|
Tx closed distal humerus fx
|
$357.50 |
$357.50 |
$357.50 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$151.00 |
$151.00 |
$151.00 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$387.50 |
$387.50 |
$387.50 |
$535.60
|
|
Tx contour defects >10.0 cc
|
$553.50 |
$553.50 |
$553.50 |
$944.00
|
|
Tx l/r atrial fib addl
|
$7,328.50 |
$7,328.50 |
$7,328.50 |
$6,769.00
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$2,874.00 |
$2,874.00 |
$2,874.00 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$2,533.00 |
$2,533.00 |
$2,533.00 |
$4,468.55
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,994.00 |
$2,994.00 |
$2,994.00 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$228.50 |
$228.50 |
$228.50 |
$416.16
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$618.50 |
$618.50 |
$618.50 |
$911.43
|
|
Ua w/micro/comp poc
|
$11.00 |
$11.00 |
$11.00 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$744.00 |
$744.00 |
$744.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$649.50 |
$649.50 |
$649.50 |
$394.20
|
|
Ultrasound breast complete
|
$634.00 |
$634.00 |
$634.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$686.50 |
$686.50 |
$686.50 |
$449.35
|
|
Ultrasound chest
|
$579.00 |
$579.00 |
$579.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$389.50 |
$389.50 |
$389.50 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$322.00 |
$322.00 |
$322.00 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$336.50 |
$336.50 |
$336.50 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$336.50 |
$336.50 |
$336.50 |
$307.00
|
|
Ultrasound encephalogram
|
$782.50 |
$782.50 |
$782.50 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$604.00 |
$604.00 |
$604.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$356.00 |
$356.00 |
$356.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$612.50 |
$612.50 |
$612.50 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$751.50 |
$751.50 |
$751.50 |
$720.15
|
|
Ultrasound guide intraoperative
|
$185.00 |
$185.00 |
$185.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$567.50 |
$567.50 |
$567.50 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$273.00 |
$273.00 |
$273.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$165.50 |
$165.50 |
$165.50 |
$311.25
|
|
Ultrasound joint complete left
|
$736.50 |
$736.50 |
$736.50 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$323.50 |
$323.50 |
$323.50 |
$425.45
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$404.00 |
$404.00 |
$404.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,253.00 |
$1,253.00 |
$1,253.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$410.00 |
$410.00 |
$410.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$693.00 |
$693.00 |
$693.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$241.00 |
$241.00 |
$241.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$416.50 |
$416.50 |
$416.50 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$442.00 |
$442.00 |
$442.00 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$621.50 |
$621.50 |
$621.50 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$533.00 |
$533.00 |
$533.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$665.50 |
$665.50 |
$665.50 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$553.50 |
$553.50 |
$553.50 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$384.00 |
$384.00 |
$384.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$548.00 |
$548.00 |
$548.00 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$687.50 |
$687.50 |
$687.50 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$436.00 |
$436.00 |
$436.00 |
$348.00
|
|
Unlisted chemotherapy px
|
$378.50 |
$378.50 |
$378.50 |
$150.00
|
|
Unlisted dialysis procedure
|
$385.00 |
