|
Trml dstrj ios bvn 1st 2 l/s
|
$1,146.40 |
$1,146.40 |
$1,146.40 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$535.20 |
$535.20 |
$535.20 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$2,555.20 |
$2,555.20 |
$2,555.20 |
$716.95
|
|
Trnscath plc stent crv crtd without prtct
|
$8,195.30 |
$8,195.30 |
$8,195.30 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$8,195.30 |
$8,195.30 |
$8,195.30 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$4,017.60 |
$4,017.60 |
$4,017.60 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,051.00 |
$11,051.00 |
$11,051.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$9,951.44 |
$9,951.44 |
$9,951.44 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$15,408.00 |
$15,408.00 |
$15,408.00 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,279.36 |
$6,279.36 |
$6,279.36 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$12,979.75 |
$12,979.75 |
$12,979.75 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,489.88 |
$6,489.88 |
$6,489.88 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,372.08 |
$4,372.08 |
$4,372.08 |
$4,418.00
|
|
Trnscath tx thromblytc vein ini day
|
$5,899.89 |
$5,899.89 |
$5,899.89 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,656.80 |
$2,656.80 |
$2,656.80 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$542.40 |
$542.40 |
$542.40 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,900.80 |
$1,900.80 |
$1,900.80 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$2,460.80 |
$2,460.80 |
$2,460.80 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,128.80 |
$2,128.80 |
$2,128.80 |
$2,551.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,954.40 |
$1,954.40 |
$1,954.40 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,534.40 |
$1,534.40 |
$1,534.40 |
$2,486.75
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$615.11 |
$615.11 |
$615.11 |
$704.80
|
|
Trnspl rej kdn mrna qpcr 139
|
$6,480.00 |
$6,480.00 |
$6,480.00 |
$3,232.32
|
|
Troponin quantitative
|
$64.28 |
$64.28 |
$64.28 |
$125.00
|
|
Tr retinal les preterm inf
|
$5,792.00 |
$5,792.00 |
$5,792.00 |
$1,794.00
|
|
Trurl dstrj prst8 tiss rf wv
|
$4,385.60 |
$4,385.60 |
$4,385.60 |
$4,228.00
|
|
Tte w or without contr, cont ecg
|
$2,329.76 |
$2,329.76 |
$2,329.76 |
$2,196.00
|
|
Tte w or without fol w/con,stres
|
$2,329.76 |
$2,329.76 |
$2,329.76 |
$1,643.14
|
|
Tte w or without fol w/cont, com
|
$2,213.03 |
$2,213.03 |
$2,213.03 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$2,213.03 |
$2,213.03 |
$2,213.03 |
$1,178.00
|
|
Tubal Ligation (Laparoscopic)
|
$920.80 |
$920.80 |
$920.80 |
$4,323.20
|
|
Tubing (oxygen) per foot
|
$0.40 |
$0.40 |
$0.40 |
$0.40
|
|
Tvh >250 gms 58290
|
$2,885.60 |
$2,885.60 |
$2,885.60 |
$6,872.92
|
|
Tvh w/mmk 58267
|
$2,665.60 |
$2,665.60 |
$2,665.60 |
$1,747.20
|
|
Tx atrial fib pulm vein isol
|
$35,050.80 |
$35,050.80 |
$35,050.80 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$1,936.90 |
$1,936.90 |
$1,936.90 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$905.60 |
$905.60 |
$905.60 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,027.20 |
$3,027.20 |
$3,027.20 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$1,692.80 |
$1,692.80 |
$1,692.80 |
$535.60
|
|
Tx contour defects >10.0 cc
|
$388.80 |
$388.80 |
$388.80 |
$918.06
|
|
Tx contour defects 1.1-5.0cc 11951
|
$262.40 |
$262.40 |
$262.40 |
$849.50
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$2,277.60 |
$2,277.60 |
$2,277.60 |
$2,277.60
|
|
Tx ectopic pregnancy ntrstl prtl rescj uter 59136
|
$2,159.20 |
$2,159.20 |
$2,159.20 |
$2,159.20
|
|
Tx l/r atrial fib addl
|
$18,268.48 |
$18,268.48 |
$18,268.48 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$1,828.80 |
$1,828.80 |
$1,828.80 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,121.03 |
$8,121.03 |
$8,121.03 |
$4,537.59
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$6,101.90 |
$6,101.90 |
$6,101.90 |
$4,595.50
|
|
Tx open nsl fx uncomp
|
$1,072.80 |
$1,072.80 |
$1,072.80 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$1,567.20 |
