|
Treat fracture of radius
|
$927.20 |
$927.20 |
$927.20 |
$1,790.00
|
|
Treat fracture of radius
|
$1,050.10 |
$1,050.10 |
$1,050.10 |
$1,849.00
|
|
Treat fracture of ulna
|
$905.65 |
$905.65 |
$905.65 |
$731.04
|
|
Treat hand dislocation
|
$855.70 |
$855.70 |
$855.70 |
$1,771.43
|
|
Treat hip dislocation
|
$1,704.65 |
$1,704.65 |
$1,704.65 |
$2,211.05
|
|
Treat hip socket fracture
|
$1,952.95 |
$1,952.95 |
$1,952.95 |
$1,392.00
|
|
Treat humerus fracture
|
$1,252.20 |
$1,252.20 |
$1,252.20 |
$1,790.00
|
|
Treat humerus fracture
|
$1,086.50 |
$1,086.50 |
$1,086.50 |
$1,790.00
|
|
Treat kneecap dislocation
|
$1,064.90 |
$1,064.90 |
$1,064.90 |
$1,068.06
|
|
Treat knee dislocation
|
$1,407.75 |
$1,407.75 |
$1,407.75 |
$2,220.89
|
|
Treat knee fracture 27530
|
$560.15 |
$560.15 |
$560.15 |
$550.73
|
|
Treat knee fracture(s)
|
$969.10 |
$969.10 |
$969.10 |
$643.26
|
|
Treat lower leg dislocation
|
$700.50 |
$700.50 |
$700.50 |
$532.60
|
|
Treat lower leg dislocation
|
$722.10 |
$722.10 |
$722.10 |
$3,908.80
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$178.15 |
$178.15 |
$178.15 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$116.05 |
$116.05 |
$116.05 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$585.75 |
$585.75 |
$585.75 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$568.20 |
$568.20 |
$568.20 |
$501.20
|
|
Treatment of heel fracture 28400
|
$462.90 |
$462.90 |
$462.90 |
$473.00
|
|
Treatment of thigh fracture
|
$1,021.70 |
$1,021.70 |
$1,021.70 |
$477.75
|
|
Treatment of thigh fracture
|
$1,625.05 |
$1,625.05 |
$1,625.05 |
$1,749.06
|
|
Treatment of thigh fracture
|
$1,073.00 |
$1,073.00 |
$1,073.00 |
$549.00
|
|
Treatment of thigh fracture
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$271.30 |
$271.30 |
$271.30 |
$371.40
|
|
Treat midfoot fracture each
|
$535.80 |
$535.80 |
$535.80 |
$1,884.74
|
|
Treat sternum fracture
|
$345.55 |
$345.55 |
$345.55 |
$423.00
|
|
Treat thigh fracture
|
$967.75 |
$967.75 |
$967.75 |
$661.00
|
|
Treat thigh fracture
|
$939.45 |
$939.45 |
$939.45 |
$1,893.86
|
|
Treat thigh fracture
|
$781.50 |
$781.50 |
$781.50 |
$618.80
|
|
Treat thigh fracture
|
$2,922.10 |
$2,922.10 |
$2,922.10 |
$2,032.10
|
|
Treat thigh fx growth plate
|
$1,035.20 |
$1,035.20 |
$1,035.20 |
$478.40
|
|
Treat thigh fx growth plate
|
$1,198.55 |
$1,198.55 |
$1,198.55 |
$1,938.38
|
|
Treat toe dislocation
|
$454.85 |
$454.85 |
$454.85 |
$756.39
|
|
Treat ulnar fracture
|
$1,008.30 |
$1,008.30 |
$1,008.30 |
$1,677.20
|
|
Treat vaginal bleeding
|
$458.90 |
$458.90 |
$458.90 |
$379.60
|
|
Treat wrist bone fracture
|
$780.10 |
$780.10 |
$780.10 |
$1,703.20
|
|
Treat wrist dislocation
|
$940.75 |
$940.75 |
$940.75 |
$656.25
|
|
Treponema pallidum antibody
|
$121.20 |
$121.20 |
$121.20 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$129.09 |
$129.09 |
$129.09 |
$43.09
|
|
Triglycerides
|
$106.70 |
$106.70 |
$106.70 |
$58.50
|
|
Trim nondyst nails
|
$62.05 |
$62.05 |
$62.05 |
$113.88
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$754.80
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,017.30 |
$2,017.30 |
$2,017.30 |
$4,872.75
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$398.55 |
$398.55 |
$398.55 |
$2,423.00
|
|
Troponin quantitative
|
$194.40 |
$194.40 |
$194.40 |
$127.60
|
|
Tte w or without contr, cont ecg
|
$1,968.40 |
$1,968.40 |
$1,968.40 |
$2,067.00
|
|
Tte w or without fol w/con,stres
|
$1,303.15 |
$1,303.15 |
$1,303.15 |
$1,632.80
|
|
Tx closed distal humerus fx
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$396.80 |
$396.80 |
$396.80 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,252.50 |
$1,252.50 |
$1,252.50 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$643.75 |
$643.75 |
