|
Treat wrist dislocation
|
$520.80 |
$520.80 |
$520.80 |
$656.25
|
|
Treponema pallidum antibody
|
$76.20 |
$76.20 |
$76.20 |
$70.20
|
|
Trg gene rearrangement anal
|
$522.00 |
$522.00 |
$522.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.94 |
$44.94 |
$44.94 |
$43.09
|
|
Trichinella antibody
|
$106.20 |
$106.20 |
$106.20 |
$70.65
|
|
Trichomonas assay w/optic
|
$63.00 |
$63.00 |
$63.00 |
$55.50
|
|
Triglycerides
|
$60.60 |
$60.60 |
$60.60 |
$56.96
|
|
Trmt of fracture (femoral shaft) 27500
|
$520.80 |
$520.80 |
$520.80 |
$754.80
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$21,454.80 |
$21,454.80 |
$21,454.80 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$19,350.60 |
$19,350.60 |
$19,350.60 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$19,448.40 |
$19,448.40 |
$19,448.40 |
$14,819.58
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,766.40 |
$4,766.40 |
$4,766.40 |
$4,735.50
|
|
Troponin quantitative
|
$91.20 |
$91.20 |
$91.20 |
$125.40
|
|
Tube trach disp innr can 5 xlt
|
$445.99 |
$445.99 |
$445.99 |
$445.99
|
|
Tx closed distal humerus fx
|
$361.80 |
$361.80 |
$361.80 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$586.80 |
$586.80 |
$586.80 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$6,061.80 |
$6,061.80 |
$6,061.80 |
$3,958.62
|
|
Tx closed tib shaft fx without manip
|
$520.80 |
$520.80 |
$520.80 |
$535.60
|
|
Ua w/micro/comp poc
|
$8.40 |
$8.40 |
$8.40 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$160.20 |
$160.20 |
$160.20 |
$394.20
|
|
Ultrasound breast complete
|
$232.20 |
$232.20 |
$232.20 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$519.00 |
$519.00 |
$519.00 |
$452.40
|
|
Ultrasound chest
|
$609.60 |
$609.60 |
$609.60 |
$459.55
|
|
Ultrasound dx ophth b-scan
|
$193.80 |
$193.80 |
$193.80 |
$300.00
|
|
Ultrasound elastography ea l target les
|
$213.00 |
$213.00 |
$213.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$213.00 |
$213.00 |
$213.00 |
$302.25
|
|
Ultrasound encephalogram
|
$379.20 |
$379.20 |
$379.20 |
$491.37
|
|
Ultrasound exam k transpl w/doppler
|
$981.00 |
$981.00 |
$981.00 |
$584.35
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$376.20 |
$376.20 |
$376.20 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$241.80 |
$241.80 |
$241.80 |
$384.45
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,441.80 |
$1,441.80 |
$1,441.80 |
$720.00
|
|
Ultrasound guide intraoperative
|
$796.80 |
$796.80 |
$796.80 |
$625.15
|
|
Ultrasound guide tissue ablation
|
$645.60 |
$645.60 |
$645.60 |
$560.00
|
|
Ultrasound joint complete left
|
$627.60 |
$627.60 |
$627.60 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$655.20 |
$655.20 |
$655.20 |
$420.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$348.00 |
$348.00 |
$348.00 |
$393.65
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$696.00 |
$696.00 |
$696.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$850.20 |
$850.20 |
$850.20 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$267.00 |
$267.00 |
$267.00 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$735.60 |
$735.60 |
$735.60 |
$451.00
|
|
Ultrasound pregnant uterus transvaginal
|
$730.80 |
$730.80 |
$730.80 |
$488.95
|
|
Ultrasound prostate/transrectal
|
$254.40 |
$254.40 |
$254.40 |
$548.64
|
|
Ultrasound retroperitoneal limited
|
$709.80 |
$709.80 |
$709.80 |
$477.10
|
|
Ultrasound scrotum and contents
|
$702.00 |
$702.00 |
$702.00 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$838.20 |
$838.20 |
$838.20 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$490.80 |
$490.80 |
$490.80 |
$423.36
|
|
Ultrasound transvaginal non obstetric
|
$804.60 |
$804.60 |
$804.60 |
$558.35
|
|
Unlisted laparoscopic liver biopy 47379
|
$20,729.56 |
$20,729.56 |
$20,729.56 |
$5,323.76
|
|
Unlisted laps px ovidct ovry
|
$22,474.48 |
$22,474.48 |
$22,474.48 |
$6,904.15
|
|
