|
Treat thigh fracture
|
$777.00 |
$777.00 |
$777.00 |
$716.95
|
|
Treat thigh fx growth plate
|
$777.00 |
$777.00 |
$777.00 |
$421.50
|
|
Treat thigh fx growth plate
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,938.38
|
|
Treat toe dislocation
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$855.66
|
|
Treat ulnar fracture
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,861.60
|
|
Treat vaginal bleeding
|
$642.00 |
$642.00 |
$642.00 |
$400.86
|
|
Treat wrist bone fracture
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,907.64
|
|
Treat wrist dislocation
|
$777.00 |
$777.00 |
$777.00 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$198,840.76 |
$198,840.76 |
$198,840.76 |
$101,032.80
|
|
Treponema pallidum antibody
|
$366.00 |
$366.00 |
$366.00 |
$72.80
|
|
Trg gene rearrangement anal
|
$2,779.00 |
$2,779.00 |
$2,779.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$146.00 |
$156.75 |
$334.06 |
$55.80
|
|
Trichinella antibody
|
$88.12 |
$88.40 |
$298.00 |
$70.65
|
|
Trichomonas assay w/optic
|
$19.70 |
$19.70 |
$19.70 |
$66.00
|
|
#tricyclicantidprssnt
|
$299.00 |
$299.00 |
$299.00 |
$57.08
|
|
Triglycerides
|
$132.00 |
$132.00 |
$132.00 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$98.00 |
$105.00 |
$928.85 |
$128.00
|
|
Trim nondyst nails
|
$220.00 |
$220.00 |
$220.00 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$777.00 |
$777.00 |
$777.00 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$35,998.00 |
$35,998.00 |
$35,998.00 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$37,996.00 |
$37,996.00 |
$37,996.00 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$35,998.00 |
$35,998.00 |
$35,998.00 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$13,387.00 |
$13,387.00 |
$13,387.00 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$26,958.00 |
$26,958.00 |
$26,958.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$35,282.00 |
$35,282.00 |
$35,282.00 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$14,959.00 |
$14,959.00 |
$14,959.00 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,277.00 |
$5,277.00 |
$5,277.00 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$11,781.00 |
$11,781.00 |
$11,781.00 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$11,781.00 |
$11,781.00 |
$11,781.00 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$5,277.00 |
$5,277.00 |
$5,277.00 |
$4,329.36
|
|
Troponin quantitative
|
$569.00 |
$1,890.17 |
$1,932.10 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$5,406.00 |
$5,406.00 |
$5,406.00 |
$1,582.75
|
|
Tubal Ligation (Laparoscopic)
|
$19,100.00 |
$19,100.00 |
$19,100.00 |
$4,948.77
|
|
Tube drain vert dev st 5-40f
|
$91.40 |
$91.40 |
$91.40 |
$72.21
|
|
Tumor cell deplete of harvst
|
$5,153.00 |
$5,153.00 |
$5,153.00 |
$547.20
|
|
Tx atrial fib pulm vein isol
|
$49,885.00 |
$122,661.50 |
$154,307.40 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$777.00 |
$777.00 |
$777.00 |
$786.00
|
|
Tx closed hip disl traumatic without anes
|
$1,763.00 |
$1,763.00 |
$1,763.00 |
$657.28
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$10,690.00 |
$10,690.00 |
$10,690.00 |
$3,874.79
|
|
Tx closed tib shaft fx without manip
|
$777.00 |
$777.00 |
$777.00 |
$635.46
|
|
Tx contour defects >10.0 cc
|
$1,804.00 |
$1,804.00 |
$1,804.00 |
$755.08
|
|
Tx contour defects 1.1-5.0cc 11951
|
$1,804.00 |
$1,804.00 |
$1,804.00 |
$724.37
|
|
Tx l/r atrial fib addl
|
$1,455.00 |
$37,412.00 |
$45,500.90 |
$7,717.80
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,342.00 |
$8,342.00 |
$8,342.00 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$18,129.00 |
$18,129.00 |
$18,129.00 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$777.00 |
$777.00 |
$777.00 |
$469.20
|
|
Tympanometry & reflex thresh
|
$444.00 |
$444.00 |
$444.00 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$1,426.00 |
$1,426.00 |
$1,426.00 |
$911.43
|
|
Ua w/micro/comp poc
|
$65.00 |
$65.00 |
