|
Trimethobenzamide hcl inj
|
$77.32 |
$77.32 |
$77.32 |
$117.49
|
|
Trim nail(s)
|
$48.75 |
$48.75 |
$48.75 |
$78.40
|
|
Trim nondyst nails
|
$144.95 |
$144.95 |
$144.95 |
$115.70
|
|
Triptorelin pamoate
|
$13,470.60 |
$13,470.60 |
$13,470.60 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$980.20 |
$980.20 |
$980.20 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,638.00 |
$1,638.00 |
$1,638.00 |
$716.95
|
|
Trnscath plc stent crv crtd without prtct
|
$15,990.00 |
$15,990.00 |
$15,990.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$17,442.75 |
$17,442.75 |
$17,442.75 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$12,827.10 |
$12,827.10 |
$12,827.10 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,409.45 |
$11,409.45 |
$11,409.45 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$11,238.50 |
$11,238.50 |
$11,238.50 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$30,009.20 |
$30,009.20 |
$30,009.20 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$25,255.10 |
$25,255.10 |
$25,255.10 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$4,418.00
|
|
Trnscath tx thromblytc vein ini day
|
$14,704.95 |
$14,704.95 |
$14,704.95 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$8,923.85 |
$8,923.85 |
$8,923.85 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$1,066.65 |
$1,066.65 |
$1,066.65 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,639.65 |
$2,639.65 |
$2,639.65 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$2,551.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,656.20 |
$1,656.20 |
$1,656.20 |
$2,406.77
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$2,698.80 |
$2,698.80 |
$2,698.80 |
$704.80
|
|
Troponin quantitative
|
$244.40 |
$244.40 |
$244.40 |
$125.00
|
|
Trurl dstrj prst8 tiss rf wv
|
$12,890.15 |
$12,890.15 |
$12,890.15 |
$4,228.00
|
|
Truskin, per sq centimeter
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Tte w or without contr, cont ecg
|
$3,691.35 |
$3,691.35 |
$3,691.35 |
$2,196.00
|
|
Tte w or without fol w/cont, com
|
$3,691.35 |
$3,691.35 |
$3,691.35 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$1,142.70 |
$1,142.70 |
$1,142.70 |
$1,178.00
|
|
Tubal Ligation (Laparoscopic)
|
$1,536.60 |
$1,536.60 |
$1,536.60 |
$4,323.20
|
|
Tube trach disp innr can 5 xlt
|
$165.10 |
$165.10 |
$165.10 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$11.70 |
$11.70 |
$11.70 |
$16.80
|
|
Tvh w/mmk 58267
|
$4,773.60 |
$4,773.60 |
$4,773.60 |
$1,747.20
|
|
Tx atrial fib pulm vein isol
|
$56,572.75 |
$56,572.75 |
$56,572.75 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$2,282.80 |
$2,282.80 |
$2,282.80 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$1,092.65 |
$1,092.65 |
$1,092.65 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$896.35 |
$896.35 |
$896.35 |
$535.60
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$3,920.80 |
$3,920.80 |
$3,920.80 |
$2,277.60
|
|
Tx l/r atrial fib addl
|
$5,417.10 |
$5,417.10 |
$5,417.10 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$12,126.40 |
$12,126.40 |
$12,126.40 |
$4,595.50
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,929.20 |
$1,929.20 |
$1,929.20 |
$4,529.60
|
|
Tx septic abortion surgical 59830
|
$1,713.40 |
$1,713.40 |
$1,713.40 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$896.35 |
$896.35 |
$896.35 |
$423.15
|
|
Tympanic membrane repair
|
$4,813.90 |
$4,813.90 |
$4,813.90 |
$2,133.48
|
|
Tympanometry & reflex thresh
|
$100.10 |
$100.10 |
$100.10 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$1,654.90 |
$1,654.90 |
$1,654.90 |
$911.43
|
|
Typhoid vaccine oral
|
$45.75 |
$45.75 |
$45.75 |
$63.28
|
|
Ua w/micro/comp poc
|
$16.90 |
$16.90 |
$16.90 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$4,332.90 |
