|
Treat thigh fx growth plate
|
$296.00 |
$296.00 |
$332.80 |
|
|
Treat ulnar fracture
|
$805.60 |
$805.60 |
$1,672.00 |
|
|
Treat vaginal bleeding
|
$944.00 |
$944.00 |
$944.00 |
|
|
Treat wrist bone fracture
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
|
|
Treat wrist dislocation
|
$521.60 |
$521.60 |
$745.60 |
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$13,945.68 |
$13,945.68 |
$39,737.05 |
|
|
Treponema pallidum antibody
|
$38.64 |
$42.19 |
$177.07 |
|
|
Treprostinil injection
|
$20,536.20 |
$20,536.20 |
$20,536.20 |
|
|
Trg gene rearrangement anal
|
$132.96 |
$139.78 |
$492.00 |
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$27.18 |
$56.48 |
$88.71 |
|
|
Triamcinolone a inj prs-free
|
$28.19 |
$32.89 |
$32.89 |
|
|
Triamcinolone hexacetonl inj
|
$43.07 |
$43.07 |
$43.07 |
|
|
Triglycerides
|
$23.52 |
$25.73 |
$149.60 |
|
|
Trilaciclib 300 mg intravenous solution
|
$2,545.06 |
$2,545.06 |
$2,545.06 |
|
|
Trimethobenzamide hci 250mg
|
$3.58 |
$3.58 |
$3.58 |
|
|
Trimethobenzamide hcl inj
|
$75.57 |
$112.70 |
$112.70 |
|
|
Trim nail(s)
|
$72.00 |
$82.94 |
$251.76 |
|
|
Trim nondyst nails
|
$72.91 |
$112.00 |
$251.76 |
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$853.27 |
$862.68 |
$1,128.24 |
|
|
Trml dstrj ios bvn ea addl
|
$70.00 |
$70.78 |
$92.54 |
|
|
Trmt of fracture (femoral shaft) 27500
|
$596.00 |
$771.20 |
$771.20 |
|
|
Trnscath plc stent crv crtd without prtct
|
$11,301.89 |
$11,301.89 |
$13,343.20 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$12,549.02 |
$12,549.02 |
$13,968.00 |
|
|
Trnscath plc stnt ante carotid art
|
$10,197.07 |
$10,197.07 |
$10,197.07 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,547.65 |
$11,547.65 |
$11,942.40 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$10,801.49 |
$10,801.49 |
$14,427.20 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$15,822.91 |
$15,822.91 |
$18,947.20 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,071.26 |
$3,071.26 |
$6,473.04 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,481.60 |
$7,178.35 |
$7,178.35 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,862.40 |
$10,647.55 |
$10,647.55 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,790.40 |
$11,878.83 |
$11,878.83 |
|
|
Trnscath tx thromblytc vein ini day
|
$3,856.80 |
$6,953.09 |
$6,953.09 |
|
|
Troponin quantitative
|
$69.70 |
$81.31 |
$212.80 |
|
|
Truss double with standard pad
|
$235.59 |
$321.83 |
$321.83 |
|
|
Truss single with standard pad
|
$82.95 |
$82.95 |
$82.95 |
|
|
Tte w or without contr, cont ecg
|
$1,672.80 |
$1,833.22 |
$2,739.20 |
|
|
Tte w or without fol w/con,stres
|
$1,770.67 |
$2,511.20 |
$2,742.54 |
|
|
Tte w or without fol w/cont, com
|
$744.91 |
$744.91 |
$1,579.48 |
|
|
Tte w or without fol w/cont, f/u
|
$508.14 |
$790.61 |
$790.61 |
|
|
Tx atrial fib pulm vein isol
|
$36,553.87 |
$36,553.87 |
$49,375.20 |
|
|
Tx closed distal humerus fx
|
$149.14 |
$162.79 |
$162.79 |
|
|
Tx closed hip disl traumatic without anes
|
$586.40 |
$612.80 |
$784.00 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$856.00 |
$856.00 |
$4,700.00 |
|
|
Tx closed tib shaft fx without manip
|
$448.00 |
$556.80 |
$608.80 |
|
|
Tx l/r atrial fib addl
|
$10,966.18 |
$10,966.18 |
$11,763.20 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$4,764.00 |
$4,764.00 |
$4,764.00 |
|
|
Tx open nsl fx uncomp
|
$5,570.40 |
$5,570.40 |
$5,570.40 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$7,470.40 |
$7,470.40 |
$7,470.40 |
|
|
Tx tarsal bone fx without manip 28450
|
$354.40 |
$354.40 |
$510.40 |
