|
Triamcinolone a inj prs-free
|
$37.50 |
$37.50 |
$37.50 |
$223.56
|
|
Trichomonas assay w/optic
|
$85.00 |
$85.00 |
$85.00 |
$55.50
|
|
Triglycerides
|
$51.00 |
$51.00 |
$51.00 |
$58.05
|
|
Trim nondyst nails
|
$67.00 |
$67.00 |
$67.00 |
$113.40
|
|
Triptorelin pamoate
|
$1,737.00 |
$1,737.00 |
$1,737.00 |
$4,619.39
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,993.50 |
$2,993.50 |
$2,993.50 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,222.50 |
$3,222.50 |
$3,222.50 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$25,721.50 |
$25,721.50 |
$25,721.50 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,865.00 |
$2,865.00 |
$2,865.00 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$11,016.50 |
$11,016.50 |
$11,016.50 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,151.50 |
$4,151.50 |
$4,151.50 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,772.50 |
$2,772.50 |
$2,772.50 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$7,533.50 |
$7,533.50 |
$7,533.50 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$7,181.50 |
$7,181.50 |
$7,181.50 |
$2,986.34
|
|
Troponin quantitative
|
$66.50 |
$66.50 |
$66.50 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$1,484.50 |
$1,484.50 |
$1,484.50 |
$2,012.40
|
|
Tube trach disp innr can 5 xlt
|
$95.00 |
$95.00 |
$95.00 |
$445.99
|
|
Tx closed hip disl traumatic without anes
|
$270.00 |
$270.00 |
$270.00 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$330.00 |
$330.00 |
$330.00 |
$535.60
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,650.00 |
$3,650.00 |
$3,650.00 |
$4,468.55
|
|
Tx tarsal bone fx without manip 28450
|
$204.50 |
$204.50 |
$204.50 |
$416.16
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$203.50 |
$203.50 |
$203.50 |
$911.43
|
|
Ua w/micro/comp poc
|
$8.00 |
$8.00 |
$8.00 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$180.00 |
$180.00 |
$180.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$289.00 |
$289.00 |
$289.00 |
$394.20
|
|
Ultrasound breast complete
|
$259.50 |
$259.50 |
$259.50 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$706.00 |
$706.00 |
$706.00 |
$449.35
|
|
Ultrasound chest
|
$289.00 |
$289.00 |
$289.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$289.00 |
$289.00 |
$289.00 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$238.00 |
$238.00 |
$238.00 |
$307.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$278.00 |
$278.00 |
$278.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$53.00 |
$53.00 |
$53.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$100.50 |
$100.50 |
$100.50 |
$720.15
|
|
Ultrasound guide intraoperative
|
$668.50 |
$668.50 |
$668.50 |
$632.85
|
|
Ultrasound joint complete left
|
$289.00 |
$289.00 |
$289.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$284.00 |
$284.00 |
$284.00 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$188.50 |
$188.50 |
$188.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$66.00 |
$66.00 |
$66.00 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$555.50 |
$555.50 |
$555.50 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$303.50 |
$303.50 |
$303.50 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$289.00 |
$289.00 |
$289.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$289.00 |
$289.00 |
$289.00 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$155.50 |
$155.50 |
$155.50 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$303.50 |
$303.50 |
$303.50 |
$486.50
|
|
Ultrasound scrotum and contents
|
$289.00 |
$289.00 |
$289.00 |
$608.90
|
|
Ultrasound transabd ea addl gest
|
$332.50 |
$332.50 |
$332.50 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$289.00 |
$289.00 |
$289.00 |
$558.35
|
|
Unlisted chemotherapy px
|
$128.50 |
$128.50 |
$128.50 |
$150.00
|
|
Unlisted dialysis procedure
|
$1,127.50 |
$1,127.50 |
$1,127.50 |
$1,144.00
|
|
Unlisted hematology&coagj px
|
$88.50 |
$88.50 |
$88.50 |
$39.52
|
|
Unlisted maaa
|
$587.00 |
$587.00 |
$587.00 |
$235.20
|
|
Unlisted mr procedure
|
$212.00 |
$212.00 |
$212.00 |
$1,163.00
|
|
Unlisted px male genital sys
|
$7,637.67 |
$7,637.67 |
$7,637.67 |
$343.55
|
|
Unlisted urinalysis px
|
$70.50 |
$70.50 |
$70.50 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$1,624.50 |
$1,624.50 |
$1,624.50 |
$1,268.17
|
|
Upgrade pm system
|
$4,988.50 |
$4,988.50 |
$4,988.50 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,850.50 |
$1,850.50 |
$1,850.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$836.00 |
$836.00 |
$836.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,441.00 |
$1,441.00 |
$1,441.00 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$4,250.00 |
$4,250.00 |
$4,250.00 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$4,500.00 |
$4,500.00 |
$4,500.00 |
$1,872.00
|
|
Urea nitrogen
|
$29.00 |
$29.00 |
$29.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$34.50 |
$34.50 |
$34.50 |
$51.75
|
|
Urea nitrogen clearance
|
$30.00 |
$30.00 |
$30.00 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$555.50 |
$555.50 |
$555.50 |
$579.73
|
|
Urethrocystography void s&i
|
$631.00 |
$631.00 |
$631.00 |
$622.35
|
|
Uric acid blood
|
$26.50 |
$26.50 |
$26.50 |
$48.75
|
|
Uric acid urine
|
$25.00 |
$25.00 |
$25.00 |
$44.33
|
|
Urinalysis microscopic only
|
$25.00 |
$25.00 |
$25.00 |
$26.35
|
|
Urinalysis (with microscopy)
|
$35.00 |
$35.00 |
$35.00 |
$55.00
|
|
Urinalysis (without microscopy)
|
$16.50 |
$16.50 |
$16.50 |
$35.75
|
|
Urine Culture Test
|
$64.50 |
$64.50 |
$64.50 |
$81.50
|
|
Urine pregnancy test
|
$33.50 |
$33.50 |
$33.50 |
$67.20
|
|
Urography, antegrade
|
$978.50 |
$978.50 |
$978.50 |
$622.35
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$130.00 |
$130.00 |
$130.00 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$113.00 |
$113.00 |
$113.00 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$225.00 |
$225.00 |
$225.00 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$45.00 |
$45.00 |
$45.00 |
$123.20
|
|
Vaccine dtap < 7 years im
|
$27.50 |
$27.50 |
$27.50 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$63.00 |
$63.00 |
$63.00 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$57.50 |
$57.50 |
$57.50 |
$105.95
|
|
Vaccine dtap-ipv/hib im
|
$106.00 |
$106.00 |
$106.00 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$28.00 |
$28.00 |
$28.00 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$12.50 |
$12.50 |
$12.50 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$68.00 |
$68.00 |
$68.00 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$95.50 |
$95.50 |
$95.50 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$32.50 |
$32.50 |
$32.50 |
$79.15
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$46.50 |
$46.50 |
$46.50 |
$84.75
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$46.50 |
$46.50 |
$46.50 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$127.00 |
$127.00 |
$127.00 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$22.00 |
$22.00 |
$22.00 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$290.50 |
$290.50 |
$290.50 |
$576.48
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$138.50 |
$138.50 |
$138.50 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$79.50 |
$79.50 |
$79.50 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$73.00 |
$73.00 |
$73.00 |
$109.50
|
|
Vaccine influenza nos 0.5ml dose im
|
$18.00 |
$18.00 |
$18.00 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$19.50 |
$19.50 |
$19.50 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$46.50 |
$46.50 |
$46.50 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$26.00 |
$26.00 |
$26.00 |
$33.60
|
