|
Transcatheter bx s&i
|
$12,632.57 |
$12,632.57 |
$12,632.57 |
$1,875.96
|
|
Transcath mv repair init prosthesis
|
$121,213.47 |
$121,213.47 |
$121,213.47 |
$17,106.18
|
|
Transcath rmvl perm ldss pmkr rv
|
$20,141.69 |
$20,141.69 |
$20,141.69 |
$4,627.00
|
|
Transferrin
|
$856.83 |
$856.83 |
$856.83 |
$87.30
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$932.77 |
$932.77 |
$932.77 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$689.00 |
$689.00 |
$689.00 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$842.96 |
$842.96 |
$842.96 |
$210.00
|
|
Treponema pallidum antibody
|
$961.07 |
$961.07 |
$961.07 |
$72.80
|
|
Trg gene rearrangement anal
|
$409.35 |
$409.35 |
$409.35 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$20.41 |
$20.41 |
$20.41 |
$48.22
|
|
Trichinella antibody
|
$1,817.91 |
$1,817.91 |
$1,817.91 |
$70.65
|
|
#tricyclicantidprssnt
|
$288.58 |
$288.58 |
$288.58 |
$57.08
|
|
Triglycerides
|
$1,753.08 |
$1,753.08 |
$1,753.08 |
$54.60
|
|
Trim nail(s)
|
$2,728.33 |
$2,728.33 |
$2,728.33 |
$70.56
|
|
Trnscath plc stent crv crtd without prtct
|
$32,891.62 |
$32,891.62 |
$32,891.62 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$32,891.62 |
$32,891.62 |
$32,891.62 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ini vein
|
$57,968.24 |
$57,968.24 |
$57,968.24 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$25,933.72 |
$25,933.72 |
$25,933.72 |
$4,969.90
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$20,418.52 |
$20,418.52 |
$20,418.52 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$20,418.52 |
$20,418.52 |
$20,418.52 |
$4,793.13
|
|
Troponin quantitative
|
$1,540.78 |
$1,540.78 |
$1,540.78 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$104,364.07 |
$104,364.07 |
$104,364.07 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$52,182.69 |
$52,182.69 |
$52,182.69 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$4,261.94 |
$4,261.94 |
$4,261.94 |
$403.26
|
|
Ultrasound chest
|
$7,124.65 |
$7,124.65 |
$7,124.65 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,498.01 |
$1,498.01 |
$1,498.01 |
$340.14
|
|
Ultrasound encephalogram
|
$6,381.77 |
$6,381.77 |
$6,381.77 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$4,484.42 |
$4,484.42 |
$4,484.42 |
$477.88
|
|
Ultrasound guide intraoperative
|
$4,505.43 |
$4,505.43 |
$4,505.43 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$3,452.32 |
$3,452.32 |
$3,452.32 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$3,452.32 |
$3,452.32 |
$3,452.32 |
$321.35
|
|
Ultrasound joint complete left
|
$3,187.80 |
$3,187.80 |
$3,187.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$6,043.10 |
$6,043.10 |
$6,043.10 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$8,897.16 |
$8,897.16 |
$8,897.16 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$7,736.49 |
$7,736.49 |
$7,736.49 |
$326.54
|
|
Ultrasound pregnant uterus follow up per fetus
|
$5,222.35 |
$5,222.35 |
$5,222.35 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$4,417.68 |
$4,417.68 |
$4,417.68 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$3,868.87 |
$3,868.87 |
$3,868.87 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$6,855.19 |
$6,855.19 |
$6,855.19 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$4,085.18 |
$4,085.18 |
$4,085.18 |
$498.00
|
|
Ultrasound scrotum and contents
|
$4,988.74 |
$4,988.74 |
$4,988.74 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$1,794.75 |
$1,794.75 |
$1,794.75 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$4,771.19 |
$4,771.19 |
$4,771.19 |
$567.44
|
|
Unlisted chemotherapy px
|
$852.38 |
$852.38 |
$852.38 |
$153.85
|
|
Unlisted CT procedure
|
$562.87 |
$562.87 |
$562.87 |
$1,043.00
|
|
Unlisted mr procedure
|
$9,185.03 |
$9,185.03 |
$9,185.03 |
$1,032.20
|
|
Unlisted surgical path px
|
$1,257.28 |
$1,257.28 |
$1,257.28 |
$71.65
|
|
Unlisted ultrasound procedure
|
$3,882.47 |
$3,882.47 |
$3,882.47 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$8,970.33 |
$8,970.33 |
$8,970.33 |
$1,505.29
|
|
Upgrade pm system
