|
Transcath biopsy
|
$9,697.60 |
$9,697.60 |
$9,697.60 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,067.20 |
$1,067.20 |
$1,067.20 |
$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 knee fracture 27530
|
$1,526.40 |
$1,526.40 |
$1,526.40 |
$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
|
$359.20 |
$359.20 |
$359.20 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$309.60 |
$309.60 |
$309.60 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$685.60 |
$685.60 |
$685.60 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$690.40 |
$690.40 |
$690.40 |
$491.50
|
|
Treatment of toe fracture 28510
|
$1,374.40 |
$1,374.40 |
$1,374.40 |
$369.70
|
|
Treat thigh fracture
|
$451.20 |
$451.20 |
$451.20 |
$618.80
|
|
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
|
$145.00 |
$145.00 |
$145.00 |
$43.21
|
|
Triglycerides
|
$24.00 |
$24.00 |
$24.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$650.60 |
$650.60 |
$650.60 |
$117.49
|
|
Trim nondyst nails
|
$100.00 |
$100.00 |
$100.00 |
$113.40
|
|
Trnscath plc vas stent w/s&i ini vein
|
$22,448.00 |
$22,448.00 |
$22,448.00 |
$15,330.11
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$5,069.50
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$3,432.00 |
$3,432.00 |
$3,432.00 |
$4,250.25
|
|
Troponin quantitative
|
$62.40 |
$62.40 |
$62.40 |
$127.20
|
|
Tx closed hip disl traumatic without anes
|
$1,441.60 |
$1,441.60 |
$1,441.60 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$759.20 |
$759.20 |
$759.20 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$723.20 |
$723.20 |
$723.20 |
$416.16
|
|
Tympanometry & reflex thresh
|
$136.00 |
$136.00 |
$136.00 |
$170.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$752.00 |
$752.00 |
$752.00 |
$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
|
$631.20 |
$631.20 |
$631.20 |
$460.85
|
|
Ultrasound elastography parenchyma
|
$249.60 |
$249.60 |
$249.60 |
$307.00
|
|
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
|
$525.60 |
$525.60 |
$525.60 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$504.00 |
$504.00 |
$504.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$941.60 |
$941.60 |
$941.60 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$636.80 |
$636.80 |
$636.80 |
$403.88
|
|
Ultrasound joint/nonvascular extremity limited left
|
$468.00 |
$468.00 |
$468.00 |
$425.45
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$336.80 |
$336.80 |
$336.80 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$836.80 |
$836.80 |
$836.80 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$533.60 |
$533.60 |
$533.60 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$533.60 |
$533.60 |
$533.60 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$486.50
|
|
Ultrasound scrotum and contents
|
$729.60 |
$729.60 |
$729.60 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$320.80 |
$320.80 |
$320.80 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$708.80 |
$708.80 |
$708.80 |
$558.35
|
|
Unlistd noninvas vasc dx std
|
$528.80 |
$528.80 |
$528.80 |
$528.80
|
|
Unlisted fluoroscopic px
|
$400.00 |
$400.00 |
$400.00 |
$305.76
|
|
Unlisted mr procedure
|
$400.00 |
$400.00 |
$400.00 |
$1,163.00
|
|
Unsched dialysis esrd pt hos
|
$872.00 |
$872.00 |
$872.00 |
$1,268.17
|
|
Upgrade pm system
|
$54,780.00 |
$54,780.00 |
$54,780.00 |
$12,077.00
|
|
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
|
$16.80 |
$16.80 |
$16.80 |
$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
|
$12.80 |
$12.80 |
$12.80 |
$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
|
$36.00 |
$36.00 |
$36.00 |
$67.20
|
|
Urography, antegrade
|
$531.20 |
$531.20 |
$531.20 |
$622.35
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$834.80 |
$834.80 |
$834.80 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$268.80 |
$268.80 |
$268.80 |
$75.39
|
|
Vaccine influenza inactivated adjuvant im
|
$643.00 |
$643.00 |
$643.00 |
$109.50
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$144.60 |
$144.60 |
$144.60 |
$47.88
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$413.60 |
$413.60 |
$413.60 |
$310.93
|
|
Vaccine mmr live subcutaneous
|
$347.60 |
$347.60 |
$347.60 |
$211.68
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$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
|
$466.60 |
$466.60 |
$466.60 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$56.80 |
$56.80 |
$56.80 |
$114.72
|
|
Vancomycin 1,000 mg intravenous injection
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$251.86
|
|
Vancomycin 750 mg intravenous solution
|
$148.80 |
$148.80 |
$148.80 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$56.80 |
$56.80 |
$56.80 |
$136.13
|
|
Varicella zoster antibody igg
|
$53.60 |
$53.60 |
$53.60 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$280.60 |
$280.60 |
$280.60 |
$325.80
|
|
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 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
|
$2,317.60 |
$2,317.60 |
$2,317.60 |
$1,204.00
|
|
Ventilator initial day
|
$2,317.60 |
$2,317.60 |
$2,317.60 |
$1,431.43
|
|
Visual audiometry (vra)
|
$140.80 |
$140.80 |
$140.80 |
$215.25
|
|
Vital capacity test
|
$210.40 |
$210.40 |
$210.40 |
$170.00
|
|
Vitamin b-12
|
$40.00 |
$40.00 |
$40.00 |
$100.00
|
|
Vitamin D Test
|
$100.00 |
$100.00 |
$100.00 |
$132.00
|
|
Warde 1003990 aldosterone
|
$169.60 |
$169.60 |
$169.60 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$116.00 |
$116.00 |
$116.00 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$54.40 |
$54.40 |
$54.40 |
$63.50
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$104.80 |
$104.80 |
$104.80 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$64.80 |
$64.80 |
$64.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$71.20 |
$71.20 |
$71.20 |
$65.20
|
