|
Treatment of toe fracture 28510
|
$812.54 |
$812.54 |
$812.54 |
$371.40
|
|
Treatment radiation delivery level 2
|
$2,197.00 |
$3,746.75 |
$3,756.00 |
$735.00
|
|
Treat metacarpal fracture
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,958.50
|
|
Treat metacarpal fracture
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$4,627.00
|
|
Treat metatarsal fracture
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
$7,913.97
|
|
Treat midfoot fracture each
|
$5,498.16 |
$5,498.16 |
$5,498.16 |
$1,893.86
|
|
Treat midfoot fracture each
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
$6,192.78
|
|
Treat radius fracture
|
$37,605.75 |
$37,605.75 |
$37,605.75 |
$9,499.20
|
|
Treat sternum fracture
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$423.00
|
|
Treat thigh fracture
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$661.00
|
|
Treat thigh fracture
|
$11,270.44 |
$11,270.44 |
$11,270.44 |
$2,021.04
|
|
Treat thigh fracture
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$716.95
|
|
Treat thigh fracture
|
$22,572.22 |
$22,572.22 |
$22,572.22 |
$2,877.00
|
|
Treat thigh fx growth plate
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$421.50
|
|
Treat thigh fx growth plate
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$1,938.38
|
|
Treat toe dislocation
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$3,839.54
|
|
Treat toe dislocation
|
$749.52 |
$749.52 |
$749.52 |
$855.66
|
|
Treat toe fracture
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$3,981.06
|
|
Treat ulnar fracture
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$1,861.60
|
|
Treat vaginal bleeding
|
$860.33 |
$860.33 |
$860.33 |
$400.86
|
|
Treat wrist bone fracture
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$1,907.64
|
|
Treat wrist dislocation
|
$2,126.45 |
$2,126.45 |
$2,126.45 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$170,352.16 |
$170,352.16 |
$170,352.16 |
$101,032.80
|
|
Treponema pallidum antibody
|
$34.65 |
$34.65 |
$191.03 |
$72.80
|
|
Trg gene rearrangement anal
|
$2,992.34 |
$2,992.34 |
$2,992.34 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$212.34 |
$212.34 |
$493.38 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$1,515.00 |
$1,515.00 |
$2,366.25 |
$1,309.80
|
|
Trichinella antibody
|
$247.29 |
$956.25 |
$1,900.00 |
$70.65
|
|
Trichomonas assay w/optic
|
$190.79 |
$190.79 |
$190.79 |
$66.00
|
|
#tricyclicantidprssnt
|
$159.31 |
$159.31 |
$159.31 |
$57.08
|
|
Triglycerides
|
$114.78 |
$114.78 |
$220.72 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$33.36 |
$204.75 |
$1,334.45 |
$128.00
|
|
Trim nail(s)
|
$174.84 |
$174.84 |
$469.50 |
$70.29
|
|
Trim nondyst nails
|
$257.03 |
$257.03 |
$257.03 |
$124.22
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$18,801.65 |
$18,801.65 |
$18,801.65 |
$15,111.95
|
|
Trml dstrj ios bvn ea addl
|
$7,080.00 |
$7,080.00 |
$7,080.00 |
$9,781.50
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$47,065.17 |
$47,065.17 |
$47,065.17 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,309.72 |
$11,309.72 |
$11,309.72 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$16,163.27 |
$16,163.27 |
$16,163.27 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$25,704.83 |
$25,704.83 |
$25,704.83 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$31,841.74 |
$31,841.74 |
$31,841.74 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$34,919.22 |
$34,919.22 |
$34,919.22 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$18,710.40 |
$18,710.40 |
$18,710.40 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$9,184.34 |
$9,184.34 |
$9,184.34 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$11,836.73 |
$11,836.73 |
$11,836.73 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$18,710.40 |
$18,710.40 |
$18,710.40 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$22,194.66 |
$22,194.66 |
$22,194.66 |
$4,329.36
|
|
Troponin quantitative
|
$249.45 |
$991.21 |
