|
Treatment of toe fracture 28510
|
$231.00 |
$231.00 |
$231.00 |
$371.40
|
|
Treatment x10sv retinopathy
|
$540.00 |
$540.00 |
$540.00 |
$1,513.20
|
|
Treat metacarpal fracture
|
$2,902.50 |
$2,902.50 |
$2,902.50 |
$4,313.40
|
|
Treat sternum fracture
|
$390.75 |
$390.75 |
$390.75 |
$423.00
|
|
Treat thigh fracture
|
$242.25 |
$242.25 |
$242.25 |
$661.00
|
|
Treat thigh fracture
|
$1,357.50 |
$1,357.50 |
$1,357.50 |
$2,032.10
|
|
Treat thigh fx growth plate
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$1,938.38
|
|
Treat ulnar fracture
|
$442.50 |
$442.50 |
$442.50 |
$1,677.20
|
|
Treat vaginal bleeding
|
$171.00 |
$171.00 |
$171.00 |
$379.60
|
|
Treat wrist bone fracture
|
$1,398.75 |
$1,398.75 |
$1,398.75 |
$1,703.20
|
|
Treat wrist dislocation
|
$606.75 |
$606.75 |
$606.75 |
$656.25
|
|
Treponema pallidum antibody
|
$195.75 |
$195.75 |
$195.75 |
$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 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$162.88 |
$162.88 |
$162.88 |
$43.09
|
|
Triamcinolone a inj prs-free
|
$3,235.98 |
$3,235.98 |
$3,235.98 |
$223.56
|
|
Trichinella antibody
|
$129.75 |
$129.75 |
$129.75 |
$70.65
|
|
Triglycerides
|
$93.00 |
$93.00 |
$93.00 |
$58.50
|
|
Trimethobenzamide hcl inj
|
$191.20 |
$191.20 |
$191.20 |
$117.49
|
|
Trim nondyst nails
|
$295.50 |
$295.50 |
$295.50 |
$113.88
|
|
Triptorelin pamoate
|
$16,454.18 |
$16,454.18 |
$16,454.18 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$12,226.50 |
$12,226.50 |
$12,226.50 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$9,781.50 |
$9,781.50 |
$9,781.50 |
$7,354.00
|
|
Trnscath plc stent crv crtd w/prtct
|
$9,030.00 |
$9,030.00 |
$9,030.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$9,800.25 |
$9,800.25 |
$9,800.25 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$13,370.25 |
$13,370.25 |
$13,370.25 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,142.75 |
$5,142.75 |
$5,142.75 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$8,571.75 |
$8,571.75 |
$8,571.75 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,949.25 |
$4,949.25 |
$4,949.25 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,623.50 |
$5,623.50 |
$5,623.50 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$3,299.25 |
$3,299.25 |
$3,299.25 |
$3,866.70
|
|
Troponin quantitative
|
$171.00 |
$171.00 |
$171.00 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$1,098.00 |
$1,098.00 |
$1,098.00 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$666.75 |
$666.75 |
$666.75 |
$1,178.00
|
|
Tx closed distal humerus fx
|
$2,847.00 |
$2,847.00 |
$2,847.00 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$201.75 |
$201.75 |
$201.75 |
$586.40
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,483.00 |
$3,483.00 |
$3,483.00 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$266.25 |
$266.25 |
$266.25 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$324.75 |
$324.75 |
$324.75 |
$419.04
|
|
Typhoid vaccine oral
|
$365.66 |
$365.66 |
$365.66 |
$63.28
|
|
Ugt1a1 gene analy common variants
|
$438.75 |
$438.75 |
$438.75 |
$438.75
|
|
Ultrasound breast complete
|
$678.75 |
$678.75 |
$678.75 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$423.00 |
$423.00 |
$423.00 |
$452.40
|
|
Ultrasound elastography ea l target les
|
$163.50 |
$163.50 |
$163.50 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$126.00 |
$126.00 |
$126.00 |
$313.95
|
|
Ultrasound encephalogram
|
$443.25 |
$443.25 |
$443.25 |
$494.92
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$734.25 |
$734.25 |
$734.25 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$863.25 |
$863.25 |
$863.25 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$446.25 |
