|
Trnscath tx thromblytc vein ini day
|
$3,724.63 |
$3,724.63 |
$3,724.63 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$4,332.25 |
$4,332.25 |
$4,332.25 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,551.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$2,164.64 |
$2,164.64 |
$2,164.64 |
$2,486.75
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$640.73 |
$640.73 |
$640.73 |
$704.80
|
|
Trnspl rej kdn mrna qpcr 139
|
$3,240.00 |
$3,240.00 |
$3,240.00 |
$3,232.32
|
|
Troponin quantitative
|
$12.47 |
$12.47 |
$12.47 |
$125.00
|
|
Tr retinal les preterm inf
|
$649.19 |
$649.19 |
$649.19 |
$1,794.00
|
|
Trurl dstrj prst8 tiss rf wv
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,228.00
|
|
Truskin, per sq centimeter
|
$127.14 |
$127.14 |
$127.14 |
$1.00
|
|
Tte w or without contr, cont ecg
|
$934.93 |
$934.93 |
$934.93 |
$2,196.00
|
|
Tte w or without fol w/con,stres
|
$934.93 |
$934.93 |
$934.93 |
$1,643.14
|
|
Tte w or without fol w/cont, com
|
$934.93 |
$934.93 |
$934.93 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$934.93 |
$934.93 |
$934.93 |
$1,178.00
|
|
Tubal Ligation (Laparoscopic)
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$4,323.20
|
|
Tumor cell deplete of harvst
|
$517.34 |
$517.34 |
$517.34 |
$1,315.60
|
|
Tvh >250 gms 58290
|
$8,750.72 |
$8,750.72 |
$8,750.72 |
$6,872.92
|
|
Tx atrial fib pulm vein isol
|
$29,030.54 |
$29,030.54 |
$29,030.54 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$283.86 |
$283.86 |
$283.86 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$283.86 |
$283.86 |
$283.86 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$283.86 |
$283.86 |
$283.86 |
$535.60
|
|
Tx contour defects >10.0 cc
|
$755.08 |
$755.08 |
$755.08 |
$918.06
|
|
Tx contour defects 1.1-5.0cc 11951
|
$755.08 |
$755.08 |
$755.08 |
$849.50
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,537.59
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,595.50
|
|
Tx open nsl fx uncomp
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,308.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,529.60
|
|
Tx tarsal bone fx without manip 28450
|
$283.86 |
$283.86 |
$283.86 |
$423.15
|
|
Tympanic membrane repair
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$2,133.48
|
|
Tympanolysis transcanal 69450
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$220.60 |
$220.60 |
$220.60 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$602.63 |
$602.63 |
$602.63 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,740.80
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$7,000.36
|
|
Tyms gene com variants
|
$174.81 |
$174.81 |
$174.81 |
$192.29
|
|
U2af1 gene common variants
|
$193.25 |
$193.25 |
$193.25 |
$243.34
|
|
Ua w/micro/comp poc
|
$4.02 |
$4.02 |
$4.02 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$69.44 |
$69.44 |
$69.44 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$234.00 |
$234.00 |
$234.00 |
$438.75
|
|
Ultrasound bone density measure
|
$125.84 |
$125.84 |
$125.84 |
$143.75
|
|
Ultrasound breast complete
|
$125.84 |
$125.84 |
$125.84 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$104.19 |
$104.19 |
$104.19 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$125.84 |
$125.84 |
$125.84 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$125.84 |
$125.84 |
$125.84 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$125.84 |
$125.84 |
$125.84 |
$307.00
|
|
Ultrasound encephalogram
|
$125.84 |
$125.84 |
$125.84 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$125.84 |
$125.84 |
$125.84 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$125.84 |
$125.84 |
$125.84 |
$477.10
|
|
Ultrasound hips infant dynamic
|
$104.19 |
$104.19 |
$104.19 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$104.19 |
$104.19 |
$104.19 |
$304.00
|
|
Ultrasound joint complete left
|
$125.84 |
$125.84 |
$125.84 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$125.84 |
$125.84 |
$125.84 |
$277.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$286.04 |
$286.04 |
$286.04 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$125.84 |
$125.84 |
$125.84 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$125.84 |
$125.84 |
$125.84 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$125.84 |
$125.84 |
$125.84 |
$459.00
|
|
Ultrasound trgt dyn mbubb 1st les
|
$356.43 |
$356.43 |
$356.43 |
$568.32
|
|
Ultraviolet therapy
|
$9.64 |
$9.64 |
$9.64 |
$39.76
|
|
Umbilical cord occlud w/us
|
$359.97 |
$359.97 |
$359.97 |
$754.00
|
|
Unlistd noninvas vasc dx std
|
$28.98 |
$28.98 |
$28.98 |
$564.60
|
|
Unlisted all/immlg svc/px
|
$28.98 |
$28.98 |
$28.98 |
$28.98
|
|
Unlisted chemotherapy px
|
$54.60 |
$54.60 |
$54.60 |
$149.15
|
|
Unlisted cranfcl&maxlfcl px
|
$274.80 |
$274.80 |
$274.80 |
$571.20
|
|
Unlisted CT procedure
|
$104.19 |
$104.19 |
$104.19 |
$740.43
|
|
Unlisted cv px dx nuc med
|
$475.51 |
$475.51 |
$475.51 |
$1,747.20
|
|
Unlisted cytogenetic study
|
$63.23 |
$63.23 |
$63.23 |
$160.00
|
|
Unlisted cytopathology px
|
$63.23 |
$63.23 |
$63.23 |
$132.08
|
|
Unlisted dx gi procedure
|
$185.15 |
$185.15 |
$185.15 |
$649.22
|
|
Unlisted endocrine px dx nuc
|
$475.51 |
$475.51 |
$475.51 |
$653.31
|
|
Unlisted fetal invas px w/us
|
$238.06 |
$238.06 |
$238.06 |
$498.40
|
|
Unlisted fluoroscopic px
|
$104.19 |
$104.19 |
$104.19 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$475.51 |
$475.51 |
$475.51 |
$995.00
|
|
Unlisted gu px dx nuc med
|
$475.51 |
$475.51 |
$475.51 |
$805.62
|
|
Unlisted hystsc px uterus
|
$238.06 |
$238.06 |
$238.06 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,463.42
|
|
Unlisted laps px appendix
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$3,617.40
|
|
Unlisted laps px bladder
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,082.74
|
|
Unlisted laps px endoc sys
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,855.00
|
|
Unlisted laps px esoph
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,904.15
|
|
Unlisted laps px renal
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,110.00
|
|
Unlisted laps px spleen
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$4,627.00
|
|
Unlisted laps px testis
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$5,628.67
|
|
Unlisted laps px ureter
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$6,376.26
|
|
Unlisted laps px uterus
|
$6,904.15 |
$6,904.15 |
$6,904.15 |
$4,627.00
|
|
Unlisted maxlfcl prosth px
|
$274.80 |
$274.80 |
$274.80 |
$571.20
|
|
Unlisted misc path test
|
$63.23 |
$63.23 |
$63.23 |
$89.40
|
|
Unlisted mr procedure
|
$104.19 |
$104.19 |
$104.19 |
$1,165.00
|
|
Unlisted muscskel px dx nuc
|
$475.51 |
$475.51 |
$475.51 |
$1,279.98
|
|
Unlisted muscskel px head
|
$274.80 |
$274.80 |
$274.80 |
$1,224.08
|