$1,948.25 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$2,759.11 |
$4,515.64 |
$9,326.00 |
$1,582.75
|
|
Tte w or without fol w/cont, com
|
$2,603.25 |
$2,603.25 |
$9,327.00 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$1,246.82 |
$1,246.82 |
$9,327.00 |
$934.93
|
|
Tubal Ligation (Laparoscopic)
|
$15,191.33 |
$15,191.33 |
$15,191.33 |
$4,948.77
|
|
Tube drain vert dev st 5-40f
|
$104.00 |
$104.00 |
$104.00 |
$72.21
|
|
Tx atrial fib pulm vein isol
|
$57,603.19 |
$114,580.50 |
$222,291.00 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$786.00
|
|
Tx closed hip disl traumatic without anes
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$635.46
|
|
Tx contour defects >10.0 cc
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
$755.08
|
|
Tx contour defects 1.1-5.0cc 11951
|
$1,693.24 |
$1,693.24 |
$1,693.24 |
$724.37
|
|
Tx l/r atrial fib addl
|
$21,079.53 |
$21,079.53 |
$21,079.53 |
$7,717.80
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$10,807.53 |
$10,807.53 |
$10,807.53 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$4,652.29 |
$4,652.29 |
$4,652.29 |
$469.20
|
|
Ua w/micro/comp poc
|
$130.34 |
$130.34 |
$922.00 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$345.46 |
$345.46 |
$2,013.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$499.25 |
$499.25 |
$1,602.55 |
$403.26
|
|
Ultrasound breast complete
|
$2,063.28 |
$2,063.28 |
$2,063.28 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,923.06 |
$1,923.06 |
$1,923.06 |
$449.35
|
|
Ultrasound chest
|
$928.13 |
$928.13 |
$1,842.92 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,466.50 |
$1,466.50 |
$1,557.54 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$3,525.59 |
$3,525.59 |
$3,525.59 |
$330.40
|
|
Ultrasound elastography ea l target les
|
$387.41 |
$387.41 |
$387.41 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$387.41 |
$387.41 |
$513.25 |
$284.25
|
|
Ultrasound encephalogram
|
$1,602.55 |
$1,602.55 |
$2,995.75 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,592.62 |
$1,592.62 |
$1,842.92 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,855.50 |
$1,855.50 |
$1,892.81 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$2,027.10 |
$2,027.10 |
$2,027.10 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$2,189.40 |
$2,189.40 |
$2,189.40 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,602.55 |
$1,602.55 |
$1,602.55 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,462.27 |
$1,462.27 |
$3,823.00 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$961.51 |
$961.51 |
$1,926.00 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$961.51 |
$961.51 |
$1,707.25 |
$321.35
|
|
Ultrasound joint complete left
|
$2,437.49 |
$2,437.49 |
$2,437.49 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,847.16 |
$1,847.16 |
$1,847.16 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,538.43 |
$1,538.43 |
$1,538.43 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,095.52 |
$1,095.52 |
$1,095.52 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,602.55 |
$1,602.55 |
$3,016.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,114.50 |
$1,114.50 |
$1,602.55 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,602.55 |
$1,602.55 |
$1,602.55 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,602.55 |
$1,602.55 |
$1,602.55 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,602.55 |
$2,677.25 |
$3,117.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,670.11 |
$1,670.11 |
$1,896.48 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,134.25 |
$1,781.50 |
$1,842.92 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$961.51 |
$961.51 |
$961.51 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$1,560.03 |
$1,560.03 |
$1,923.75 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$744.95 |
$744.95 |
$1,842.92 |
$567.44
|
|
Unlistd noninvas vasc dx std
|
$1,285.41 |
$1,285.41 |
$1,285.41 |
$819.65
|
|
Unlisted cytogenetic study
|
$604.27 |
$604.27 |
$604.27 |
$132.48
|
