|
Treat elbow dislocation
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$2,322.40
|
|
Treat elbow fracture
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$2,055.00
|
|
Treat finger fracture each
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,592.00
|
|
Treat foot dislocation
|
$261.75 |
$261.75 |
$261.75 |
$535.60
|
|
Treat fracture of radius
|
$1,514.25 |
$1,514.25 |
$1,514.25 |
$1,839.55
|
|
Treat fracture of radius
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,849.00
|
|
Treat fracture of ulna
|
$2,169.75 |
$2,169.75 |
$2,169.75 |
$731.04
|
|
Treat hip dislocation
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$2,211.05
|
|
Treat humerus fracture
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,808.80
|
|
Treat humerus fracture
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,790.00
|
|
Treat knee dislocation
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$2,211.05
|
|
Treat knee fracture 27530
|
$344.25 |
$344.25 |
$344.25 |
$550.73
|
|
Treat knee fracture(s)
|
$642.00 |
$642.00 |
$642.00 |
$643.26
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$8,370.75 |
$8,370.75 |
$8,370.75 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$8,370.75 |
$8,370.75 |
$8,370.75 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$8,370.75 |
$8,370.75 |
$8,370.75 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,996.00 |
$3,996.00 |
$3,996.00 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$333.75 |
$333.75 |
$333.75 |
$226.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$320.25 |
$320.25 |
$320.25 |
$148.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$7,085.25 |
$7,085.25 |
$7,085.25 |
$4,230.80
|
|
Treatment of ankle fracture 27786
|
$358.50 |
$358.50 |
$358.50 |
$528.00
|
|
Treatment of fibula fracture 27780
|
$558.75 |
$558.75 |
$558.75 |
$528.00
|
|
Treatment of foot infection
|
$1,872.75 |
$1,872.75 |
$1,872.75 |
$2,928.60
|
|
Treatment of heel fracture 28400
|
$352.50 |
$352.50 |
$352.50 |
$478.40
|
|
Treatment of miscarriage
|
$9,051.75 |
$9,051.75 |
$9,051.75 |
$4,146.69
|
|
Treatment of thigh fracture
|
$732.75 |
$732.75 |
$732.75 |
$487.50
|
|
Treatment of thigh fracture
|
$2,068.50 |
$2,068.50 |
$2,068.50 |
$1,749.06
|
|
Treatment of thigh fracture
|
$525.75 |
$525.75 |
$525.75 |
$570.40
|
|
Treatment of thigh fracture
|
$2,093.25 |
$2,093.25 |
$2,093.25 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$315.00 |
$315.00 |
$315.00 |
$371.40
|
|
Treatment x10sv retinopathy
|
$674.25 |
$674.25 |
$674.25 |
$1,513.20
|
|
Treat metacarpal fracture
|
$3,767.25 |
$3,767.25 |
$3,767.25 |
$4,289.60
|
|
Treat sternum fracture
|
$423.00 |
$423.00 |
$423.00 |
$423.00
|
|
Treat thigh fracture
|
$261.75 |
$261.75 |
$261.75 |
$661.00
|
|
Treat thigh fracture
|
$1,695.00 |
$1,695.00 |
$1,695.00 |
$2,008.18
|
|
Treat thigh fx growth plate
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,938.38
|
|
Treat ulnar fracture
|
$1,198.50 |
$1,198.50 |
$1,198.50 |
$1,678.55
|
|
Treat vaginal bleeding
|
$235.50 |
$235.50 |
$235.50 |
$392.00
|
|
Treat wrist bone fracture
|
$1,815.75 |
$1,815.75 |
$1,815.75 |
$1,749.06
|
|
Treat wrist dislocation
|
$656.25 |
$656.25 |
$656.25 |
$656.25
|
|
Treponema pallidum antibody
|
$169.50 |
$169.50 |
$169.50 |
$72.05
|
|
Treprostinil injection
|
$21,186.46 |
$21,186.46 |
$21,186.46 |
$19,071.84
|
|
Treprostinil, non-comp unit
|
$12,632.52 |
$12,632.52 |
$12,632.52 |
$2,970.72
|
|
Trg gene rearrangement anal
|
$732.00 |
$732.00 |
$732.00 |
$465.30
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$162.88 |
$162.88 |
$162.88 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$3,235.98 |
$3,235.98 |
$3,235.98 |
$223.56
|
|
Trichinella antibody
|
$140.25 |
$140.25 |
$140.25 |
$70.65
|
|
Triglycerides
|
$78.75 |
$78.75 |
$78.75 |
$57.91
|
|
Trimethobenzamide hcl inj
|
$191.20 |
$191.20 |
$191.20 |
$117.49
|
|
Trim nail(s)
|
$69.75 |
$69.75 |
$69.75 |
$78.40
|
|
Trim nondyst nails
|
$318.75 |
$318.75 |
$318.75 |
$115.70
|
|
