|
Trnscath tx thromblytc vein ini day
|
$509.40 |
$3,150.00 |
$11,666.16 |
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,085.60 |
$2,085.60 |
$2,656.80 |
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$435.00 |
$435.00 |
$963.60 |
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,493.40 |
$1,950.00 |
$6,433.80 |
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$1,152.60 |
$1,948.80 |
$2,460.80 |
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$1,152.60 |
$1,672.20 |
$4,375.44 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,152.60 |
$1,529.40 |
$1,954.40 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,102.80 |
$1,189.20 |
$1,534.40 |
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$615.11 |
$615.11 |
$615.11 |
|
|
Trnspl rej kdn mrna qpcr 139
|
$6,480.00 |
$6,480.00 |
$6,480.00 |
|
|
Troponin quantitative
|
$61.50 |
$170.80 |
$317.60 |
|
|
Tr retinal les preterm inf
|
$1,308.96 |
$3,814.80 |
$28,727.17 |
|
|
Trurl dstrj prst8 tiss rf wv
|
$4,385.60 |
$13,470.86 |
$13,470.86 |
|
|
Tte w or without contr, cont ecg
|
$1,470.24 |
$3,311.40 |
$4,760.00 |
|
|
Tte w or without fol w/con,stres
|
$1,285.20 |
$2,210.64 |
$2,322.10 |
|
|
Tte w or without fol w/cont, com
|
$1,864.08 |
$1,864.08 |
$2,210.64 |
|
|
Tte w or without fol w/cont, f/u
|
$1,692.44 |
$1,692.44 |
$1,692.44 |
|
|
Tubal Ligation (Laparoscopic)
|
$711.00 |
$920.80 |
$43,722.05 |
|
|
Tube drain vert dev st 5-40f
|
$198.00 |
$198.00 |
$198.00 |
|
|
Tube trach disp innr can 5 xlt
|
$72.16 |
$146.40 |
$784.78 |
|
|
Tube trach disp innr can 6 xlt
|
$9.60 |
$9.60 |
$9.60 |
|
|
Tube trach fen sz 6 uncuffed
|
$84.52 |
$132.00 |
$758.88 |
|
|
Tubing (oxygen) per foot
|
$0.40 |
$20.40 |
$20.40 |
|
|
Tubular dressing
|
$14.06 |
$14.06 |
$55.44 |
|
|
Tvh >250 gms 58290
|
$2,244.00 |
$2,244.00 |
$28,405.82 |
|
|
Tvh w/mmk 58267
|
$2,058.60 |
$2,058.60 |
$2,665.60 |
|
|
Tx atrial fib pulm vein isol
|
$9,150.00 |
$21,205.10 |
$59,086.08 |
|
|
Tx closed distal humerus fx
|
$270.00 |
$348.60 |
$2,739.60 |
|
|
Tx closed hip disl traumatic without anes
|
$131.25 |
$540.00 |
$1,448.64 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,236.60 |
$3,684.74 |
$7,008.48 |
|
|
Tx closed tib shaft fx without manip
|
$270.00 |
$541.20 |
$8,405.60 |
|
|
Tx contour defects >10.0 cc
|
$388.80 |
$388.80 |
$388.80 |
|
|
Tx contour defects 1.1-5.0cc 11951
|
$110.40 |
$110.40 |
$262.40 |
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$1,776.60 |
$1,776.60 |
$2,277.60 |
|
|
Tx ectopic pregnancy ntrstl prtl rescj uter 59136
|
$1,792.20 |
$1,792.20 |
$2,159.20 |
|
|
Tx l/r atrial fib addl
|
$1,924.30 |
$6,005.00 |
$21,592.80 |
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$1,038.60 |
$1,172.40 |
$8,117.40 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$937.20 |
$3,648.24 |
$13,283.20 |
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,020.60 |
$5,224.80 |
$10,535.00 |
|
|
Tx open nsl fx uncomp
|
$910.80 |
$910.80 |
$1,072.80 |
|
|
Tx open nsl sptl fx
|
$1,261.20 |
$1,261.20 |
$1,567.20 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,065.00 |
$7,008.48 |
$8,633.80 |
|
|
Tx septic abortion surgical 59830
|
$896.40 |
$896.40 |
$1,094.40 |
|
|
Tx tarsal bone fx without manip 28450
|
$410.40 |
$451.20 |
$1,166.40 |
|
|
Tympanic membrane repair
|
$759.00 |
$1,856.00 |
$9,566.09 |
|
|
Tympanolysis transcanal 69450
|
$1,069.80 |
$1,069.80 |
$33,635.40 |
|
|
Tympanometry & reflex thresh
|
$49.60 |
$116.90 |
$304.80 |
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$530.00 |
$751.85 |
$11,083.72 |
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$2,705.40 |
$6,740.80 |
$57,155.08 |
