|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$133.20 |
$133.20 |
$133.20 |
$56.38
|
|
Transcath biopsy
|
$9,697.60 |
$9,697.60 |
$9,697.60 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,907.20 |
$1,907.20 |
$1,907.20 |
$1,915.00
|
|
Transferrin
|
$50.00 |
$50.00 |
$50.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,714.40 |
$1,714.40 |
$1,714.40 |
$983.00
|
|
Treat finger fracture each
|
$2,829.60 |
$2,829.60 |
$2,829.60 |
$1,536.00
|
|
Treat fracture of radius
|
$864.00 |
$864.00 |
$864.00 |
$1,790.00
|
|
Treat humerus fracture
|
$580.00 |
$580.00 |
$580.00 |
$1,771.43
|
|
Treat knee fracture 27530
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$550.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$549.60 |
$549.60 |
$549.60 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$255.20 |
$255.20 |
$255.20 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$252.00 |
$252.00 |
$252.00 |
$203.35
|
|
Treatment of heel fracture 28400
|
$513.60 |
$513.60 |
$513.60 |
$473.00
|
|
Treatment of thigh fracture
|
$400.00 |
$400.00 |
$400.00 |
$476.16
|
|
Treatment of toe fracture 28510
|
$752.00 |
$752.00 |
$752.00 |
$369.70
|
|
Treat thigh fracture
|
$2,353.60 |
$2,353.60 |
$2,353.60 |
$1,893.86
|
|
Treat thigh fx growth plate
|
$988.80 |
$988.80 |
$988.80 |
$475.68
|
|
Treponema pallidum antibody
|
$65.60 |
$65.60 |
$65.60 |
$70.40
|
|
Trg gene rearrangement anal
|
$838.40 |
$838.40 |
$838.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$35.60 |
$35.60 |
$35.60 |
$43.21
|
|
Triglycerides
|
$28.00 |
$28.00 |
$28.00 |
$58.05
|
|
Trim nondyst nails
|
$100.00 |
$100.00 |
$100.00 |
$113.40
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$12,987.20 |
$12,987.20 |
$12,987.20 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$22,448.00 |
$22,448.00 |
$22,448.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$22,448.00 |
$22,448.00 |
$22,448.00 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,248.80 |
$5,248.80 |
$5,248.80 |
$4,523.96
|
|
Troponin quantitative
|
$118.40 |
$118.40 |
$118.40 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$57,468.00 |
$57,468.00 |
$57,468.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$596.80 |
$596.80 |
$596.80 |
$581.07
|
|
Tx tarsal bone fx without manip 28450
|
$441.60 |
$441.60 |
$441.60 |
$416.16
|
|
Ultrasound abdomen aorta screening study aaa
|
$300.80 |
$300.80 |
$300.80 |
$394.20
|
|
Ultrasound breast complete
|
$540.80 |
$540.80 |
$540.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$492.00 |
$492.00 |
$492.00 |
$449.35
|
|
Ultrasound chest
|
$724.00 |
$724.00 |
$724.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$329.60 |
$329.60 |
$329.60 |
$338.00
|
|
Ultrasound encephalogram
|
$588.80 |
$588.80 |
$588.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$544.00 |
$544.00 |
$544.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$909.60 |
$909.60 |
$909.60 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$504.00 |
$504.00 |
$504.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$720.15
|
|
Ultrasound guide intraoperative
|
$1,126.40 |
$1,126.40 |
$1,126.40 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$636.80 |
$636.80 |
$636.80 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$558.40 |
$558.40 |
$558.40 |
$311.25
|
|
Ultrasound joint complete left
|
$575.20 |
$575.20 |
$575.20 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$468.00 |
$468.00 |
$468.00 |
$425.45
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$892.00 |
$892.00 |
$892.00 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$666.40 |
$666.40 |
$666.40 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$728.00 |
$728.00 |
$728.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$534.40 |
$534.40 |
