|
Treat spinal cord lesion
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,142.50
|
|
Treat spinal cord lesion
|
$2,188.39 |
$2,188.39 |
$2,188.39 |
$1,337.00
|
|
Treat thigh fracture
|
$544.83 |
$544.83 |
$670.56 |
$661.00
|
|
Treat thigh fracture
|
$3,188.88 |
$3,188.88 |
$3,924.78 |
$1,893.86
|
|
Treat thigh fracture
|
$494.49 |
$494.49 |
$608.60 |
$618.80
|
|
Treat thigh fx growth plate
|
$494.49 |
$494.49 |
$608.60 |
$475.68
|
|
Treat toe dislocation
|
$850.82 |
$850.82 |
$850.82 |
$756.00
|
|
Treat toe fracture
|
$5,940.88 |
$5,940.88 |
$5,940.88 |
$3,839.54
|
|
Treat ulnar fracture
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$1,678.55
|
|
Treat vaginal bleeding
|
$558.63 |
$558.63 |
$599.71 |
$392.00
|
|
Treat wrist bone fracture
|
$4,572.13 |
$4,572.13 |
$4,572.13 |
$1,749.06
|
|
Treat wrist dislocation
|
$763.42 |
$763.42 |
$819.58 |
$656.25
|
|
Treponema pallidum antibody
|
$47.89 |
$47.89 |
$58.94 |
$72.05
|
|
Trg gene rearrangement anal
|
$729.18 |
$729.18 |
$897.45 |
$465.30
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$4.76 |
$4.76 |
$5.86 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$0.46 |
$0.46 |
$0.57 |
$223.56
|
|
Trichinella antibody
|
$45.47 |
$45.47 |
$55.96 |
$70.65
|
|
#tricyclicantidprssnt
|
$132.74 |
$132.74 |
$163.37 |
$48.81
|
|
Triglycerides
|
$20.78 |
$20.78 |
$25.58 |
$58.05
|
|
Trim nondyst nails
|
$192.19 |
$192.19 |
$206.34 |
$115.20
|
|
Triptorelin pamoate
|
$1,145.95 |
$1,145.95 |
$1,235.12 |
$4,619.39
|
|
Trmt of fracture (femoral shaft) 27500
|
$623.11 |
$623.11 |
$766.90 |
$716.95
|
|
Trnscath plc stent crv crtd without prtct
|
$18,071.58 |
$18,071.58 |
$22,241.94 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$819.42 |
$819.42 |
$819.42 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$1,046.71 |
$1,046.71 |
$1,046.71 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$10,159.66 |
$10,159.66 |
$10,582.23 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$10,582.23 |
$10,582.23 |
$11,184.86 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$20,251.58 |
$20,251.58 |
$21,741.66 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,509.50 |
$6,509.50 |
$6,988.46 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$12,290.60 |
$12,290.60 |
$13,194.92 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,535.44 |
$2,535.44 |
$2,722.00 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,535.44 |
$2,535.44 |
$2,722.00 |
$4,444.80
|
|
Trnscath tx thromblytc vein ini day
|
$6,509.50 |
$6,509.50 |
$6,988.46 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$6,343.78 |
$6,343.78 |
$6,343.78 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$3,171.89 |
$3,171.89 |
$3,171.89 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,699.50 |
$2,699.50 |
$2,699.50 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$2,699.50 |
$2,699.50 |
$2,699.50 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,299.08 |
$2,299.08 |
$2,299.08 |
$2,527.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$2,147.39 |
$2,147.39 |
$2,642.94 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$2,048.16 |
$2,048.16 |
$2,048.16 |
$2,406.77
|
|
Troponin quantitative
|
$36.55 |
$36.55 |
$44.98 |
$125.00
|
|
Tte w or without contr, cont ecg
|
$2,086.62 |
$2,086.62 |
$2,240.14 |
$2,196.00
|
|
Tte w or without fol w/con,stres
|
$2,086.62 |
$2,086.62 |
$2,086.62 |
$1,643.14
|
|
Tube trach fen sz 6 uncuffed
|
$276.41 |
$276.41 |
$340.20 |
$155.98
|
|
Tumor cell deplete of harvst
|
$845.49 |
$845.49 |
$845.49 |
$1,315.60
|
|
Tx atrial fib pulm vein isol
|
$37,561.02 |
$37,561.02 |
$37,561.02 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$763.42 |
$763.42 |
$819.58 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$8,441.76 |
$8,441.76 |
$9,062.90 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$763.42 |
$763.42 |
$819.58 |
$535.60
|
|
Tx contour defects 1.1-5.0cc 11951
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$849.50
