|
Treat foot dislocation
|
$448.80 |
$448.80 |
$448.80 |
$478.40
|
|
Treat foot dislocation
|
$448.80 |
$448.80 |
$448.80 |
$404.04
|
|
Treat fracture of radius
|
$1,958.40 |
$1,958.40 |
$1,958.40 |
$2,030.33
|
|
Treat fracture of radius
|
$3,126.30 |
$3,126.30 |
$3,126.30 |
$2,316.75
|
|
Treat fracture of ulna
|
$626.79 |
$626.79 |
$626.79 |
$766.72
|
|
Treat hand dislocation
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$1,893.86
|
|
Treat hip dislocation
|
$3,068.67 |
$3,068.67 |
$3,068.67 |
$2,561.90
|
|
Treat hip dislocation
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$3,152.05
|
|
Treat hip socket fracture
|
$1,257.15 |
$1,257.15 |
$1,257.15 |
$1,340.10
|
|
Treat humerus fracture
|
$28,431.48 |
$28,431.48 |
$28,431.48 |
$11,850.08
|
|
Treat humerus fracture
|
$1,958.40 |
$1,958.40 |
$1,958.40 |
$1,950.60
|
|
Treat humerus fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$12,653.00
|
|
Treat humerus fracture
|
$2,485.74 |
$2,485.74 |
$2,485.74 |
$2,045.35
|
|
Treat kneecap dislocation
|
$3,152.82 |
$3,152.82 |
$3,152.82 |
$1,351.35
|
|
Treat knee dislocation
|
$3,126.30 |
$3,126.30 |
$3,126.30 |
$2,592.08
|
|
Treat knee fracture 27530
|
$448.80 |
$448.80 |
$448.80 |
$580.20
|
|
Treat knee fracture(s)
|
$448.80 |
$448.80 |
$448.80 |
$642.00
|
|
Treat knuckle dislocation
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$1,893.86
|
|
Treat lower leg dislocation
|
$448.80 |
$448.80 |
$448.80 |
$532.60
|
|
Treat lower leg dislocation
|
$6,447.42 |
$6,447.42 |
$6,447.42 |
$4,350.00
|
|
Treat lower leg fracture
|
$28,431.48 |
$28,431.48 |
$28,431.48 |
$12,905.86
|
|
Treat lower leg fracture
|
$28,431.48 |
$28,431.48 |
$28,431.48 |
$12,653.00
|
|
Treat lower leg joint
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$14,326.92 |
$14,326.92 |
$14,326.92 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$6,912.54 |
$6,912.54 |
$6,912.54 |
$3,806.40
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$402.90 |
$402.90 |
$402.90 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$6,124.08 |
$6,124.08 |
$6,124.08 |
$3,820.53
|
|
Treatment mouth roof lesion
|
$6,161.82 |
$6,161.82 |
$6,161.82 |
$4,350.00
|
|
Treatment of ankle fracture
|
$14,326.92 |
$14,326.92 |
$14,326.92 |
$7,907.11
|
|
Treatment of ankle fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$7,907.11
|
|
Treatment of ankle fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$7,348.32
|
|
Treatment of ankle fracture 27786
|
$691.05 |
$691.05 |
$691.05 |
$580.00
|
|
Treatment of fibula fracture
|
$14,326.92 |
$14,326.92 |
$14,326.92 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$448.80 |
$448.80 |
$448.80 |
$558.75
|
|
Treatment of heel fracture 28400
|
$448.80 |
$448.80 |
$448.80 |
$494.00
|
|
Treatment of miscarriage
|
$6,124.08 |
$6,124.08 |
$6,124.08 |
$4,146.69
|
|
Treatment of thigh fracture
|
$451.35 |
$451.35 |
$451.35 |
$467.25
|
|
Treatment of thigh fracture
|
$3,126.30 |
$3,126.30 |
$3,126.30 |
$1,893.86
|
|
Treatment of thigh fracture
|
$448.80 |
$448.80 |
$448.80 |
$659.00
|
|
Treatment of thigh fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$6,651.45
|
|
Treatment of thigh fracture
|
$2,001.75 |
$2,001.75 |
$2,001.75 |
$2,055.00
|
|
Treatment of tibia fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$6,183.84
|
|
Treatment of toe fracture 28510
|
$448.80 |
$448.80 |
$448.80 |
$371.40
|
|
Treat metacarpal fracture
|
$6,486.18 |
$6,486.18 |
$6,486.18 |
$3,958.50
|
|
Treat metacarpal fracture
|
$6,486.18 |
$6,486.18 |
$6,486.18 |
$4,627.00
|
|
Treat metatarsal fracture
|
$14,326.92 |
$14,326.92 |
$14,326.92 |
$7,913.97
|
|
Treat midfoot fracture each
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$1,893.86
|
|
Treat sternum fracture
|
$451.35 |
$451.35 |
$451.35 |
$423.00
|
|
Treat thigh fracture
|
$448.80 |
$448.80 |
$448.80 |
$661.00
|
|
Treat thigh fracture
|
$14,413.11 |
$14,413.11 |
$14,413.11 |
