|
Treat finger fracture each
|
$494.00 |
$494.00 |
$494.00 |
$1,815.75
|
|
Treat foot dislocation
|
$752.00 |
$752.00 |
$752.00 |
$435.60
|
|
Treat foot dislocation
|
$752.00 |
$752.00 |
$752.00 |
$527.28
|
|
Treat foot dislocation
|
$734.00 |
$734.00 |
$734.00 |
$478.40
|
|
Treat fracture of radius
|
$4,533.00 |
$4,533.00 |
$4,533.00 |
$2,030.33
|
|
Treat fracture of ulna
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$766.72
|
|
Treat hip dislocation
|
$4,122.00 |
$4,122.00 |
$4,122.00 |
$2,561.90
|
|
Treat humerus fracture
|
$3,354.00 |
$3,354.00 |
$3,354.00 |
$1,950.60
|
|
Treat humerus fracture
|
$2,938.00 |
$2,938.00 |
$2,938.00 |
$2,045.35
|
|
Treat knee fracture 27530
|
$494.00 |
$494.00 |
$494.00 |
$580.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$592.00 |
$592.00 |
$592.00 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$592.00 |
$592.00 |
$592.00 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$210.00
|
|
Treatment of ankle fracture 27786
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$580.00
|
|
Treatment of fibula fracture 27780
|
$494.00 |
$494.00 |
$494.00 |
$558.75
|
|
Treatment of heel fracture 28400
|
$494.00 |
$494.00 |
$494.00 |
$494.00
|
|
Treatment of thigh fracture
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$467.25
|
|
Treatment of thigh fracture
|
$425.00 |
$425.00 |
$425.00 |
$659.00
|
|
Treatment of thigh fracture
|
$3,354.00 |
$3,354.00 |
$3,354.00 |
$2,055.00
|
|
Treatment of toe fracture 28510
|
$1,073.00 |
$1,073.00 |
$1,073.00 |
$371.40
|
|
Treatment radiation delivery level 2
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$735.00
|
|
Treat ulnar fracture
|
$2,938.00 |
$2,938.00 |
$2,938.00 |
$1,861.60
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$9,282.00 |
$9,282.00 |
$9,282.00 |
$101,032.80
|
|
Treponema pallidum antibody
|
$228.00 |
$228.00 |
$228.00 |
$72.80
|
|
Treprostinil injection
|
$352.57 |
$352.57 |
$352.57 |
$841.84
|
|
Treprostinil, non-comp unit
|
$936.78 |
$936.78 |
$936.78 |
$2,160.47
|
|
Trg gene rearrangement anal
|
$630.00 |
$630.00 |
$630.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$13.08 |
$13.08 |
$13.08 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$3,089.24 |
$3,089.24 |
$3,089.24 |
$1,309.80
|
|
Triamcinolone hexacetonl inj
|
$244.97 |
$244.97 |
$244.97 |
$122.74
|
|
Trichinella antibody
|
$130.00 |
$130.00 |
$130.00 |
$70.65
|
|
#tricyclicantidprssnt
|
$150.00 |
$150.00 |
$150.00 |
$57.08
|
|
Triglycerides
|
$38.00 |
$38.00 |
$38.00 |
$54.60
|
|
Trilaciclib 300 mg intravenous solution
|
$5,474.00 |
$5,474.00 |
$5,474.00 |
$5.39
|
|
Trimethobenzamide hcl inj
|
$79.28 |
$79.28 |
$79.28 |
$128.00
|
|
Trim nondyst nails
|
$334.00 |
$334.00 |
$334.00 |
$124.22
|
|
Triptorelin pamoate
|
$14,726.25 |
$14,726.25 |
$14,726.25 |
$4,619.39
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,816.00 |
$2,816.00 |
$2,816.00 |
$2,986.34
|
|
Troponin quantitative
|
$393.00 |
$393.00 |
$393.00 |
$123.75
|
|
Tx closed hip disl traumatic without anes
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$10,786.00 |
$10,786.00 |
$10,786.00 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$635.46
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$10,323.00 |
$10,323.00 |
$10,323.00 |
$4,281.00
|
|
Tx tarsal bone fx without manip 28450
|
$494.00 |
$494.00 |
$494.00 |
$469.20
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$6,108.96 |
$6,108.96 |
$6,108.96 |
$17,191.88
|
|
Ugt1a1 gene analy common variants
|
$298.00 |
$298.00 |
$298.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$667.00 |
$667.00 |
$667.00 |
$403.26
|
|
Ultrasound breast complete
|
$878.00 |
$878.00 |
$878.00 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$585.00 |
$585.00 |
$585.00 |
$449.35
|
|
Ultrasound chest
