|
Tib/per revasc w/ather add-on 37233
|
$31,358.00 |
$31,358.00 |
$31,358.00 |
$9,769.65
|
|
Tilt table study
|
$1,274.00 |
$1,274.00 |
$1,274.00 |
$1,507.01
|
|
Tissue culture placenta
|
$947.50 |
$947.50 |
$947.50 |
$457.00
|
|
Tissue culture skin/biopsy
|
$458.50 |
$458.50 |
$458.50 |
$484.00
|
|
Tissue culture tumor
|
$949.50 |
$949.50 |
$949.50 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$71.00 |
$71.00 |
$71.00 |
$47.20
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$243.50 |
$243.50 |
$243.50 |
$1,134.00
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$57.00 |
$57.00 |
$57.00 |
$18,999.96
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$17.50 |
$17.50 |
$17.50 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$100.00 |
$100.00 |
$100.00 |
$44.16
|
|
Tixagev and cilgav inj
|
$450.00 |
$450.00 |
$450.00 |
$224.55
|
|
Tlso rigid lined custom fab
|
$3,279.00 |
$3,279.00 |
$3,279.00 |
$2,831.21
|
|
Tobramycin peak therapeutic drug level
|
$232.50 |
$232.50 |
$232.50 |
$120.60
|
|
Tomosynthesis breast screen bilateral
|
$358.00 |
$358.00 |
$358.00 |
$72.68
|
|
Toxoplasma antibody igg
|
$325.00 |
$325.00 |
$325.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$330.00 |
$330.00 |
$330.00 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$378.00 |
$378.00 |
$378.00 |
$790.68
|
|
Tprnl plmt biodegrdabl matrl
|
$7,705.00 |
$7,705.00 |
$7,705.00 |
$7,144.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$38.50 |
$38.50 |
$38.50 |
$101.25
|
|
Transcath biopsy
|
$10,019.50 |
$10,019.50 |
$10,019.50 |
$4,285.93
|
|
Transcath closure of asd
|
$16,467.50 |
$16,467.50 |
$16,467.50 |
$16,741.40
|
|
Transcatheter bx s&i
|
$3,686.00 |
$3,686.00 |
$3,686.00 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$618.00 |
$618.00 |
$618.00 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$1,644.00 |
$1,644.00 |
$1,644.00 |
$12,418.00
|
|
Transcutaneous hgb 88738
|
$15.00 |
$15.00 |
$15.00 |
$13.80
|
|
Transferrin
|
$319.50 |
$319.50 |
$319.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$2,200.00 |
$2,200.00 |
$2,200.00 |
$983.00
|
|
Transparent film >16<=48 in
|
$124.50 |
$124.50 |
$124.50 |
$12.95
|
|
Trauma partial team response w/critical care services level 4
|
$7,360.50 |
$7,360.50 |
$7,360.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$940.80
|
|
Treat ankle dislocation
|
$4,087.00 |
$4,087.00 |
$4,087.00 |
$2,358.40
|
|
Treat kneecap dislocation
|
$453.00 |
$453.00 |
$453.00 |
$1,068.90
|
|
Treatment incomplete abortion completed surgically any trimester
|
$2,872.50 |
$2,872.50 |
$2,872.50 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$344.00 |
$344.00 |
$344.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$344.00 |
$344.00 |
$344.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$250.00 |
$250.00 |
$250.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,631.00 |
$3,631.00 |
$3,631.00 |
$3,982.44
|
|
Treatment of miscarriage
|
$3,191.50 |
$3,191.50 |
$3,191.50 |
$4,146.69
|
|
Treat wrist dislocation
|
$106.50 |
$106.50 |
$106.50 |
$656.25
|
|
Treponema pallidum antibody
|
$264.50 |
$264.50 |
$264.50 |
$70.40
|
|
Trg gene rearrangement anal
|
$358.00 |
$358.00 |
$358.00 |
$455.70
|
|
Triglycerides
|
$189.00 |
$189.00 |
$189.00 |
$58.05
|
|
Trim nail(s)
|
$755.50 |
$755.50 |
$755.50 |
$79.00
|
|
Trim nondyst nails
|
$755.50 |
$755.50 |
$755.50 |
$113.40
|
|
Trnscath plc stent crv crtd w/prtct
|
$8,506.50 |
$8,506.50 |
$8,506.50 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$25,961.50 |
$25,961.50 |
$25,961.50 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$25,961.50 |
$25,961.50 |
$25,961.50 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$25,961.50 |
$25,961.50 |
$25,961.50 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$11,575.00 |
$11,575.00 |
$11,575.00 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,778.00 |
$4,778.00 |
