|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$2,986.34
|
|
Troponin quantitative
|
$72.50 |
$92.50 |
$170.80 |
$125.00
|
|
Trurl dstrj prst8 tiss rf wv
|
$13,470.86 |
$13,470.86 |
$13,470.86 |
$4,228.00
|
|
Tte w or without contr, cont ecg
|
$4,760.00 |
$4,760.00 |
$4,760.00 |
$2,196.00
|
|
Tube trach disp innr can 5 xlt
|
$384.27 |
$384.27 |
$384.27 |
$445.99
|
|
Tube trach fen sz 6 uncuffed
|
$351.35 |
$351.35 |
$351.35 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$25,300.00 |
$25,300.00 |
$27,258.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$270.00 |
$270.00 |
$644.70 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,630.00 |
$3,630.00 |
$5,628.70 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$270.00 |
$270.00 |
$270.00 |
$535.60
|
|
Tx l/r atrial fib addl
|
$1,924.30 |
$1,924.30 |
$7,005.00 |
$6,986.85
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,630.00 |
$3,630.00 |
$5,406.80 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$10,535.00 |
$10,535.00 |
$10,535.00 |
$4,595.50
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$8,633.80 |
$8,633.80 |
$8,633.80 |
$4,529.60
|
|
Tympanometry & reflex thresh
|
$116.90 |
$116.90 |
$180.00 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$11,083.72 |
$11,083.72 |
$11,083.72 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$57,155.08 |
$57,155.08 |
$57,155.08 |
$6,740.80
|
|
Tyms gene com variants
|
$175.00 |
$175.00 |
$175.00 |
$192.29
|
|
Ua w/micro/comp poc
|
$7.26 |
$7.26 |
$7.26 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$14,115.75 |
$14,115.75 |
$14,115.75 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$235.00 |
$235.00 |
$823.20 |
$438.75
|
|
Ultrasound breast complete
|
$354.09 |
$532.00 |
$645.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$321.75 |
$438.90 |
$515.00 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$112.86 |
$355.00 |
$969.50 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$150.00 |
$150.00 |
$300.00 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$434.00 |
$434.00 |
$434.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$310.53 |
$310.53 |
$482.30 |
$318.45
|
|
Ultrasound encephalogram
|
$109.23 |
$520.00 |
$1,406.30 |
$496.36
|
|
Ultrasound exam k transpl w/doppler
|
$428.34 |
$515.00 |
$1,237.60 |
$578.70
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$233.31 |
$330.00 |
$1,120.70 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$171.27 |
$625.00 |
$1,705.20 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$134.31 |
$240.00 |
$1,292.20 |
$388.08
|
|
Ultrasound guide intraoperative
|
$249.81 |
$392.50 |
$2,104.20 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$590.00 |
$590.00 |
$2,603.30 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$195.03 |
$440.00 |
$1,275.40 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$160.71 |
$327.50 |
$1,087.80 |
$311.25
|
|
Ultrasound joint complete left
|
$540.00 |
$568.59 |
$1,269.80 |
$560.25
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$132.66 |
$245.70 |
$402.50 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$387.50 |
$402.50 |
$1,598.10 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$271.26 |
$335.00 |
$819.70 |
$336.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$383.79 |
$825.00 |
$1,360.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$259.71 |
$357.50 |
$830.90 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$347.16 |
$530.00 |
$1,085.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$168.63 |
$415.00 |
$1,559.60 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$205.92 |
$620.00 |
$1,157.10 |
$423.36
|
|
Ultrasound trgt dyn mbubb 1st les
|
$325.38 |
$325.38 |
$3,213.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$4,034.80 |
$4,034.80 |
$4,034.80 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$342.50 |
$342.50 |
$851.20 |
$223.80
|
|
Unlisted chemotherapy px
|
$150.00 |
$150.00 |
$380.80 |
$149.15
|
|
Unlisted CT procedure
|
$120.00 |
$438.57 |