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$712.00 |
$712.00 |
$712.00 |
|
|
Ua w/micro/comp poc
|
$38.40 |
$50.40 |
$50.40 |
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$14,596.44 |
$14,596.44 |
$15,853.47 |
|
|
Ultrasound breast complete
|
$229.44 |
$357.67 |
$704.80 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$172.08 |
$268.24 |
$516.00 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$126.82 |
$197.74 |
$516.00 |
|
|
Ultrasound dx ophth b-scan
|
$423.20 |
$423.20 |
$423.20 |
|
|
Ultrasound elastography ea l target les
|
$192.86 |
$344.12 |
$344.12 |
|
|
Ultrasound elastography parenchyma
|
$238.70 |
$283.53 |
$405.94 |
|
|
Ultrasound encephalogram
|
$283.53 |
$328.80 |
$533.60 |
|
|
Ultrasound exam k transpl w/doppler
|
$630.95 |
$658.40 |
$905.60 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$380.83 |
$656.00 |
$686.67 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$286.61 |
$525.50 |
$961.60 |
|
|
Ultrasound guidance for vascular access
|
$519.20 |
$633.12 |
$1,127.20 |
|
|
Ultrasound guide intraoperative
|
$682.80 |
$915.49 |
$1,037.60 |
|
|
Ultrasound guide tissue ablation
|
$1,821.02 |
$1,821.02 |
$1,821.02 |
|
|
Ultrasound hips infant dynamic
|
$341.47 |
$457.74 |
$645.60 |
|
|
Ultrasound infant hips ltd without stress
|
$391.20 |
$456.68 |
$620.80 |
|
|
Ultrasound joint complete left
|
$341.47 |
$457.74 |
$729.60 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$283.53 |
$305.09 |
$683.20 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$202.40 |
$457.74 |
$507.20 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$425.21 |
$761.66 |
$1,044.80 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$380.83 |
$510.83 |
$637.90 |
|
|
Ultrasound prostate/transrectal
|
$455.28 |
$601.16 |
$812.00 |
|
|
Ultrasound spinal canal and contents
|
$292.80 |
$457.74 |
$641.60 |
|
|
Ultrasound transabd ea addl gest
|
$283.53 |
$380.83 |
$609.60 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$249.22 |
$333.31 |
$333.31 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$137.14 |
$174.89 |
$174.89 |
|
|
Ultraviolet therapy
|
$65.46 |
$81.48 |
$81.48 |
|
|
Umbilical artery cath newborn 36660
|
$157.60 |
$157.60 |
$157.60 |
|
|
Umbilical cord occlud w/us
|
$253.51 |
$253.51 |
$400.42 |
|
|
Unit mobile power mpu
|
$12,228.48 |
$14,266.56 |
$14,266.56 |
|
|
Unlisted chemotherapy px
|
$163.69 |
$239.57 |
$296.88 |
|
|
Unlisted cranfcl&maxlfcl px
|
$4,292.00 |
$4,292.00 |
$5,912.00 |
|
|
Unlisted CT procedure
|
$147.20 |
$147.20 |
$147.20 |
|
|
Unlisted cv px dx nuc med
|
$665.62 |
$665.62 |
$665.62 |
|
|
Unlisted cytogenetic study
|
$172.42 |
$181.22 |
$234.98 |
|
|
Unlisted dialysis procedure
|
$1,588.00 |
$1,588.00 |
$1,620.00 |
|
|
Unlisted dx gi procedure
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
|
|
Unlisted fluoroscopic px
|
$400.00 |
$400.00 |
$400.00 |
|
|
Unlisted gi px dx nuc med
|
$412.18 |
$673.46 |
$673.46 |
|
|
Unlisted gu px dx nuc med
|
$805.62 |
$805.62 |
$805.62 |
|
|
Unlisted mr procedure
|
$1,094.50 |
$2,422.17 |
$2,772.11 |
|
|
Unlisted muscskel px dx nuc
|
$665.62 |
$665.62 |
$665.62 |
|
|
Unlisted muscskel px head
|
$335.94 |
$335.94 |
$6,272.00 |
|
|
Unlisted neurological dx px
|
$804.80 |
$804.80 |
$804.80 |
|
|
Unlisted orl service/px
|
$307.87 |
$323.79 |
$323.79 |
|
|
Unlisted procedure eyelids
|
$717.60 |
$717.60 |
$717.60 |
|
|
Unlisted procedure larynx
|
$5,832.00 |
$5,832.00 |
$5,832.00 |
|
|
Unlisted procedure liver
|
$845.26 |
$845.26 |
$1,416.91 |
|
|
Unlisted procedure microbiology
|
$2,911.66 |
$2,911.66 |
$3,729.32 |
|
