|
Treatment mouth roof lesion
|
$12,121.20 |
$12,121.20 |
$12,121.20 |
$4,256.70
|
|
Treatment of anal fissure
|
$538.20 |
$538.20 |
$538.20 |
$1,278.72
|
|
Treatment of ankle fracture
|
$2,275.00 |
$2,275.00 |
$2,275.00 |
$7,913.97
|
|
Treatment of ankle fracture
|
$2,761.20 |
$2,761.20 |
$2,761.20 |
$8,453.60
|
|
Treatment of ankle fracture
|
$2,914.60 |
$2,914.60 |
$2,914.60 |
$7,906.00
|
|
Treatment of ankle fracture
|
$3,421.60 |
$3,421.60 |
$3,421.60 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$896.35 |
$896.35 |
$896.35 |
$528.00
|
|
Treatment of fibula fracture
|
$2,514.20 |
$2,514.20 |
$2,514.20 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$896.35 |
$896.35 |
$896.35 |
$528.00
|
|
Treatment of gum lesion
|
$5,536.70 |
$5,536.70 |
$5,536.70 |
$3,164.85
|
|
Treatment of heel fracture 28400
|
$896.35 |
$896.35 |
$896.35 |
$478.40
|
|
Treatment of miscarriage
|
$10,333.70 |
$10,333.70 |
$10,333.70 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$348.40 |
$348.40 |
$348.40 |
$3,734.50
|
|
Treatment of penis lesion
|
$2,839.20 |
$2,839.20 |
$2,839.20 |
$4,081.37
|
|
Treatment of penis lesion
|
$1,807.00 |
$1,807.00 |
$1,807.00 |
$3,515.40
|
|
Treatment of thigh fracture
|
$1,677.00 |
$1,677.00 |
$1,677.00 |
$487.50
|
|
Treatment of thigh fracture
|
$5,109.00 |
$5,109.00 |
$5,109.00 |
$4,785.00
|
|
Treatment of thigh fracture
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$570.40
|
|
Treatment of thigh fracture
|
$2,116.40 |
$2,116.40 |
$2,116.40 |
$6,389.60
|
|
Treatment of thigh fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,790.00
|
|
Treatment of thigh fracture
|
$4,321.20 |
$4,321.20 |
$4,321.20 |
$2,896.50
|
|
Treatment of thigh fracture
|
$3,764.80 |
$3,764.80 |
$3,764.80 |
$2,254.50
|
|
Treatment of thigh fracture
|
$5,505.50 |
$5,505.50 |
$5,505.50 |
$4,380.00
|
|
Treatment of thigh fracture
|
$3,796.00 |
$3,796.00 |
$3,796.00 |
$3,796.00
|
|
Treatment of tibia fracture
|
$3,260.40 |
$3,260.40 |
$3,260.40 |
$6,347.40
|
|
Treatment of tibia fracture
|
$3,757.00 |
$3,757.00 |
$3,757.00 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$896.35 |
$896.35 |
$896.35 |
$371.40
|
|
Treatment of urethra lesion
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$2,874.36
|
|
Treatment radiation delivery level 2
|
$2,753.40 |
$2,753.40 |
$2,753.40 |
$835.20
|
|
Treat metatarsal fracture
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$8,241.00
|
|
Treat neck spine fracture
|
$5,418.40 |
$5,418.40 |
$5,418.40 |
$3,572.80
|
|
Treat odontoid fx without graft
|
$5,907.20 |
$5,907.20 |
$5,907.20 |
$5,448.00
|
|
Treat pelvic ring fracture
|
$5,441.80 |
$5,441.80 |
$5,441.80 |
$3,332.00
|
|
Treat radius fracture
|
$2,563.60 |
$2,563.60 |
$2,563.60 |
$9,791.00
|
|
Treat sternum fracture
|
$896.35 |
$896.35 |
$896.35 |
$423.00
|
|
Treat thigh fracture
|
$1,510.60 |
$1,510.60 |
$1,510.60 |
$661.00
|
|
Treat thigh fracture
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$6,510.40
|
|
Treat thigh fracture
|
$4,578.60 |
$4,578.60 |
$4,578.60 |
$3,933.60
|
|
Treat thigh fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,893.86
|
|
Treat thigh fracture
|
$4,726.80 |
$4,726.80 |
$4,726.80 |
$4,726.80
|
|
Treat thigh fracture
|
$1,255.80 |
$1,255.80 |
$1,255.80 |
$618.80
|
|
Treat thigh fracture
|
$2,802.80 |
$2,802.80 |
$2,802.80 |
$2,802.80
|
|
Treat thigh fracture
|
$3,590.60 |
$3,590.60 |
$3,590.60 |
$2,008.18
|
|
Treat thigh fracture
|
$4,726.80 |
$4,726.80 |
$4,726.80 |
$3,580.50
|
|
Treat thorax spine fracture
|
$5,400.20 |
$5,400.20 |
$5,400.20 |
$3,624.00
|
|
Treat thumb fracture
|
$2,064.40 |
$2,064.40 |
$2,064.40 |
$3,839.54
|
|
Treat ulnar fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,678.55
|
|
Treat ulnar fracture
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$6,653.00
|
|
Treat vaginal bleeding
|
$751.40 |
$751.40 |
$751.40 |
$392.00
|
|
Treat wrist bone fracture
|
$5,981.95 |
$5,981.95 |
$5,981.95 |
$1,749.06
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$8,608.52 |
$8,608.52 |
$8,608.52 |
$73,346.25
|
|
Treponema pallidum antibody
|
$91.65 |
$91.65 |
$91.65 |
$72.05
|
|
Treprostinil injection
|
$1,489.78 |
$1,489.78 |
$1,489.78 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$1,021.80 |
$1,021.80 |
$1,021.80 |
$465.30
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$195.00 |
$195.00 |
$195.00 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
$223.56
|
|
Trichinella antibody
|
$28.60 |
$28.60 |
$28.60 |
$70.65
|
|
Triglycerides
|
$70.85 |
$70.85 |
$70.85 |
$58.05
|
|
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 |
$115.20
|
|
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
|
$3,835.00 |
$3,835.00 |
$3,835.00 |
$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 |
$4,444.80
|
|
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/<
|
$2,860.65 |
$2,860.65 |
$2,860.65 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$2,527.20
|
|
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/<
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$2,406.77
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$2,698.80 |
$2,698.80 |
$2,698.80 |
$704.80
|
|
Troponin quantitative
|
$115.70 |
$115.70 |
$115.70 |
$125.00
|
|
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
|
$3,691.35 |
$3,691.35 |
$3,691.35 |
$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
|
|
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 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 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 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
|