|
|
Tx l/r atrial fib addl
|
$11,134.71 |
$11,134.71 |
$11,134.71 |
$6,986.85
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$8,441.76 |
$8,441.76 |
$9,062.90 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$7,311.85 |
$7,311.85 |
$8,441.76 |
$4,595.50
|
|
Tx tarsal bone fx without manip 28450
|
$654.26 |
$654.26 |
$805.25 |
$423.15
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$1,152.40 |
$1,152.40 |
$1,152.40 |
$911.43
|
|
Ua w/micro/comp poc
|
$11.78 |
$11.78 |
$14.50 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$685.93 |
$685.93 |
$844.22 |
$438.75
|
|
Ultrasound breast complete
|
$425.45 |
$425.45 |
$456.76 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$222.56 |
$222.56 |
$238.91 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$425.45 |
$425.45 |
$456.76 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$425.45 |
$425.45 |
$425.45 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$328.61 |
$328.61 |
$355.60 |
$318.45
|
|
Ultrasound encephalogram
|
$425.45 |
$425.45 |
$456.76 |
$496.36
|
|
Ultrasound exam k transpl w/doppler
|
$355.60 |
$355.60 |
$425.45 |
$578.70
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$425.45 |
$425.45 |
$456.76 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$419.49 |
$419.49 |
$1,000.73 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$209.49 |
$209.49 |
$224.24 |
$388.08
|
|
Ultrasound guide intraoperative
|
$144.51 |
$144.51 |
$586.68 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$686.19 |
$686.19 |
$686.19 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$222.56 |
$222.56 |
$223.54 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$222.56 |
$222.56 |
$222.56 |
$311.25
|
|
Ultrasound joint complete left
|
$425.45 |
$425.45 |
$456.76 |
$560.25
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$251.07 |
$251.07 |
$309.01 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$222.74 |
$222.74 |
$352.77 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$230.30 |
$230.30 |
$286.39 |
$336.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$646.80 |
$646.80 |
$796.06 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$425.45 |
$425.45 |
$456.76 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$355.60 |
$355.60 |
$425.45 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$345.59 |
$345.59 |
$425.45 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$144.51 |
$144.51 |
$230.30 |
$423.36
|
|
Ultrasound trgt dyn mbubb 1st les
|
$435.65 |
$435.65 |
$435.65 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$435.65 |
$435.65 |
$435.65 |
$348.00
|
|
Unit mobile power mpu
|
$15,600.00 |
$15,600.00 |
$15,600.00 |
$14,359.52
|
|
Unlisted chemotherapy px
|
$99.79 |
$99.79 |
$122.82 |
$149.15
|
|
Unlisted CT procedure
|
$211.95 |
$211.95 |
$211.95 |
$732.70
|
|
Unlisted cytogenetic study
|
$130.14 |
$130.14 |
$160.18 |
$160.00
|
|
Unlisted dialysis procedure
|
$1,033.55 |
$1,033.55 |
$1,272.06 |
$1,144.00
|
|
Unlisted fetal invas px w/us
|
$1,667.91 |
$1,667.91 |
$2,052.81 |
$498.40
|
|
Unlisted fluoroscopic px
|
$222.56 |
$222.56 |
$222.56 |
$305.76
|
|
Unlisted laps px appendix
|
$14,223.16 |
$14,223.16 |
$14,223.16 |
$3,617.40
|
|
Unlisted misc path test
|
$130.14 |
$130.14 |
$160.18 |
$89.40
|
|
Unlisted mr procedure
|
$344.66 |
$344.66 |
$455.20 |
$1,165.00
|
|
Unlisted neurological dx px
|
$689.09 |
$689.09 |
$848.11 |
$242.50
|
|
Unlisted procedure liver
|
$1,385.57 |
$1,385.57 |
$1,705.31 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$1,043.48 |
$1,043.48 |
$1,284.28 |
$530.00
|
|
Unlisted procedure rectum
|
$2,393.41 |
$2,393.41 |
$2,393.41 |
$1,278.72
|
|
Unlisted procedure spine
|
$763.42 |
$763.42 |
$939.60 |
$4,706.35
|
|
Unlisted px abdomen muscskel
|
$18,672.82 |
$18,672.82 |
$22,981.94 |
$2,053.50
|
|
Unlisted px biliary tract
|
$2,195.76 |
$2,195.76 |
$2,195.76 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$368.32 |
$368.32 |
$453.32 |
$222.00
|
