|
Trauma partial team response w/critical care services level 4
|
$7,141.80 |
$7,141.80 |
$7,141.80 |
$4,471.50
|
|
Treat ankle dislocation
|
$3,449.40 |
$3,449.40 |
$3,449.40 |
$2,358.40
|
|
Treat big toe fracture
|
$4,856.40 |
$4,856.40 |
$4,856.40 |
$4,454.10
|
|
Treat clavicle dislocation 23545
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$692.80
|
|
Treat elbow dislocation
|
$3,590.40 |
$3,590.40 |
$3,590.40 |
$2,311.20
|
|
Treat elbow fracture
|
$3,097.80 |
$3,097.80 |
$3,097.80 |
$2,027.40
|
|
Treat finger fracture each
|
$3,098.40 |
$3,098.40 |
$3,098.40 |
$1,592.00
|
|
Treat foot dislocation
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$405.60
|
|
Treat fracture of radius
|
$2,335.80 |
$2,335.80 |
$2,335.80 |
$1,821.60
|
|
Treat fracture of radius
|
$3,037.80 |
$3,037.80 |
$3,037.80 |
$1,849.00
|
|
Treat fracture of ulna
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$726.05
|
|
Treat hand dislocation
|
$4,193.40 |
$4,193.40 |
$4,193.40 |
$1,771.43
|
|
Treat hip dislocation
|
$4,618.20 |
$4,618.20 |
$4,618.20 |
$2,211.05
|
|
Treat hip dislocation
|
$5,682.00 |
$5,682.00 |
$5,682.00 |
$2,612.00
|
|
Treat hip socket fracture
|
$9,225.60 |
$9,225.60 |
$9,225.60 |
$1,344.00
|
|
Treat humerus fracture
|
$3,037.80 |
$3,037.80 |
$3,037.80 |
$1,790.00
|
|
Treat humerus fracture
|
$3,123.00 |
$3,123.00 |
$3,123.00 |
$1,790.00
|
|
Treat kneecap dislocation
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$1,068.06
|
|
Treat knee dislocation
|
$3,332.40 |
$3,332.40 |
$3,332.40 |
$2,220.89
|
|
Treat knuckle dislocation
|
$4,209.00 |
$4,209.00 |
$4,209.00 |
$1,693.20
|
|
Treat knuckle dislocation
|
$5,799.00 |
$5,799.00 |
$5,799.00 |
$4,332.00
|
|
Treat lower leg dislocation
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$532.60
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,535.00 |
$8,535.00 |
$8,535.00 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$139.80 |
$139.80 |
$139.80 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$139.80 |
$139.80 |
$139.80 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$3,096.60 |
$3,096.60 |
$3,096.60 |
$528.00
|
|
Treatment of thigh fracture
|
$4,193.40 |
$4,193.40 |
$4,193.40 |
$487.50
|
|
Treatment of thigh fracture
|
$4,809.60 |
$4,809.60 |
$4,809.60 |
$1,749.06
|
|
Treatment of thigh fracture
|
$3,021.60 |
$3,021.60 |
$3,021.60 |
$548.90
|
|
Treatment of thigh fracture
|
$2,334.00 |
$2,334.00 |
$2,334.00 |
$1,790.00
|
|
Treat metacarpal fracture
|
$6,345.60 |
$6,345.60 |
$6,345.60 |
$5,741.00
|
|
Treat midfoot fracture each
|
$4,066.80 |
$4,066.80 |
$4,066.80 |
$1,884.74
|
|
Treat toe dislocation
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$756.00
|
|
Treat ulnar fracture
|
$3,191.40 |
$3,191.40 |
$3,191.40 |
$1,678.55
|
|
Treat vaginal bleeding
|
$3,085.80 |
$3,085.80 |
$3,085.80 |
$379.60
|
|
Treat wrist bone fracture
|
$2,312.40 |
$2,312.40 |
$2,312.40 |
$1,679.04
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$262.80 |
$262.80 |
$262.80 |
$73,346.25
|
|
Treponema pallidum antibody
|
$143.40 |
$143.40 |
$143.40 |
$72.05
|
|
Treprostinil, non-comp unit
|
$3,894.40 |
$3,894.40 |
$3,894.40 |
$2,970.72
|
|
Trg gene rearrangement anal
|
$1,148.40 |
$1,148.40 |
$1,148.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$32.60 |
$32.60 |
$32.60 |
$43.00
|
|
Triglycerides
|
$44.40 |
$44.40 |
$44.40 |
$58.05
|
|
Trim nail(s)
|
$106.20 |
$106.20 |
$106.20 |
$78.40
|
|
Trim nondyst nails
|
$163.20 |
$163.20 |
$163.20 |
$114.48
|
|
Trnscath plc stent crv crtd without prtct
|
$8,652.00 |
$8,652.00 |
$8,652.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$8,652.00 |
$8,652.00 |
$8,652.00 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$7,544.40 |
$7,544.40 |
$7,544.40 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$15,319.20 |
$15,319.20 |
$15,319.20 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$15,319.20 |
$15,319.20 |
$15,319.20 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$15,319.20 |
$15,319.20 |
$15,319.20 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$7,031.40 |