$7,372.60
|
|
Treat thigh fracture
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$2,021.04
|
|
Treat thigh fracture
|
$448.80 |
$448.80 |
$448.80 |
$716.95
|
|
Treat thigh fracture
|
$3,323.16 |
$3,323.16 |
$3,323.16 |
$2,090.14
|
|
Treat thigh fx growth plate
|
$448.80 |
$448.80 |
$448.80 |
$421.50
|
|
Treat toe dislocation
|
$771.12 |
$771.12 |
$771.12 |
$855.66
|
|
Treat toe fracture
|
$6,447.42 |
$6,447.42 |
$6,447.42 |
$3,981.06
|
|
Treat ulnar fracture
|
$2,734.11 |
$2,734.11 |
$2,734.11 |
$1,861.60
|
|
Treat vaginal bleeding
|
$282.54 |
$282.54 |
$282.54 |
$400.86
|
|
Treat wrist bone fracture
|
$3,107.43 |
$3,107.43 |
$3,107.43 |
$1,907.64
|
|
Treat wrist dislocation
|
$855.27 |
$855.27 |
$855.27 |
$760.00
|
|
Treponema pallidum antibody
|
$195.84 |
$195.84 |
$195.84 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$84.15 |
$84.15 |
$84.15 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$127.32 |
$127.32 |
$127.32 |
$1,309.80
|
|
#tricyclicantidprssnt
|
$5.56 |
$5.56 |
$5.56 |
$57.08
|
|
Triglycerides
|
$143.31 |
$143.31 |
$143.31 |
$54.60
|
|
Trim nondyst nails
|
$185.64 |
$185.64 |
$185.64 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$448.80 |
$448.80 |
$448.80 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$11,603.52 |
$11,603.52 |
$11,603.52 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$20,683.05 |
$20,683.05 |
$20,683.05 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$13,634.85 |
$13,634.85 |
$13,634.85 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$10,953.27 |
$10,953.27 |
$10,953.27 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$14,819.58 |
$14,819.58 |
$14,819.58 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$10,032.21 |
$10,032.21 |
$10,032.21 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$11,174.61 |
$11,174.61 |
$11,174.61 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,427.02 |
$6,427.02 |
$6,427.02 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,427.02 |
$6,427.02 |
$6,427.02 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$11,174.61 |
$11,174.61 |
$11,174.61 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$7,088.49 |
$7,088.49 |
$7,088.49 |
$4,805.85
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$2,413.83 |
$2,413.83 |
$2,413.83 |
$2,343.60
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,760.74 |
$3,760.74 |
$3,760.74 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,760.74 |
$3,760.74 |
$3,760.74 |
$3,322.20
|
|
Troponin quantitative
|
$356.49 |
$356.49 |
$356.49 |
$123.75
|
|
Tube trach disp innr can 5 xlt
|
$774.69 |
$774.69 |
$774.69 |
$460.58
|
|
Tx atrial fib pulm vein isol
|
$26,151.27 |
$26,151.27 |
$26,151.27 |
$32,426.20
|
|
Tx closed hip disl traumatic without anes
|
$1,446.87 |
$1,446.87 |
$1,446.87 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$5,427.93 |
$5,427.93 |
$5,427.93 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$608.94 |
$608.94 |
$608.94 |
$635.46
|
|
Tx l/r atrial fib addl
|
$3,190.05 |
$3,190.05 |
$3,190.05 |
$7,717.80
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$6,447.42 |
$6,447.42 |
$6,447.42 |
$4,449.44
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$6,249.54 |
$6,249.54 |
$6,249.54 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$13,636.89 |
$13,636.89 |
$13,636.89 |
$4,281.00
|
|
Tx open nsl fx uncomp
|
$6,161.82 |
$6,161.82 |
$6,161.82 |
$4,007.22
|
|
Tx open nsl sptl fx
|
$6,486.18 |
$6,486.18 |
$6,486.18 |
$4,289.04
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$6,447.42 |
$6,447.42 |
$6,447.42 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$448.80 |
$448.80 |
$448.80 |
$469.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$412.08 |
$412.08 |
$412.08 |
$403.26
|
|
Ultrasound breast complete
|
$599.76 |
$599.76 |
$599.76 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$599.76 |
$599.76 |
$599.76 |
$449.35
|
