|
Tl-201 thallium diag per mci
|
$78.40 |
$78.40 |
$78.40 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$45.81 |
$45.81 |
$45.81 |
$152.36
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,328.00 |
$2,328.00 |
$2,328.00 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$322.40 |
$322.40 |
$322.40 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$96.80 |
$96.80 |
$96.80 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$93.60 |
$93.60 |
$93.60 |
$74.10
|
|
Tprnl plmt biodegrdabl matrl
|
$6,167.20 |
$6,167.20 |
$6,167.20 |
$7,144.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,850.40 |
$1,850.40 |
$1,850.40 |
$1,437.45
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$113.60 |
$113.60 |
$113.60 |
$102.27
|
|
Transcath biopsy
|
$4,918.40 |
$4,918.40 |
$4,918.40 |
$4,285.93
|
|
Transcath closure of asd
|
$19,500.80 |
$19,500.80 |
$19,500.80 |
$17,041.80
|
|
Transcatheter bx s&i
|
$2,979.20 |
$2,979.20 |
$2,979.20 |
$1,950.85
|
|
Transcath occlusion non-cns
|
$8,744.80 |
$8,744.80 |
$8,744.80 |
$10,270.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$660.80 |
$660.80 |
$660.80 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$371.20 |
$371.20 |
$371.20 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$3,883.20 |
$3,883.20 |
$3,883.20 |
$4,523.04
|
|
Treat ankle dislocation
|
$2,205.60 |
$2,205.60 |
$2,205.60 |
$2,360.00
|
|
Treat big toe fracture
|
$6,136.00 |
$6,136.00 |
$6,136.00 |
$4,485.60
|
|
Treat clavicle dislocation 23545
|
$692.80 |
$692.80 |
$692.80 |
$692.80
|
|
Treat elbow dislocation
|
$2,256.80 |
$2,256.80 |
$2,256.80 |
$2,272.50
|
|
Treat elbow fracture
|
$2,395.20 |
$2,395.20 |
$2,395.20 |
$2,026.50
|
|
Treat finger fracture each
|
$5,701.60 |
$5,701.60 |
$5,701.60 |
$4,307.52
|
|
Treat finger fracture each
|
$768.80 |
$768.80 |
$768.80 |
$1,592.00
|
|
Treat foot dislocation
|
$510.40 |
$510.40 |
$510.40 |
$405.60
|
|
Treat foot dislocation
|
$3,432.00 |
$3,432.00 |
$3,432.00 |
$4,192.86
|
|
Treat foot dislocation
|
$705.60 |
$705.60 |
$705.60 |
$534.05
|
|
Treat fracture of radius
|
$1,001.60 |
$1,001.60 |
$1,001.60 |
$1,790.00
|
|
Treat fracture of radius
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$1,849.00
|
|
Treat fracture of ulna
|
$1,830.40 |
$1,830.40 |
$1,830.40 |
$731.04
|
|
Treat hand dislocation
|
$1,591.20 |
$1,591.20 |
$1,591.20 |
$1,771.43
|
|
Treat hip dislocation
|
$1,878.40 |
$1,878.40 |
$1,878.40 |
$2,211.05
|
|
Treat hip socket fracture
|
$1,617.60 |
$1,617.60 |
$1,617.60 |
$1,392.00
|
|
Treat humerus fracture
|
$1,650.40 |
$1,650.40 |
$1,650.40 |
$1,790.00
|
|
Treat kneecap dislocation
|
$1,572.80 |
$1,572.80 |
$1,572.80 |
$1,068.06
|
|
Treat knee dislocation
|
$3,408.00 |
$3,408.00 |
$3,408.00 |
$2,220.89
|
|
Treat knee fracture 27530
|
$561.60 |
$561.60 |
$561.60 |
$550.73
|
|
Treat knee fracture(s)
|
$669.60 |
$669.60 |
$669.60 |
$643.26
|
|
Treat knuckle dislocation
|
$1,090.40 |
$1,090.40 |
$1,090.40 |
$1,726.01
|
|
Treatment incomplete abortion completed surgically any trimester
|
$5,692.80 |
$5,692.80 |
$5,692.80 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$260.00 |
$260.00 |
$260.00 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$196.80 |
$196.80 |
$196.80 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$580.00 |
$580.00 |
$580.00 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$552.80 |
$552.80 |
$552.80 |
$501.20
|
|
Treatment of foot infection
|
$4,271.20 |
$4,271.20 |
$4,271.20 |
$2,939.13
|
|
Treatment of heel fracture 28400
|
$538.40 |
$538.40 |
$538.40 |
$473.00
|
|
Treatment of thigh fracture
|
$739.20 |
$739.20 |
$739.20 |
$477.75
|
|
Treatment of thigh fracture
|
$1,888.00 |
$1,888.00 |
$1,888.00 |
$1,749.06
|
|
Treatment of thigh fracture
|
$570.40 |
$570.40 |
$570.40 |
$549.00
|
|
Treatment of thigh fracture
|
$1,914.40 |
$1,914.40 |
$1,914.40 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$416.00 |
$416.00 |
$416.00 |
$371.40
|
|
