|
Transferrin
|
$81.00 |
$81.00 |
$81.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$2,807.50 |
$2,807.50 |
$2,807.50 |
$983.00
|
|
Transparent film >16<=48 in
|
$144.00 |
$144.00 |
$144.00 |
$12.95
|
|
Trauma partial team response w/critical care services level 4
|
$3,807.50 |
$3,807.50 |
$3,807.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$2,151.00 |
$2,151.00 |
$2,151.00 |
$940.80
|
|
Treat ankle dislocation
|
$2,558.50 |
$2,558.50 |
$2,558.50 |
$2,358.40
|
|
Treat finger fracture each
|
$992.50 |
$992.50 |
$992.50 |
$1,536.00
|
|
Treat fracture of radius
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$1,790.00
|
|
Treat fracture of ulna
|
$469.00 |
$469.00 |
$469.00 |
$726.05
|
|
Treat humerus fracture
|
$2,029.00 |
$2,029.00 |
$2,029.00 |
$1,771.43
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$320.00 |
$320.00 |
$320.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$318.50 |
$318.50 |
$318.50 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$230.00 |
$230.00 |
$230.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,700.50 |
$1,700.50 |
$1,700.50 |
$3,982.44
|
|
Treatment of foot infection
|
$3,012.00 |
$3,012.00 |
$3,012.00 |
$3,821.05
|
|
Treatment of toe fracture 28510
|
$420.50 |
$420.50 |
$420.50 |
$369.70
|
|
Treat wrist bone fracture
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$1,548.40
|
|
Treat wrist dislocation
|
$96.00 |
$96.00 |
$96.00 |
$656.25
|
|
Treponema pallidum antibody
|
$86.50 |
$86.50 |
$86.50 |
$70.40
|
|
Trg gene rearrangement anal
|
$390.00 |
$390.00 |
$390.00 |
$455.70
|
|
Triglycerides
|
$96.50 |
$96.50 |
$96.50 |
$58.05
|
|
Trim nondyst nails
|
$56.00 |
$56.00 |
$56.00 |
$113.40
|
|
Trnscath plc stent crv crtd without prtct
|
$14,905.00 |
$14,905.00 |
$14,905.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$10,793.00 |
$10,793.00 |
$10,793.00 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$8,272.00 |
$8,272.00 |
$8,272.00 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$6,324.50 |
$6,324.50 |
$6,324.50 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$6,106.00 |
$6,106.00 |
$6,106.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$12,626.50 |
$12,626.50 |
$12,626.50 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,549.50 |
$3,549.50 |
$3,549.50 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,253.00 |
$1,253.00 |
$1,253.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,795.00 |
$2,795.00 |
$2,795.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,795.00 |
$2,795.00 |
$2,795.00 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$1,252.00 |
$1,252.00 |
$1,252.00 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,063.00 |
$3,063.00 |
$3,063.00 |
$2,986.34
|
|
Troponin quantitative
|
$409.00 |
$409.00 |
$409.00 |
$127.20
|
|
Tube trach fen sz 6 uncuffed
|
$117.00 |
$117.00 |
$117.00 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$13,320.50 |
$13,320.50 |
$13,320.50 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$248.50 |
$248.50 |
$248.50 |
$581.07
|
|
Tx contour defects 1.1-5.0cc 11951
|
$568.50 |
$568.50 |
$568.50 |
$804.23
|
|
Tx l/r atrial fib addl
|
$10,575.50 |
$10,575.50 |
$10,575.50 |
$6,769.00
|
|
Ugt1a1 gene analy common variants
|
$1,137.00 |
$1,137.00 |
$1,137.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$267.50 |
$267.50 |
$267.50 |
$394.20
|
|
Ultrasound breast complete
|
$696.00 |
$696.00 |
$696.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$520.50 |
$520.50 |
$520.50 |
$449.35
|
|
Ultrasound chest
|
$178.50 |
$178.50 |
$178.50 |
$460.85
|
|
Ultrasound encephalogram
|
$223.50 |
$223.50 |
$223.50 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$176.50 |
$176.50 |
$176.50 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$151.00 |
$151.00 |
$151.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$213.50 |
