|
Trnscath plc vas stent w/s&i ea addl vein
|
$13,400.40 |
$13,401.00 |
$17,983.80 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$12,642.00 |
$13,400.40 |
$18,933.60 |
$14,872.52
|
|
Trnscath retrv pq vasc fb w/guide
|
$7,321.20 |
$9,246.00 |
$24,280.80 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,929.20 |
$6,690.00 |
$15,167.40 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,099.00 |
$6,261.60 |
$9,296.40 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,869.60 |
$6,741.00 |
$11,678.40 |
$4,444.80
|
|
Trnscath tx thromblytc vein ini day
|
$5,929.20 |
$8,889.00 |
$15,167.40 |
$3,900.60
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$7,683.60 |
$8,968.80 |
$15,103.20 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$2,118.60 |
$2,118.60 |
$2,118.60 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,955.80 |
$3,955.80 |
$5,214.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,955.80 |
$3,955.80 |
$3,955.80 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$3,955.80 |
$3,955.80 |
$9,337.20 |
$2,527.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$3,955.80 |
$3,955.80 |
$7,986.60 |
$2,486.75
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$3,768.60 |
$4,071.60 |
$7,827.00 |
$2,406.77
|
|
Troponin quantitative
|
$83.40 |
$165.00 |
$291.00 |
$125.00
|
|
Tte w or without contr, cont ecg
|
$1,973.40 |
$2,577.00 |
$3,415.80 |
$2,196.00
|
|
Tte w or without fol w/con,stres
|
$2,536.80 |
$2,536.80 |
$2,860.20 |
$1,643.14
|
|
Tte w or without fol w/cont, com
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$1,266.50
|
|
Tte w or without fol w/cont, f/u
|
$1,928.40 |
$1,928.40 |
$2,043.00 |
$1,178.00
|
|
Tube drain vert dev st 5-40f
|
$16.80 |
$16.80 |
$16.80 |
$27.60
|
|
Tube trach disp innr can 5 xlt
|
$394.80 |
$775.20 |
$4,183.80 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$13.80 |
$13.80 |
$76.80 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$76.20 |
$198.60 |
$3,744.60 |
$155.98
|
|
Tubular dressing
|
$2.40 |
$11.40 |
$85.80 |
$28.46
|
|
Tx atrial fib pulm vein isol
|
$48,183.60 |
$48,183.60 |
$59,370.00 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$75.60 |
$90.60 |
$342.00 |
$589.00
|
|
Tx closed hip disl traumatic without anes
|
$1,980.60 |
$2,512.20 |
$3,560.40 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,015.00 |
$3,316.20 |
$3,594.00 |
$4,043.32
|
|
Tx closed tib shaft fx without manip
|
$4,470.00 |
$4,470.00 |
$4,470.00 |
$535.60
|
|
Tx l/r atrial fib addl
|
$48,183.60 |
$48,183.60 |
$59,370.00 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$5,134.20 |
$5,134.20 |
$6,308.40 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$4,558.80 |
$5,007.60 |
$7,773.00 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$3,601.80 |
$3,601.80 |
$5,289.00 |
$4,595.50
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$4,282.80 |
$4,706.40 |
$5,854.20 |
$4,529.60
|
|
Tympanic membrane repair
|
$6,809.40 |
$6,809.40 |
$8,426.40 |
$2,133.48
|
|
Tympanometry & reflex thresh
|
$312.00 |
$312.00 |
$312.00 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$2,274.00 |
$2,813.40 |
$4,470.00 |
$911.43
|
|
Tyms gene com variants
|
$1,009.80 |
$1,009.80 |
$1,070.40 |
$192.29
|
|
Ua w/micro/comp poc
|
$18.60 |
$25.80 |
$33.60 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$133.20 |
$133.20 |
$133.20 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$1,240.20 |
$1,240.20 |
$1,252.20 |
$438.75
|
|
Ultrasound bone density measure
|
$55.80 |
$55.80 |
$55.80 |
$143.75
|
|
Ultrasound breast complete
|
$511.80 |
$597.60 |
$1,416.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$284.40 |
$894.00 |
$1,187.40 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$425.40 |
$425.40 |
$745.20 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$438.00 |
$500.40 |
$600.60 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$891.60 |
$891.60 |
$945.00 |
$180.00
|
|
Ultrasound encephalogram
|
$520.80 |
$720.00 |
$1,273.80 |
