|
Tray bonemarrw oncontrol 102mm
|
$9,053.56 |
$9,053.56 |
$9,053.56 |
$940.80
|
|
Treat ectopic pregnancy
|
$12,356.08 |
$12,356.08 |
$12,356.08 |
$6,707.99
|
|
Treat elbow dislocation
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$2,256.80
|
|
Treat elbow fracture
|
$2,667.00 |
$2,667.00 |
$2,667.00 |
$1,919.00
|
|
Treat finger fracture each
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$1,592.00
|
|
Treat fracture of ulna
|
$394.20 |
$394.20 |
$394.20 |
$726.05
|
|
Treat hip dislocation
|
$2,593.80 |
$2,593.80 |
$2,593.80 |
$2,192.00
|
|
Treat humerus fracture
|
$40,988.17 |
$40,988.17 |
$40,988.17 |
$12,585.65
|
|
Treat lower leg joint
|
$33,553.84 |
$33,553.84 |
$33,553.84 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$21,727.63 |
$21,727.63 |
$21,727.63 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$24,103.55 |
$24,103.55 |
$24,103.55 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$32,767.17 |
$32,767.17 |
$32,767.17 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$6,506.76 |
$6,506.76 |
$6,506.76 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$239.40 |
$239.40 |
$239.40 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$202.80 |
$202.80 |
$202.80 |
$143.48
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$361.20 |
$361.20 |
$361.20 |
$203.49
|
|
Treatment missed abortion completed surgically 1st trimester
|
$6,528.18 |
$6,528.18 |
$6,528.18 |
$3,982.44
|
|
Treatment of ankle fracture
|
$26,467.78 |
$26,467.78 |
$26,467.78 |
$8,412.89
|
|
Treatment of ankle fracture
|
$42,883.27 |
$42,883.27 |
$42,883.27 |
$8,453.60
|
|
Treatment of ankle fracture
|
$41,310.41 |
$41,310.41 |
$41,310.41 |
$7,907.11
|
|
Treatment of tibia fracture
|
$48,204.95 |
$48,204.95 |
$48,204.95 |
$6,839.00
|
|
Treatment of tibia fracture
|
$63,676.38 |
$63,676.38 |
$63,676.38 |
$7,087.60
|
|
Treatment radiation delivery level 2
|
$1,722.00 |
$1,722.00 |
$1,722.00 |
$787.80
|
|
Treat metatarsal fracture
|
$24,752.59 |
$24,752.59 |
$24,752.59 |
$8,412.89
|
|
Treat spinal cord lesion
|
$3,071.40 |
$3,071.40 |
$3,071.40 |
$1,337.00
|
|
Treat thigh fracture
|
$394.20 |
$394.20 |
$394.20 |
$618.80
|
|
Treat ulnar fracture
|
$20,536.85 |
$20,536.85 |
$20,536.85 |
$5,926.25
|
|
Treat wrist bone fracture
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$1,588.95
|
|
Treat wrist dislocation
|
$252.00 |
$252.00 |
$252.00 |
$656.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$41,330.88 |
$41,330.88 |
$41,330.88 |
$68,943.21
|
|
Treponema pallidum antibody
|
$261.60 |
$261.60 |
$261.60 |
$69.60
|
|
Trg gene rearrangement anal
|
$889.80 |
$889.80 |
$889.80 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.40 |
$44.40 |
$44.40 |
$43.05
|
|
Trichinella antibody
|
$360.00 |
$360.00 |
$360.00 |
$70.65
|
|
Triglycerides
|
$97.20 |
$97.20 |
$97.20 |
$56.94
|
|
Trilaciclib 300 mg intravenous solution
|
$6,194.04 |
$6,194.04 |
$6,194.04 |
$3,903.74
|
|
Trim nondyst nails
|
$500.40 |
$500.40 |
$500.40 |
$115.70
|
|
Trnscath plc stent crv crtd without prtct
|
$2,193.00 |
$2,193.00 |
$2,193.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,307.60 |
$2,307.60 |
$2,307.60 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$28,298.40 |
$28,298.40 |
$28,298.40 |
$7,058.50
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$21,632.40 |
$21,632.40 |
$21,632.40 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$26,407.20 |
$26,407.20 |
$26,407.20 |
$8,753.00
|
|
Trnscath plc vas stent w/s&i ini vein
|
$26,791.80 |
$26,791.80 |
$26,791.80 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,009.00 |
$6,009.00 |
$6,009.00 |
$4,698.73
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$9,687.60 |
$9,687.60 |
$9,687.60 |
$5,110.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$16,000.80 |
$16,000.80 |
$16,000.80 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,736.60 |
$5,736.60 |