$65.00 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$975.00 |
$975.00 |
$975.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,663.00 |
$1,663.00 |
$1,663.00 |
$403.26
|
|
Ultrasound breast complete
|
$789.00 |
$789.00 |
$789.00 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$751.00 |
$751.00 |
$751.00 |
$449.35
|
|
Ultrasound chest
|
$959.00 |
$959.00 |
$1,322.01 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,257.00 |
$1,257.00 |
$1,838.56 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$736.00 |
$736.00 |
$736.00 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$710.00 |
$710.00 |
$710.00 |
$284.25
|
|
Ultrasound encephalogram
|
$982.26 |
$982.26 |
$1,267.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,827.00 |
$1,827.00 |
$1,827.00 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$952.00 |
$952.00 |
$4,435.19 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$957.00 |
$957.00 |
$957.00 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,679.00 |
$1,679.00 |
$1,679.00 |
$701.35
|
|
Ultrasound guide intraoperative
|
$3,022.00 |
$3,022.00 |
$3,471.42 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$656.00 |
$656.00 |
$656.00 |
$321.35
|
|
Ultrasound joint complete left
|
$2,183.00 |
$2,183.00 |
$2,183.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,102.00 |
$1,102.00 |
$3,097.01 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$785.00 |
$785.00 |
$6,507.18 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$282.00 |
$282.00 |
$6,507.18 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,511.00 |
$1,511.00 |
$6,100.41 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,005.00 |
$1,005.00 |
$3,853.93 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$436.00 |
$436.00 |
$4,858.14 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,199.00 |
$1,199.00 |
$6,507.18 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$2,551.00 |
$2,551.00 |
$2,551.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,487.00 |
$1,487.00 |
$5,574.61 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,438.00 |
$1,438.00 |
$4,691.74 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$671.40 |
$671.40 |
$865.00 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$282.00 |
$282.00 |
$282.00 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,539.00 |
$1,539.00 |
$4,615.47 |
$567.44
|
|
Umbilical artery cath newborn 36660
|
$1,932.00 |
$1,932.00 |
$1,932.00 |
$265.85
|
|
Unlistd noninvas vasc dx std
|
$179.00 |
$179.00 |
$179.00 |
$819.65
|
|
Unlisted chemotherapy px
|
$414.00 |
$414.00 |
$414.00 |
$153.85
|
|
Unlisted CT procedure
|
$9,309.00 |
$9,309.00 |
$9,309.00 |
$1,043.00
|
|
Unlisted cytogenetic study
|
$250.00 |
$250.00 |
$250.00 |
$132.48
|
|
Unlisted fluoroscopic px
|
$1,862.00 |
$1,862.00 |
$1,862.00 |
$324.85
|
|
Unlisted mr procedure
|
$9,605.00 |
$9,605.00 |
$9,605.00 |
$1,032.20
|
|
Unlisted procedure microbiology
|
$1,358.00 |
$1,358.00 |
$1,358.00 |
$487.50
|
|
Unlisted px casting/strpg
|
$534.00 |
$534.00 |
$534.00 |
$224.93
|
|
Unlisted px foot/toes
|
$11,310.00 |
$11,310.00 |
$11,310.00 |
$3,105.70
|
|
Unlisted px med radj physics
|
$1,147.80 |
$1,147.80 |
$1,147.80 |
$376.03
|
|
Unlisted px pelvis/hip joint
|
$19,435.00 |
$19,435.00 |
$19,435.00 |
$2,108.82
|
|
Unlisted surgical path px
|
$250.00 |
$250.00 |
$250.00 |
$71.65
|
|
Unlisted transfusion med px
|
$2,227.00 |
$2,227.00 |
$2,227.00 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$5,223.00 |
$5,223.00 |
$5,223.00 |
$1,480.70
|
|
Upgrade pm system
|
$27,737.00 |
$27,737.00 |
$27,737.00 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$12,774.00 |
$12,774.00 |
$21,747.53 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$12,774.00 |
$12,774.00 |
$12,774.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$8,096.00 |
$8,096.00 |
$13,049.68 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$3,055.00 |
$3,055.00 |
$3,055.00 |
$1,588.59
|