Triptorelin pamoate
|
$16,454.18 |
$16,454.18 |
$16,454.18 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$15,258.00 |
$15,258.00 |
$15,258.00 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$10,173.00 |
$10,173.00 |
$10,173.00 |
$7,354.00
|
|
Trnscath plc stent crv crtd without prtct
|
$7,944.75 |
$7,944.75 |
$7,944.75 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$9,767.25 |
$9,767.25 |
$9,767.25 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$7,463.25 |
$7,463.25 |
$7,463.25 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$7,374.00 |
$7,374.00 |
$7,374.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$10,059.75 |
$10,059.75 |
$10,059.75 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,869.25 |
$3,869.25 |
$3,869.25 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$8,034.75 |
$8,034.75 |
$8,034.75 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,505.25 |
$4,505.25 |
$4,505.25 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$15,764.25 |
$15,764.25 |
$15,764.25 |
$4,418.00
|
|
Trnscath tx thromblytc vein ini day
|
$2,489.25 |
$2,489.25 |
$2,489.25 |
$3,900.60
|
|
Troponin quantitative
|
$180.00 |
$180.00 |
$180.00 |
$125.00
|
|
Tte w or without fol w/con,stres
|
$1,949.25 |
$1,949.25 |
$1,949.25 |
$1,643.14
|
|
Tte w or without fol w/cont, com
|
$1,922.25 |
$1,922.25 |
$1,922.25 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$1,341.75 |
$1,341.75 |
$1,341.75 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$29,199.75 |
$29,199.75 |
$29,199.75 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$3,632.25 |
$3,632.25 |
$3,632.25 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$261.75 |
$261.75 |
$261.75 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,767.25 |
$3,767.25 |
$3,767.25 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$362.25 |
$362.25 |
$362.25 |
$535.60
|
|
Tx contour defects 1.1-5.0cc 11951
|
$2,245.50 |
$2,245.50 |
$2,245.50 |
$849.50
|
|
Tx l/r atrial fib addl
|
$10,523.25 |
$10,523.25 |
$10,523.25 |
$6,986.85
|
|
Tx tarsal bone fx without manip 28450
|
$365.25 |
$365.25 |
$365.25 |
$423.15
|
|
Tympanometry & reflex thresh
|
$141.75 |
$141.75 |
$141.75 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$2,048.25 |
$2,048.25 |
$2,048.25 |
$911.43
|
|
Typhoid vaccine oral
|
$365.66 |
$365.66 |
$365.66 |
$63.28
|
|
Ua w/micro/comp poc
|
$100.50 |
$100.50 |
$100.50 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$438.75 |
$438.75 |
$438.75 |
$438.75
|
|
Ultrasound breast complete
|
$510.00 |
$510.00 |
$510.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$478.50 |
$478.50 |
$478.50 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$561.00 |
$561.00 |
$561.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$404.25 |
$404.25 |
$404.25 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$177.00 |
$177.00 |
$177.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$284.25 |
$284.25 |
$284.25 |
$307.00
|
|
Ultrasound encephalogram
|
$463.50 |
$463.50 |
$463.50 |
$485.48
|
|
Ultrasound exam k transpl w/doppler
|
$967.50 |
$967.50 |
$967.50 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$535.50 |
$535.50 |
$535.50 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,074.75 |
$1,074.75 |
$1,074.75 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$511.50 |
$511.50 |
$511.50 |
$388.08
|
|
Ultrasound guide intraoperative
|
$822.00 |
$822.00 |
$822.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$1,032.75 |
$1,032.75 |
$1,032.75 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$382.50 |
$382.50 |
$382.50 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$311.25 |
$311.25 |
$311.25 |
$304.00
|
|
Ultrasound joint complete left
|
$808.50 |
$808.50 |
$808.50 |
$560.92
|
|
Ultrasound ob >=14wks ea addl gest
|
$849.75 |
$849.75 |
$849.75 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$602.25 |
$602.25 |
$602.25 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$915.75 |
$915.75 |
$915.75 |
$698.50
|
