|
Triglycerides
|
$60.60 |
$60.60 |
$60.60 |
$58.05
|
|
Trim nondyst nails
|
$266.40 |
$266.40 |
$266.40 |
$113.40
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$36,855.19 |
$36,855.19 |
$36,855.19 |
$15,226.08
|
|
Trnscath plc stent crv crtd without prtct
|
$12,131.40 |
$12,131.40 |
$12,131.40 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$27,679.80 |
$27,679.80 |
$27,679.80 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$23,861.40 |
$23,861.40 |
$23,861.40 |
$6,069.00
|
|
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 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$19,448.40 |
$19,448.40 |
$19,448.40 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,766.40 |
$4,766.40 |
$4,766.40 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$13,874.40 |
$13,874.40 |
$13,874.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$8,968.80 |
$8,968.80 |
$8,968.80 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$8,968.80 |
$8,968.80 |
$8,968.80 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$13,874.40 |
$13,874.40 |
$13,874.40 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$32,828.92 |
$41,594.69 |
$46,329.65 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$32,828.92 |
$41,594.69 |
$46,329.65 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$10,822.08 |
$26,731.74 |
$28,807.68 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$28,785.46 |
$28,785.46 |
$113,436.77 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$21,658.12 |
$21,658.12 |
$24,125.65 |
$2,406.77
|
|
Troponin quantitative
|
$91.20 |
$91.20 |
$91.20 |
$127.20
|
|
Tube trach disp innr can 5 xlt
|
$445.99 |
$445.99 |
$445.99 |
$445.99
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$20,374.43 |
$20,374.43 |
$20,374.43 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$13,935.12 |
$13,935.12 |
$13,935.12 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$20,374.43 |
$20,374.43 |
$20,374.43 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$21,309.31 |
$25,703.16 |
$29,560.36 |
$4,499.12
|
|
Ua w/micro/comp poc
|
$8.40 |
$8.40 |
$8.40 |
$23.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$160.20 |
$160.20 |
$168.00 |
$394.20
|
|
Ultrasound bone density measure
|
$345.00 |
$345.00 |
$345.00 |
$143.75
|
|
Ultrasound breast complete
|
$232.20 |
$641.40 |
$641.40 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$519.00 |
$544.80 |
$544.80 |
$449.35
|
|
Ultrasound chest
|
$609.60 |
$609.60 |
$609.60 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$483.60 |
$483.60 |
$507.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$193.80 |
$193.80 |
$193.80 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$223.80 |
$223.80 |
$223.80 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$223.80 |
$223.80 |
$223.80 |
$307.00
|
|
Ultrasound encephalogram
|
$637.80 |
$637.80 |
$637.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$981.00 |
$1,030.20 |
$1,030.20 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$790.20 |
$790.20 |
$790.20 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$241.80 |
$241.80 |
$241.80 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,441.80 |
$1,441.80 |
$1,441.80 |
$720.15
|
|
Ultrasound guide intraoperative
|
$796.80 |
$836.40 |
$836.40 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$645.60 |
$678.00 |
$678.00 |
$560.00
|
|
Ultrasound joint complete left
|
$627.60 |
$658.80 |
$658.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$655.20 |
$655.20 |
$655.20 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$696.00 |
$696.00 |
$730.80 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$696.00 |
$696.00 |
$730.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$850.20 |
$850.20 |
$892.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$533.40 |
$533.40 |
$559.80 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$735.60 |
$735.60 |
