|
Treatment mouth roof lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,350.00
|
|
Treatment of anal fissure
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,073.68
|
|
Treatment of anal fissure w/dilat 46940
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,997.10
|
|
Treatment of ankle fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,907.11
|
|
Treatment of ankle fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,907.11
|
|
Treatment of ankle fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,348.32
|
|
Treatment of ankle fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,807.24
|
|
Treatment of ankle fracture 27786
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$580.00
|
|
Treatment of choroid lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,126.50
|
|
Treatment of corneal lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$436.44
|
|
Treatment of eyelid lesions
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$326.69
|
|
Treatment of fibula fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$558.75
|
|
Treatment of foot infection
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Treatment of foot infection
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,594.44
|
|
Treatment of gum lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,164.85
|
|
Treatment of heel fracture 28400
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$494.00
|
|
Treatment of miscarriage
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,544.29
|
|
Treatment of penis lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,081.37
|
|
Treatment of penis lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,386.84
|
|
Treatment of rectal prolapse
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,010.01
|
|
Treatment of retinal lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,580.87
|
|
Treatment of retinal lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,522.19
|
|
Treatment of retinal lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,881.00
|
|
Treatment of thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$467.25
|
|
Treatment of thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Treatment of thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$659.00
|
|
Treatment of thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,651.45
|
|
Treatment of thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,055.00
|
|
Treatment of tibia fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,183.84
|
|
Treatment of tibia fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,110.00
|
|
Treatment of tibia fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,347.40
|
|
Treatment of toe fracture 28510
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$371.40
|
|
Treatment of urethra lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,891.34
|
|
Treatment of urethra lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,935.76
|
|
Treatment of urethra lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,424.12
|
|
Treatment radiation delivery level 2
|
$211.80 |
$211.80 |
$211.80 |
$735.00
|
|
Treatment x10sv retinopathy
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,574.83
|
|
Treat metacarpal fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,958.50
|
|
Treat metacarpal fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,627.00
|
|
Treat metatarsal fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Treat metatarsal fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,913.97
|
|
Treat midfoot fracture each
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,893.86
|
|
Treat midfoot fracture each
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,192.78
|
|
Treat penis lesion graft
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,631.74
|
|
Treat penis lesion graft
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,976.07
|
|
Treat radius fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,750.12
|
|
Treat radius fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$9,499.20
|
|
Treat sesamoid bone fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,855.00
|
|
Treat skull fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,621.80
|
|
Treat spinal cord lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$985.43
|
|
Treat spinal cord lesion
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,304.32
|
|
Treat sternum fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$423.00
|
|
Treat tail bone fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,786.00
|
|
Treat thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$661.00
|
|
Treat thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,372.60
|
|
Treat thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$2,021.04
|
|
Treat thigh fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$716.95
|
|
Treat thigh fx growth plate
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$421.50
|
|
Treat thigh fx growth plate
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,938.38
|
|
Treat thumb fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Treat thumb fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Treat toe dislocation
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,839.54
|
|
Treat toe dislocation
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$855.66
|
|
Treat toe dislocation
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,111.65
|
|
Treat toe fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,981.06
|
|
Treat trigeminal nerve
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,610.79
|
|
Treat trigeminal tract
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$3,786.00
|
|
Treat ulnar fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,861.60
|
|
Treat ulnar fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,419.00
|
|
Treat vaginal bleeding
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$400.86
|
|
Treat wrist bone fracture
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$1,907.64
|
|
Treat wrist dislocation
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$760.00
|
|
Treponema pallidum ag if
|
$13.40 |
$13.40 |
$13.40 |
$13.40
|
|
Treponema pallidum antibody
|
$14.56 |
$14.56 |
$14.56 |
$72.80
|
|
Trg gene rearrangement anal
|
$221.65 |
$221.65 |
$221.65 |
$455.70
|
|
Trh stimulation panel
|
$73.93 |
$73.93 |
$73.93 |
$73.93
|
|
Trichinella antibody
|
$13.82 |
$13.82 |
$13.82 |
$70.65
|
|
Trichomonas assay w/optic
|
$16.82 |
$16.82 |
$16.82 |
$66.00
|
|
#tricyclicantidprssnt
|
$61.21 |
$61.21 |
$61.21 |
$57.08
|
|
Triglycerides
|
$6.31 |
$6.31 |
$6.31 |
$54.60
|
|
Trim nail(s)
|
$43.93 |
$43.93 |
$43.93 |
$70.29
|
|
Trim nondyst nails
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$124.22
|
|
Trluml dil aq o/f can without st
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,760.49
|
|
Trluml dil aq o/f can w/st
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$5,716.03
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$15,111.95
|
|
Trmt of fracture (femoral shaft) 27500
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$5,741.00 |
$5,741.00 |
$5,741.00 |
$4,805.85
|
