|
Treat metatarsal fracture
|
$78,806.95 |
$78,806.95 |
$78,806.95 |
$8,412.89
|
|
Treat radius fracture
|
$43,949.24 |
$43,949.24 |
$43,949.24 |
$7,741.60
|
|
Treat radius fracture
|
$27,902.51 |
$27,902.51 |
$27,902.51 |
$14,061.89
|
|
Treat spinal cord lesion
|
$2,386.20 |
$2,386.20 |
$2,386.20 |
$1,337.00
|
|
Treat toe dislocation
|
$29,966.47 |
$29,966.47 |
$29,966.47 |
$763.50
|
|
Treat ulnar fracture
|
$43,949.24 |
$43,949.24 |
$43,949.24 |
$5,926.25
|
|
Treponema pallidum antibody
|
$75.60 |
$75.60 |
$75.60 |
$70.40
|
|
Trg gene rearrangement anal
|
$642.00 |
$642.00 |
$642.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$35.40 |
$35.40 |
$35.40 |
$43.09
|
|
Trichinella antibody
|
$129.60 |
$129.60 |
$129.60 |
$70.65
|
|
Trichomonas assay w/optic
|
$66.60 |
$66.60 |
$66.60 |
$56.70
|
|
Triglycerides
|
$63.60 |
$63.60 |
$63.60 |
$57.85
|
|
Trilaciclib 300 mg intravenous solution
|
$4,500.36 |
$4,500.36 |
$4,500.36 |
$3,903.74
|
|
Trim nondyst nails
|
$96.60 |
$96.60 |
$96.60 |
$115.70
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$42,595.09 |
$42,595.09 |
$42,595.09 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$42,595.09 |
$42,595.09 |
$42,595.09 |
$7,080.00
|
|
Trnscath plc stent crv crtd without prtct
|
$25,612.20 |
$25,612.20 |
$25,612.20 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$8,263.80 |
$8,263.80 |
$8,263.80 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$4,489.80 |
$4,489.80 |
$4,489.80 |
$6,311.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$23,200.80 |
$23,200.80 |
$23,200.80 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$23,635.80 |
$23,635.80 |
$23,635.80 |
$8,753.00
|
|
Trnscath plc vas stent w/s&i ini vein
|
$23,635.80 |
$23,635.80 |
$23,635.80 |
$14,819.58
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,574.20 |
$3,574.20 |
$3,574.20 |
$4,735.50
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$7,002.60 |
$7,002.60 |
$7,002.60 |
$5,190.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$7,002.60 |
$7,002.60 |
$7,002.60 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,002.60 |
$7,002.60 |
$7,002.60 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$7,002.60 |
$7,002.60 |
$7,002.60 |
$3,866.70
|
|
Troponin quantitative
|
$146.40 |
$146.40 |
$146.40 |
$127.20
|
|
Tube trach disp innr can 5 xlt
|
$506.30 |
$506.30 |
$506.30 |
$445.99
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,109.12 |
$8,109.12 |
$8,109.12 |
$4,499.12
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$30,996.96 |
$30,996.96 |
$30,996.96 |
$17,921.01
|
|
Ugt1a1 gene analy common variants
|
$619.20 |
$619.20 |
$619.20 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$258.60 |
$258.60 |
$258.60 |
$394.20
|
|
Ultrasound breast complete
|
$603.00 |
$603.00 |
$603.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$603.00 |
$603.00 |
$603.00 |
$452.00
|
|
Ultrasound chest
|
$691.20 |
$691.20 |
$691.20 |
$460.85
|
|
Ultrasound encephalogram
|
$70.20 |
$70.20 |
$70.20 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$795.00 |
$795.00 |
$795.00 |
$585.15
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$804.00 |
$804.00 |
$804.00 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$920.40 |
$920.40 |
$920.40 |
$388.08
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,088.40 |
$1,088.40 |
$1,088.40 |
$720.15
|
|
Ultrasound guide tissue ablation
|
$324.60 |
$324.60 |
$324.60 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$483.60 |
$483.60 |
$483.60 |
$403.88
|
|
Ultrasound joint complete left
|
$69.00 |
$69.00 |
$69.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$901.20 |
$901.20 |
$901.20 |
$424.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$609.00 |
$609.00 |
$609.00 |
$393.86
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$261.00 |
$261.00 |
$261.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$567.00 |
$567.00 |
$567.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$189.00 |
