|
Trichinella antibody
|
$55.20 |
$55.20 |
$55.20 |
$70.20
|
|
Trichomonas assay w/optic
|
$10.00 |
$10.00 |
$10.00 |
$55.50
|
|
#tricyclicantidprssnt
|
$45.20 |
$45.20 |
$45.20 |
$50.86
|
|
Triglycerides
|
$25.60 |
$25.60 |
$25.60 |
$58.05
|
|
Trim nondyst nails
|
$106.80 |
$106.80 |
$106.80 |
$113.40
|
|
Trnscath plc stent crv crtd without prtct
|
$5,422.40 |
$5,422.40 |
$5,422.40 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$7,257.60 |
$7,257.60 |
$7,257.60 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$5,422.40 |
$5,422.40 |
$5,422.40 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,959.20 |
$3,959.20 |
$3,959.20 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$4,777.60 |
$4,777.60 |
$4,777.60 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$9,982.00 |
$9,982.00 |
$9,982.00 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,101.20 |
$5,101.20 |
$5,101.20 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,050.40 |
$4,050.40 |
$4,050.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,400.40 |
$1,400.40 |
$1,400.40 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,400.40 |
$1,400.40 |
$1,400.40 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$3,551.20 |
$3,551.20 |
$3,551.20 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,543.20 |
$2,543.20 |
$2,543.20 |
$2,986.34
|
|
Troponin quantitative
|
$45.20 |
$45.20 |
$45.20 |
$127.20
|
|
Tube trach disp innr can 5 xlt
|
$518.40 |
$518.40 |
$518.40 |
$445.99
|
|
Tube trach fen sz 6 uncuffed
|
$366.40 |
$366.40 |
$366.40 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$32,254.40 |
$32,254.40 |
$32,254.40 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$392.80 |
$392.80 |
$392.80 |
$581.07
|
|
Tx l/r atrial fib addl
|
$3,136.40 |
$3,136.40 |
$3,136.40 |
$6,769.00
|
|
Ua w/micro/comp poc
|
$16.00 |
$16.00 |
$16.00 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$346.80 |
$346.80 |
$346.80 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$225.60 |
$225.60 |
$225.60 |
$394.20
|
|
Ultrasound breast complete
|
$420.80 |
$420.80 |
$420.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$219.60 |
$219.60 |
$219.60 |
$449.35
|
|
Ultrasound chest
|
$420.80 |
$420.80 |
$420.80 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$420.80 |
$420.80 |
$420.80 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$105.60 |
$105.60 |
$105.60 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$214.40 |
$214.40 |
$214.40 |
$307.00
|
|
Ultrasound encephalogram
|
$420.80 |
$420.80 |
$420.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$420.80 |
$420.80 |
$420.80 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$420.80 |
$420.80 |
$420.80 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$222.40 |
$222.40 |
$222.40 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,148.40 |
$1,148.40 |
$1,148.40 |
$720.15
|
|
Ultrasound guide intraoperative
|
$883.60 |
$883.60 |
$883.60 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$222.40 |
$222.40 |
$222.40 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$219.60 |
$219.60 |
$219.60 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$219.60 |
$219.60 |
$219.60 |
$311.25
|
|
Ultrasound joint complete left
|
$420.80 |
$420.80 |
$420.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$420.80 |
$420.80 |
$420.80 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$920.40 |
$920.40 |
$920.40 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$802.40 |
$802.40 |
$802.40 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$420.80 |
$420.80 |
$420.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$420.80 |
$420.80 |
