|
Trnscath plc stnt ante carotid art
|
$11,305.55 |
$11,305.55 |
$11,305.55 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$9,834.60 |
$9,834.60 |
$9,834.60 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$9,834.60 |
$9,834.60 |
$9,834.60 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$19,822.53 |
$19,822.53 |
$19,822.53 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,985.25 |
$1,985.25 |
$1,985.25 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,246.80 |
$5,246.80 |
$5,246.80 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$3,409.80 |
$3,409.80 |
$3,409.80 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$3,409.80 |
$3,409.80 |
$3,409.80 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$5,246.80 |
$5,246.80 |
$5,246.80 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$6,288.35 |
$6,288.35 |
$6,288.35 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$4,054.15 |
$4,054.15 |
$4,054.15 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$4,195.18 |
$4,195.18 |
$4,195.18 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,355.65 |
$2,355.65 |
$2,355.65 |
$2,527.20
|
|
Troponin quantitative
|
$204.18 |
$204.18 |
$204.18 |
$127.20
|
|
Tte w or without fol w/con,stres
|
$1,031.28 |
$1,031.28 |
$1,031.28 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$881.70 |
$881.70 |
$881.70 |
$1,254.50
|
|
Tte w or without fol w/cont, f/u
|
$418.90 |
$418.90 |
$418.90 |
$1,178.00
|
|
Tube trach disp innr can 5 xlt
|
$711.20 |
$711.20 |
$711.20 |
$445.99
|
|
Tube trach fen sz 6 uncuffed
|
$108.50 |
$108.50 |
$108.50 |
$155.98
|
|
Tumor cell deplete of harvst
|
$17,064.23 |
$17,064.23 |
$17,064.23 |
$1,315.60
|
|
Tx atrial fib pulm vein isol
|
$60,522.10 |
$60,522.10 |
$60,522.10 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$650.45 |
$650.45 |
$650.45 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$6,617.23 |
$6,617.23 |
$6,617.23 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$885.15 |
$885.15 |
$885.15 |
$535.60
|
|
Tx l/r atrial fib addl
|
$19,184.90 |
$19,184.90 |
$19,184.90 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$4,239.75 |
$4,239.75 |
$4,239.75 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$4,468.55 |
$4,468.55 |
$4,468.55 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$3,604.65 |
$3,604.65 |
$3,604.65 |
$4,529.60
|
|
Tx tarsal bone fx without manip 28450
|
$394.45 |
$394.45 |
$394.45 |
$419.73
|
|
Tympanometry & reflex thresh
|
$112.63 |
$112.63 |
$112.63 |
$173.18
|
|
Typhoid vaccine oral
|
$215.25 |
$215.25 |
$215.25 |
$63.28
|
|
Ua w/micro/comp poc
|
$40.35 |
$40.35 |
$40.35 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$22,232.53 |
$22,232.53 |
$22,232.53 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$254.35 |
$254.35 |
$254.35 |
$438.75
|
|
Ultrasound breast complete
|
$519.75 |
$519.75 |
$519.75 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$346.53 |
$346.53 |
$346.53 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$262.80 |
$262.80 |
$262.80 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$335.68 |
$335.68 |
$335.68 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$275.98 |
$275.98 |
$275.98 |
$313.95
|
|
Ultrasound encephalogram
|
$388.98 |
$388.98 |
$388.98 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$487.73 |
$487.73 |
$487.73 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$335.50 |
$335.50 |
$335.50 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$519.53 |
$519.53 |
$519.53 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$505.00 |
$505.00 |
$505.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$625.15 |
$625.15 |
$625.15 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$378.10 |
$378.10 |
$378.10 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$364.15 |
$364.15 |
$364.15 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$364.15 |
$364.15 |
$364.15 |
$311.25
