327.79 |
$1,327.79 |
$2,489.25
|
|
Vein x-ray skull
|
$406.93 |
$406.93 |
$406.93 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$648.62 |
$648.62 |
$648.62 |
$1,344.60
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$487.70 |
$487.70 |
$487.70 |
$188.65
|
