|
Tympanolysis transcanal 69450
|
$3,819.23 |
$3,819.23 |
$3,819.23 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$184.26 |
$184.26 |
$184.26 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$599.72 |
$599.72 |
$599.72 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$6,966.64 |
$6,966.64 |
$6,966.64 |
$6,740.80
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$6,966.64 |
$6,966.64 |
$6,966.64 |
$7,000.36
|
|
Tyms gene com variants
|
$174.81 |
$174.81 |
$174.81 |
$192.29
|
|
U2af1 gene common variants
|
$193.25 |
$193.25 |
$193.25 |
$243.34
|
|
Ua w/micro/comp poc
|
$4.02 |
$4.02 |
$4.02 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$71.90 |
$71.90 |
$71.90 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$234.00 |
$234.00 |
$234.00 |
$438.75
|
|
Ultrasound bone density measure
|
$125.23 |
$125.23 |
$125.23 |
$143.75
|
|
Ultrasound breast complete
|
$125.23 |
$125.23 |
$125.23 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$103.69 |
$103.69 |
$103.69 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$125.23 |
$125.23 |
$125.23 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$125.23 |
$125.23 |
$125.23 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$125.23 |
$125.23 |
$125.23 |
$307.00
|
|
Ultrasound encephalogram
|
$125.23 |
$125.23 |
$125.23 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$125.23 |
$125.23 |
$125.23 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$125.23 |
$125.23 |
$125.23 |
$477.10
|
|
Ultrasound hips infant dynamic
|
$103.69 |
$103.69 |
$103.69 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$103.69 |
$103.69 |
$103.69 |
$304.00
|
|
Ultrasound joint complete left
|
$125.23 |
$125.23 |
$125.23 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$125.23 |
$125.23 |
$125.23 |
$277.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$284.66 |
$284.66 |
$284.66 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$125.23 |
$125.23 |
$125.23 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$125.23 |
$125.23 |
$125.23 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$125.23 |
$125.23 |
$125.23 |
$459.00
|
|
Ultrasound trgt dyn mbubb 1st les
|
$209.65 |
$209.65 |
$209.65 |
$568.32
|
|
Ultraviolet therapy
|
$10.45 |
$10.45 |
$10.45 |
$39.76
|
|
Umbilical cord occlud w/us
|
$358.23 |
$358.23 |
$358.23 |
$754.00
|
|
Unlistd noninvas vasc dx std
|
$28.84 |
$28.84 |
$28.84 |
$564.60
|
|
Unlisted all/immlg svc/px
|
$28.84 |
$28.84 |
$28.84 |
$28.98
|
|
Unlisted chemotherapy px
|
$54.34 |
$54.34 |
$54.34 |
$149.15
|
|
Unlisted cranfcl&maxlfcl px
|
$273.48 |
$273.48 |
$273.48 |
$571.20
|
|
Unlisted CT procedure
|
$103.69 |
$103.69 |
$103.69 |
$740.43
|
|
Unlisted cv px dx nuc med
|
$473.22 |
$473.22 |
$473.22 |
$1,747.20
|
|
Unlisted cytogenetic study
|
$62.92 |
$62.92 |
$62.92 |
$160.00
|
|
Unlisted cytopathology px
|
$62.92 |
$62.92 |
$62.92 |
$132.08
|
|
Unlisted dx gi procedure
|
$184.26 |
$184.26 |
$184.26 |
$649.22
|
|
Unlisted endocrine px dx nuc
|
$473.22 |
$473.22 |
$473.22 |
$653.31
|
|
Unlisted fetal invas px w/us
|
$236.91 |
$236.91 |
$236.91 |
$498.40
|
|
Unlisted fluoroscopic px
|
$103.69 |
$103.69 |
$103.69 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$473.22 |
$473.22 |
$473.22 |
$995.00
|
|
Unlisted gu px dx nuc med
|
$473.22 |
$473.22 |
$473.22 |
$805.62
|
|
Unlisted hystsc px uterus
|
$236.91 |
$236.91 |
$236.91 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,463.42
|
|
Unlisted laps px appendix
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$3,617.40
|
|