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$771.00 |
$771.00 |
$771.00 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$906.00 |
$906.00 |
$906.00 |
$330.40
|
|
Ultrasound encephalogram
|
$868.00 |
$868.00 |
$868.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,894.00 |
$1,894.00 |
$1,894.00 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$857.00 |
$857.00 |
$857.00 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$2,225.00 |
$2,225.00 |
$2,225.00 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,894.00 |
$1,894.00 |
$1,894.00 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$868.00 |
$868.00 |
$868.00 |
$403.00
|
|
Ultrasound joint complete left
|
$1,181.00 |
$1,181.00 |
$1,181.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$576.00 |
$576.00 |
$576.00 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$680.00 |
$680.00 |
$680.00 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$438.00 |
$438.00 |
$438.00 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,721.00 |
$1,721.00 |
$1,721.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$866.00 |
$866.00 |
$866.00 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$857.00 |
$857.00 |
$857.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$868.00 |
$868.00 |
$868.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,352.00 |
$1,352.00 |
$1,352.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,460.00 |
$1,460.00 |
$1,460.00 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$896.00 |
$896.00 |
$896.00 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$569.00 |
$569.00 |
$569.00 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,427.00 |
$1,427.00 |
$1,427.00 |
$567.44
|
|
Unsched dialysis esrd pt hos
|
$3,903.00 |
$3,903.00 |
$3,903.00 |
$1,469.76
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,500.00 |
$5,500.00 |
$5,500.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$7,324.00 |
$7,324.00 |
$7,324.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,476.00 |
$3,476.00 |
$3,476.00 |
$2,013.08
|
|
Urea nitrogen
|
$38.00 |
$38.00 |
$38.00 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$75.00 |
$75.00 |
$75.00 |
$50.00
|
|
Urea nitrogen clearance
|
$384.00 |
$384.00 |
$384.00 |
$33.57
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,723.00 |
$1,723.00 |
$1,723.00 |
$574.40
|
|
Urethrocystography void s&i
|
$2,532.00 |
$2,532.00 |
$2,532.00 |
$634.50
|
|
Uric acid blood
|
$38.00 |
$38.00 |
$38.00 |
$46.64
|
|
Uric acid urine
|
$38.00 |
$38.00 |
$38.00 |
$46.75
|
|
Urinalysis microscopic only
|
$150.00 |
$150.00 |
$150.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$107.00 |
$107.00 |
$107.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$75.00 |
$75.00 |
$75.00 |
$48.14
|
|
Urinalysis (without microscopy)
|
$90.00 |
$90.00 |
$90.00 |
$38.99
|
|
Urine Culture Test
|
$51.00 |
$51.00 |
$51.00 |
$84.81
|
|
Urine pregnancy test
|
$86.00 |
$86.00 |
$86.00 |
$66.40
|
|
Urography, antegrade
|
$1,685.00 |
$1,685.00 |
$1,685.00 |
$593.37
|
|
Urography inf drip &/or bolus
|
$1,429.00 |
$1,429.00 |
$1,429.00 |
$641.69
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$272.39 |
$272.39 |
$272.39 |
$5,521.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$97,450.01 |
$97,450.01 |
$97,450.01 |
$56,553.85
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$658.00 |
$658.00 |
$658.00 |
$223.08
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$1,204.98 |
$1,204.98 |
$1,204.98 |
$218.88
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$1,212.52 |
$1,212.52 |
$1,212.52 |
$239.85
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$808.50 |
$808.50 |
$808.50 |
$131.67
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$1,811.25 |
$1,811.25 |
$1,811.25 |
$91.00
|
|
Vaccine dtap < 7 years im
|
$199.71 |
$199.71 |
$199.71 |
$87.80
|
