|
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
|
$35,888.58 |
$35,888.58 |
$35,888.58 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$56,099.46 |
$56,099.46 |
$56,099.46 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$18,504.72 |
$18,504.72 |
$18,504.72 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$22,266.58 |
$22,266.58 |
$22,266.58 |
$2,371.50
|
|
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 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 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$520.80 |
$520.80 |
$520.80 |
$535.60
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$12,134.27 |
$12,134.27 |
$12,134.27 |
$4,468.55
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$20,053.02 |
$20,053.02 |
$20,053.02 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$520.80 |
$520.80 |
$520.80 |
$416.16
|
|
Ua w/micro/comp poc
|
$8.40 |
$8.40 |
$8.40 |
$23.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$168.00 |
$168.00 |
$168.00 |
$394.20
|
|
Ultrasound bone density measure
|
$345.00 |
$345.00 |
$345.00 |
$143.75
|
|
Ultrasound breast complete
|
$641.40 |
$641.40 |
$641.40 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$544.80 |
$544.80 |
$544.80 |
$449.35
|
|
Ultrasound chest
|
$609.60 |
$609.60 |
$609.60 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$507.60 |
$507.60 |
$507.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$203.40 |
$203.40 |
$203.40 |
$296.80
|
|
Ultrasound encephalogram
|
$669.60 |
$669.60 |
$669.60 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$1,030.20 |
$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
|
$836.40 |
$836.40 |
$836.40 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$678.00 |
$678.00 |
$678.00 |
$560.00
|
|
Ultrasound joint complete left
|
$658.80 |
$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
|
$730.80 |
$730.80 |
$730.80 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$730.80 |
$730.80 |
$730.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$892.80 |
$892.80 |
$892.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$559.80 |
$559.80 |
$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
|
$533.40 |
$533.40 |
$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 transvaginal non obstetric
|
$804.60 |
$804.60 |
$804.60 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$141.00 |
$141.00 |
$141.00 |
$206.64
|
|
Unlisted laparoscopic liver biopy 47379
|
$27,099.91 |
$27,099.91 |
$27,099.91 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$23,746.96 |
$23,746.96 |
$23,746.96 |
$6,838.32
|
|
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
|
$99,974.30 |
$99,974.30 |
$99,974.30 |
$2,765.60
|
|
Unlisted px foot/toes
|
$46,462.85 |
$46,462.85 |
$46,462.85 |
$1,225.50
|
|
Unlisted px hands/fingers
|
$378.00 |
$378.00 |
$378.00 |
$354.20
|
|
Unlisted px pelvis/hip joint
|
$27,909.23 |
$27,909.23 |
$27,909.23 |
$3,118.44
|
|
Unlisted px small intestine
|
$1,559.40 |
$1,559.40 |
$1,559.40 |
$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)
|
$8,594.46 |
$8,594.46 |
$8,594.46 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$11,375.00 |
$11,375.00 |
$11,375.00 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$12,874.07 |
$12,874.07 |
$12,874.07 |
$1,872.00
|
|
Urea nitrogen
|
$87.60 |
$87.60 |
$87.60 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$28.80 |
$28.80 |
$28.80 |
$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
|
$612.60 |
$612.60 |
$612.60 |
$579.73
|
|
Urethrocystography void s&i
|
$746.40 |
$746.40 |
$746.40 |
$622.35
|
|
Uric acid urine
|
$10.80 |
$10.80 |
$10.80 |
$44.33
|
|
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
|
|
Urography, antegrade
|
$793.80 |
$793.80 |
$793.80 |
$622.35
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$62,967.18 |
$62,967.18 |
$62,967.18 |
$51,633.07
|
|
Vaccine dtap < 7 years im
|
$62.88 |
$62.88 |
$62.88 |
$68.19
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$28.50 |
$28.50 |
$28.50 |
$43.12
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$281.34 |
$281.34 |
$281.34 |
$218.40
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.06 |
$0.06 |
$0.06 |
$75.39
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$124.14 |
$124.14 |
$124.14 |
$76.50
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$354.18 |
$354.18 |
$354.18 |
$329.24
|
|
Vaccine mmr live subcutaneous
|
$208.14 |
$208.14 |
$208.14 |
$211.68
|
|
Vaccine td preservative free >= 7 years im
|
$89.76 |
$89.76 |
$89.76 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$408.06 |
$408.06 |
$408.06 |
$365.17
|
|
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
|
$9.30 |
$9.30 |
$9.30 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$32.40 |
$32.40 |
$32.40 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$358.74 |
$358.74 |
$358.74 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$193.14 |
$193.14 |
$193.14 |
$90.33
|
|
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 |
$18,732.33
|
|
Vein x-ray adrenal gland
|
$3,663.60 |
$3,663.60 |
$3,663.60 |
$2,845.80
|
|
Vein x-ray kidney
|
$3,663.60 |
$3,663.60 |
$3,663.60 |
$2,766.73
|
|
Vein x-ray liver
|
$3,312.00 |
$3,312.00 |
$3,312.00 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$4,332.60 |
$4,332.60 |
$4,332.60 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$7,232.40 |
$7,232.40 |
$7,232.40 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$3,363.60 |
$3,363.60 |
$3,363.60 |
$2,452.80
|
|
Vein x-ray skull
|
$3,663.60 |
$3,663.60 |
$3,663.60 |
$2,141.00
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$1,063.80 |
$1,063.80 |
$1,063.80 |
$202.80
|