Unlisted laps px bladder
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,082.74
|
|
Unlisted laps px endoc sys
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,855.00
|
|
Unlisted laps px esoph
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,904.15
|
|
Unlisted laps px renal
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,110.00
|
|
Unlisted laps px spleen
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$4,627.00
|
|
Unlisted laps px testis
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$5,628.67
|
|
Unlisted laps px ureter
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$6,376.26
|
|
Unlisted laps px uterus
|
$6,870.89 |
$6,870.89 |
$6,870.89 |
$4,627.00
|
|
Unlisted maxlfcl prosth px
|
$273.48 |
$273.48 |
$273.48 |
$571.20
|
|
Unlisted misc path test
|
$62.92 |
$62.92 |
$62.92 |
$89.40
|
|
Unlisted mr procedure
|
$103.69 |
$103.69 |
$103.69 |
$1,165.00
|
|
Unlisted muscskel px dx nuc
|
$473.22 |
$473.22 |
$473.22 |
$1,279.98
|
|
Unlisted muscskel px head
|
$273.48 |
$273.48 |
$273.48 |
$1,224.08
|
|
Unlisted neurological dx px
|
$184.26 |
$184.26 |
$184.26 |
$242.50
|
|
Unlisted nrvs sys px dx nuc
|
$473.22 |
$473.22 |
$473.22 |
$891.41
|
|
Unlisted oph svc/procedure
|
$28.84 |
$28.84 |
$28.84 |
$40.26
|
|
Unlisted orl service/px
|
$28.84 |
$28.84 |
$28.84 |
$132.60
|
|
Unlisted procedure colon
|
$1,073.68 |
$1,073.68 |
$1,073.68 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$352.04 |
$352.04 |
$352.04 |
$2,174.90
|
|
Unlisted procedure larynx
|
$273.48 |
$273.48 |
$273.48 |
$924.00
|
|
Unlisted procedure liver
|
$828.59 |
$828.59 |
$828.59 |
$2,287.20
|
|
Unlisted procedure orbit
|
$352.04 |
$352.04 |
$352.04 |
$437.00
|
|
Unlisted procedure pancreas
|
$828.59 |
$828.59 |
$828.59 |
$4,810.00
|
|
Unlisted procedure rectum
|
$1,073.68 |
$1,073.68 |
$1,073.68 |
$1,278.72
|
|
Unlisted procedure spine
|
$282.50 |
$282.50 |
$282.50 |
$4,706.35
|
|
Unlisted psychiatric service/proc 90899
|
$35.08 |
$35.08 |
$35.08 |
$277.76
|
|
Unlisted px abdomen muscskel
|
$282.50 |
$282.50 |
$282.50 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$273.48 |
$273.48 |
$273.48 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$2,685.92 |
$2,685.92 |
$2,685.92 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$282.50 |
$282.50 |
$282.50 |
$2,765.60
|
|
Unlisted px biliary tract
|
$1,104.13 |
$1,104.13 |
$1,104.13 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$185.82 |
$185.82 |
$185.82 |
$222.00
|
|
Unlisted px conjunctiva
|
$352.04 |
$352.04 |
$352.04 |
$479.62
|
|
Unlisted px exc pressure ulc
|
$828.59 |
$828.59 |
$828.59 |
$973.71
|
|
Unlisted px external ear
|
$273.48 |
$273.48 |
$273.48 |
$325.68
|
|
Unlisted px extraocular musc
|
$352.04 |
$352.04 |
$352.04 |
$739.20
|
|
Unlisted px foot/toes
|
$282.50 |
$282.50 |
$282.50 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$282.50 |
$282.50 |
$282.50 |
$859.50
|
|
Unlisted px hands/fingers
|
$282.50 |
$282.50 |
$282.50 |
$349.70
|
|
Unlisted px inner ear
|
$273.48 |
$273.48 |
$273.48 |
$571.20
|
|
Unlisted px lacrimal system
|
$352.04 |
$352.04 |
$352.04 |
$416.50
|
|
Unlisted px leg/ankle
|
$282.50 |
$282.50 |
$282.50 |
$813.24
|
|
Unlisted px male genital sys
|
$286.42 |
$286.42 |
$286.42 |
$362.00
|
|
Unlisted px med radj physics
|
$156.36 |
$156.36 |
$156.36 |
$462.35
|
|
Unlisted px middle ear
|
$273.48 |
$273.48 |
$273.48 |
$343.50
|
|
Unlisted px neck/thorax
|
$273.48 |
$273.48 |
$273.48 |
$571.20
|
|
Unlisted px palate uvula
|
$273.48 |
$273.48 |
$273.48 |
$274.80
|