|
Transfusion blood/blood component(s)
|
$787.02 |
$787.02 |
$787.02 |
$1,005.00
|
|
Trauma partial team response w/critical care services level 4
|
$9,363.90 |
$9,363.90 |
$9,363.90 |
$5,701.54
|
|
Treat ankle dislocation
|
$3,518.58 |
$3,518.58 |
$3,518.58 |
$2,132.50
|
|
Treat ankle dislocation
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$5,886.74
|
|
Treat big toe fracture
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,839.54
|
|
Treat clavicle dislocation 23545
|
$1,187.16 |
$1,187.16 |
$1,187.16 |
$759.61
|
|
Treat elbow dislocation
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$2,323.75
|
|
Treat elbow fracture
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$2,055.00
|
|
Treat elbow fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$7,807.24
|
|
Treat eyelid by injection
|
$847.08 |
$847.08 |
$847.08 |
$449.82
|
|
Treat finger fracture each
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,981.06
|
|
Treat finger fracture each
|
$2,074.02 |
$2,074.02 |
$2,074.02 |
$1,808.00
|
|
Treat foot dislocation
|
$840.06 |
$840.06 |
$840.06 |
$435.60
|
|
Treat foot dislocation
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,839.54
|
|
Treat foot dislocation
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$585.75
|
|
Treat foot dislocation
|
$840.06 |
$840.06 |
$840.06 |
$510.40
|
|
Treat foot dislocation
|
$924.30 |
$924.30 |
$924.30 |
$404.04
|
|
Treat fracture of radius
|
$3,531.06 |
$3,531.06 |
$3,531.06 |
$2,030.33
|
|
Treat fracture of radius
|
$3,216.72 |
$3,216.72 |
$3,216.72 |
$2,377.20
|
|
Treat fracture of ulna
|
$2,500.68 |
$2,500.68 |
$2,500.68 |
$772.56
|
|
Treat hand dislocation
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$1,893.86
|
|
Treat hip dislocation
|
$3,216.72 |
$3,216.72 |
$3,216.72 |
$2,472.00
|
|
Treat hip dislocation
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$3,152.05
|
|
Treat hip socket fracture
|
$464.88 |
$464.88 |
$464.88 |
$1,520.36
|
|
Treat humerus fracture
|
$29,260.14 |
$29,260.14 |
$29,260.14 |
$10,701.24
|
|
Treat humerus fracture
|
$1,295.58 |
$1,295.58 |
$1,295.58 |
$1,958.91
|
|
Treat humerus fracture
|
$29,260.14 |
$29,260.14 |
$29,260.14 |
$10,902.51
|
|
Treat humerus fracture
|
$1,295.58 |
$1,295.58 |
$1,295.58 |
$2,045.35
|
|
Treat kneecap dislocation
|
$924.30 |
$924.30 |
$924.30 |
$1,426.98
|
|
Treat knee dislocation
|
$3,216.72 |
$3,216.72 |
$3,216.72 |
$2,421.00
|
|
Treat knee fracture 27530
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$580.20
|
|
Treat knee fracture(s)
|
$404.04 |
$404.04 |
$404.04 |
$645.00
|
|
Treat knuckle dislocation
|
$3,166.80 |
$3,166.80 |
$3,166.80 |
$1,893.86
|
|
Treat lower leg dislocation
|
$404.04 |
$404.04 |
$404.04 |
$532.60
|
|
Treat lower leg dislocation
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,839.54
|
|
Treat lower leg fracture
|
$29,260.14 |
$29,260.14 |
$29,260.14 |
$12,299.10
|
|
Treat lower leg fracture
|
$29,260.14 |
$29,260.14 |
$29,260.14 |
$10,629.07
|
|
Treat lower leg joint
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$5,855.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$7,907.11
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$12,898.86 |
$12,898.86 |
$12,898.86 |
$7,907.11
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,402.94 |
$8,402.94 |
$8,402.94 |
$3,762.53
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$424.32 |
$424.32 |
$424.32 |
$203.49
|
|
Treatment missed abortion completed surgically 1st trimester
|
$5,513.82 |
$5,513.82 |
$5,513.82 |
$3,786.00
|
|
Treatment mouth roof lesion
|
$5,548.14 |
$5,548.14 |
$5,548.14 |
$3,837.72
|
|
Treatment of ankle fracture
|
$12,898.86 |
$12,898.86 |
$12,898.86 |
$6,839.00
|
|
Treatment of ankle fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$7,456.70
|
|
Treatment of ankle fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$6,662.72
|
|
Treatment of ankle fracture 27786
|
$1,441.44 |
$1,441.44 |
$1,441.44 |
$574.20
|
|
Treatment of fibula fracture
|
$12,898.86 |
