|
Transcath occlusion cns
|
$7,752.40 |
$7,752.40 |
$7,752.40 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$5,540.80 |
$5,540.80 |
$5,540.80 |
$10,031.28
|
|
Trans cath replace aortic valve 33366
|
$31,747.20 |
$31,747.20 |
$31,747.20 |
$14,363.70
|
|
Transcath rmvl perm ldss pmkr rv
|
$3,838.80 |
$3,838.80 |
$3,838.80 |
$4,775.16
|
|
Transferrin
|
$104.00 |
$104.00 |
$104.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,900.80 |
$1,900.80 |
$1,900.80 |
$983.00
|
|
Trauma partial team response w/critical care services level 4
|
$12,724.80 |
$12,724.80 |
$12,724.80 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$566.16 |
$566.16 |
$566.16 |
$940.80
|
|
Treat eyelid lesion 67850
|
$913.20 |
$913.20 |
$913.20 |
$1,146.13
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$113.60 |
$113.60 |
$113.60 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$112.40 |
$112.40 |
$112.40 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$160.80 |
$160.80 |
$160.80 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$267.60 |
$267.60 |
$267.60 |
$520.80
|
|
Treatment of foot infection
|
$3,491.20 |
$3,491.20 |
$3,491.20 |
$2,614.25
|
|
Treatment of foot infection
|
$5,211.60 |
$5,211.60 |
$5,211.60 |
$3,821.05
|
|
Treatment of heel fracture 28400
|
$219.60 |
$219.60 |
$219.60 |
$473.00
|
|
Treatment of retinal lesion
|
$585.20 |
$585.20 |
$585.20 |
$1,033.14
|
|
Treatment radiation delivery level 2
|
$495.20 |
$495.20 |
$495.20 |
$767.65
|
|
Treatment x10sv retinopathy
|
$585.20 |
$585.20 |
$585.20 |
$1,513.20
|
|
Treponema pallidum antibody
|
$30.80 |
$30.80 |
$30.80 |
$70.40
|
|
Trg gene rearrangement anal
|
$436.40 |
$436.40 |
$436.40 |
$455.70
|
|
Trichomonas assay w/optic
|
$36.80 |
$36.80 |
$36.80 |
$55.50
|
|
Triglycerides
|
$59.20 |
$59.20 |
$59.20 |
$58.05
|
|
Trim nondyst nails
|
$96.00 |
$96.00 |
$96.00 |
$113.40
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$22,049.20 |
$22,049.20 |
$22,049.20 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$22,049.20 |
$22,049.20 |
$22,049.20 |
$7,354.00
|
|
Trnscath plc stent crv crtd without prtct
|
$2,164.40 |
$2,164.40 |
$2,164.40 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$1,767.20 |
$1,767.20 |
$1,767.20 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$3,781.60 |
$3,781.60 |
$3,781.60 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$8,222.40 |
$8,222.40 |
$8,222.40 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$9,238.00 |
$9,238.00 |
$9,238.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$16,999.60 |
$16,999.60 |
$16,999.60 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,587.20 |
$3,587.20 |
$3,587.20 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,139.20 |
$5,139.20 |
$5,139.20 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,139.20 |
$5,139.20 |
$5,139.20 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,139.20 |
$5,139.20 |
$5,139.20 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$5,139.20 |
$5,139.20 |
$5,139.20 |
$3,866.70
|
|
Troponin quantitative
|
$92.00 |
$92.00 |
$92.00 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,234.00 |
$2,234.00 |
$2,234.00 |
$2,012.40
|
|
Tte w or without fol w/con,stres
|
$1,519.60 |
$1,519.60 |
$1,519.60 |
$1,632.80
|
|
Tx atrial fib pulm vein isol
|
$21,833.20 |
$21,833.20 |
$21,833.20 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$2,962.00 |
$2,962.00 |
$2,962.00 |
$6,769.00
|
|
Ua w/micro/comp poc
|
$16.00 |
$16.00 |
$16.00 |
$23.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$212.40 |
$212.40 |
$212.40 |
$394.20
|
|
Ultrasound breast complete
|
$483.20 |
$483.20 |
$483.20 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$224.00 |
$224.00 |
$224.00 |
$449.35
|
|
Ultrasound chest
|
$790.40 |
$790.40 |
$790.40 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$205.60 |
$205.60 |
