|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$583.50 |
$583.50 |
$583.50 |
$43.00
|
|
Trichinella antibody
|
$325.00 |
$325.00 |
$325.00 |
$70.65
|
|
Triglycerides
|
$145.00 |
$145.00 |
$145.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$227.97 |
$227.97 |
$227.97 |
$117.49
|
|
Trim nondyst nails
|
$320.00 |
$320.00 |
$320.00 |
$115.20
|
|
Triptorelin pamoate
|
$2,194.93 |
$2,194.93 |
$2,194.93 |
$4,619.39
|
|
Trluml dil aq o/f can without st
|
$7,564.00 |
$7,564.00 |
$7,564.00 |
$5,497.39
|
|
Trluml dil aq o/f can w/st
|
$7,564.00 |
$7,564.00 |
$7,564.00 |
$4,942.18
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$34,758.00 |
$34,758.00 |
$34,758.00 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$17,379.00 |
$17,379.00 |
$17,379.00 |
$7,354.00
|
|
Trnscath plc stent crv crtd without prtct
|
$6,339.00 |
$6,339.00 |
$6,339.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$24,150.00 |
$24,150.00 |
$24,150.00 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$4,865.00 |
$4,865.00 |
$4,865.00 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$8,723.00 |
$8,723.00 |
$8,723.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,723.00 |
$8,723.00 |
$8,723.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$8,811.00 |
$8,811.00 |
$8,811.00 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$11,000.00 |
$11,000.00 |
$11,000.00 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$9,177.00 |
$9,177.00 |
$9,177.00 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,514.00 |
$6,514.00 |
$6,514.00 |
$4,444.80
|
|
Trnscath tx thromblytc vein ini day
|
$11,645.00 |
$11,645.00 |
$11,645.00 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$16,385.00 |
$16,385.00 |
$16,385.00 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$2,527.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$2,406.77
|
|
Troponin quantitative
|
$325.00 |
$325.00 |
$325.00 |
$125.00
|
|
Tte w or without contr, cont ecg
|
$5,737.00 |
$5,737.00 |
$5,737.00 |
$2,196.00
|
|
Tte w or without fol w/cont, com
|
$4,757.00 |
$4,757.00 |
$4,757.00 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$2,621.00 |
$2,621.00 |
$2,621.00 |
$1,178.00
|
|
Tubal Ligation (Laparoscopic)
|
$8,661.00 |
$8,661.00 |
$8,661.00 |
$4,323.20
|
|
Tx atrial fib pulm vein isol
|
$16,666.00 |
$16,666.00 |
$16,666.00 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$2,210.00 |
$2,210.00 |
$2,210.00 |
$586.80
|
|
Tx closed tib shaft fx without manip
|
$620.00 |
$620.00 |
$620.00 |
$535.60
|
|
Tx contour defects 1.1-5.0cc 11951
|
$1,762.00 |
$1,762.00 |
$1,762.00 |
$849.50
|
|
Tx l/r atrial fib addl
|
$11,573.00 |
$11,573.00 |
$11,573.00 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$9,383.00 |
$9,383.00 |
$9,383.00 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$4,595.50
|
|
Tx open nsl fx uncomp
|
$7,811.00 |
$7,811.00 |
$7,811.00 |
$3,837.72
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$4,529.60
|
|
Tx septic abortion surgical 59830
|
$11,483.00 |
$11,483.00 |
$11,483.00 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$423.15
|
|
Tympanometry & reflex thresh
|
$461.00 |
$461.00 |
$461.00 |
$173.18
|
|
Ua w/micro/comp poc
|
$90.00 |
$90.00 |
$90.00 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$172.59 |
$172.59 |
$172.59 |
$21,992.26
|
|
Ultrasound breast complete
|
$568.00 |
$568.00 |
$568.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$568.00 |
$568.00 |
$568.00 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$478.00 |
$478.00 |
$478.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$3,970.00 |
$3,970.00 |
$3,970.00 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$570.00 |
