|
Trnscath plc stnt ante carotid art
|
$3,917.34 |
$3,917.34 |
$3,917.34 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,917.74 |
$2,917.74 |
$2,917.74 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,068.94 |
$3,068.94 |
$3,068.94 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$6,714.96 |
$6,714.96 |
$6,714.96 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,453.66 |
$3,453.66 |
$3,453.66 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$6,703.62 |
$6,703.62 |
$6,703.62 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,578.02 |
$5,578.02 |
$5,578.02 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,379.34 |
$4,379.34 |
$4,379.34 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$5,871.18 |
$5,871.18 |
$5,871.18 |
$3,866.70
|
|
Troponin quantitative
|
$15.96 |
$15.96 |
$15.96 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$855.54 |
$855.54 |
$855.54 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$957.18 |
$957.18 |
$957.18 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$432.18 |
$432.18 |
$432.18 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$23,868.60 |
$23,868.60 |
$23,868.60 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$3,594.78 |
$3,594.78 |
$3,594.78 |
$6,986.85
|
|
Ugt1a1 gene analy common variants
|
$294.84 |
$294.84 |
$294.84 |
$438.75
|
|
Ultrasound breast complete
|
$257.04 |
$257.04 |
$257.04 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$210.42 |
$210.42 |
$210.42 |
$452.40
|
|
Ultrasound encephalogram
|
$107.94 |
$107.94 |
$107.94 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$281.40 |
$281.40 |
$281.40 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$162.54 |
$162.54 |
$162.54 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$510.30 |
$510.30 |
$510.30 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$146.58 |
$146.58 |
$146.58 |
$388.08
|
|
Ultrasound guide intraoperative
|
$439.74 |
$439.74 |
$439.74 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$281.40 |
$281.40 |
$281.40 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$107.94 |
$107.94 |
$107.94 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$78.96 |
$78.96 |
$78.96 |
$311.25
|
|
Ultrasound joint complete left
|
$282.66 |
$282.66 |
$282.66 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$126.84 |
$126.84 |
$126.84 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$86.94 |
$86.94 |
$86.94 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$265.02 |
$265.02 |
$265.02 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$129.78 |
$129.78 |
$129.78 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$269.64 |
$269.64 |
$269.64 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$166.74 |
$166.74 |
$166.74 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$296.52 |
$296.52 |
$296.52 |
$419.50
|
|
Unlisted hematology&coagj px
|
$23.94 |
$23.94 |
$23.94 |
$39.52
|
|
Unlisted mr procedure
|
$1,249.50 |
$1,249.50 |
$1,249.50 |
$1,165.00
|
|
Unlisted procedure microbiology
|
$359.52 |
$359.52 |
$359.52 |
$530.00
|
|
Unlisted transfusion med px
|
$112.56 |
$112.56 |
$112.56 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$831.60 |
$831.60 |
$831.60 |
$1,292.33
|
|
Upgrade pm system
|
$8,276.94 |
$8,276.94 |
$8,276.94 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$78.96 |
$78.96 |
$78.96 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$809.34 |
$809.34 |
$809.34 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$647.22 |
$647.22 |
$647.22 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,194.48 |
$1,194.48 |
$1,194.48 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$995.40 |
$995.40 |
$995.40 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$796.32 |
$796.32 |
$796.32 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$78.96 |
$78.96 |
