|
Treat elbow fracture
|
$5,618.40 |
$5,618.40 |
$5,618.40 |
$2,125.60
|
|
Treat elbow fracture
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$8,453.60
|
|
Treat eyelid by injection
|
$411.84 |
$411.84 |
$411.84 |
$472.21
|
|
Treat finger fracture each
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$4,108.00
|
|
Treat finger fracture each
|
$1,744.32 |
$1,744.32 |
$1,744.32 |
$1,815.75
|
|
Treat foot dislocation
|
$547.20 |
$547.20 |
$547.20 |
$435.60
|
|
Treat foot dislocation
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$3,935.24
|
|
Treat foot dislocation
|
$547.20 |
$547.20 |
$547.20 |
$527.28
|
|
Treat foot dislocation
|
$547.20 |
$547.20 |
$547.20 |
$478.40
|
|
Treat foot dislocation
|
$547.20 |
$547.20 |
$547.20 |
$404.04
|
|
Treat fracture of radius
|
$2,103.36 |
$2,103.36 |
$2,103.36 |
$2,030.33
|
|
Treat fracture of radius
|
$1,626.72 |
$1,626.72 |
$1,626.72 |
$2,316.75
|
|
Treat fracture of ulna
|
$547.20 |
$547.20 |
$547.20 |
$766.72
|
|
Treat hand dislocation
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$1,893.86
|
|
Treat hip dislocation
|
$4,472.64 |
$4,472.64 |
$4,472.64 |
$2,561.90
|
|
Treat hip dislocation
|
$5,493.60 |
$5,493.60 |
$5,493.60 |
$3,152.05
|
|
Treat hip socket fracture
|
$1,119.36 |
$1,119.36 |
$1,119.36 |
$1,340.10
|
|
Treat humerus fracture
|
$8,412.96 |
$8,412.96 |
$8,412.96 |
$11,850.08
|
|
Treat humerus fracture
|
$1,841.28 |
$1,841.28 |
$1,841.28 |
$1,950.60
|
|
Treat humerus fracture
|
$8,412.96 |
$8,412.96 |
$8,412.96 |
$12,653.00
|
|
Treat humerus fracture
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$2,045.35
|
|
Treat kneecap dislocation
|
$5,325.12 |
$5,325.12 |
$5,325.12 |
$1,351.35
|
|
Treat knee dislocation
|
$4,472.64 |
$4,472.64 |
$4,472.64 |
$2,592.08
|
|
Treat knee fracture 27530
|
$496.80 |
$496.80 |
$496.80 |
$580.20
|
|
Treat knee fracture(s)
|
$547.20 |
$547.20 |
$547.20 |
$642.00
|
|
Treat knuckle dislocation
|
$1,123.68 |
$1,123.68 |
$1,123.68 |
$1,893.86
|
|
Treat lower leg dislocation
|
$475.68 |
$475.68 |
$475.68 |
$532.60
|
|
Treat lower leg dislocation
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$4,350.00
|
|
Treat lower leg fracture
|
$8,412.96 |
$8,412.96 |
$8,412.96 |
$12,905.86
|
|
Treat lower leg fracture
|
$8,412.96 |
$8,412.96 |
$8,412.96 |
$12,653.00
|
|
Treat lower leg joint
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$4,258.08 |
$4,258.08 |
$4,258.08 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$7,092.48 |
$7,092.48 |
$7,092.48 |
$3,806.40
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$431.52 |
$431.52 |
$431.52 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$4,100.64 |
$4,100.64 |
$4,100.64 |
$3,820.53
|
|
Treatment mouth roof lesion
|
$4,803.84 |
$4,803.84 |
$4,803.84 |
$4,350.00
|
|
Treatment of ankle fracture
|
$4,896.00 |
$4,896.00 |
$4,896.00 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$7,348.32
|
|
Treatment of ankle fracture 27786
|
$132.96 |
$132.96 |
$132.96 |
$580.00
|
|
Treatment of fibula fracture
|
$4,258.08 |
$4,258.08 |
$4,258.08 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$475.68 |
$475.68 |
$475.68 |
$558.75
|
|
Treatment of heel fracture 28400
|
$475.68 |
$475.68 |
$475.68 |
$494.00
|
|
Treatment of miscarriage
|
$4,100.64 |
$4,100.64 |
$4,100.64 |
$4,146.69
|
|
Treatment of thigh fracture
|
$476.16 |
$476.16 |
$476.16 |
$467.25
|
|
Treatment of thigh fracture
|
$1,831.68 |
$1,831.68 |
$1,831.68 |
$1,893.86
|
|
Treatment of thigh fracture
|
$475.68 |
$475.68 |
$475.68 |
$659.00
|
|
Treatment of thigh fracture
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$6,651.45
|
|
Treatment of thigh fracture
|
$1,626.72 |
$1,626.72 |
$1,626.72 |
$2,055.00
|
|
Treatment of tibia fracture
|
$4,264.80 |
$4,264.80 |
$4,264.80 |
$6,183.84
|
|