Treatment radiation delivery level 2
|
$2,852.80 |
$2,852.80 |
$2,852.80 |
$830.70
|
|
Treat sternum fracture
|
$576.80 |
$576.80 |
$576.80 |
$423.00
|
|
Treat thigh fracture
|
$648.00 |
$648.00 |
$648.00 |
$661.00
|
|
Treat thigh fracture
|
$1,650.40 |
$1,650.40 |
$1,650.40 |
$1,893.86
|
|
Treat thigh fracture
|
$740.80 |
$740.80 |
$740.80 |
$618.80
|
|
Treat thigh fracture
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$2,032.10
|
|
Treat thigh fx growth plate
|
$296.00 |
$296.00 |
$296.00 |
$478.40
|
|
Treat ulnar fracture
|
$805.60 |
$805.60 |
$805.60 |
$1,677.20
|
|
Treat vaginal bleeding
|
$944.00 |
$944.00 |
$944.00 |
$379.60
|
|
Treat wrist bone fracture
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$1,703.20
|
|
Treat wrist dislocation
|
$745.60 |
$745.60 |
$745.60 |
$656.25
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$56.69 |
$56.69 |
$56.69 |
$43.09
|
|
Trim nondyst nails
|
$118.40 |
$118.40 |
$118.40 |
$113.88
|
|
Trmt of fracture (femoral shaft) 27500
|
$771.20 |
$771.20 |
$771.20 |
$754.80
|
|
Trnscath plc stent crv crtd without prtct
|
$13,343.20 |
$13,343.20 |
$13,343.20 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$13,968.00 |
$13,968.00 |
$13,968.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,942.40 |
$11,942.40 |
$11,942.40 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$14,427.20 |
$14,427.20 |
$14,427.20 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$18,947.20 |
$18,947.20 |
$18,947.20 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,092.80 |
$5,092.80 |
$5,092.80 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,481.60 |
$4,481.60 |
$4,481.60 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,862.40 |
$4,862.40 |
$4,862.40 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$3,856.80 |
$3,856.80 |
$3,856.80 |
$3,866.70
|
|
Truss single with standard pad
|
$82.95 |
$82.95 |
$82.95 |
$128.80
|
|
Tte w or without contr, cont ecg
|
$2,739.20 |
$2,739.20 |
$2,739.20 |
$2,067.00
|
|
Tte w or without fol w/con,stres
|
$2,399.20 |
$2,399.20 |
$2,399.20 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$1,175.20 |
$1,175.20 |
$1,175.20 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$567.20 |
$567.20 |
$567.20 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$49,375.20 |
$49,375.20 |
$49,375.20 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$784.00 |
$784.00 |
$784.00 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,700.00 |
$4,700.00 |
$4,700.00 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$608.80 |
$608.80 |
$608.80 |
$535.60
|
|
Tx l/r atrial fib addl
|
$11,763.20 |
$11,763.20 |
$11,763.20 |
$6,986.85
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$4,764.00 |
$4,764.00 |
$4,764.00 |
$4,499.12
|
|
Tx open nsl fx uncomp
|
$5,570.40 |
$5,570.40 |
$5,570.40 |
$3,926.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$7,470.40 |
$7,470.40 |
$7,470.40 |
$4,637.36
|
|
Tx tarsal bone fx without manip 28450
|
$510.40 |
$510.40 |
$510.40 |
$419.04
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$712.00 |
$712.00 |
$712.00 |
$911.43
|
|
Ultrasound breast complete
|
$536.00 |
$536.00 |
$536.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$481.60 |
$481.60 |
$481.60 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$396.00 |
$396.00 |
$396.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$423.20 |
$423.20 |
$423.20 |
$296.80
|
|
Ultrasound encephalogram
|
$328.80 |
$328.80 |
$328.80 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$668.80 |
$668.80 |
$668.80 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$640.00 |
$640.00 |
$640.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$895.20 |
$895.20 |
$895.20 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$560.80 |
$560.80 |
$560.80 |
$388.08
|
|
Ultrasound guide intraoperative
|
$850.40 |
$850.40 |
$850.40 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$485.60 |
$485.60 |
$485.60 |
$403.88
|
