|
Treat thigh fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,893.86
|
|
Treat thigh fracture
|
$716.95 |
$716.95 |
$716.95 |
$618.80
|
|
Treat thigh fracture
|
$1,183.00 |
$1,183.00 |
$1,183.00 |
$2,008.18
|
|
Treat ulnar fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,678.55
|
|
Treat vaginal bleeding
|
$601.25 |
$601.25 |
$601.25 |
$379.60
|
|
Treat wrist bone fracture
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,679.04
|
|
Treat wrist dislocation
|
$716.95 |
$716.95 |
$716.95 |
$656.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$8,608.52 |
$8,608.52 |
$8,608.52 |
$73,346.25
|
|
Treponema pallidum antibody
|
$59.15 |
$59.15 |
$59.15 |
$72.05
|
|
Treprostinil injection
|
$1,489.78 |
$1,489.78 |
$1,489.78 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$903.50 |
$903.50 |
$903.50 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$43.80 |
$43.80 |
$43.80 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
$223.56
|
|
Trichinella antibody
|
$56.55 |
$56.55 |
$56.55 |
$70.65
|
|
Trichomonas assay w/optic
|
$68.90 |
$68.90 |
$68.90 |
$57.40
|
|
#tricyclicantidprssnt
|
$23.40 |
$23.40 |
$23.40 |
$50.54
|
|
Triglycerides
|
$26.00 |
$26.00 |
$26.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$77.32 |
$77.32 |
$77.32 |
$117.49
|
|
Trim nondyst nails
|
$115.70 |
$115.70 |
$115.70 |
$114.48
|
|
Triptorelin pamoate
|
$13,470.60 |
$13,470.60 |
$13,470.60 |
$4,619.39
|
|
Trmt of fracture (femoral shaft) 27500
|
$716.95 |
$716.95 |
$716.95 |
$754.80
|
|
Trnscath plc stent crv crtd without prtct
|
$12,792.00 |
$12,792.00 |
$12,792.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$13,954.20 |
$13,954.20 |
$13,954.20 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$10,261.55 |
$10,261.55 |
$10,261.55 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$9,127.30 |
$9,127.30 |
$9,127.30 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,990.80 |
$8,990.80 |
$8,990.80 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$24,007.10 |
$24,007.10 |
$24,007.10 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$20,203.95 |
$20,203.95 |
$20,203.95 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$11,763.70 |
$11,763.70 |
$11,763.70 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$3,567.20 |
$3,567.20 |
$3,567.20 |
$2,486.75
|
|
Trnsplj pd lvr&bwl cd154+cll
|
$2,873.65 |
$2,873.65 |
$2,873.65 |
$704.80
|
|
Troponin quantitative
|
$55.90 |
$55.90 |
$55.90 |
$127.20
|
|
Trurl dstrj prst8 tiss rf wv
|
$10,312.25 |
$10,312.25 |
$10,312.25 |
$4,228.00
|
|
Tte w or without contr, cont ecg
|
$2,952.95 |
$2,952.95 |
$2,952.95 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$2,952.95 |
$2,952.95 |
$2,952.95 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$2,952.95 |
$2,952.95 |
$2,952.95 |
$1,254.50
|
|
Tte w or without fol w/cont, f/u
|
$2,952.95 |
$2,952.95 |
$2,952.95 |
$1,178.00
|
|
Tube trach disp innr can 5 xlt
|
$141.70 |
$141.70 |
$141.70 |
$445.99
|
|
Tube trach fen sz 6 uncuffed
|
$160.88 |
$160.88 |
$160.88 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$45,258.20 |
$45,258.20 |
$45,258.20 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$716.95 |
$716.95 |
$716.95 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$716.95 |
$716.95 |
$716.95 |
$535.60
|
|
Tx l/r atrial fib addl
|
$4,333.55 |
$4,333.55 |
$4,333.55 |
$6,986.85
|
|
Tx tarsal bone fx without manip 28450
|
$716.95 |
$716.95 |
$716.95 |
$419.73
|
|
Tympanometry & reflex thresh
|
$406.90 |
$406.90 |
$406.90 |
$173.18
|
|
Typhoid vaccine oral
|
$45.75 |
$45.75 |
$45.75 |
$63.28
|
|
Ua w/micro/comp poc
|
$18.20 |
$18.20 |
$18.20 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$4,332.90 |
$4,332.90 |