|
|
Ultrasound joint complete left
|
$503.35 |
$503.35 |
$503.35 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$241.55 |
$241.55 |
$241.55 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$196.53 |
$196.53 |
$196.53 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$553.05 |
$553.05 |
$553.05 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$299.28 |
$299.28 |
$299.28 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$475.98 |
$475.98 |
$475.98 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$406.38 |
$406.38 |
$406.38 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$304.85 |
$304.85 |
$304.85 |
$421.00
|
|
Ultraviolet therapy
|
$95.10 |
$95.10 |
$95.10 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$115.10 |
$115.10 |
$115.10 |
$223.80
|
|
Unlistd noninvas vasc dx std
|
$564.60 |
$564.60 |
$564.60 |
$564.60
|
|
Unlisted CT procedure
|
$1,268.98 |
$1,268.98 |
$1,268.98 |
$732.70
|
|
Unlisted dialysis procedure
|
$766.68 |
$766.68 |
$766.68 |
$1,144.00
|
|
Unlisted fetal invas px w/us
|
$647.18 |
$647.18 |
$647.18 |
$498.40
|
|
Unlisted fluoroscopic px
|
$324.85 |
$324.85 |
$324.85 |
$305.76
|
|
Unlisted hematology&coagj px
|
$477.50 |
$477.50 |
$477.50 |
$39.52
|
|
Unlisted mr procedure
|
$907.23 |
$907.23 |
$907.23 |
$1,163.00
|
|
Unlisted orl service/px
|
$292.80 |
$292.80 |
$292.80 |
$132.60
|
|
Unlisted procedure microbiology
|
$650.13 |
$650.13 |
$650.13 |
$530.00
|
|
Unlisted px biliary tract
|
$568.23 |
$568.23 |
$568.23 |
$3,055.00
|
|
Unlisted px male genital sys
|
$897.95 |
$897.95 |
$897.95 |
$387.84
|
|
Unlisted px med radj physics
|
$462.35 |
$462.35 |
$462.35 |
$462.35
|
|
Unlisted px small intestine
|
$1,008.13 |
$1,008.13 |
$1,008.13 |
$2,118.35
|
|
Unlisted ultrasound procedure
|
$426.63 |
$426.63 |
$426.63 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$1,000.93 |
$1,000.93 |
$1,000.93 |
$1,296.00
|
|
Upgrade pm system
|
$8,460.55 |
$8,460.55 |
$8,460.55 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$231.50 |
$231.50 |
$231.50 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,550.20 |
$1,550.20 |
$1,550.20 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,425.85 |
$1,425.85 |
$1,425.85 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,656.05 |
$2,656.05 |
$2,656.05 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,413.48 |
$2,413.48 |
$2,413.48 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,013.08 |
$2,013.08 |
$2,013.08 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$269.53 |
$269.53 |
$269.53 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$331.63 |
$331.63 |
$331.63 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$527.35 |
$527.35 |
$527.35 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$497.93 |
$497.93 |
$497.93 |
$607.20
|
|
Urea nitrogen
|
$46.23 |
$46.23 |
$46.23 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$57.10 |
$57.10 |
$57.10 |
$51.84
|
|
Urea nitrogen clearance
|
$49.43 |
$49.43 |
$49.43 |
$34.02
|
|
Urethrcystgrphy rtrgrde s&i
|
$554.28 |
$554.28 |
$554.28 |
$584.00
|
|
Urethrocystography void s&i
|
$586.50 |
$586.50 |
$586.50 |
$634.50
|
|
Uric acid blood
|
$60.85 |
$60.85 |
$60.85 |
$49.32
|
|
Uric acid urine
|
$52.75 |
$52.75 |
$52.75 |
$44.52
|
|
Urinalysis microscopic only
|
$53.83 |
$53.83 |
$53.83 |
$26.35
|
|
Urinalysis (with microscopy)
|
$40.35 |
$40.35 |
$40.35 |
$55.20
|
|
Urinalysis (without microscopy)
|
$52.38 |
$52.38 |
$52.38 |
$35.91
|
|
Urine Culture Test
|
$119.23 |
$119.23 |
$119.23 |
$82.32
|
|
Urine flow measurement 51736
|
$223.48 |
$223.48 |
$223.48 |
$210.00
|
|
Urine pregnancy test
|
$71.60 |
$71.60 |
$71.60 |
$68.21
|
|
Urography, antegrade
|
$557.50 |
$557.50 |
$557.50 |
$622.35
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$4,249.73 |
$4,249.73 |
$4,249.73 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$56,553.85 |
$56,553.85 |
$56,553.85 |
$51,633.07
|