|
$86,674.21 |
$86,674.21 |
$86,674.21 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$20,488.72 |
$20,488.72 |
$20,488.72 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$14,792.79 |
$14,792.79 |
$14,792.79 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$14,792.79 |
$14,792.79 |
$14,792.79 |
$2,013.08
|
|
Urea nitrogen
|
$928.02 |
$928.02 |
$928.02 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$844.12 |
$844.12 |
$844.12 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$2,007.81 |
$2,007.81 |
$2,007.81 |
$574.40
|
|
Urethrocystography void s&i
|
$5,524.62 |
$5,524.62 |
$5,524.62 |
$634.50
|
|
Uric acid blood
|
$877.18 |
$877.18 |
$877.18 |
$46.64
|
|
Uric acid urine
|
$537.75 |
$537.75 |
$537.75 |
$46.75
|
|
Urinalysis qual/semiquant excpt ia
|
$170.35 |
$170.35 |
$170.35 |
$25.72
|
|
Urinalysis (with microscopy)
|
$734.79 |
$734.79 |
$734.79 |
$48.14
|
|
Urine Culture Test
|
$1,268.72 |
$1,268.72 |
$1,268.72 |
$84.81
|
|
Urine pregnancy test
|
$717.00 |
$717.00 |
$717.00 |
$66.40
|
|
Urography, antegrade
|
$12,805.14 |
$12,805.14 |
$12,805.14 |
$593.37
|
|
Urography inf drip &/or bolus
|
$6,703.61 |
$6,703.61 |
$6,703.61 |
$641.69
|
|
Vaccine dtap < 7 years im
|
$242.68 |
$242.68 |
$242.68 |
$87.80
|
|
Vaccine dtap-ipv/hib im
|
$240.62 |
$240.62 |
$240.62 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$729.16 |
$729.16 |
$729.16 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$37.31 |
$37.31 |
$37.31 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$1,528.63 |
$1,528.63 |
$1,528.63 |
$178.07
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$300.51 |
$300.51 |
$300.51 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$136.46 |
$136.46 |
$136.46 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$627.10 |
$627.10 |
$627.10 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$84.46 |
$84.46 |
$84.46 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$173.60 |
$173.60 |
$173.60 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$51.70 |
$51.70 |
$51.70 |
$48.29
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$535.25 |
$535.25 |
$535.25 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$250.28 |
$250.28 |
$250.28 |
$349.15
|
|
Vaccine mmr live subcutaneous
|
$519.37 |
$519.37 |
$519.37 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$804.01 |
$804.01 |
$804.01 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,420.90 |
$1,420.90 |
$1,420.90 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$66.12 |
$66.12 |
$66.12 |
$385.45
|
|
Vaccine polio (ipv) subcutaneous/im
|
$1,632.96 |
$1,632.96 |
$1,632.96 |
$119.17
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,198.26 |
$1,198.26 |
$1,198.26 |
$1,196.00
|
|
Vaccine td preservative free >= 7 years im
|
$508.03 |
$508.03 |
$508.03 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$1,127.61 |
$1,127.61 |
$1,127.61 |
$115.00
|
|
Valvuloplasty aortic
|
$21,784.44 |
$21,784.44 |
$21,784.44 |
$7,324.85
|
|
Valvuloplasty mitral
|
$10,696.40 |
$10,696.40 |
$10,696.40 |
$10,435.39
|
|
Vancomycin peak therapeutic drug level
|
$1,092.02 |
$1,092.02 |
$1,092.02 |
$126.79
|
|
Veeg cont 2-12 hrs
|
$3,926.18 |
$3,926.18 |
$3,926.18 |
$1,485.05
|
|
Veeg intrmnt 2-12 hrs
|
$4,790.27 |
$4,790.27 |
$4,790.27 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$3,926.18 |
$3,926.18 |
$3,926.18 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$3,926.18 |
$3,926.18 |
$3,926.18 |
$704.79
|
|
Vein x-ray liver
|
$10,346.39 |
$10,346.39 |
$10,346.39 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$12,805.14 |
$12,805.14 |
$12,805.14 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$10,346.39 |
$10,346.39 |
$10,346.39 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$12,805.14 |
$12,805.14 |
$12,805.14 |
$2,489.25
|
|
Vein x-ray skull
|
$5,518.32 |
$5,518.32 |
$5,518.32 |
$2,301.09
|
|
Venous sampling s&i
|
$7,342.23 |
$7,342.23 |
$7,342.23 |
$4,416.78
|
|
Ventilator each subsequent day
|
$17,140.13 |
$17,140.13 |
$17,140.13 |
$1,305.92
|