Treatment of toe fracture 28510
|
$475.68 |
$475.68 |
$475.68 |
$371.40
|
|
Treatment radiation delivery level 2
|
$887.04 |
$887.04 |
$887.04 |
$735.00
|
|
Treat metacarpal fracture
|
$4,893.60 |
$4,893.60 |
$4,893.60 |
$3,958.50
|
|
Treat metacarpal fracture
|
$4,893.60 |
$4,893.60 |
$4,893.60 |
$4,627.00
|
|
Treat metatarsal fracture
|
$4,258.08 |
$4,258.08 |
$4,258.08 |
$7,913.97
|
|
Treat midfoot fracture each
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$1,893.86
|
|
Treat spinal cord lesion
|
$1,078.56 |
$1,078.56 |
$1,078.56 |
$1,304.32
|
|
Treat sternum fracture
|
$476.16 |
$476.16 |
$476.16 |
$423.00
|
|
Treat thigh fracture
|
$475.68 |
$475.68 |
$475.68 |
$661.00
|
|
Treat thigh fracture
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$7,372.60
|
|
Treat thigh fracture
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$2,021.04
|
|
Treat thigh fracture
|
$475.68 |
$475.68 |
$475.68 |
$716.95
|
|
Treat thigh fracture
|
$1,541.76 |
$1,541.76 |
$1,541.76 |
$2,090.14
|
|
Treat thigh fx growth plate
|
$475.68 |
$475.68 |
$475.68 |
$421.50
|
|
Treat toe dislocation
|
$4,865.76 |
$4,865.76 |
$4,865.76 |
$855.66
|
|
Treat toe fracture
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$3,981.06
|
|
Treat ulnar fracture
|
$1,123.68 |
$1,123.68 |
$1,123.68 |
$1,861.60
|
|
Treat vaginal bleeding
|
$488.16 |
$488.16 |
$488.16 |
$400.86
|
|
Treat wrist bone fracture
|
$1,123.68 |
$1,123.68 |
$1,123.68 |
$1,907.64
|
|
Treat wrist dislocation
|
$547.20 |
$547.20 |
$547.20 |
$760.00
|
|
Treponema pallidum antibody
|
$67.68 |
$67.68 |
$67.68 |
$72.80
|
|
Treprostinil injection
|
$25,824.00 |
$25,824.00 |
$25,824.00 |
$841.84
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.76 |
$44.76 |
$44.76 |
$55.80
|
|
#tricyclicantidprssnt
|
$5.24 |
$5.24 |
$5.24 |
$57.08
|
|
Triglycerides
|
$34.56 |
$34.56 |
$34.56 |
$54.60
|
|
Trimethobenzamide hci 250mg
|
$5.28 |
$5.28 |
$5.28 |
$5.28
|
|
Trimethobenzamide hcl inj
|
$154.09 |
$154.09 |
$154.09 |
$128.00
|
|
Trim nondyst nails
|
$257.76 |
$257.76 |
$257.76 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$504.48 |
$504.48 |
$504.48 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$7,668.48 |
$7,668.48 |
$7,668.48 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,701.44 |
$11,701.44 |
$11,701.44 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$6,050.88 |
$6,050.88 |
$6,050.88 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$6,595.20 |
$6,595.20 |
$6,595.20 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$14,000.16 |
$14,000.16 |
$14,000.16 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,197.76 |
$6,197.76 |
$6,197.76 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$7,116.48 |
$7,116.48 |
$7,116.48 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,663.36 |
$6,663.36 |
$6,663.36 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,662.40 |
$6,662.40 |
$6,662.40 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$4,795.20 |
$4,795.20 |
$4,795.20 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$7,944.48 |
$7,944.48 |
$7,944.48 |
$4,805.85
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$3,454.08 |
$3,454.08 |
$3,454.08 |
$2,343.60
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$4,528.80 |
$4,528.80 |
$4,528.80 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,347.04 |
$3,347.04 |
$3,347.04 |
$3,322.20
|
|
Troponin quantitative
|
$102.24 |
$102.24 |
$102.24 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$2,006.88 |
$2,006.88 |
$2,006.88 |
$1,876.20
|
|
Tte w or without fol w/con,stres
|
$2,006.40 |
$2,006.40 |
$2,006.40 |
$1,582.75
|
|
Tube trach disp innr can 5 xlt
|
$649.96 |
$649.96 |
$649.96 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$13,690.08 |
$13,690.08 |
$13,690.08 |
$32,426.20
|