$1,941.10 |
$732.70
|
|
Unlisted cytogenetic study
|
$47.85 |
$47.85 |
$47.85 |
$160.00
|
|
Unlisted dx gi procedure
|
$1,908.20 |
$1,908.20 |
$1,908.20 |
$649.22
|
|
Unlisted fetal invas px w/us
|
$606.90 |
$606.90 |
$606.90 |
$498.40
|
|
Unlisted fluoroscopic px
|
$70.29 |
$1,140.00 |
$26,511.80 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$995.00
|
|
Unlisted hematology&coagj px
|
$16.50 |
$16.50 |
$179.20 |
$39.52
|
|
Unlisted hystsc px uterus
|
$24,891.31 |
$24,891.31 |
$24,891.31 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$32,138.30 |
$32,138.30 |
$32,138.30 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$41,005.55 |
$41,005.55 |
$41,005.55 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$31,288.27 |
$31,288.27 |
$31,288.27 |
$5,419.00
|
|
Unlisted laps px appendix
|
$48,925.57 |
$48,925.57 |
$48,925.57 |
$3,617.40
|
|
Unlisted laps px bladder
|
$46,359.10 |
$46,359.10 |
$46,359.10 |
$5,082.74
|
|
Unlisted laps px esoph
|
$41,301.50 |
$41,301.50 |
$41,301.50 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$58,200.55 |
$58,200.55 |
$58,200.55 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$63,853.41 |
$63,853.41 |
$63,853.41 |
$6,904.15
|
|
Unlisted laps px renal
|
$92,851.73 |
$92,851.73 |
$92,851.73 |
$5,110.00
|
|
Unlisted laps px ureter
|
$41,228.08 |
$41,228.08 |
$41,228.08 |
$6,376.26
|
|
Unlisted laps px uterus
|
$16,931.84 |
$16,931.84 |
$16,931.84 |
$4,627.00
|
|
Unlisted maaa
|
$284.90 |
$284.90 |
$284.90 |
$235.20
|
|
Unlisted mr procedure
|
$122.50 |
$1,105.83 |
$7,322.70 |
$1,165.00
|
|
Unlisted procedure colon
|
$14,931.39 |
$14,931.39 |
$14,931.39 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$33,050.76 |
$33,050.76 |
$33,050.76 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$20,330.52 |
$20,330.52 |
$20,330.52 |
$2,174.90
|
|
Unlisted procedure larynx
|
$29,138.14 |
$29,138.14 |
$29,138.14 |
$924.00
|
|
Unlisted procedure liver
|
$26,043.50 |
$26,043.50 |
$26,043.50 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$555.00 |
$555.00 |
$6,416.90 |
$530.00
|
|
Unlisted procedure pancreas
|
$20,297.40 |
$20,297.40 |
$20,297.40 |
$4,810.00
|
|
Unlisted procedure rectum
|
$1,125.00 |
$1,125.00 |
$18,955.01 |
$1,278.72
|
|
Unlisted procedure spine
|
$282.50 |
$282.50 |
$282.50 |
$4,706.35
|
|
Unlisted procedure urinary 58750
|
$77,098.49 |
$77,098.49 |
$77,098.49 |
$926.40
|
|
Unlisted px abdomen muscskel
|
$3,161.20 |
$3,161.20 |
$3,161.20 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$122,103.02 |
$122,103.02 |
$122,103.02 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$35,224.48 |
$35,224.48 |
$35,224.48 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$15,766.10 |
$15,766.10 |
$15,766.10 |
$2,765.60
|
|
Unlisted px biliary tract
|
$41,475.59 |
$41,475.59 |
$41,475.59 |
$3,055.00
|
|
Unlisted px conjunctiva
|
$15,526.08 |
$15,526.08 |
$15,526.08 |
$479.62
|
|
Unlisted px external ear
|
$39,142.47 |
$39,142.47 |
$39,142.47 |
$325.68
|
|
Unlisted px extraocular musc
|
$12,626.66 |
$12,626.66 |
$12,626.66 |
$739.20
|
|
Unlisted px inner ear
|
$40,001.67 |
$40,001.67 |
$40,001.67 |
$571.20
|
|
Unlisted px leg/ankle
|
$13,652.80 |
$13,652.80 |
$13,652.80 |
$813.24
|
|
Unlisted px male genital sys
|
$18,410.33 |
$18,410.33 |
$18,410.33 |
$362.00
|
|
Unlisted px med radj physics
|
$1,124.20 |
$1,124.20 |
$1,124.20 |
$462.35
|
|
Unlisted px middle ear
|
$16,700.18 |
$16,700.18 |
$16,700.18 |
$343.50
|
|
Unlisted px palate uvula
|
$17,105.28 |
$17,105.28 |
$17,105.28 |
$274.80
|
|
Unlisted px pelvis/hip joint
|
$900.00 |
$900.00 |
$900.00 |
$3,251.90
|
|
Unlisted px posterior segmnt
|
$15,743.22 |
$15,743.22 |
$15,743.22 |
$3,173.34
|
|
Unlisted px salivry glnd/dux
|
$1,100.00 |
$1,100.00 |
$33,824.94 |
$1,265.16
|
|
Unlisted px small intestine
|
$13,778.91 |
$13,778.91 |
$13,778.91 |
$2,118.35
|
|
Unlisted px temporal bone
|
$102,980.61 |
$102,980.61 |
$102,980.61 |
$571.20
|
|
Unlisted px ther rad tx plng
|
$141.24 |
$141.24 |
$141.24 |
$182.00
|