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$2,403.60 |
$2,403.60 |
$47,438.34 |
|
|
Tyms gene com variants
|
$175.00 |
$175.00 |
$350.40 |
|
|
Typhoid vaccine oral
|
$100.00 |
$100.00 |
$100.00 |
|
|
Ua w/micro/comp poc
|
$7.26 |
$33.25 |
$122.40 |
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$120.51 |
$1,324.69 |
$69,564.95 |
|
|
Ugt1a1 gene analy common variants
|
$145.00 |
$524.16 |
$915.12 |
|
|
Ultrasound bone density measure
|
$29.60 |
$29.60 |
$255.00 |
|
|
Ultrasound breast complete
|
$175.00 |
$635.00 |
$1,429.92 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$150.00 |
$505.00 |
$1,200.80 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$112.86 |
$355.00 |
$969.50 |
|
|
Ultrasound dx ophth b-scan
|
$150.00 |
$300.00 |
$705.00 |
|
|
Ultrasound elastography ea l target les
|
$108.00 |
$380.10 |
$434.00 |
|
|
Ultrasound elastography parenchyma
|
$150.00 |
$338.40 |
$819.00 |
|
|
Ultrasound encephalogram
|
$109.23 |
$570.24 |
$1,406.30 |
|
|
Ultrasound exam k transpl w/doppler
|
$267.12 |
$753.00 |
$1,321.80 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$150.00 |
$647.40 |
$1,236.24 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$171.27 |
$921.60 |
$1,705.20 |
|
|
Ultrasound guidance for vascular access
|
$72.60 |
$447.50 |
$1,292.20 |
|
|
Ultrasound guide intraoperative
|
$249.81 |
$768.96 |
$2,104.20 |
|
|
Ultrasound guide tissue ablation
|
$485.22 |
$950.40 |
$2,603.30 |
|
|
Ultrasound hips infant dynamic
|
$187.50 |
$480.96 |
$1,434.24 |
|
|
Ultrasound infant hips ltd without stress
|
$160.71 |
$531.80 |
$1,154.88 |
|
|
Ultrasound joint complete left
|
$238.80 |
$815.76 |
$1,784.80 |
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$132.66 |
$245.70 |
$402.50 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$62.50 |
$557.90 |
$2,093.60 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$62.50 |
$390.96 |
$826.56 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$361.80 |
$867.00 |
$1,693.20 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$212.50 |
$601.20 |
$1,241.60 |
|
|
Ultrasound prostate/transrectal
|
$318.60 |
$872.64 |
$1,463.40 |
|
|
Ultrasound spinal canal and contents
|
$110.40 |
$465.84 |
$1,559.60 |
|
|
Ultrasound transabd ea addl gest
|
$205.92 |
$624.96 |
$1,157.10 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$325.38 |
$3,213.00 |
$3,213.00 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$308.40 |
$4,034.80 |
$4,034.80 |
|
|
Ultraviolet therapy
|
$22.50 |
$27.60 |
$86.36 |
|
|
Umbilical artery cath newborn 36660
|
$88.80 |
$295.20 |
$851.20 |
|
|
Umbilical cord occlud w/us
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
|
|
Umbilicoplasty 15847
|
$655.80 |
$655.80 |
$834.40 |
|
|
Unit mobile power mpu
|
$12,250.42 |
$12,250.42 |
$20,627.40 |
|
|
Unlistd noninvas vasc dx std
|
$67.50 |
$67.50 |
$3,664.20 |
|
|
Unlisted chemotherapy px
|
$75.90 |
$150.00 |
$540.40 |
|
|
Unlisted cranfcl&maxlfcl px
|
$501.84 |
$501.84 |
$501.84 |
|
|
Unlisted CT procedure
|
$120.00 |
$1,941.10 |
$3,577.20 |
|
|
Unlisted cytogenetic study
|
$47.85 |
$1,631.40 |
$2,434.80 |
|
|
Unlisted dialysis procedure
|
$522.00 |
$570.00 |
$4,940.00 |
|
|
Unlisted dx gi procedure
|
$1,908.20 |
$1,908.20 |
$1,908.20 |
|
|
Unlisted endocrine px dx nuc
|
$753.60 |
$753.60 |
$907.20 |
|
|
Unlisted fetal invas px w/us
|
$297.50 |
$606.90 |
$606.90 |
|
|
Unlisted fluoroscopic px
|
$70.29 |
$1,140.00 |
$26,511.80 |
|
|
Unlisted gi px dx nuc med
|
$868.20 |
$944.40 |
$1,530.00 |
|
|
Unlisted hematology&coagj px
|
$6.48 |
$65.10 |
$179.20 |
|
|
Unlisted hystsc px uterus
|
$14,815.88 |
$22,528.35 |
$25,169.37 |
|