$4,332.90 |
$4,332.90 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$1,049.75 |
$1,049.75 |
$1,049.75 |
$438.75
|
|
Ultrasound breast complete
|
$805.35 |
$805.35 |
$805.35 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$688.35 |
$688.35 |
$688.35 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$739.70 |
$739.70 |
$739.70 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$596.70 |
$596.70 |
$596.70 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$122.20 |
$122.20 |
$122.20 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$169.00 |
$169.00 |
$169.00 |
$307.00
|
|
Ultrasound encephalogram
|
$596.70 |
$596.70 |
$596.70 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$596.70 |
$596.70 |
$596.70 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$817.05 |
$817.05 |
$817.05 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$893.10 |
$893.10 |
$893.10 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$216.45 |
$216.45 |
$216.45 |
$388.08
|
|
Ultrasound guide intraoperative
|
$945.10 |
$945.10 |
$4,846.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$567.45 |
$567.45 |
$746.00 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$494.00 |
$494.00 |
$494.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$494.00 |
$494.00 |
$494.00 |
$304.00
|
|
Ultrasound joint complete left
|
$596.70 |
$596.70 |
$596.70 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$596.70 |
$596.70 |
$596.70 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$832.65 |
$832.65 |
$832.65 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$815.10 |
$815.10 |
$815.10 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,167.00 |
$1,167.00 |
$1,849.25 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$839.80 |
$839.80 |
$839.80 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$776.10 |
$776.10 |
$776.10 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$596.70 |
$596.70 |
$596.70 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$994.50 |
$994.50 |
$1,306.00 |
$417.15
|
|
Ultrasound trgt dyn mbubb 1st les
|
$421.20 |
$421.20 |
$421.20 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$221.00 |
$221.00 |
$221.00 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$204.75 |
$204.75 |
$204.75 |
$223.80
|
|
Umbilicoplasty 15847
|
$3,788.20 |
$3,788.20 |
$3,788.20 |
$4,172.97
|
|
Unit mobile power mpu
|
$7,722.00 |
$7,722.00 |
$7,722.00 |
$14,359.52
|
|
Unlistd noninvas vasc dx std
|
$1,025.05 |
$1,025.05 |
$1,025.05 |
$564.60
|
|
Unlisted chemotherapy px
|
$88.40 |
$88.40 |
$88.40 |
$149.15
|
|
Unlisted cranfcl&maxlfcl px
|
$3,187.60 |
$3,187.60 |
$3,187.60 |
$571.20
|
|
Unlisted CT procedure
|
$1,043.00 |
$1,043.00 |
$8,697.00 |
$740.43
|
|
Unlisted fetal invas px w/us
|
$328.25 |
$328.25 |
$328.25 |
$498.40
|
|
Unlisted fluoroscopic px
|
$30,872.40 |
$30,872.40 |
$30,872.40 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$910.00 |
$910.00 |
$910.00 |
$995.00
|
|
Unlisted hystsc px uterus
|
$1,134.90 |
$1,134.90 |
$1,134.90 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$14,824.55 |
$14,824.55 |
$14,824.55 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$2,624.70 |
$2,624.70 |
$2,624.70 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$8,529.95 |
$8,529.95 |
$8,529.95 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$9,700.60 |
$9,700.60 |
$9,700.60 |
$6,463.42
|
|
Unlisted laps px appendix
|
$397.80 |
$397.80 |
$397.80 |
$3,617.40
|
|
Unlisted laps px bladder
|
$10,743.20 |
$10,743.20 |
$10,743.20 |
$5,082.74
|
|
Unlisted laps px esoph
|
$6,429.80 |
$6,429.80 |
$6,429.80 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$4,560.40 |
$4,560.40 |
$4,560.40 |
$6,870.89
|