$735.60 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$730.80 |
$730.80 |
$730.80 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$508.20 |
$508.20 |
$533.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$745.20 |
$745.20 |
$745.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$702.00 |
$702.00 |
$702.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$880.20 |
$880.20 |
$880.20 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$490.80 |
$490.80 |
$515.40 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$804.60 |
$804.60 |
$804.60 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$141.00 |
$141.00 |
$141.00 |
$206.64
|
|
Umbilicoplasty 15847
|
$32,117.35 |
$32,117.35 |
$32,117.35 |
$4,172.97
|
|
Unlisted CT procedure
|
$241.80 |
$241.80 |
$241.80 |
$732.70
|
|
Unlisted dx gi procedure
|
$14,041.56 |
$14,041.56 |
$14,041.56 |
$649.22
|
|
Unlisted hystsc px uterus
|
$25,788.34 |
$25,788.34 |
$25,788.34 |
$2,803.60
|
|
Unlisted laparoscopic liver biopy 47379
|
$35,018.35 |
$35,018.35 |
$43,717.64 |
$5,419.00
|
|
Unlisted laps px ovidct ovry
|
$15,958.86 |
$15,958.86 |
$15,958.86 |
$6,904.15
|
|
Unlisted muscskel px head
|
$85,851.95 |
$85,851.95 |
$85,851.95 |
$478.46
|
|
Unlisted procedure colon
|
$1,702.20 |
$1,702.20 |
$1,702.20 |
$1,702.50
|
|
Unlisted procedure liver
|
$5,652.60 |
$5,652.60 |
$5,652.60 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,994.00 |
$2,994.00 |
$2,994.00 |
$523.50
|
|
Unlisted px arthroscopy
|
$49,845.95 |
$49,845.95 |
$52,305.86 |
$2,765.60
|
|
Unlisted px foot/toes
|
$18,265.41 |
$23,702.29 |
$40,636.29 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$14,296.87 |
$14,296.87 |
$14,296.87 |
$593.60
|
|
Unlisted px hands/fingers
|
$11,966.82 |
$11,966.82 |
$14,578.02 |
$354.20
|
|
Unlisted px leg/ankle
|
$10,699.02 |
$10,699.02 |
$15,678.24 |
$811.00
|
|
Unlisted px med radj physics
|
$206.40 |
$206.40 |
$206.40 |
$462.35
|
|
Unlisted px palate uvula
|
$76,850.45 |
$76,850.45 |
$76,850.45 |
$274.80
|
|
Unlisted px pelvis/hip joint
|
$47,669.22 |
$47,669.22 |
$47,669.22 |
$3,118.44
|
|
Unlisted px small intestine
|
$8,497.86 |
$8,497.86 |
$8,497.86 |
$2,102.10
|
|
Unlisted transfusion med px
|
$193.20 |
$193.20 |
$193.20 |
$147.50
|
|
Unlisted ultrasound procedure
|
$299.40 |
$299.40 |
$299.40 |
$321.20
|
|
Upper Endoscopy (EGD, diagnostic)
|
$5,876.96 |
$8,209.80 |
$12,417.26 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$6,237.08 |
$7,937.09 |
$14,761.24 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$9,951.36 |
$13,380.42 |
$14,897.15 |
$1,872.00
|
|
Urea nitrogen
|
$87.60 |
$87.60 |
$87.60 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$32.40 |
$32.40 |
$32.40 |
$51.75
|
|
Urea nitrogen clearance
|
$16.20 |
$16.20 |
$16.20 |
$42.25
|
|
Ureteral embolization/occl
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$2,181.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$408.60 |
$612.60 |
$612.60 |
$579.73
|
|
Urethrocystography void s&i
|
$436.20 |
$746.40 |
$746.40 |
$622.35
|
|
Uric acid blood
|
$53.40 |
$53.40 |
$53.40 |
$48.75
|
|
Uric acid urine
|
$57.00 |
$57.00 |
$57.00 |
$44.33
|
|
Urinalysis microscopic only
|
$14.40 |
$14.40 |
$14.40 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$10.20 |
$10.20 |
$10.20 |
$25.72
|
|
Urinalysis (with microscopy)
|
$27.00 |
$27.00 |
$27.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$31.80 |
$31.80 |
$31.80 |
$35.75
|
|
Urine Culture Test
|
$89.40 |
$89.40 |
$89.40 |
$81.50
|
|
Urine pregnancy test
|
$51.60 |
$51.60 |
$51.60 |
$67.20
|
|
Urography, antegrade
|
$530.40 |
$793.80 |
$793.80 |
$622.35
|
|
Use 1st target lesion
|
$223.80 |
$223.80 |
$223.80 |
$332.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$53,347.20 |
$53,347.20 |
$53,347.20 |
$51,633.07
|
|
Vaccine dtap < 7 years im
|
$62.88 |
$62.88 |
$62.88 |
$68.19
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$66.90 |
$66.90 |
$66.90 |
$70.26
|