$78.96 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$84.00 |
$84.00 |
$84.00 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$229.32 |
$229.32 |
$229.32 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$200.76 |
$200.76 |
$200.76 |
$607.20
|
|
Urea nitrogen
|
$5.04 |
$5.04 |
$5.04 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$21.84 |
$21.84 |
$21.84 |
$52.00
|
|
Ureteral embolization/occl
|
$1,504.44 |
$1,504.44 |
$1,504.44 |
$2,079.31
|
|
Ureteral reflux study
|
$253.26 |
$253.26 |
$253.26 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$206.22 |
$206.22 |
$206.22 |
$584.00
|
|
Urethrocystography void s&i
|
$220.08 |
$220.08 |
$220.08 |
$631.40
|
|
Uric acid blood
|
$5.88 |
$5.88 |
$5.88 |
$49.44
|
|
Uric acid urine
|
$30.24 |
$30.24 |
$30.24 |
$45.36
|
|
Urinalysis microscopic only
|
$4.20 |
$4.20 |
$4.20 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$2.94 |
$2.94 |
$2.94 |
$25.72
|
|
Urinalysis (with microscopy)
|
$4.20 |
$4.20 |
$4.20 |
$55.20
|
|
Urinalysis (without microscopy)
|
$22.26 |
$22.26 |
$22.26 |
$36.00
|
|
Urine Culture Test
|
$10.50 |
$10.50 |
$10.50 |
$83.00
|
|
Urine pregnancy test
|
$24.36 |
$24.36 |
$24.36 |
$68.78
|
|
Urography, antegrade
|
$278.46 |
$278.46 |
$278.46 |
$622.35
|
|
Urography inf drip &/or bolus
|
$464.94 |
$464.94 |
$464.94 |
$642.50
|
|
Vaccine Administration (one shot)
|
$55.02 |
$55.02 |
$55.02 |
$67.70
|
|
Valproic acid total therapeutic drug level
|
$27.72 |
$27.72 |
$27.72 |
$115.00
|
|
Valvuloplasty aortic
|
$4,814.46 |
$4,814.46 |
$4,814.46 |
$7,944.16
|
|
Valvuloplasty mitral
|
$4,950.96 |
$4,950.96 |
$4,950.96 |
$10,877.90
|
|
Valvuloplasty pulmonary
|
$4,521.30 |
$4,521.30 |
$4,521.30 |
$11,945.20
|
|
Vancomycin peak therapeutic drug level
|
$17.22 |
$17.22 |
$17.22 |
$136.13
|
|
Varicella zoster antibody igg
|
$22.26 |
$22.26 |
$22.26 |
$86.80
|
|
Veeg cont 2-12 hrs
|
$971.04 |
$971.04 |
$971.04 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$1,359.54 |
$1,359.54 |
$1,359.54 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$893.34 |
$893.34 |
$893.34 |
$994.91
|
|
Veeg unmon 12-26 hrs
|
$1,165.08 |
$1,165.08 |
$1,165.08 |
$1,794.68
|
|
Veeg unmon 2-12 hrs
|
$776.58 |
$776.58 |
$776.58 |
$826.15
|
|
Vein x-ray adrenal gland
|
$2,441.88 |
$2,441.88 |
$2,441.88 |
$2,833.34
|
|
Vein x-ray adrenal glands
|
$2,865.24 |
$2,865.24 |
$2,865.24 |
$3,456.00
|
|
Vein x-ray eye socket
|
$2,291.94 |
$2,291.94 |
$2,291.94 |
$1,438.32
|
|
Vein x-ray kidney
|
$2,168.46 |
$2,168.46 |
$2,168.46 |
$2,870.00
|
|
Vein x-ray liver
|
$1,954.68 |
$1,954.68 |
$1,954.68 |
$3,312.00
|
|
Vein x-ray liver w/hemodynam
|
$2,669.10 |
$2,669.10 |
$2,669.10 |
$3,610.20
|
|
Vein x-ray liver w/hemodynam
|
$2,171.82 |
$2,171.82 |
$2,171.82 |
$3,662.50
|
|
Vein x-ray liver without hemodyn
|
$2,639.28 |
$2,639.28 |
$2,639.28 |
$2,452.80
|
|
Vein x-ray skull
|
$1,575.84 |
$1,575.84 |
$1,575.84 |
$2,236.50
|
|
Vein x-ray skull epidural
|
$2,441.88 |
$2,441.88 |
$2,441.88 |
$1,596.00
|
|
Vein x-ray spleen/liver
|
$1,648.50 |
$1,648.50 |
$1,648.50 |
$3,434.00
|
|
Venogram ext bil s&i
|
$1,171.38 |
$1,171.38 |
$1,171.38 |
$1,829.42
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$1,382.58
|
|
Venous mech thrombectomy
|
$6,023.64 |
$6,023.64 |
$6,023.64 |
$8,184.00
|
|
Venous m-thrombectomy add-on
|
$3,082.38 |
$3,082.38 |
$3,082.38 |
$5,094.75
|
|
Venous sampling s&i
|
$2,852.22 |
$2,852.22 |
$2,852.22 |
$4,200.00
|
|
Ventilator each subsequent day
|
$967.26 |
$967.26 |
$967.26 |
$1,184.00
|
|
Ventilator Management (first day)
|
$1,343.16 |
$1,343.16 |
$1,343.16 |
$1,434.60
|
|
Version cephalic external
|
$266.70 |
$266.70 |
$266.70 |
$2,361.75
|
|
Very long chain fatty acids
|
$86.10 |
$86.10 |
$86.10 |
$139.88
|
|
Video Swallow Study (Modified Barium Swallow)
|
$181.44 |
$181.44 |
$181.44 |
$524.50
|
