|
Treat thigh fracture
|
$1,704.78 |
$1,704.78 |
$1,704.78 |
$2,802.80
|
|
Treat thigh fracture
|
$2,185.92 |
$2,185.92 |
$2,185.92 |
$2,032.10
|
|
Treat thigh fracture
|
$2,792.46 |
$2,792.46 |
$2,792.46 |
$3,580.50
|
|
Treat thorax spine fracture
|
$3,439.26 |
$3,439.26 |
$3,439.26 |
$3,624.00
|
|
Treat thumb fracture
|
$1,153.68 |
$1,153.68 |
$1,153.68 |
$2,508.80
|
|
Treat thumb fracture
|
$1,483.02 |
$1,483.02 |
$1,483.02 |
$3,786.00
|
|
Treat toe dislocation
|
$523.38 |
$523.38 |
$523.38 |
$3,839.54
|
|
Treat toe fracture
|
$946.44 |
$946.44 |
$946.44 |
$3,839.54
|
|
Treat ulnar fracture
|
$1,529.88 |
$1,529.88 |
$1,529.88 |
$5,926.25
|
|
Treat vaginal bleeding
|
$277.20 |
$277.20 |
$277.20 |
$379.60
|
|
Treat wrist bone fracture
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$1,548.40
|
|
Treat wrist dislocation
|
$993.30 |
$993.30 |
$993.30 |
$656.25
|
|
Treponema pallidum antibody
|
$170.94 |
$170.94 |
$170.94 |
$70.40
|
|
Trg gene rearrangement anal
|
$171.60 |
$171.60 |
$171.60 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$28.38 |
$28.38 |
$28.38 |
$43.21
|
|
Triamcinolone diacetate inj
|
$46.20 |
$46.20 |
$46.20 |
$3.60
|
|
Triamcinolone hexacetonl inj
|
$12.54 |
$12.54 |
$12.54 |
$21.36
|
|
Trichinella antibody
|
$49.37 |
$49.37 |
$49.37 |
$70.20
|
|
#tricyclicantidprssnt
|
$38.28 |
$38.28 |
$38.28 |
$50.86
|
|
Triglycerides
|
$35.64 |
$35.64 |
$35.64 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$79.86 |
$79.86 |
$79.86 |
$117.49
|
|
Trim nail(s)
|
$504.24 |
$504.24 |
$504.24 |
$79.00
|
|
Trim nondyst nails
|
$33.66 |
$33.66 |
$33.66 |
$113.40
|
|
Trluml dil aq o/f can without st
|
$1,445.40 |
$1,445.40 |
$1,445.40 |
$5,419.00
|
|
Trluml dil aq o/f can w/st
|
$1,670.46 |
$1,670.46 |
$1,670.46 |
$4,928.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,233.54 |
$1,233.54 |
$1,233.54 |
$754.80
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,083.62 |
$2,083.62 |
$2,083.62 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$440.88 |
$440.88 |
$440.88 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$319.44 |
$319.44 |
$319.44 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$650.76 |
$650.76 |
$650.76 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$643.50 |
$643.50 |
$643.50 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$820.38 |
$820.38 |
$820.38 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$491.04 |
$491.04 |
$491.04 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$259.38 |
$259.38 |
$259.38 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$720.72 |
$720.72 |
$720.72 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$1,987.26 |
$1,987.26 |
$1,987.26 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$476.52 |
$476.52 |
$476.52 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,799.16 |
$1,799.16 |
$1,799.16 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$1,894.86 |
$1,894.86 |
$1,894.86 |
$3,078.00
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$1,642.08 |
$1,642.08 |
$1,642.08 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,500.84 |
$1,500.84 |
$1,500.84 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,492.92 |
$1,492.92 |
$1,492.92 |
$2,406.77
|
|
Troponin quantitative
|
$125.40 |
$125.40 |
$125.40 |
$127.20
|
|
Trurl dstrj prst8 tiss rf wv
|
$881.10 |
$881.10 |
$881.10 |
$4,228.00
|
|
Tubal Ligation (Laparoscopic)
|
$841.50 |
$841.50 |
$841.50 |
$4,323.20
|
|
Tvh >250 gms 58290
|
$2,568.72 |
$2,568.72 |
$2,568.72 |
$6,872.92
|
|
Tvh w/mmk 58267
|
$2,395.14 |
$2,395.14 |
$2,395.14 |
$2,058.60
|
|
Tx closed hip disl traumatic without anes
|
$386.10 |
$386.10 |
$386.10 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,360.26 |
$1,360.26 |
$1,360.26 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$850.74 |
$850.74 |
$850.74 |
$535.60
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$1,733.16 |
$1,733.16 |