$534.40 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$626.40 |
$626.40 |
$626.40 |
$486.50
|
|
Ultrasound scrotum and contents
|
$702.40 |
$702.40 |
$702.40 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$592.00 |
$592.00 |
$592.00 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$708.80 |
$708.80 |
$708.80 |
$558.35
|
|
Unlisted CT procedure
|
$1,177.60 |
$1,177.60 |
$1,177.60 |
$732.70
|
|
Unlisted mr procedure
|
$942.40 |
$942.40 |
$942.40 |
$1,163.00
|
|
Unsched dialysis esrd pt hos
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$700.50 |
$700.50 |
$700.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$633.50 |
$633.50 |
$633.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$454.00 |
$454.00 |
$454.00 |
$2,034.41
|
|
Urea nitrogen
|
$20.00 |
$20.00 |
$20.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$23.20 |
$23.20 |
$23.20 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$672.00 |
$672.00 |
$672.00 |
$579.73
|
|
Urethrocystography void s&i
|
$600.00 |
$600.00 |
$600.00 |
$622.35
|
|
Uric acid blood
|
$15.00 |
$15.00 |
$15.00 |
$48.75
|
|
Uric acid urine
|
$20.80 |
$20.80 |
$20.80 |
$44.33
|
|
Urinalysis microscopic only
|
$15.20 |
$15.20 |
$15.20 |
$26.35
|
|
Urinalysis (with microscopy)
|
$10.00 |
$10.00 |
$10.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$10.00 |
$10.00 |
$10.00 |
$35.75
|
|
Urine Culture Test
|
$25.00 |
$25.00 |
$25.00 |
$81.50
|
|
Urine pregnancy test
|
$43.20 |
$43.20 |
$43.20 |
$67.20
|
|
Urography, antegrade
|
$531.20 |
$531.20 |
$531.20 |
$622.35
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$217.20 |
$217.20 |
$217.20 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$70.00 |
$70.00 |
$70.00 |
$75.39
|
|
Vaccine influenza inactivated adjuvant im
|
$167.20 |
$167.20 |
$167.20 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$37.60 |
$37.60 |
$37.60 |
$47.88
|
|
Vaccine mmr live subcutaneous
|
$141.60 |
$141.60 |
$141.60 |
$211.68
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$567.60 |
$567.60 |
$567.60 |
$563.36
|
|
Vaccine rabies im
|
$1,368.40 |
$1,368.40 |
$1,368.40 |
$858.95
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$750.80 |
$750.80 |
$750.80 |
$1,104.47
|
|
Vaccine tdap >=7 years im
|
$121.40 |
$121.40 |
$121.40 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$56.80 |
$56.80 |
$56.80 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$561.00 |
$561.00 |
$561.00 |
$251.86
|
|
Vancomycin peak therapeutic drug level
|
$67.20 |
$67.20 |
$67.20 |
$136.13
|
|
Varicella zoster antibody igg
|
$53.60 |
$53.60 |
$53.60 |
$86.80
|
|
Vedolizumab 300 mg intravenous solution
|
$22,378.60 |
$22,378.60 |
$22,378.60 |
$18,732.33
|
|
Veeg ea 12-26hr cont mntr
|
$2,765.60 |
$2,765.60 |
$2,765.60 |
$3,225.60
|
|
Veeg unmon 12-26 hrs
|
$2,904.00 |
$2,904.00 |
$2,904.00 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$2,904.00 |
$2,904.00 |
$2,904.00 |
$826.15
|
|
Vein x-ray liver w/hemodynam
|
$6,960.00 |
$6,960.00 |
$6,960.00 |
$3,483.84
|
|
Ven blood coll snf/hha
|
$16.80 |
$16.80 |
$16.80 |
$15.65
|
|
Venogram ext bil s&i
|
$4,980.00 |
$4,980.00 |
$4,980.00 |
$1,797.50
|
|
Venogram extremity supervision & interpretation unilateral
|
$3,320.00 |
$3,320.00 |
$3,320.00 |
$1,366.20
|
|
Venous mech thrombectomy
|
$10,528.00 |
$10,528.00 |
$10,528.00 |
$7,965.00
|
|
Ventilator each subsequent day
|
$2,020.00 |
$2,020.00 |
$2,020.00 |
$1,204.00
|
|
Ventilator initial day
|
$2,300.80 |
$2,300.80 |
$2,300.80 |
$1,431.43
|
|
Version cephalic external
|
$935.20 |
$935.20 |
$935.20 |
$2,361.75
|
|
Very long chain fatty acids
|
$82.40 |
$82.40 |
$82.40 |
$139.88
|
|
Vincristine 1 mg/ml intravenous solution
|
$63.20 |
$63.20 |
$63.20 |
$87.15
|
|
Vital capacity test
|
$210.40 |
$210.40 |
$210.40 |
$170.00
|
|
Vitamin b-12
|
$40.00 |
$40.00 |
$40.00 |
$100.00
|
