|
Unlisted fluoroscopic px
|
$3,433.99 |
$3,433.99 |
$3,433.99 |
$305.76
|
|
Unlisted hystsc px uterus
|
$2,803.60 |
$2,803.60 |
$2,803.60 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$6,307.38 |
$6,307.38 |
$6,307.38 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$6,838.32 |
$6,838.32 |
$6,838.32 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$4,981.62 |
$4,981.62 |
$4,981.62 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$9,492.80 |
$9,492.80 |
$9,492.80 |
$6,463.42
|
|
Unlisted laps px appendix
|
$3,617.40 |
$3,617.40 |
$3,617.40 |
$3,617.40
|
|
Unlisted laps px bladder
|
$5,082.74 |
$5,082.74 |
$5,082.74 |
$5,082.74
|
|
Unlisted laps px endoc sys
|
$5,631.01 |
$5,631.01 |
$5,631.01 |
$5,855.00
|
|
Unlisted laps px esoph
|
$5,042.16 |
$5,042.16 |
$5,042.16 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$10,635.94 |
$10,635.94 |
$10,635.94 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$4,713.11 |
$4,713.11 |
$4,713.11 |
$6,904.15
|
|
Unlisted laps px renal
|
$8,914.07 |
$8,914.07 |
$8,914.07 |
$5,110.00
|
|
Unlisted laps px testis
|
$5,628.67 |
$5,628.67 |
$5,628.67 |
$5,628.67
|
|
Unlisted laps px ureter
|
$5,787.59 |
$5,787.59 |
$5,787.59 |
$6,376.26
|
|
Unlisted laps px uterus
|
$8,151.73 |
$8,151.73 |
$8,151.73 |
$4,627.00
|
|
Unlisted maxlfcl prosth px
|
$1,432.65 |
$1,432.65 |
$1,432.65 |
$571.20
|
|
Unlisted misc path test
|
$89.40 |
$89.40 |
$89.40 |
$89.40
|
|
Unlisted mr procedure
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$1,165.00
|
|
Unlisted muscskel px head
|
$187.43 |
$187.43 |
$187.43 |
$1,224.08
|
|
Unlisted oph svc/procedure
|
$213.51 |
$213.51 |
$213.51 |
$40.26
|
|
Unlisted orl service/px
|
$334.27 |
$334.27 |
$334.27 |
$132.60
|
|
Unlisted procedure colon
|
$1,839.55 |
$1,839.55 |
$1,839.55 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$5,817.32 |
$5,817.32 |
$5,817.32 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$479.62 |
$479.62 |
$479.62 |
$2,174.90
|
|
Unlisted procedure larynx
|
$5,107.38 |
$5,107.38 |
$5,107.38 |
$924.00
|
|
Unlisted procedure liver
|
$3,950.78 |
$3,950.78 |
$3,950.78 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,221.36 |
$2,221.36 |
$2,221.36 |
$530.00
|
|
Unlisted procedure orbit
|
$479.62 |
$479.62 |
$479.62 |
$437.00
|
|
Unlisted procedure pancreas
|
$7,194.87 |
$7,194.87 |
$7,194.87 |
$4,810.00
|
|
Unlisted procedure rectum
|
$745.48 |
$745.48 |
$745.48 |
$1,278.72
|
|
Unlisted procedure spine
|
$9,362.69 |
$9,362.69 |
$9,362.69 |
$4,706.35
|
|
Unlisted px abdomen muscskel
|
$11,582.59 |
$11,582.59 |
$11,582.59 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$235.82 |
$235.82 |
$235.82 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$3,110.31 |
$3,110.31 |
$3,110.31 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$13,708.47 |
$13,708.47 |
$13,708.47 |
$2,765.60
|
|
Unlisted px biliary tract
|
$11,636.44 |
$11,636.44 |
$11,636.44 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$224.93 |
$224.93 |
$224.93 |
$222.00
|
|
Unlisted px conjunctiva
|
$479.62 |
$479.62 |
$479.62 |
$479.62
|
|
Unlisted px diaphragm
|
$6,547.57 |
$6,547.57 |
$6,547.57 |
$6,325.20
|
|
Unlisted px exc pressure ulc
|
$626.83 |
$626.83 |
$626.83 |
$973.71
|
|
Unlisted px external ear
|
$7,359.08 |
$7,359.08 |
$7,359.08 |
$325.68
|
|
Unlisted px extraocular musc
|
$3,718.79 |
$3,718.79 |
$3,718.79 |
$739.20
|
|
Unlisted px foot/toes
|
$7,763.00 |
$7,763.00 |
$7,763.00 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$6,515.57 |
$6,515.57 |
$6,515.57 |
$859.50
|
|
Unlisted px hands/fingers
|
$6,841.45 |
$6,841.45 |
$6,841.45 |
$349.70
|
|
Unlisted px inner ear
|
$17,114.99 |
$17,114.99 |
$17,114.99 |
$571.20
|
|
Unlisted px lacrimal system
|
$479.62 |
$479.62 |
$479.62 |
$416.50
|
|
Unlisted px leg/ankle
|
$6,818.24 |
$6,818.24 |
$6,818.24 |
$813.24
|
|
Unlisted px male genital sys
|