$1,733.16 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$1,196.58 |
$1,196.58 |
$1,196.58 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,300.86 |
$1,300.86 |
$1,300.86 |
$4,421.00
|
|
Tx open nsl fx uncomp
|
$1,047.42 |
$1,047.42 |
$1,047.42 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$1,490.94 |
$1,490.94 |
$1,490.94 |
$4,308.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,402.50 |
$1,402.50 |
$1,402.50 |
$4,499.12
|
|
Tx septic abortion surgical 59830
|
$1,027.62 |
$1,027.62 |
$1,027.62 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$517.44 |
$517.44 |
$517.44 |
$416.16
|
|
Tympanic membrane repair
|
$886.38 |
$886.38 |
$886.38 |
$2,638.87
|
|
Tympanolysis transcanal 69450
|
$1,308.78 |
$1,308.78 |
$1,308.78 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$51.48 |
$51.48 |
$51.48 |
$170.00
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$712.80 |
$712.80 |
$712.80 |
$911.43
|
|
Ua w/micro/comp poc
|
$10.56 |
$10.56 |
$10.56 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$153.20 |
$153.20 |
$153.20 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$475.20 |
$475.20 |
$475.20 |
$394.20
|
|
Ultrasound breast complete
|
$918.72 |
$918.72 |
$918.72 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$712.14 |
$712.14 |
$712.14 |
$449.35
|
|
Ultrasound chest
|
$652.74 |
$652.74 |
$652.74 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$237.60 |
$237.60 |
$237.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$128.70 |
$128.70 |
$128.70 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$73.92 |
$73.92 |
$73.92 |
$307.00
|
|
Ultrasound encephalogram
|
$219.78 |
$219.78 |
$219.78 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$401.28 |
$401.28 |
$401.28 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$671.22 |
$671.22 |
$671.22 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$578.82 |
$578.82 |
$578.82 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$788.04 |
$788.04 |
$788.04 |
$720.15
|
|
Ultrasound guide intraoperative
|
$622.38 |
$622.38 |
$622.38 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$254.10 |
$254.10 |
$254.10 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$181.50 |
$181.50 |
$181.50 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$76.56 |
$76.56 |
$76.56 |
$311.25
|
|
Ultrasound joint complete left
|
$525.36 |
$525.36 |
$525.36 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$638.88 |
$638.88 |
$638.88 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$842.16 |
$842.16 |
$842.16 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$674.52 |
$674.52 |
$674.52 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$751.74 |
$751.74 |
$751.74 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$442.20 |
$442.20 |
$442.20 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$350.46 |
$350.46 |
$350.46 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$275.22 |
$275.22 |
$275.22 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$543.18 |
$543.18 |
$543.18 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$531.96 |
$531.96 |
$531.96 |
$486.50
|
|
Ultrasound scrotum and contents
|
$531.96 |
$531.96 |
$531.96 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$480.48 |
$480.48 |
$480.48 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$220.44 |
$220.44 |
$220.44 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$356.40 |
$356.40 |
$356.40 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$151.80 |
$151.80 |
$151.80 |
$206.64
|
|
Umbilicoplasty 15847
|
$1,424.28 |
$1,424.28 |
$1,424.28 |
$4,172.97
|
|
Unlistd noninvas vasc dx std
|
$31.02 |
$31.02 |
$31.02 |
$528.80
|
|
Unlisted laparoscopic liver biopy 47379
|
$2,426.82 |
$2,426.82 |
$2,426.82 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$707.52 |
$707.52 |
$707.52 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$2,813.58 |
$2,813.58 |
$2,813.58 |
$5,419.00
|