Unlisted procedure microbiology
|
$2,994.00 |
$2,994.00 |
$2,994.00 |
$487.50
|
|
Unlisted px arthroscopy
|
$20,888.94 |
$20,888.94 |
$20,888.94 |
$2,765.60
|
|
Unlisted px hands/fingers
|
$378.00 |
$378.00 |
$378.00 |
$378.00
|
|
Unlisted px male genital sys
|
$19,416.24 |
$19,416.24 |
$19,416.24 |
$374.40
|
|
Unlisted transfusion med px
|
$193.20 |
$193.20 |
$193.20 |
$147.50
|
|
Unlisted ultrasound procedure
|
$299.40 |
$299.40 |
$299.40 |
$332.16
|
|
Upper Endoscopy (EGD, diagnostic)
|
$6,510.00 |
$6,510.00 |
$6,510.00 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$8,686.72 |
$8,686.72 |
$8,686.72 |
$1,760.00
|
|
Urea nitrogen
|
$87.60 |
$87.60 |
$87.60 |
$40.87
|
|
Urea nitrogen 24 hour urine
|
$32.40 |
$32.40 |
$32.40 |
$52.00
|
|
Urea nitrogen clearance
|
$16.20 |
$16.20 |
$16.20 |
$45.12
|
|
Ureteral embolization/occl
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$2,546.42
|
|
Urethrcystgrphy rtrgrde s&i
|
$408.60 |
$408.60 |
$408.60 |
$584.00
|
|
Urethrocystography void s&i
|
$436.20 |
$436.20 |
$436.20 |
$637.80
|
|
Uric acid blood
|
$53.40 |
$53.40 |
$53.40 |
$49.32
|
|
Uric acid urine
|
$57.00 |
$57.00 |
$57.00 |
$44.22
|
|
Urinalysis microscopic only
|
$14.40 |
$14.40 |
$14.40 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$10.20 |
$10.20 |
$10.20 |
$25.72
|
|
Urinalysis (with microscopy)
|
$27.00 |
$27.00 |
$27.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$31.80 |
$31.80 |
$31.80 |
$36.00
|
|
Urine Culture Test
|
$89.40 |
$89.40 |
$89.40 |
$81.00
|
|
Urine pregnancy test
|
$51.60 |
$51.60 |
$51.60 |
$67.20
|
|
Urography, antegrade
|
$378.00 |
$378.00 |
$378.00 |
$622.35
|
|
Use 1st target lesion
|
$213.00 |
$213.00 |
$213.00 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$18,313.80 |
$18,313.80 |
$18,313.80 |
$5,084.76
|
|
Vaccine dtap < 7 years im
|
$62.88 |
$62.88 |
$62.88 |
$70.99
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$66.90 |
$66.90 |
$66.90 |
$71.62
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$153.42 |
$153.42 |
$153.42 |
$84.75
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.06 |
$0.06 |
$0.06 |
$72.72
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$124.14 |
$124.14 |
$124.14 |
$76.50
|
|
Vaccine mmr live subcutaneous
|
$208.14 |
$208.14 |
$208.14 |
$213.00
|
|
Vaccine rabies im
|
$958.32 |
$958.32 |
$958.32 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$104.52 |
$104.52 |
$104.52 |
$132.88
|
|
Vaccine td preservative free >= 7 years im
|
$89.76 |
$89.76 |
$89.76 |
$112.10
|
|
Vad univ batt charger hm 1440
|
$16,007.74 |
$16,007.74 |
$16,007.74 |
$14,827.28
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$30.24 |
$30.24 |
$30.24 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$78.00 |
$78.00 |
$78.00 |
$114.48
|
|
Vancomycin 1,000 mg intravenous injection
|
$958.80 |
$958.80 |
$958.80 |
$246.70
|
|
Vancomycin 750 mg intravenous solution
|
$108.84 |
$108.84 |
$108.84 |
$90.33
|
|
Vancomycin hcl injection
|
$164.70 |
$164.70 |
$164.70 |
$154.40
|
|
Vancomycin peak therapeutic drug level
|
$94.80 |
$94.80 |
$94.80 |
$132.00
|
|
Varicella zoster antibody igg
|
$32.40 |
$32.40 |
$32.40 |
$86.80
|
|
Varus/valgus strap padded/li
|
$113.86 |
$113.86 |
$113.86 |
$115.53
|
|
Vasopressin 20 unit/ml intravenous solution
|
$22.56 |
$22.56 |
$22.56 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$40,434.84 |
$40,434.84 |
$40,434.84 |
$18,719.82
|
|
Vein x-ray kidney
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$2,975.28
|
|
Vein x-ray skull
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$2,301.09
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
$197.04
|
|
Venogram ext bil s&i
|
$1,503.60 |
$1,503.60 |
$1,503.60 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$2,404.80 |
$2,404.80 |
$2,404.80 |
$1,382.58
|
|
Venous mech thrombectomy
|
$17,833.20 |
$17,833.20 |
$17,833.20 |
$8,184.00
|