$7,031.40 |
$7,031.40 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$6,346.80 |
$6,346.80 |
$6,346.80 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,359.80 |
$5,359.80 |
$5,359.80 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,698.60 |
$7,698.60 |
$7,698.60 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$6,346.80 |
$6,346.80 |
$6,346.80 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$10,259.40 |
$10,259.40 |
$10,259.40 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,559.20 |
$3,559.20 |
$3,559.20 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$4,755.00 |
$4,755.00 |
$4,755.00 |
$2,527.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$4,007.40 |
$4,007.40 |
$4,007.40 |
$2,406.77
|
|
Troponin quantitative
|
$83.40 |
$83.40 |
$83.40 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,410.80 |
$2,410.80 |
$2,410.80 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$696.00 |
$696.00 |
$696.00 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$766.80 |
$766.80 |
$766.80 |
$1,254.50
|
|
Tte w or without fol w/cont, f/u
|
$520.80 |
$520.80 |
$520.80 |
$1,178.00
|
|
Tube trach disp innr can 5 xlt
|
$472.80 |
$472.80 |
$472.80 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$85.20 |
$85.20 |
$85.20 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$264.60 |
$264.60 |
$264.60 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$48,916.80 |
$48,916.80 |
$48,916.80 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$104.40 |
$104.40 |
$104.40 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$2,313.60 |
$2,313.60 |
$2,313.60 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,335.80 |
$2,335.80 |
$2,335.80 |
$3,977.49
|
|
Tx l/r atrial fib addl
|
$48,916.80 |
$48,916.80 |
$48,916.80 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$6,869.40 |
$6,869.40 |
$6,869.40 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$6,670.80 |
$6,670.80 |
$6,670.80 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$4,234.20 |
$4,234.20 |
$4,234.20 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$7,082.40 |
$7,082.40 |
$7,082.40 |
$4,529.60
|
|
Tympanometry & reflex thresh
|
$240.00 |
$240.00 |
$240.00 |
$173.18
|
|
Tyms gene com variants
|
$999.60 |
$999.60 |
$999.60 |
$192.29
|
|
Ugt1a1 gene analy common variants
|
$1,240.20 |
$1,240.20 |
$1,240.20 |
$438.75
|
|
Ultrasound breast complete
|
$877.80 |
$877.80 |
$877.80 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$616.80 |
$616.80 |
$616.80 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$441.60 |
$441.60 |
$441.60 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$616.20 |
$616.20 |
$616.20 |
$296.80
|
|
Ultrasound encephalogram
|
$703.20 |
$703.20 |
$703.20 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$469.20 |
$469.20 |
$469.20 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$370.80 |
$370.80 |
$370.80 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$468.00 |
$468.00 |
$468.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$468.00 |
$468.00 |
$468.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$879.00 |
$879.00 |
$879.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$1,108.80 |
$1,108.80 |
$1,108.80 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$561.00 |
$561.00 |
$561.00 |
$403.88
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$352.20 |
$352.20 |
$352.20 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$828.60 |
$828.60 |
$828.60 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$430.80 |
$430.80 |
$430.80 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$1,177.80 |
$1,177.80 |
$1,177.80 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$430.80 |
$430.80 |
$430.80 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$430.80 |
$430.80 |
$430.80 |
$421.00
|
|
Unlisted CT procedure
|
$624.00 |
$624.00 |
$624.00 |
$732.70
|
|
Unlisted mr procedure
|
$360.00 |
$360.00 |
$360.00 |
$1,163.00
|
|
Unlisted procedure colon
|
$2,799.00 |
$2,799.00 |
$2,799.00 |
$1,839.55
|