$1,567.20 |
$1,567.20 |
$4,308.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$1,463.20 |
$1,463.20 |
$1,463.20 |
$4,529.60
|
|
Tx septic abortion surgical 59830
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$896.40
|
|
Tx tarsal bone fx without manip 28450
|
$523.20 |
$523.20 |
$523.20 |
$423.15
|
|
Tympanic membrane repair
|
$1,856.00 |
$1,856.00 |
$1,856.00 |
$2,133.48
|
|
Tympanolysis transcanal 69450
|
$2,659.20 |
$2,659.20 |
$2,659.20 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$49.60 |
$49.60 |
$49.60 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$966.40 |
$966.40 |
$966.40 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$6,740.80 |
$6,740.80 |
$6,740.80 |
$6,740.80
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$6,043.20 |
$6,043.20 |
$6,043.20 |
$7,000.36
|
|
Tyms gene com variants
|
$350.40 |
$350.40 |
$350.40 |
$192.29
|
|
Typhoid vaccine oral
|
$100.00 |
$100.00 |
$100.00 |
$63.28
|
|
Ua w/micro/comp poc
|
$25.72 |
$25.72 |
$25.72 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$468.00 |
$468.00 |
$468.00 |
$438.75
|
|
Ultrasound bone density measure
|
$29.60 |
$29.60 |
$29.60 |
$143.75
|
|
Ultrasound breast complete
|
$790.12 |
$790.12 |
$790.12 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$758.04 |
$758.04 |
$758.04 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$329.50 |
$329.50 |
$329.50 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$158.40 |
$158.40 |
$158.40 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$108.00 |
$108.00 |
$108.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$189.60 |
$189.60 |
$189.60 |
$307.00
|
|
Ultrasound encephalogram
|
$252.67 |
$252.67 |
$252.67 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$769.79 |
$769.79 |
$769.79 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$427.18 |
$427.18 |
$427.18 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$499.72 |
$499.72 |
$499.72 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$489.33 |
$489.33 |
$489.33 |
$388.08
|
|
Ultrasound guide intraoperative
|
$934.67 |
$934.67 |
$934.67 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$632.76 |
$632.76 |
$632.76 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$271.20 |
$271.20 |
$271.20 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$266.44 |
$266.44 |
$266.44 |
$304.00
|
|
Ultrasound joint complete left
|
$459.28 |
$459.28 |
$459.28 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$191.20 |
$191.20 |
$191.20 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$518.19 |
$518.19 |
$518.19 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$228.04 |
$228.04 |
$228.04 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$421.60 |
$421.60 |
$421.60 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$499.99 |
$499.99 |
$499.99 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$529.96 |
$529.96 |
$529.96 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$468.94 |
$468.94 |
$468.94 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$424.80 |
$424.80 |
$424.80 |
$417.15
|
|
Ultrasound trgt dyn mbubb 1st les
|
$516.00 |
$516.00 |
$516.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$348.00 |
$348.00 |
$348.00 |
$348.00
|
|
Ultraviolet therapy
|
$15.20 |
$15.20 |
$15.20 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$183.30 |
$183.30 |
$183.30 |
$223.80
|
|
Umbilical cord occlud w/us
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
$754.00
|
|
Umbilicoplasty 15847
|
$834.40 |
$834.40 |
$834.40 |
$4,172.97
|
|
Unlisted CT procedure
|
$298.79 |
$298.79 |
$298.79 |
$740.43
|
|
Unlisted cv px dx nuc med
|
$1,384.34 |
$1,384.34 |
$1,384.34 |
$1,747.20
|
|
Unlisted endocrine px dx nuc
|
$1,066.00 |
$1,066.00 |
$1,066.00 |
$653.31
|
|
Unlisted gi px dx nuc med
|
$1,539.67 |
$1,539.67 |
$1,539.67 |
$995.00
|
|
Unlisted gu px dx nuc med
|
$1,384.34 |
$1,384.34 |
$1,384.34 |
$805.62
|
|
Unlisted hematology&coagj px
|
$33.57 |
$33.57 |
$33.57 |
$39.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$1,218.40 |
$1,218.40 |
$1,218.40 |
$6,307.38
|
