|
Transferrin
|
$50.70 |
$50.70 |
$50.70 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,283.10 |
$1,283.10 |
$1,283.10 |
$988.24
|
|
Transperi needle place pros
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$6,203.00
|
|
Trastuzumab 150 mg intravenous solution
|
$4,256.17 |
$4,256.17 |
$4,256.17 |
$3,401.26
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$3,565.48 |
$3,565.48 |
$3,565.48 |
$7,620.16
|
|
Trauma partial team response w/critical care services level 4
|
$5,430.75 |
$5,430.75 |
$5,430.75 |
$5,941.07
|
|
Tray bonemarrw oncontrol 102mm
|
$310.14 |
$310.14 |
$310.14 |
$1,094.25
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$742.30 |
$742.30 |
$742.30 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$456.30 |
$456.30 |
$456.30 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$142.35 |
$142.35 |
$142.35 |
$210.00
|
|
Treatment of foot infection
|
$2,428.40 |
$2,428.40 |
$2,428.40 |
$1,893.86
|
|
Treatment of foot infection
|
$2,510.30 |
$2,510.30 |
$2,510.30 |
$3,594.44
|
|
Treatment radiation delivery level 2
|
$767.65 |
$767.65 |
$767.65 |
$735.00
|
|
Treponema pallidum antibody
|
$66.95 |
$66.95 |
$66.95 |
$72.80
|
|
Trg gene rearrangement anal
|
$217.10 |
$217.10 |
$217.10 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$45.73 |
$45.73 |
$45.73 |
$48.22
|
|
Trichinella antibody
|
$83.85 |
$83.85 |
$83.85 |
$70.65
|
|
Trichomonas assay w/optic
|
$14.30 |
$14.30 |
$14.30 |
$66.00
|
|
#tricyclicantidprssnt
|
$96.85 |
$96.85 |
$96.85 |
$57.08
|
|
Triglycerides
|
$35.75 |
$35.75 |
$35.75 |
$54.60
|
|
Trim nail(s)
|
$135.20 |
$135.20 |
$135.20 |
$70.56
|
|
Trim nondyst nails
|
$82.55 |
$82.55 |
$82.55 |
$124.22
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$29,940.30 |
$29,940.30 |
$29,940.30 |
$15,111.95
|
|
Trml dstrj ios bvn ea addl
|
$14,970.80 |
$14,970.80 |
$14,970.80 |
$9,781.50
|
|
Trnscath plc stent crv crtd without prtct
|
$5,851.30 |
$5,851.30 |
$5,851.30 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$25,756.25 |
$25,756.25 |
$25,756.25 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$16,485.30 |
$16,485.30 |
$16,485.30 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,606.85 |
$3,606.85 |
$3,606.85 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,606.85 |
$3,606.85 |
$3,606.85 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$14,428.70 |
$14,428.70 |
$14,428.70 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,402.75 |
$3,402.75 |
$3,402.75 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$30,592.90 |
$30,592.90 |
$30,592.90 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$12,473.50 |
$12,473.50 |
$12,473.50 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$11,911.90 |
$11,911.90 |
$11,911.90 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$23,283.00 |
$23,283.00 |
$23,283.00 |
$4,329.36
|
|
Troponin quantitative
|
$38.35 |
$38.35 |
$38.35 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$1,582.75 |
$1,582.75 |
$1,582.75 |
$1,446.48
|
|
Tte w or without fol w/cont, com
|
$1,725.10 |
$1,725.10 |
$1,725.10 |
$1,453.15
|
|
Tx atrial fib pulm vein isol
|
$39,633.75 |
$39,633.75 |
$39,633.75 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$2,666.30 |
$2,666.30 |
$2,666.30 |
$7,717.80
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$371.80 |
$371.80 |
$371.80 |
$911.43
|
|
Ugt1a1 gene analy common variants
|
$1,498.90 |
$1,498.90 |
$1,498.90 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$246.35 |
$246.35 |
$246.35 |
$403.26
|
|
Ultrasound breast complete
|
$1,233.70 |
$1,233.70 |
$1,233.70 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$834.60 |
$834.60 |
$834.60 |
$449.35
|
|
Ultrasound chest
|
$351.65 |
$351.65 |
$351.65 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$265.85 |
$265.85 |
$265.85 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$516.10 |
$516.10 |
$516.10 |
$284.25
|
|
Ultrasound encephalogram
|
$458.90 |
$458.90 |