$12,898.86 |
$12,898.86 |
$5,855.00
|
|
Treatment of fibula fracture 27780
|
$1,238.64 |
$1,238.64 |
$1,238.64 |
$558.75
|
|
Treatment of heel fracture 28400
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$482.40
|
|
Treatment of miscarriage
|
$5,513.82 |
$5,513.82 |
$5,513.82 |
$3,958.20
|
|
Treatment of thigh fracture
|
$464.88 |
$464.88 |
$464.88 |
$621.60
|
|
Treatment of thigh fracture
|
$3,216.72 |
$3,216.72 |
$3,216.72 |
$1,772.97
|
|
Treatment of thigh fracture
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$635.20
|
|
Treatment of thigh fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$6,651.45
|
|
Treatment of thigh fracture
|
$2,269.02 |
$2,269.02 |
$2,269.02 |
$1,935.75
|
|
Treatment of tibia fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$5,886.74
|
|
Treatment of toe fracture 28510
|
$840.06 |
$840.06 |
$840.06 |
$362.00
|
|
Treat metacarpal fracture
|
$6,675.24 |
$6,675.24 |
$6,675.24 |
$3,839.54
|
|
Treat metacarpal fracture
|
$6,675.24 |
$6,675.24 |
$6,675.24 |
$4,350.00
|
|
Treat metatarsal fracture
|
$12,898.86 |
$12,898.86 |
$12,898.86 |
$5,779.90
|
|
Treat midfoot fracture each
|
$1,195.74 |
$1,195.74 |
$1,195.74 |
$1,893.86
|
|
Treat sternum fracture
|
$1,026.48 |
$1,026.48 |
$1,026.48 |
$423.00
|
|
Treat thigh fracture
|
$2,109.12 |
$2,109.12 |
$2,109.12 |
$661.00
|
|
Treat thigh fracture
|
$14,834.04 |
$14,834.04 |
$14,834.04 |
$5,868.23
|
|
Treat thigh fracture
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$1,893.86
|
|
Treat thigh fracture
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$716.95
|
|
Treat thigh fx growth plate
|
$404.04 |
$404.04 |
$404.04 |
$421.50
|
|
Treat toe dislocation
|
$924.30 |
$924.30 |
$924.30 |
$937.15
|
|
Treat toe fracture
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,839.54
|
|
Treat ulnar fracture
|
$1,295.58 |
$1,295.58 |
$1,295.58 |
$1,790.00
|
|
Treat vaginal bleeding
|
$347.10 |
$347.10 |
$347.10 |
$359.04
|
|
Treat wrist bone fracture
|
$2,797.08 |
$2,797.08 |
$2,797.08 |
$1,893.86
|
|
Treat wrist dislocation
|
$1,356.42 |
$1,356.42 |
$1,356.42 |
$760.00
|
|
Treponema pallidum antibody
|
$131.82 |
$131.82 |
$131.82 |
$73.45
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$50.70 |
$50.70 |
$50.70 |
$44.19
|
|
Triglycerides
|
$54.60 |
$54.60 |
$54.60 |
$55.90
|
|
Trim nondyst nails
|
$113.88 |
$113.88 |
$113.88 |
$122.85
|
|
Trmt of fracture (femoral shaft) 27500
|
$404.04 |
$404.04 |
$404.04 |
$796.00
|
|
Trnscath tx thromblytc vein ini day
|
$6,679.92 |
$6,679.92 |
$6,679.92 |
$4,201.80
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$7,295.34 |
$7,295.34 |
$7,295.34 |
$4,667.00
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$3,647.28 |
$3,647.28 |
$3,647.28 |
$1,906.40
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,870.36 |
$3,870.36 |
$3,870.36 |
$2,837.09
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,870.36 |
$3,870.36 |
$3,870.36 |
$3,146.85
|
|
Troponin quantitative
|
$295.62 |
$295.62 |
$295.62 |
$124.80
|
|
Tx closed hip disl traumatic without anes
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$650.45
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,928.04 |
$4,928.04 |
$4,928.04 |
$3,839.54
|
|
Tx closed tib shaft fx without manip
|
$1,078.74 |
$1,078.74 |
$1,078.74 |
$643.75
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$4,369.20
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$3,839.54
|
|
Tx open nsl fx uncomp
|
$5,548.14 |
$5,548.14 |
$5,548.14 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$6,675.24 |
$6,675.24 |
$6,675.24 |
$3,839.54
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$5,804.76 |
$5,804.76 |
$5,804.76 |
$4,379.10
|
|
Tx tarsal bone fx without manip 28450
|
$840.06 |
$840.06 |
$840.06 |
$439.20
|
|
Ugt1a1 gene analy common variants
|
$300.30 |
$300.30 |
$300.30 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$906.36 |
$906.36 |
$906.36 |
$409.20
|
|
Ultrasound breast complete
|
$631.80 |
$631.80 |
$631.80 |
$528.41
|