$205.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$88.00 |
$88.00 |
$88.00 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$538.80 |
$538.80 |
$538.80 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$538.80 |
$538.80 |
$538.80 |
$307.00
|
|
Ultrasound encephalogram
|
$340.00 |
$340.00 |
$340.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$418.80 |
$418.80 |
$418.80 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$240.80 |
$240.80 |
$240.80 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$400.80 |
$400.80 |
$400.80 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$508.80 |
$508.80 |
$508.80 |
$720.15
|
|
Ultrasound guide intraoperative
|
$741.20 |
$741.20 |
$741.20 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$214.80 |
$214.80 |
$214.80 |
$403.88
|
|
Ultrasound joint complete left
|
$514.40 |
$514.40 |
$514.40 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$356.80 |
$356.80 |
$356.80 |
$425.45
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$192.00 |
$192.00 |
$192.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$304.00 |
$304.00 |
$304.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$247.20 |
$247.20 |
$247.20 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$425.60 |
$425.60 |
$425.60 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$479.60 |
$479.60 |
$479.60 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$501.60 |
$501.60 |
$501.60 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$834.40 |
$834.40 |
$834.40 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$538.00 |
$538.00 |
$538.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$448.00 |
$448.00 |
$448.00 |
$608.90
|
|
Ultrasound transabd ea addl gest
|
$245.20 |
$245.20 |
$245.20 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$552.00 |
$552.00 |
$552.00 |
$558.35
|
|
Unlisted procedure spine
|
$4,166.80 |
$4,166.80 |
$4,166.80 |
$4,659.85
|
|
Unlisted px ther rad tx plng
|
$588.40 |
$588.40 |
$588.40 |
$182.00
|
|
Unsched dialysis esrd pt hos
|
$2,296.00 |
$2,296.00 |
$2,296.00 |
$1,268.17
|
|
Upgrade pm system
|
$9,982.40 |
$9,982.40 |
$9,982.40 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,603.20 |
$1,603.20 |
$1,603.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,093.60 |
$1,093.60 |
$1,093.60 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,032.80 |
$1,032.80 |
$1,032.80 |
$2,034.41
|
|
Urea nitrogen
|
$76.48 |
$76.48 |
$76.48 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$32.40 |
$32.40 |
$32.40 |
$51.75
|
|
Ureteral reflux study
|
$940.00 |
$940.00 |
$940.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$458.00 |
$458.00 |
$458.00 |
$579.73
|
|
Urethrocystography void s&i
|
$458.00 |
$458.00 |
$458.00 |
$622.35
|
|
Uric acid blood
|
$35.20 |
$35.20 |
$35.20 |
$48.75
|
|
Uric acid urine
|
$44.00 |
$44.00 |
$44.00 |
$44.33
|
|
Urinalysis microscopic only
|
$10.00 |
$10.00 |
$10.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$26.40 |
$26.40 |
$26.40 |
$55.00
|
|
Urinalysis (without microscopy)
|
$19.20 |
$19.20 |
$19.20 |
$35.75
|
|
Urinary reflex study
|
$170.40 |
$170.40 |
$170.40 |
$216.05
|
|
Urine Culture Test
|
$68.80 |
$68.80 |
$68.80 |
$81.50
|
|
Urine pregnancy test
|
$71.20 |
$71.20 |
$71.20 |
$67.20
|
|
Urography, antegrade
|
$676.80 |
$676.80 |
$676.80 |
$622.35
|
|
Urography inf drip &/or bolus
|
$337.20 |
$337.20 |
$337.20 |
$642.50
|
|
Use 1st target lesion
|
$538.80 |
$538.80 |
$538.80 |
$332.00
|
|
Valproic acid total therapeutic drug level
|
$162.40 |
$162.40 |
$162.40 |
$114.72
|
|
Valvuloplasty aortic
|
$7,830.80 |
$7,830.80 |
$7,830.80 |
$7,830.80
|
|
Valvuloplasty aortic valve
|
$38,644.80 |
$38,644.80 |
$38,644.80 |
$5,068.00
|
|
Valvuloplasty aortic valve
|
$38,644.80 |
$38,644.80 |
$38,644.80 |
$6,624.80
|
|
Valvuloplasty mitral
|
$15,588.00 |
$15,588.00 |
$15,588.00 |
$10,877.90
|
