|
Treat foot dislocation
|
$104.48 |
$104.48 |
$104.48 |
$478.40
|
|
Treat fracture of radius
|
$345.97 |
$345.97 |
$345.97 |
$2,030.33
|
|
Treat hand dislocation
|
$938.26 |
$938.26 |
$938.26 |
$1,893.86
|
|
Treat heel fracture
|
$2,634.53 |
$2,634.53 |
$2,634.53 |
$7,907.11
|
|
Treat hip dislocation
|
$889.70 |
$889.70 |
$889.70 |
$2,561.90
|
|
Treat hip dislocation
|
$889.70 |
$889.70 |
$889.70 |
$3,152.05
|
|
Treat hip socket fracture
|
$119.22 |
$119.22 |
$119.22 |
$1,340.10
|
|
Treat humerus fracture
|
$345.97 |
$345.97 |
$345.97 |
$1,950.60
|
|
Treat humerus fracture
|
$345.97 |
$345.97 |
$345.97 |
$2,045.35
|
|
Treat humerus fracture
|
$2,686.14 |
$2,686.14 |
$2,686.14 |
$9,346.40
|
|
Treat kneecap dislocation
|
$1,094.84 |
$1,094.84 |
$1,094.84 |
$1,351.35
|
|
Treat knee dislocation
|
$1,094.59 |
$1,094.59 |
$1,094.59 |
$2,592.08
|
|
Treat knee fracture 27530
|
$205.14 |
$205.14 |
$205.14 |
$580.20
|
|
Treat knee fracture(s)
|
$205.14 |
$205.14 |
$205.14 |
$642.00
|
|
Treat knuckle dislocation
|
$1,053.92 |
$1,053.92 |
$1,053.92 |
$1,893.86
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$2,713.08 |
$2,713.08 |
$2,713.08 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$2,713.08 |
$2,713.08 |
$2,713.08 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$2,713.08 |
$2,713.08 |
$2,713.08 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$1,337.35 |
$1,337.35 |
$1,337.35 |
$3,806.40
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$52.62 |
$52.62 |
$52.62 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$16.02 |
$16.02 |
$16.02 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$57.20 |
$57.20 |
$57.20 |
$210.00
|
|
Treatment of ankle fracture 27786
|
$205.14 |
$205.14 |
$205.14 |
$580.00
|
|
Treatment of fibula fracture 27780
|
$205.14 |
$205.14 |
$205.14 |
$558.75
|
|
Treatment of heel fracture 28400
|
$205.14 |
$205.14 |
$205.14 |
$494.00
|
|
Treatment of thigh fracture
|
$205.14 |
$205.14 |
$205.14 |
$659.00
|
|
Treatment of thigh fracture
|
$1,050.11 |
$1,050.11 |
$1,050.11 |
$2,055.00
|
|
Treatment of toe fracture 28510
|
$205.14 |
$205.14 |
$205.14 |
$371.40
|
|
Treatment radiation delivery level 2
|
$353.34 |
$353.34 |
$353.34 |
$735.00
|
|
Treat midfoot fracture each
|
$345.97 |
$345.97 |
$345.97 |
$1,893.86
|
|
Treat thigh fracture
|
$345.97 |
$345.97 |
$345.97 |
$2,021.04
|
|
Treat thigh fracture
|
$643.13 |
$643.13 |
$643.13 |
$2,090.14
|
|
Treat toe dislocation
|
$1,148.99 |
$1,148.99 |
$1,148.99 |
$855.66
|
|
Treat ulnar fracture
|
$345.97 |
$345.97 |
$345.97 |
$1,861.60
|
|
Treat vaginal bleeding
|
$121.26 |
$121.26 |
$121.26 |
$400.86
|
|
Treat wrist bone fracture
|
$345.97 |
$345.97 |
$345.97 |
$1,907.64
|
|
Treat wrist dislocation
|
$148.46 |
$148.46 |
$148.46 |
$760.00
|
|
Treponema pallidum antibody
|
$42.46 |
$42.46 |
$42.46 |
$72.80
|
|
Trg gene rearrangement anal
|
$664.74 |
$664.74 |
$664.74 |
$455.70
|
|
Triglycerides
|
$27.20 |
$27.20 |
$27.20 |
$54.60
|
|
Trim nondyst nails
|
$40.42 |
$40.42 |
$40.42 |
$124.22
|
|
Trnscath plc stent crv crtd without prtct
|
$1,767.97 |
$1,767.97 |
$1,767.97 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$1,578.59 |
$1,578.59 |
$1,578.59 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$2,027.25 |
$2,027.25 |
$2,027.25 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$1,598.67 |
$1,598.67 |
$1,598.67 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$3,407.05 |
$3,407.05 |
$3,407.05 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,685.61 |
$1,685.61 |
$1,685.61 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,362.52 |
$1,362.52 |
$1,362.52 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,345.49 |
$1,345.49 |
$1,345.49 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,422.25 |
$1,422.25 |
$1,422.25 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,410.08 |