$446.25 |
$446.25 |
$388.08
|
|
Ultrasound guide intraoperative
|
$970.50 |
$970.50 |
$970.50 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$954.75 |
$954.75 |
$954.75 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$310.50 |
$310.50 |
$310.50 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$295.50 |
$295.50 |
$295.50 |
$311.25
|
|
Ultrasound joint complete left
|
$783.75 |
$783.75 |
$783.75 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$879.75 |
$879.75 |
$879.75 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$648.75 |
$648.75 |
$648.75 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$925.50 |
$925.50 |
$925.50 |
$698.50
|
|
Ultrasound spinal canal and contents
|
$998.25 |
$998.25 |
$998.25 |
$463.00
|
|
Unit mobile power mpu
|
$18,857.25 |
$18,857.25 |
$18,857.25 |
$14,359.52
|
|
Unlisted chemotherapy px
|
$41.25 |
$41.25 |
$41.25 |
$149.15
|
|
Unlisted CT procedure
|
$1,518.00 |
$1,518.00 |
$1,518.00 |
$732.70
|
|
Unlisted maaa
|
$1,618.50 |
$1,618.50 |
$1,618.50 |
$235.20
|
|
Unlisted misc path test
|
$975.00 |
$975.00 |
$975.00 |
$89.40
|
|
Unlisted mr procedure
|
$1,535.25 |
$1,535.25 |
$1,535.25 |
$1,165.00
|
|
Unlisted orl service/px
|
$117.00 |
$117.00 |
$117.00 |
$132.60
|
|
Unlisted procedure colon
|
$5,822.25 |
$5,822.25 |
$5,822.25 |
$1,839.55
|
|
Unlisted procedure liver
|
$2,694.00 |
$2,694.00 |
$2,694.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$256.50 |
$256.50 |
$256.50 |
$530.00
|
|
Unlisted procedure rectum
|
$849.00 |
$849.00 |
$849.00 |
$1,223.20
|
|
Unlisted px abdomen muscskel
|
$1,461.75 |
$1,461.75 |
$1,461.75 |
$1,956.50
|
|
Unlisted px foot/toes
|
$3,556.50 |
$3,556.50 |
$3,556.50 |
$1,239.20
|
|
Unlisted px neck/thorax
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$571.20
|
|
Unlisted px tongue flr mouth
|
$1,565.25 |
$1,565.25 |
$1,565.25 |
$282.50
|
|
Unlisted ultrasound procedure
|
$462.00 |
$462.00 |
$462.00 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$285.00 |
$285.00 |
$285.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,619.25 |
$1,619.25 |
$1,619.25 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,473.75 |
$1,473.75 |
$1,473.75 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,259.00 |
$2,259.00 |
$2,259.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,169.50 |
$3,169.50 |
$3,169.50 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$267.75 |
$267.75 |
$267.75 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$515.25 |
$515.25 |
$515.25 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,400.75 |
$2,400.75 |
$2,400.75 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,538.75 |
$2,538.75 |
$2,538.75 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$690.00 |
$690.00 |
$690.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$570.00 |
$570.00 |
$570.00 |
$607.20
|
|
Uppr gi scope w/submuc inj
|
$2,091.00 |
$2,091.00 |
$2,091.00 |
$1,872.00
|
|
Urea nitrogen
|
$42.00 |
$42.00 |
$42.00 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$156.00 |
$156.00 |
$156.00 |
$52.00
|
|
Urea nitrogen clearance
|
$54.75 |
$54.75 |
$54.75 |
$38.35
|
|
Ureteral reflux study
|
$1,251.75 |
$1,251.75 |
$1,251.75 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$699.75 |
$699.75 |
$699.75 |
$584.00
|
|
Urethrocystography void s&i
|
$707.25 |
$707.25 |
$707.25 |
$631.40
|
|
Uric acid blood
|
$65.25 |
$65.25 |
$65.25 |
$49.44
|
|
Uric acid urine
|
$54.75 |
$54.75 |
$54.75 |
$45.36
|
|
Urinalysis (with microscopy)
|
$118.50 |
$118.50 |
$118.50 |
$55.20
|
|
Urinalysis (without microscopy)
|
$51.00 |
$51.00 |
$51.00 |
$36.00
|
|
Urine Culture Test
|
$101.25 |
$101.25 |
$101.25 |
$83.00
|