$6,664.68 |
$6,664.68 |
$6,664.68 |
$362.00
|
|
Unlisted px med radj physics
|
$376.03 |
$376.03 |
$376.03 |
$462.35
|
|
Unlisted px middle ear
|
$1,975.05 |
$1,975.05 |
$1,975.05 |
$343.50
|
|
Unlisted px neck/thorax
|
$2,680.22 |
$2,680.22 |
$2,680.22 |
$571.20
|
|
Unlisted px palate uvula
|
$187.43 |
$187.43 |
$187.43 |
$274.80
|
|
Unlisted px pelvis/hip joint
|
$10,031.98 |
$10,031.98 |
$10,031.98 |
$3,251.90
|
|
Unlisted px salivry glnd/dux
|
$4,032.00 |
$4,032.00 |
$4,032.00 |
$1,173.42
|
|
Unlisted px small intestine
|
$3,029.95 |
$3,029.95 |
$3,029.95 |
$2,118.35
|
|
Unlisted px ther rad tx plng
|
$398.11 |
$398.11 |
$398.11 |
$182.00
|
|
Unlisted px tongue flr mouth
|
$220.76 |
$220.76 |
$220.76 |
$282.50
|
|
Unlisted px vestibule mouth
|
$187.43 |
$187.43 |
$187.43 |
$456.96
|
|
Unlisted spec derm svc/px
|
$177.40 |
$177.40 |
$177.40 |
$223.08
|
|
Unlisted special svc px/rprt
|
$210.00 |
$210.00 |
$210.00 |
$90.00
|
|
Unlisted ultrasound procedure
|
$403.43 |
$403.43 |
$3,075.41 |
$335.00
|
|
Unlisted vasc endoscopy px
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$1,523.20
|
|
Unlstd laps px sprmatic cord
|
$4,713.11 |
$4,713.11 |
$4,713.11 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$789.50 |
$789.50 |
$1,091.14 |
$1,316.90
|
|
Upgrade pm system
|
$16,123.59 |
$16,123.59 |
$16,123.59 |
$12,087.24
|
|
Upper Arm (Humerus) X-ray (left side)
|
$399.22 |
$399.22 |
$627.24 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$660.27 |
$660.27 |
$2,041.20 |
$1,652.95
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,841.55 |
$1,841.55 |
$1,980.37 |
$1,422.05
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,402.41 |
$3,402.41 |
$3,855.61 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,039.85 |
$2,039.85 |
$2,517.10 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,192.54 |
$2,192.54 |
$2,198.29 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$313.72 |
$313.72 |
$403.23 |
$320.45
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$313.72 |
$313.72 |
$508.78 |
$380.82
|
|
Upper GI Barium X-ray (barium and gas)
|
$408.60 |
$408.60 |
$665.87 |
$657.77
|
|
Upper GI Barium X-ray (barium only)
|
$483.77 |
$483.77 |
$622.09 |
$603.20
|
|
Urachal cyst/sinus excision 51500
|
$6,082.67 |
$6,082.67 |
$6,082.67 |
$6,082.67
|
|
Urea nitrogen
|
$63.50 |
$63.50 |
$75.09 |
$42.00
|
|
Urea nitrogen 24 hour urine
|
$71.51 |
$71.51 |
$90.41 |
$51.77
|
|
Urea nitrogen clearance
|
$20.07 |
$20.07 |
$20.07 |
$34.02
|
|
Ureteral embolization/occl
|
$1,515.59 |
$1,515.59 |
$1,515.59 |
$2,079.31
|
|
Ureteral reflux study
|
$1,200.74 |
$1,200.74 |
$1,200.74 |
$952.50
|
|
Ureter endoscopy
|
$1,780.46 |
$1,780.46 |
$1,780.46 |
$3,326.40
|
|
Ureter endoscopy & biopsy
|
$4,704.07 |
$4,704.07 |
$4,704.07 |
$5,696.72
|
|
Ureter endoscopy & catheter
|
$1,780.46 |
$1,780.46 |
$1,780.46 |
$3,326.40
|
|
Ureter endoscopy & treatment
|
$4,627.89 |
$4,627.89 |
$4,627.89 |
$5,631.74
|
|
Ureter endoscopy & treatment
|
$3,935.24 |
$3,935.24 |
$3,935.24 |
$5,631.74
|
|
Ureteroureterostomy 50760
|
$2,773.01 |
$2,773.01 |
$2,773.01 |
$2,773.01
|
|
Urethrcystgrphy rtrgrde s&i
|
$946.62 |
$946.62 |
$1,109.77 |
$592.80
|
|
Urethrlys transvag with scope
|
$6,379.33 |
$6,379.33 |
$6,379.33 |
$4,081.37
|
|
Urethrocystography void s&i
|
$712.66 |
$712.66 |
$712.66 |
$631.75
|
|
Uric acid blood
|
$78.37 |
$78.37 |
$85.95 |
$48.96
|
|
Uric acid urine
|
$54.55 |
$54.55 |
$90.41 |
$44.14
|
|
Urinalysis microscopic only
|
$26.46 |
$26.46 |
$57.65 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$46.86 |
$46.86 |
$46.86 |
$25.72
|
|
Urinalysis (with microscopy)
|
$60.42 |
$60.42 |
$77.87 |
$54.60
|
|
Urinalysis (without microscopy)
|
$42.77 |
$42.77 |
$96.30 |
$35.15
|
|
Urinary bldr retent nuc study
|
$337.17 |
$337.17 |
$337.17 |
$350.66
|
|
Urinary reflex study
|
$316.14 |
$316.14 |
$316.14 |
$216.05
|