$2,410.08 |
$2,410.08 |
$4,329.36
|
|
Troponin quantitative
|
$48.81 |
$48.81 |
$48.81 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$531.03 |
$531.03 |
$531.03 |
$1,582.75
|
|
Tube trach disp innr can 5 xlt
|
$21.10 |
$21.10 |
$21.10 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$7,968.67 |
$7,968.67 |
$7,968.67 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$106.77 |
$106.77 |
$106.77 |
$786.00
|
|
Tx closed hip disl traumatic without anes
|
$205.14 |
$205.14 |
$205.14 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,356.67 |
$1,356.67 |
$1,356.67 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$229.55 |
$229.55 |
$229.55 |
$635.46
|
|
Tx l/r atrial fib addl
|
$3,824.95 |
$3,824.95 |
$3,824.95 |
$7,717.80
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$2,686.14 |
$2,686.14 |
$2,686.14 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,686.14 |
$2,686.14 |
$2,686.14 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$205.14 |
$205.14 |
$205.14 |
$469.20
|
|
Ua w/micro/comp poc
|
$13.22 |
$13.22 |
$13.22 |
$24.45
|
|
Ultrasound breast complete
|
$87.45 |
$87.45 |
$87.45 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$87.45 |
$87.45 |
$87.45 |
$449.35
|
|
Ultrasound chest
|
$160.91 |
$160.91 |
$160.91 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$112.87 |
$112.87 |
$112.87 |
$340.14
|
|
Ultrasound encephalogram
|
$162.44 |
$162.44 |
$162.44 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$222.43 |
$222.43 |
$222.43 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$125.07 |
$125.07 |
$125.07 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$355.38 |
$355.38 |
$355.38 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$235.65 |
$235.65 |
$235.65 |
$701.35
|
|
Ultrasound guide intraoperative
|
$253.44 |
$253.44 |
$253.44 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$100.41 |
$100.41 |
$100.41 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$130.92 |
$130.92 |
$130.92 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$114.39 |
$114.39 |
$114.39 |
$321.35
|
|
Ultrasound joint complete left
|
$154.05 |
$154.05 |
$154.05 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$135.49 |
$135.49 |
$135.49 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$89.48 |
$89.48 |
$89.48 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$51.35 |
$51.35 |
$51.35 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$202.35 |
$202.35 |
$202.35 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$137.53 |
$137.53 |
$137.53 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$108.29 |
$108.29 |
$108.29 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$152.78 |
$152.78 |
$152.78 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$119.48 |
$119.48 |
$119.48 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$213.53 |
$213.53 |
$213.53 |
$498.00
|
|
Ultrasound scrotum and contents
|
$197.52 |
$197.52 |
$197.52 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$83.13 |
$83.13 |
$83.13 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$141.34 |
$141.34 |
$141.34 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$201.08 |
$201.08 |
$201.08 |
$567.44
|
|
Unlistd noninvas vasc dx std
|
$227.51 |
$227.51 |
$227.51 |
$819.65
|
|
Unlisted CT procedure
|
$521.11 |
$521.11 |
$521.11 |
$1,043.00
|
|
Unlisted cytogenetic study
|
$278.35 |
$278.35 |
$278.35 |
$132.48
|
|
Unlisted fluoroscopic px
|
$110.07 |
$110.07 |
$110.07 |
$324.85
|
|
Unlisted mr procedure
|
$575.77 |
$575.77 |
$575.77 |
$1,032.20
|
|
Unlisted neurological dx px
|
$53.64 |
$53.64 |
$53.64 |
$185.15
|
|
Unlisted procedure rectum
|
$314.20 |
$314.20 |
$314.20 |
$1,278.72
|
|
Unlisted px accessory sinus
|
$71.94 |
$71.94 |
$71.94 |
$257.26
|
|
Unlisted px ant segment eye
|
$550.60 |
$550.60 |
$550.60 |
$2,698.92
|