$5,736.60 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$13,250.40 |
$13,250.40 |
$13,250.40 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$23,036.98 |
$23,036.98 |
$23,036.98 |
$2,371.50
|
|
Troponin quantitative
|
$130.20 |
$130.20 |
$130.20 |
$125.00
|
|
Tube trach disp innr can 5 xlt
|
$445.99 |
$445.99 |
$445.99 |
$445.99
|
|
Tx closed distal humerus fx
|
$360.00 |
$360.00 |
$360.00 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$252.00 |
$252.00 |
$252.00 |
$568.80
|
|
Ua w/micro/comp poc
|
$54.60 |
$54.60 |
$54.60 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$619.20 |
$619.20 |
$619.20 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$166.80 |
$166.80 |
$166.80 |
$394.20
|
|
Ultrasound breast complete
|
$105.00 |
$105.00 |
$105.00 |
$530.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$642.60 |
$642.60 |
$642.60 |
$455.20
|
|
Ultrasound chest
|
$829.80 |
$829.80 |
$829.80 |
$458.44
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,734.60 |
$1,734.60 |
$1,734.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$173.40 |
$173.40 |
$173.40 |
$300.00
|
|
Ultrasound encephalogram
|
$70.20 |
$70.20 |
$70.20 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$894.60 |
$894.60 |
$894.60 |
$578.70
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$354.60 |
$354.60 |
$354.60 |
$384.45
|
|
Ultrasound guided needle placement supervision & interpretation
|
$841.80 |
$841.80 |
$841.80 |
$720.00
|
|
Ultrasound guide intraoperative
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$625.15
|
|
Ultrasound guide tissue ablation
|
$601.20 |
$601.20 |
$601.20 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$541.80 |
$541.80 |
$541.80 |
$311.25
|
|
Ultrasound joint complete left
|
$69.00 |
$69.00 |
$69.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$765.00 |
$765.00 |
$765.00 |
$419.25
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$69.00 |
$69.00 |
$69.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$964.20 |
$964.20 |
$964.20 |
$393.43
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$627.60 |
$627.60 |
$627.60 |
$331.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$238.20 |
$238.20 |
$238.20 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$627.60 |
$627.60 |
$627.60 |
$451.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,099.80 |
$1,099.80 |
$1,099.80 |
$488.40
|
|
Ultrasound prostate/transrectal
|
$69.00 |
$69.00 |
$69.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$964.20 |
$964.20 |
$964.20 |
$477.10
|
|
Ultrasound scrotum and contents
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$1,008.60 |
$1,008.60 |
$1,008.60 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$61.20 |
$61.20 |
$61.20 |
$423.36
|
|
Ultrasound transvaginal non obstetric
|
$1,008.60 |
$1,008.60 |
$1,008.60 |
$558.35
|
|
Unlisted chemotherapy px
|
$58.80 |
$58.80 |
$58.80 |
$150.00
|
|
Unlisted laparoscopic liver biopy 47379
|
$39,287.56 |
$39,287.56 |
$39,287.56 |
$5,323.76
|
|
Unlisted misc path test
|
$40.20 |
$40.20 |
$40.20 |
$89.40
|
|
Unlisted procedure liver
|
$939.00 |
$939.00 |
$939.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$206.40 |
$206.40 |
$206.40 |
$487.50
|
|
Unlisted px abdomen muscskel
|
$19,709.49 |
$19,709.49 |
$19,709.49 |
$1,848.60
|
|
Unlisted px hands/fingers
|
$378.00 |
$378.00 |
$378.00 |
$378.00
|
|
Unlisted px small intestine
|
$1,506.60 |
$1,506.60 |
$1,506.60 |
$1,914.50
|
|
Unlisted ultrasound procedure
|
$462.60 |
$462.60 |
$462.60 |
$332.16
|
|
Upper Endoscopy (EGD, diagnostic)
|
$3,394.08 |
$3,394.08 |
$3,394.08 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$7,429.09 |
$7,429.09 |
$7,429.09 |
$1,707.60
|
|
Uppr gi scope w/submuc inj
|
$7,433.76 |
$7,433.76 |
$7,433.76 |
$1,764.00
|
|
Urea nitrogen
|
$37.20 |
$37.20 |
$37.20 |
$40.80
|
|
Urea nitrogen 24 hour urine
|
$67.20 |
$67.20 |
$67.20 |
$51.84
|
|
Urea nitrogen clearance
|
$16.80 |
$16.80 |
$16.80 |
$45.12
|