$385.00 |
$385.00 |
$1,144.00
|
|
Unlisted dx gi procedure
|
$241.00 |
$241.00 |
$241.00 |
$649.22
|
|
Unlisted mr procedure
|
$1,331.50 |
$1,331.50 |
$1,331.50 |
$1,163.00
|
|
Unlisted muscskel px head
|
$2,538.50 |
$2,538.50 |
$2,538.50 |
$478.46
|
|
Unlisted procedure colon
|
$1,331.00 |
$1,331.00 |
$1,331.00 |
$1,702.50
|
|
Unlisted procedure microbiology
|
$2,820.50 |
$2,820.50 |
$2,820.50 |
$523.50
|
|
Unlisted procedure orbit
|
$384.50 |
$384.50 |
$384.50 |
$436.44
|
|
Unlisted procedure rectum
|
$1,249.00 |
$1,249.00 |
$1,249.00 |
$1,220.35
|
|
Unlisted procedure spine
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
$4,659.85
|
|
Unlisted px abdomen muscskel
|
$375.00 |
$375.00 |
$375.00 |
$1,848.60
|
|
Unlisted px ant segment eye
|
$2,870.00 |
$2,870.00 |
$2,870.00 |
$2,698.92
|
|
Unlisted px biliary tract
|
$2,039.00 |
$2,039.00 |
$2,039.00 |
$2,718.10
|
|
Unlisted px external ear
|
$268.00 |
$268.00 |
$268.00 |
$325.68
|
|
Unlisted px foot/toes
|
$1,069.50 |
$1,069.50 |
$1,069.50 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$345.50 |
$345.50 |
$345.50 |
$593.60
|
|
Unlisted px hands/fingers
|
$180.00 |
$180.00 |
$180.00 |
$354.20
|
|
Unlisted px leg/ankle
|
$399.50 |
$399.50 |
$399.50 |
$811.00
|
|
Unlisted px male genital sys
|
$220.00 |
$220.00 |
$220.00 |
$343.55
|
|
Unlisted px middle ear
|
$326.00 |
$326.00 |
$326.00 |
$343.50
|
|
Unlisted px neck/thorax
|
$322.00 |
$322.00 |
$322.00 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$383.00 |
$383.00 |
$383.00 |
$3,118.44
|
|
Unlisted px salivry glnd/dux
|
$2,465.00 |
$2,465.00 |
$2,465.00 |
$1,265.16
|
|
Unlisted px small intestine
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$2,102.10
|
|
Unlisted px tongue flr mouth
|
$268.00 |
$268.00 |
$268.00 |
$282.50
|
|
Unlisted surgical path px
|
$53.90 |
$53.90 |
$53.90 |
$217.75
|
|
Unlisted ultrasound procedure
|
$121.00 |
$121.00 |
$121.00 |
$321.20
|
|
Unlisted urinalysis px
|
$7.50 |
$7.50 |
$7.50 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$935.00 |
$935.00 |
$935.00 |
$1,268.17
|
|
Upgrade pm system
|
$14,965.50 |
$14,965.50 |
$14,965.50 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,861.50 |
$1,861.50 |
$1,861.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,778.50 |
$1,778.50 |
$1,778.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,410.50 |
$1,410.50 |
$1,410.50 |
$2,034.41
|
|
Upper ext fx orthosis rad/ul
|
$232.88 |
$232.88 |
$232.88 |
$619.49
|
|
Urea nitrogen
|
$54.00 |
$54.00 |
$54.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$27.00 |
$27.00 |
$27.00 |
$51.75
|
|
Urea nitrogen clearance
|
$66.00 |
$66.00 |
$66.00 |
$42.25
|
|
Ureteral embolization/occl
|
$1,436.50 |
$1,436.50 |
$1,436.50 |
$2,181.40
|
|
Ureteral reflux study
|
$914.00 |
$914.00 |
$914.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$371.00 |
$371.00 |
$371.00 |
$579.73
|
|
Urethrocystography void s&i
|
$448.00 |
$448.00 |
$448.00 |
$622.35
|
|
Uric acid blood
|
$53.50 |
$53.50 |
$53.50 |
$48.75
|
|
Uric acid urine
|
$30.50 |
$30.50 |
$30.50 |
$44.33
|
|
Urinalysis microscopic only
|
$24.00 |
$24.00 |
$24.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$89.50 |
$89.50 |
$89.50 |
$55.00
|
|
Urinalysis (without microscopy)
|
$52.00 |
$52.00 |
$52.00 |
$35.75
|
|
Urinary pouch w/barrier
|
$5.70 |
$5.70 |
$5.70 |
$5.70
|
|
Urine Culture Test
|
$95.00 |
$95.00 |
$95.00 |
$81.50
|
|
Urine pregnancy test
|
$157.00 |
$157.00 |
$157.00 |
$67.20
|
|
Urography, antegrade
|
$464.50 |
$464.50 |
$464.50 |
$622.35
|
|
Use 1st target lesion
|
$336.50 |
$336.50 |
$336.50 |
$332.00
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$72.96 |
$72.96 |
$72.96 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$72.96 |
$72.96 |
$72.96 |
$209.40
|