$189.00 |
$189.00 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$819.60 |
$819.60 |
$819.60 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$263.40 |
$263.40 |
$263.40 |
$490.00
|
|
Ultrasound prostate/transrectal
|
$1,489.20 |
$1,489.20 |
$1,489.20 |
$549.95
|
|
Ultrasound retroperitoneal limited
|
$910.20 |
$910.20 |
$910.20 |
$479.60
|
|
Ultrasound scrotum and contents
|
$1,277.40 |
$1,277.40 |
$1,277.40 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$825.60 |
$825.60 |
$825.60 |
$459.00
|
|
Ultrasound transvaginal non obstetric
|
$980.40 |
$980.40 |
$980.40 |
$558.35
|
|
Ultraviolet therapy
|
$81.00 |
$81.00 |
$81.00 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$296.40 |
$296.40 |
$296.40 |
$205.80
|
|
Unlisted misc path test
|
$40.20 |
$40.20 |
$40.20 |
$89.40
|
|
Unlisted procedure liver
|
$4,756.80 |
$4,756.80 |
$4,756.80 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,976.60 |
$2,976.60 |
$2,976.60 |
$490.70
|
|
Unlisted procedure spine
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$4,876.04
|
|
Unlisted px arthroscopy
|
$8,326.38 |
$8,326.38 |
$8,326.38 |
$2,765.60
|
|
Unlisted px forearm/wrist
|
$23,868.86 |
$23,868.86 |
$23,868.86 |
$593.60
|
|
Unlisted px med radj physics
|
$505.20 |
$505.20 |
$505.20 |
$462.35
|
|
Unlisted px neck/thorax
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$571.20
|
|
Unlisted ultrasound procedure
|
$856.80 |
$856.80 |
$856.80 |
$326.40
|
|
Upper Endoscopy (EGD, diagnostic)
|
$5,998.68 |
$5,998.68 |
$5,998.68 |
$1,794.22
|
|
Upper Endoscopy (EGD, with biopsy)
|
$6,657.52 |
$6,657.52 |
$6,657.52 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$6,731.52 |
$6,731.52 |
$6,731.52 |
$1,774.00
|
|
Urea nitrogen
|
$63.60 |
$63.60 |
$63.60 |
$40.95
|
|
Urea nitrogen 24 hour urine
|
$63.60 |
$63.60 |
$63.60 |
$52.00
|
|
Urea nitrogen clearance
|
$16.80 |
$16.80 |
$16.80 |
$45.12
|
|
Ureteral reflux study
|
$702.00 |
$702.00 |
$702.00 |
$962.42
|
|
Urethrcystgrphy rtrgrde s&i
|
$279.60 |
$279.60 |
$279.60 |
$584.00
|
|
Urethrocystography void s&i
|
$335.40 |
$335.40 |
$335.40 |
$648.05
|
|
Uric acid blood
|
$67.80 |
$67.80 |
$67.80 |
$49.44
|
|
Uric acid urine
|
$116.40 |
$116.40 |
$116.40 |
$44.22
|
|
Urinalysis microscopic only
|
$37.80 |
$37.80 |
$37.80 |
$26.46
|
|
Urinalysis (with microscopy)
|
$90.60 |
$90.60 |
$90.60 |
$55.44
|
|
Urinalysis (without microscopy)
|
$61.20 |
$61.20 |
$61.20 |
$36.00
|
|
Urine Culture Test
|
$148.80 |
$148.80 |
$148.80 |
$81.27
|
|
Urine pregnancy test
|
$51.60 |
$51.60 |
$51.60 |
$67.80
|
|
Urography, antegrade
|
$327.60 |
$327.60 |
$327.60 |
$622.35
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$40,666.32 |
$40,666.32 |
$40,666.32 |
$50,368.90
|
|
Vaccine dtap-ipv-hib-hepb im
|
$68.40 |
$68.40 |
$68.40 |
$174.72
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$30.18 |
$30.18 |
$30.18 |
$42.90
|
|
Vaccine hepatitis a (hepa) adult im
|
$90.00 |
$90.00 |
$90.00 |
$168.95
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$350.46 |
$350.46 |
$350.46 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.06 |
$0.06 |
$0.06 |
$74.42
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$107.94 |
$107.94 |
$107.94 |
$76.50
|
|
Vaccine mmr live subcutaneous
|
$220.50 |
$220.50 |
$220.50 |
$213.00
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$263.46 |
$263.46 |
$263.46 |
$252.87
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$637.26 |
$637.26 |
$637.26 |
$563.36
|
|
Vaccine tdap >=7 years im
|
$110.70 |
$110.70 |
$110.70 |
$132.88
|
|
Vaccine td preservative free >= 7 years im
|
$95.10 |
$95.10 |
$95.10 |
$112.10
|
|
Vad univ batt charger hm 1440
|
$18,172.63 |
$18,172.63 |
$18,172.63 |
$14,827.28
|
|
Vaginal bx
|
$10,215.94 |
$10,215.94 |
$10,215.94 |
$455.94
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$27.36 |
$27.36 |
$27.36 |
$24.12
|
|
Valproic acid total therapeutic drug level
|
$186.60 |
$186.60 |
$186.60 |
$114.48
|