$420.80 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$420.80 |
$420.80 |
$420.80 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$420.80 |
$420.80 |
$420.80 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$420.80 |
$420.80 |
$420.80 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$420.80 |
$420.80 |
$420.80 |
$486.50
|
|
Ultrasound scrotum and contents
|
$420.80 |
$420.80 |
$420.80 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$420.80 |
$420.80 |
$420.80 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$893.60 |
$893.60 |
$893.60 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$420.80 |
$420.80 |
$420.80 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$451.60 |
$451.60 |
$451.60 |
$206.64
|
|
Unit mobile power mpu
|
$14,612.80 |
$14,612.80 |
$14,612.80 |
$14,612.80
|
|
Unlisted chemotherapy px
|
$92.80 |
$92.80 |
$92.80 |
$150.00
|
|
Unlisted cytogenetic study
|
$160.00 |
$160.00 |
$160.00 |
$160.18
|
|
Unlisted dx gi procedure
|
$433.20 |
$433.20 |
$433.20 |
$649.22
|
|
Unlisted fluoroscopic px
|
$220.00 |
$220.00 |
$220.00 |
$305.76
|
|
Unlisted procedure larynx
|
$492.40 |
$492.40 |
$492.40 |
$924.00
|
|
Unlisted procedure liver
|
$1,307.20 |
$1,307.20 |
$1,307.20 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$25.20 |
$25.20 |
$25.20 |
$523.50
|
|
Unlisted procedure rectum
|
$1,223.20 |
$1,223.20 |
$1,223.20 |
$1,220.35
|
|
Unlisted px abdomen muscskel
|
$302.80 |
$302.80 |
$302.80 |
$1,848.60
|
|
Unlisted px biliary tract
|
$1,767.20 |
$1,767.20 |
$1,767.20 |
$2,718.10
|
|
Unlisted px casting/strpg
|
$248.00 |
$248.00 |
$248.00 |
$219.70
|
|
Unlisted px diaphragm
|
$6,325.20 |
$6,325.20 |
$6,325.20 |
$6,547.57
|
|
Unlisted px foot/toes
|
$392.80 |
$392.80 |
$392.80 |
$1,225.50
|
|
Unlisted px med radj physics
|
$244.40 |
$244.40 |
$244.40 |
$462.35
|
|
Unlisted transfusion med px
|
$28.80 |
$28.80 |
$28.80 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
$1,268.17
|
|
Upgrade pm system
|
$12,482.00 |
$12,482.00 |
$12,482.00 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,302.80 |
$1,302.80 |
$1,302.80 |
$2,034.41
|
|
Urea nitrogen
|
$17.60 |
$17.60 |
$17.60 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$21.20 |
$21.20 |
$21.20 |
$51.75
|
|
Urea nitrogen clearance
|
$29.20 |
$29.20 |
$29.20 |
$42.25
|
|
Ureteral embolization/occl
|
$1,294.80 |
$1,294.80 |
$1,294.80 |
$2,181.40
|
|
Urethrcystgrphy rtrgrde s&i
|
$876.80 |
$876.80 |
$876.80 |
$579.73
|
|
Urethrocystography void s&i
|
$876.80 |
$876.80 |
$876.80 |
$622.35
|
|
Uric acid blood
|
$20.00 |
$20.00 |
$20.00 |
$48.75
|
|
Uric acid urine
|
$21.20 |
$21.20 |
$21.20 |
$44.33
|
|
Urinalysis microscopic only
|
$12.00 |
$12.00 |
$12.00 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$10.00 |
$10.00 |
$10.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$14.00 |
$14.00 |
$14.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$10.00 |
$10.00 |
$10.00 |
$35.75
|
|
Urine Culture Test
|
$36.00 |
$36.00 |
$36.00 |
$81.50
|
|
Urine pregnancy test
|
$30.40 |
$30.40 |
$30.40 |
$67.20
|
|
Urography, antegrade
|
$969.20 |
$969.20 |
$969.20 |
$622.35
|
|
Use 1st target lesion
|
$200.40 |
$200.40 |
$200.40 |
$332.00
|
|
User adjustable heel height
|
$1,111.60 |
$1,111.60 |
$1,111.60 |
$2,004.80
|
|
Vaccine dtap < 7 years im
|
$32.00 |
$32.00 |
$32.00 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$1.07 |
$1.07 |
$1.07 |
$164.63
|
|
Vaccine dtap-ipv-hib-hepb im
|
$1.07 |
$1.07 |
$1.07 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$1.07 |
$1.07 |
$1.07 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$1.07 |
$1.07 |
$1.07 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$5.32 |
$5.32 |
$5.32 |
$43.12
|