$4,332.90 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$1,049.75 |
$1,049.75 |
$1,049.75 |
$438.75
|
|
Ultrasound breast complete
|
$477.10 |
$477.10 |
$477.10 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$395.20 |
$395.20 |
$395.20 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$477.10 |
$477.10 |
$477.10 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$477.10 |
$477.10 |
$477.10 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$477.10 |
$477.10 |
$477.10 |
$313.95
|
|
Ultrasound encephalogram
|
$477.10 |
$477.10 |
$477.10 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$477.10 |
$477.10 |
$477.10 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$477.10 |
$477.10 |
$477.10 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$560.95 |
$560.95 |
$560.95 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$172.90 |
$172.90 |
$172.90 |
$388.08
|
|
Ultrasound guide intraoperative
|
$547.95 |
$547.95 |
$547.95 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$453.70 |
$453.70 |
$453.70 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$395.20 |
$395.20 |
$395.20 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$395.20 |
$395.20 |
$395.20 |
$311.25
|
|
Ultrasound joint complete left
|
$477.10 |
$477.10 |
$477.10 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$477.10 |
$477.10 |
$477.10 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$462.15 |
$462.15 |
$462.15 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$462.15 |
$462.15 |
$462.15 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,084.20 |
$1,084.20 |
$1,084.20 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$477.10 |
$477.10 |
$477.10 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$477.10 |
$477.10 |
$477.10 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$477.10 |
$477.10 |
$477.10 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$425.10 |
$425.10 |
$425.10 |
$421.00
|
|
Umbilical artery cath newborn 36660
|
$163.80 |
$163.80 |
$163.80 |
$223.80
|
|
Unlistd noninvas vasc dx std
|
$819.65 |
$819.65 |
$819.65 |
$564.60
|
|
Unlisted chemotherapy px
|
$458.25 |
$458.25 |
$458.25 |
$143.75
|
|
Unlisted CT procedure
|
$6,541.60 |
$6,541.60 |
$6,541.60 |
$732.70
|
|
Unlisted dx gi procedure
|
$311.35 |
$311.35 |
$311.35 |
$649.22
|
|
Unlisted fluoroscopic px
|
$24,244.35 |
$24,244.35 |
$24,244.35 |
$305.76
|
|
Unlisted maaa
|
$68.90 |
$68.90 |
$68.90 |
$235.20
|
|
Unlisted misc path test
|
$239.85 |
$239.85 |
$239.85 |
$89.40
|
|
Unlisted mr procedure
|
$6,541.60 |
$6,541.60 |
$6,541.60 |
$1,163.00
|
|
Unlisted procedure colon
|
$1,365.65 |
$1,365.65 |
$1,365.65 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$5,200.00 |
$5,200.00 |
$5,200.00 |
$1,998.88
|
|
Unlisted procedure pancreas
|
$4,810.00 |
$4,810.00 |
$4,810.00 |
$4,810.00
|
|
Unlisted procedure spine
|
$8,660.60 |
$8,660.60 |
$8,660.60 |
$4,659.85
|
|
Unlisted px abdomen muscskel
|
$1,305.20 |
$1,305.20 |
$1,305.20 |
$1,956.50
|
|
Unlisted px ant segment eye
|
$2,561.65 |
$2,561.65 |
$2,561.65 |
$2,698.92
|
|
Unlisted px biliary tract
|
$27,540.50 |
$27,540.50 |
$27,540.50 |
$3,055.00
|
|
Unlisted px foot/toes
|
$3,105.70 |
$3,105.70 |
$3,105.70 |
$1,239.20
|
|
Unlisted px leg/ankle
|
$793.00 |
$793.00 |
$793.00 |
$882.30
|
|
Unlisted px male genital sys
|
$8,636.55 |
$8,636.55 |
$8,636.55 |
$387.84
|
|
Unlisted px middle ear
|
$10,822.50 |
$10,822.50 |
$10,822.50 |
$343.50
|
|
Unlisted px pelvis/hip joint
|
$8,660.60 |
$8,660.60 |
$8,660.60 |
$3,251.90
|
|
Unlisted px small intestine
|
$2,118.35 |
$2,118.35 |
$2,118.35 |
$2,118.35
|
|
Unlisted reprod med lab proc
|
$245.70 |
$245.70 |
$245.70 |
$70.00
|
|
Unlisted special svc px/rprt
|
$421.20 |
$421.20 |
$421.20 |
$90.00
|