$570.00 |
$570.00 |
$318.45
|
|
Ultrasound encephalogram
|
$1,754.00 |
$1,754.00 |
$1,754.00 |
$496.36
|
|
Ultrasound exam k transpl w/doppler
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$578.70
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$947.00 |
$947.00 |
$947.00 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,583.00 |
$1,583.00 |
$1,583.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$254.00 |
$254.00 |
$254.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$742.00 |
$742.00 |
$742.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$946.00 |
$946.00 |
$946.00 |
$560.00
|
|
Ultrasound joint complete left
|
$1,709.00 |
$1,709.00 |
$1,709.00 |
$560.25
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$312.00 |
$312.00 |
$312.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$558.00 |
$558.00 |
$558.00 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$528.00 |
$528.00 |
$528.00 |
$336.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$568.00 |
$568.00 |
$568.00 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$3,970.00 |
$3,970.00 |
$3,970.00 |
$557.40
|
|
Umbilical artery cath newborn 36660
|
$522.00 |
$522.00 |
$522.00 |
$223.80
|
|
Umbilicoplasty 15847
|
$7,418.00 |
$7,418.00 |
$7,418.00 |
$4,172.97
|
|
Unit mobile power mpu
|
$13,305.60 |
$13,305.60 |
$13,305.60 |
$14,359.52
|
|
Unlistd noninvas vasc dx std
|
$1,408.00 |
$1,408.00 |
$1,408.00 |
$564.60
|
|
Unlisted chemotherapy px
|
$121.00 |
$121.00 |
$121.00 |
$149.15
|
|
Unlisted cv px dx nuc med
|
$8,594.00 |
$8,594.00 |
$8,594.00 |
$1,747.20
|
|
Unlisted hystsc px uterus
|
$8,661.00 |
$8,661.00 |
$8,661.00 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$8,446.00 |
$8,446.00 |
$8,446.00 |
$6,307.38
|
|
Unlisted laps px ureter
|
$8,446.00 |
$8,446.00 |
$8,446.00 |
$6,376.26
|
|
Unlisted mr procedure
|
$2,296.00 |
$2,296.00 |
$2,296.00 |
$1,165.00
|
|
Unlisted muscskel px head
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$1,224.08
|
|
Unlisted procedure colon
|
$9,900.00 |
$9,900.00 |
$9,900.00 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$10,476.00 |
$10,476.00 |
$10,476.00 |
$2,174.90
|
|
Unlisted procedure larynx
|
$375.00 |
$375.00 |
$375.00 |
$924.00
|
|
Unlisted procedure liver
|
$5,139.00 |
$5,139.00 |
$5,139.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$795.00 |
$795.00 |
$795.00 |
$530.00
|
|
Unlisted procedure orbit
|
$5,364.00 |
$5,364.00 |
$5,364.00 |
$437.00
|
|
Unlisted procedure pancreas
|
$11,936.00 |
$11,936.00 |
$11,936.00 |
$4,810.00
|
|
Unlisted px abdomen muscskel
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$16,385.00 |
$16,385.00 |
$16,385.00 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$4,684.00 |
$4,684.00 |
$4,684.00 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$8,295.00 |
$8,295.00 |
$8,295.00 |
$2,765.60
|
|
Unlisted px biliary tract
|
$11,936.00 |
$11,936.00 |
$11,936.00 |
$3,055.00
|
|
Unlisted px foot/toes
|
$10,290.00 |
$10,290.00 |
$10,290.00 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$6,949.00 |
$6,949.00 |
$6,949.00 |
$859.50
|
|
Unlisted px leg/ankle
|
$9,800.00 |
$9,800.00 |
$9,800.00 |
$813.24
|
|
Unlisted px male genital sys
|
$23,713.00 |
$23,713.00 |
$23,713.00 |
$362.00
|
|
Unlisted px neck/thorax
|
$5,335.00 |
$5,335.00 |
$5,335.00 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$10,290.00 |
$10,290.00 |
$10,290.00 |
$3,251.90
|
|
Unlisted px small intestine
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$2,118.35
|
|
Unlisted special svc px/rprt
|
$7,309.00 |
$7,309.00 |
$7,309.00 |
$90.00
|
|
Unlisted transfusion med px
|
$78.00 |
$78.00 |
$78.00 |
$147.50
|