$4,778.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,385.50 |
$5,385.50 |
$5,385.50 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,385.50 |
$5,385.50 |
$5,385.50 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$4,778.00 |
$4,778.00 |
$4,778.00 |
$3,866.70
|
|
Troponin quantitative
|
$166.50 |
$166.50 |
$166.50 |
$127.20
|
|
Trurl dstrj prst8 tiss rf wv
|
$3,056.50 |
$3,056.50 |
$3,056.50 |
$4,228.00
|
|
Tube trach fen sz 6 uncuffed
|
$101.00 |
$101.00 |
$101.00 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$24,767.00 |
$24,767.00 |
$24,767.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$455.00 |
$455.00 |
$455.00 |
$581.07
|
|
Tx l/r atrial fib addl
|
$5,139.00 |
$5,139.00 |
$5,139.00 |
$6,769.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$819.00 |
$819.00 |
$819.00 |
$394.20
|
|
Ultrasound breast complete
|
$625.00 |
$625.00 |
$625.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$625.00 |
$625.00 |
$625.00 |
$449.35
|
|
Ultrasound chest
|
$803.50 |
$803.50 |
$803.50 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$320.00 |
$320.00 |
$320.00 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$92.50 |
$92.50 |
$92.50 |
$307.00
|
|
Ultrasound encephalogram
|
$973.00 |
$973.00 |
$973.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$405.00 |
$405.00 |
$405.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,481.00 |
$1,481.00 |
$1,481.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$735.00 |
$735.00 |
$735.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$884.00 |
$884.00 |
$884.00 |
$720.15
|
|
Ultrasound guide intraoperative
|
$1,513.00 |
$1,513.00 |
$1,513.00 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$846.50 |
$846.50 |
$846.50 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$260.00 |
$260.00 |
$260.00 |
$311.25
|
|
Ultrasound joint complete left
|
$710.50 |
$710.50 |
$710.50 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$355.50 |
$355.50 |
$355.50 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$902.50 |
$902.50 |
$902.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$339.50 |
$339.50 |
$339.50 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$816.50 |
$816.50 |
$816.50 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$973.00 |
$973.00 |
$973.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$890.00 |
$890.00 |
$890.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$679.50 |
$679.50 |
$679.50 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$819.00 |
$819.00 |
$819.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$1,149.50 |
$1,149.50 |
$1,149.50 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$994.00 |
$994.00 |
$994.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$628.00 |
$628.00 |
$628.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$1,193.00 |
$1,193.00 |
$1,193.00 |
$558.35
|
|
Unit mobile power mpu
|
$13,624.50 |
$13,624.50 |
$13,624.50 |
$14,612.80
|
|
Unlisted chemotherapy px
|
$34.00 |
$34.00 |
$34.00 |
$150.00
|
|
Unlisted procedure spine
|
$1,877.50 |
$1,877.50 |
$1,877.50 |
$4,659.85
|
|
Unlisted psychiatric service/proc 90899
|
$270.50 |
$270.50 |
$270.50 |
$277.76
|
|
Unlisted px med radj physics
|
$394.50 |
$394.50 |
$394.50 |
$462.35
|
|
Unlisted urinalysis px
|
$17.50 |
$17.50 |
$17.50 |
$25.72
|
|
Unsched dialysis esrd pt hos
|
$497.00 |
$497.00 |
$497.00 |
$1,268.17
|
|
Upgrade pm system
|
$29,386.50 |
$29,386.50 |
$29,386.50 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,692.00 |
$5,692.00 |
$5,692.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$5,253.00 |
$5,253.00 |
$5,253.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,953.50 |
$4,953.50 |
$4,953.50 |
$2,034.41
|
|
Urea nitrogen
|
$67.50 |
$67.50 |
$67.50 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$184.50 |
$184.50 |
$184.50 |
$51.75
|
|
Ureteral reflux study
|
$1,504.00 |
$1,504.00 |
$1,504.00 |
$952.50
|