$213.50 |
$213.50 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$559.00 |
$559.00 |
$559.00 |
$720.15
|
|
Ultrasound joint complete left
|
$126.50 |
$126.50 |
$126.50 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$157.50 |
$157.50 |
$157.50 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$195.50 |
$195.50 |
$195.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$124.00 |
$124.00 |
$124.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$253.50 |
$253.50 |
$253.50 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$127.50 |
$127.50 |
$127.50 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$230.50 |
$230.50 |
$230.50 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$533.50 |
$533.50 |
$533.50 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$421.50 |
$421.50 |
$421.50 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$233.00 |
$233.00 |
$233.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$351.00 |
$351.00 |
$351.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$420.00 |
$420.00 |
$420.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$109.00 |
$109.00 |
$109.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$359.00 |
$359.00 |
$359.00 |
$558.35
|
|
Unit mobile power mpu
|
$15,672.50 |
$15,672.50 |
$15,672.50 |
$14,612.80
|
|
Unlisted CT procedure
|
$586.00 |
$586.00 |
$586.00 |
$732.70
|
|
Unlisted fluoroscopic px
|
$160.00 |
$160.00 |
$160.00 |
$305.76
|
|
Unlisted procedure spine
|
$1,293.00 |
$1,293.00 |
$1,293.00 |
$4,659.85
|
|
Unlisted resp px dx nuc med
|
$521.00 |
$521.00 |
$521.00 |
$670.60
|
|
Unlisted urinalysis px
|
$19.00 |
$19.00 |
$19.00 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$497.00 |
$497.00 |
$497.00 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,525.00 |
$1,525.00 |
$1,525.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,202.50 |
$1,202.50 |
$1,202.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$2,034.41
|
|
Urea nitrogen
|
$115.50 |
$115.50 |
$115.50 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$75.50 |
$75.50 |
$75.50 |
$51.75
|
|
Ureteral reflux study
|
$375.50 |
$375.50 |
$375.50 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$510.00 |
$510.00 |
$510.00 |
$579.73
|
|
Urethrocystography void s&i
|
$548.00 |
$548.00 |
$548.00 |
$622.35
|
|
Uric acid blood
|
$75.00 |
$75.00 |
$75.00 |
$48.75
|
|
Uric acid urine
|
$82.00 |
$82.00 |
$82.00 |
$44.33
|
|
Urinalysis microscopic only
|
$17.00 |
$17.00 |
$17.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$43.50 |
$43.50 |
$43.50 |
$55.00
|
|
Urinalysis (without microscopy)
|
$39.50 |
$39.50 |
$39.50 |
$35.75
|
|
Urine Culture Test
|
$137.00 |
$137.00 |
$137.00 |
$81.50
|
|
Urine pregnancy test
|
$189.50 |
$189.50 |
$189.50 |
$67.20
|
|
Urography, antegrade
|
$398.50 |
$398.50 |
$398.50 |
$622.35
|
|
Vacuum drain bottle/tube kit
|
$1,516.50 |
$1,516.50 |
$1,516.50 |
$325.20
|
|
Vad battery clip set hmii 14-v li-ion
|
$3,241.00 |
$3,241.00 |
$3,241.00 |
$2,002.00
|
|
Vad cable power module dc input
|
$5,892.50 |
$5,892.50 |
$5,892.50 |
$731.74
|
|
Vad univ batt charger hm 1440
|
$21,213.00 |
$21,213.00 |
$21,213.00 |
$14,827.28
|
|
Valproic acid total therapeutic drug level
|
$144.50 |
$144.50 |
$144.50 |
$114.72
|
|
Valvuloplasty aortic
|
$4,586.50 |
$4,586.50 |
$4,586.50 |
$7,830.80
|
|
Valvuloplasty mitral
|
$17,841.00 |
$17,841.00 |
$17,841.00 |
$10,877.90
|
|
Vancomycin peak therapeutic drug level
|
$114.50 |
$114.50 |
$114.50 |
$136.13
|
|
Vanomycin dna amp probe
|
$43.00 |
$43.00 |
$43.00 |
$78.40
|
|
Varicella zoster antibody igg
|
$134.50 |
$134.50 |
$134.50 |
$86.80
|
|
Veeg cont 2-12 hrs
|
$1,354.00 |
$1,354.00 |
$1,354.00 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$3,514.00 |
$3,514.00 |
$3,514.00 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$805.00 |
$805.00 |
$805.00 |
$961.00
|