$458.90 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$497.25 |
$497.25 |
$497.25 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$583.70 |
$583.70 |
$583.70 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$594.75 |
$594.75 |
$594.75 |
$701.35
|
|
Ultrasound guide intraoperative
|
$676.65 |
$676.65 |
$676.65 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$813.80 |
$813.80 |
$813.80 |
$498.40
|
|
Ultrasound joint complete left
|
$642.85 |
$642.85 |
$642.85 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$386.75 |
$386.75 |
$386.75 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$386.10 |
$386.10 |
$386.10 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$282.10 |
$282.10 |
$282.10 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$708.50 |
$708.50 |
$708.50 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$486.20 |
$486.20 |
$486.20 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$369.85 |
$369.85 |
$369.85 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$459.55 |
$459.55 |
$459.55 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$719.55 |
$719.55 |
$719.55 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$378.95 |
$378.95 |
$378.95 |
$498.00
|
|
Ultrasound scrotum and contents
|
$454.35 |
$454.35 |
$454.35 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$491.40 |
$491.40 |
$491.40 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$438.75 |
$438.75 |
$438.75 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$541.45 |
$541.45 |
$541.45 |
$567.44
|
|
Unit mobile power mpu
|
$17,052.34 |
$17,052.34 |
$17,052.34 |
$17,052.34
|
|
Unlisted chemotherapy px
|
$578.50 |
$578.50 |
$578.50 |
$153.85
|
|
Unlisted CT procedure
|
$1,815.45 |
$1,815.45 |
$1,815.45 |
$1,043.00
|
|
Unlisted fluoroscopic px
|
$1,642.55 |
$1,642.55 |
$1,642.55 |
$324.85
|
|
Unlisted mr procedure
|
$274.30 |
$274.30 |
$274.30 |
$1,032.20
|
|
Unlisted procedure colon
|
$565.50 |
$565.50 |
$565.50 |
$1,580.44
|
|
Unlisted procedure microbiology
|
$487.50 |
$487.50 |
$487.50 |
$487.50
|
|
Unlisted procedure pancreas
|
$1,803.75 |
$1,803.75 |
$1,803.75 |
$2,967.75
|
|
Unlisted procedure spine
|
$4,659.85 |
$4,659.85 |
$4,659.85 |
$4,706.35
|
|
Unlisted px biliary tract
|
$1,803.75 |
$1,803.75 |
$1,803.75 |
$2,718.10
|
|
Unlisted px male genital sys
|
$471.25 |
$471.25 |
$471.25 |
$897.95
|
|
Unlisted px pelvis/hip joint
|
$1,674.40 |
$1,674.40 |
$1,674.40 |
$2,108.82
|
|
Unlisted px small intestine
|
$581.10 |
$581.10 |
$581.10 |
$2,118.35
|
|
Unlisted reprod med lab proc
|
$128.05 |
$128.05 |
$128.05 |
$70.00
|
|
Unlisted ultrasound procedure
|
$714.35 |
$714.35 |
$714.35 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$2,886.00 |
$2,886.00 |
$2,886.00 |
$1,505.29
|
|
Upgrade pm system
|
$12,792.00 |
$12,792.00 |
$12,792.00 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,049.45 |
$2,049.45 |
$2,049.45 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,810.25 |
$1,810.25 |
$1,810.25 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,496.30 |
$1,496.30 |
$1,496.30 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,086.50 |
$2,086.50 |
$2,086.50 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,260.70 |
$2,260.70 |
$2,260.70 |
$1,656.60
|
|
Uppr gi scope w/submuc inj
|
$2,581.15 |
$2,581.15 |
$2,581.15 |
$1,773.85
|
|
Urea nitrogen
|
$6.50 |
$6.50 |
$6.50 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$31.85 |
$31.85 |
$31.85 |
$50.00
|
|
Urea nitrogen clearance
|
$20.15 |
$20.15 |
$20.15 |
$33.57
|
|
Ureteral embolization/occl
|
$1,040.65 |
$1,040.65 |
$1,040.65 |
$3,041.22
|
|
Ureteral reflux study
|
$2,453.10 |
$2,453.10 |
$2,453.10 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$776.75 |
$776.75 |
$776.75 |
$574.40
|
|
Urethrocystography void s&i
|
$804.05 |
$804.05 |
$804.05 |
$634.50
|
|
Uric acid blood
|
$10.40 |
$10.40 |
$10.40 |
$46.64
|
|
Uric acid urine
|
$102.05 |
$102.05 |
$102.05 |
$46.75
|