$496.36
|
|
Ultrasound exam k transpl w/doppler
|
$464.40 |
$736.20 |
$1,408.20 |
$578.70
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$425.40 |
$425.40 |
$615.60 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$301.20 |
$1,018.80 |
$2,769.60 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$168.60 |
$189.60 |
$381.60 |
$388.08
|
|
Ultrasound guide intraoperative
|
$536.40 |
$1,401.00 |
$1,819.80 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$1,058.40 |
$1,058.40 |
$1,097.40 |
$560.00
|
|
Ultrasound joint complete left
|
$576.60 |
$925.20 |
$1,263.00 |
$560.25
|
|
Ultrasound ob >=14wks ea addl gest
|
$936.00 |
$1,555.20 |
$1,759.20 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$150.60 |
$197.40 |
$1,168.20 |
$336.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,048.20 |
$1,279.20 |
$1,629.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$225.60 |
$474.00 |
$1,057.80 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$649.80 |
$829.20 |
$1,914.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$720.00 |
$797.40 |
$1,041.60 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$349.80 |
$349.80 |
$1,279.20 |
$423.36
|
|
Ultrasound trgt dyn mbubb 1st les
|
$1,413.60 |
$1,413.60 |
$1,413.60 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$1,413.60 |
$1,413.60 |
$1,413.60 |
$348.00
|
|
Umbilical cord occlud w/us
|
$3,562.80 |
$3,562.80 |
$3,562.80 |
$754.00
|
|
Unit mobile power mpu
|
$34,384.20 |
$34,384.20 |
$34,384.20 |
$14,359.52
|
|
Unlisted cranfcl&maxlfcl px
|
$2,406.60 |
$2,406.60 |
$2,406.60 |
$571.20
|
|
Unlisted CT procedure
|
$624.00 |
$624.00 |
$1,655.40 |
$732.70
|
|
Unlisted cytogenetic study
|
$27.60 |
$27.60 |
$27.60 |
$160.00
|
|
Unlisted dx gi procedure
|
$158.40 |
$158.40 |
$247.20 |
$649.22
|
|
Unlisted fetal invas px w/us
|
$357.60 |
$357.60 |
$357.60 |
$498.40
|
|
Unlisted fluoroscopic px
|
$199.20 |
$199.20 |
$199.20 |
$305.76
|
|
Unlisted hematology&coagj px
|
$37.80 |
$41.40 |
$2,942.40 |
$39.52
|
|
Unlisted misc path test
|
$213.60 |
$213.60 |
$299.40 |
$89.40
|
|
Unlisted mr procedure
|
$909.00 |
$4,125.00 |
$6,868.80 |
$1,165.00
|
|
Unlisted orl service/px
|
$42.60 |
$111.60 |
$357.60 |
$132.60
|
|
Unlisted procedure colon
|
$2,449.20 |
$2,449.20 |
$3,264.60 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$152.40 |
$152.40 |
$152.40 |
$1,998.88
|
|
Unlisted procedure larynx
|
$104.40 |
$104.40 |
$134.40 |
$924.00
|
|
Unlisted procedure liver
|
$3,186.00 |
$3,186.00 |
$3,186.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$243.00 |
$339.60 |
$525.60 |
$530.00
|
|
Unlisted procedure orbit
|
$911.40 |
$911.40 |
$911.40 |
$437.00
|
|
Unlisted procedure pancreas
|
$152.40 |
$152.40 |
$152.40 |
$4,810.00
|
|
Unlisted procedure rectum
|
$532.20 |
$554.40 |
$845.40 |
$1,278.72
|
|
Unlisted px ant segment eye
|
$89.40 |
$615.60 |
$3,823.80 |
$2,698.92
|
|
Unlisted px biliary tract
|
$2,636.40 |
$2,636.40 |
$2,636.40 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$75.60 |
$93.00 |
$292.80 |
$222.00
|
|
Unlisted px conjunctiva
|
$888.60 |
$888.60 |
$888.60 |
$479.62
|
|
Unlisted px external ear
|
$75.60 |
$75.60 |
$949.20 |
$325.68
|
|
Unlisted px forearm/wrist
|
$102.60 |
$102.60 |
$382.20 |
$859.50
|
|
Unlisted px hands/fingers
|
$3,639.60 |
$4,115.40 |
$6,231.60 |
$349.70
|
|
Unlisted px leg/ankle
|
$348.60 |
$348.60 |
$348.60 |
$813.24
|
|
Unlisted px male genital sys
|
$75.60 |
$90.60 |
$165.00 |
$362.00
|
|
Unlisted px mediastinum
|
$76.80 |
$76.80 |
$76.80 |
$397.60
|
|
Unlisted px posterior segmnt
|
$4,036.20 |
$4,036.20 |
$5,381.40 |
$3,173.34
|
|
Unlisted px salivry glnd/dux
|
$93.60 |
$93.60 |
$464.40 |
$1,265.16
|
|
Unlisted px small intestine
|
$2,236.20 |
$2,744.40 |
$2,995.80 |
$2,118.35
|
|
Unlisted px tongue flr mouth
|
$86.40 |
$104.40 |
$370.80 |
$282.50
|
|
Unlisted resp px dx nuc med
|
$1,750.80 |
$1,750.80 |
$1,750.80 |
$670.60
|
|
Unlisted surgical path px
|
$13,368.60 |
$13,368.60 |
$13,368.60 |
$217.75
|