$643.75 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$402.25 |
$402.25 |
$402.25 |
$419.04
|
|
Tympanometry & reflex thresh
|
$194.40 |
$194.40 |
$194.40 |
$173.18
|
|
Ua w/micro/comp poc
|
$56.00 |
$56.00 |
$56.00 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$1,377.25 |
$1,377.25 |
$1,377.25 |
$438.75
|
|
Ultrasound breast complete
|
$525.10 |
$525.10 |
$525.10 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$552.05 |
$552.05 |
$552.05 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$322.60 |
$322.60 |
$322.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$109.25 |
$109.25 |
$109.25 |
$296.80
|
|
Ultrasound encephalogram
|
$596.55 |
$596.55 |
$596.55 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$642.50 |
$642.50 |
$642.50 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$616.80 |
$616.80 |
$616.80 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$674.85 |
$674.85 |
$674.85 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$637.05 |
$637.05 |
$637.05 |
$388.08
|
|
Ultrasound guide intraoperative
|
$904.30 |
$904.30 |
$904.30 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$265.00 |
$265.00 |
$265.00 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$427.85 |
$427.85 |
$427.85 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$427.85 |
$427.85 |
$427.85 |
$311.25
|
|
Ultrasound joint complete left
|
$738.30 |
$738.30 |
$738.30 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$558.75 |
$558.75 |
$558.75 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$372.55 |
$372.55 |
$372.55 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$877.25 |
$877.25 |
$877.25 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$727.50 |
$727.50 |
$727.50 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$770.75 |
$770.75 |
$770.75 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$607.35 |
$607.35 |
$607.35 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$877.25 |
$877.25 |
$877.25 |
$419.50
|
|
Umbilical artery cath newborn 36660
|
$148.45 |
$148.45 |
$148.45 |
$223.80
|
|
Unlisted chemotherapy px
|
$179.50 |
$179.50 |
$179.50 |
$149.15
|
|
Unlisted dialysis procedure
|
$1,429.30 |
$1,429.30 |
$1,429.30 |
$1,144.00
|
|
Unlisted procedure rectum
|
$476.40 |
$476.40 |
$476.40 |
$1,223.20
|
|
Unlisted px biliary tract
|
$674.85 |
$674.85 |
$674.85 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$103.90 |
$103.90 |
$103.90 |
$222.00
|
|
Unlisted px small intestine
|
$1,424.45 |
$1,424.45 |
$1,424.45 |
$2,118.35
|
|
Unlisted ultrasound procedure
|
$491.35 |
$491.35 |
$491.35 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$383.30 |
$383.30 |
$383.30 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,420.00 |
$2,420.00 |
$2,420.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,865.25 |
$1,865.25 |
$1,865.25 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,186.60 |
$3,186.60 |
$3,186.60 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,438.90 |
$2,438.90 |
$2,438.90 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$400.85 |
$400.85 |
$400.85 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$469.65 |
$469.65 |
$469.65 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$1,385.70 |
$1,385.70 |
$1,385.70 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$1,033.85 |
$1,033.85 |
$1,033.85 |
$607.20
|
|
Urea nitrogen
|
$22.95 |
$22.95 |
$22.95 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$63.45 |
$63.45 |
$63.45 |
$52.00
|
|
Urea nitrogen clearance
|
$64.75 |
$64.75 |
$64.75 |
$38.35
|
|
Ureteral reflux study
|
$1,206.60 |
$1,206.60 |
$1,206.60 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,194.50 |
$1,194.50 |
$1,194.50 |
$584.00
|
|
Urethrocystography void s&i
|
$1,137.75 |
$1,137.75 |
$1,137.75 |
$631.40
|
