|
Treat knee fracture 27530
|
$591.69 |
$591.69 |
$591.69 |
$535.60
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$317.46 |
$317.46 |
$317.46 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$248.82 |
$248.82 |
$248.82 |
$141.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$310.86 |
$310.86 |
$310.86 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$465.96 |
$465.96 |
$465.96 |
$515.20
|
|
Treatment of fibula fracture 27780
|
$302.94 |
$302.94 |
$302.94 |
$478.40
|
|
Treatment of foot infection
|
$3,644.52 |
$3,644.52 |
$3,644.52 |
$2,398.34
|
|
Treatment of heel fracture 28400
|
$124.41 |
$124.41 |
$124.41 |
$473.00
|
|
Treatment of thigh fracture
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$193.05 |
$193.05 |
$193.05 |
$342.65
|
|
Treat midfoot fracture each
|
$481.80 |
$481.80 |
$481.80 |
$1,824.50
|
|
Treat thigh fracture
|
$285.45 |
$285.45 |
$285.45 |
$661.00
|
|
Treat thigh fracture
|
$481.80 |
$481.80 |
$481.80 |
$1,884.74
|
|
Treat toe dislocation
|
$206.58 |
$206.58 |
$206.58 |
$763.50
|
|
Treat ulnar fracture
|
$671.55 |
$671.55 |
$671.55 |
$1,672.00
|
|
Treat vaginal bleeding
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$379.60
|
|
Treat wrist bone fracture
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$1,703.20
|
|
Treat wrist dislocation
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$656.25
|
|
Treponema pallidum antibody
|
$165.99 |
$165.99 |
$165.99 |
$70.85
|
|
Trg gene rearrangement anal
|
$452.10 |
$452.10 |
$452.10 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$43.21 |
$43.21 |
$43.21 |
$43.80
|
|
Triglycerides
|
$89.43 |
$89.43 |
$89.43 |
$57.85
|
|
Trim nail(s)
|
$48.84 |
$48.84 |
$48.84 |
$77.60
|
|
Trim nondyst nails
|
$1,323.96 |
$1,323.96 |
$1,323.96 |
$115.70
|
|
Trnscath plc stent crv crtd without prtct
|
$5,644.32 |
$5,644.32 |
$5,644.32 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$4,617.69 |
$4,617.69 |
$4,617.69 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$2,351.91 |
$2,351.91 |
$2,351.91 |
$6,391.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,441.67 |
$2,441.67 |
$2,441.67 |
$8,321.86
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,083.52 |
$3,083.52 |
$3,083.52 |
$8,392.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$3,280.53 |
$3,280.53 |
$3,280.53 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,801.60 |
$3,801.60 |
$3,801.60 |
$4,627.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,424.61 |
$1,424.61 |
$1,424.61 |
$5,006.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,785.30 |
$1,785.30 |
$1,785.30 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,785.30 |
$1,785.30 |
$1,785.30 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$855.36 |
$855.36 |
$855.36 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,301.09 |
$2,301.09 |
$2,301.09 |
$4,805.85
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,056.79 |
$3,056.79 |
$3,056.79 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$3,361.71 |
$3,361.71 |
$3,361.71 |
$3,091.20
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,995.08 |
$2,995.08 |
$2,995.08 |
$2,371.50
|
|
Troponin quantitative
|
$310.20 |
$310.20 |
$310.20 |
$128.80
|
|
Tte w or without contr, cont ecg
|
$2,850.21 |
$2,850.21 |
$2,850.21 |
$1,966.90
|
|
Tte w or without fol w/con,stres
|
$4,121.04 |
$4,121.04 |
$4,121.04 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$1,204.50 |
$1,204.50 |
$1,204.50 |
$1,266.50
|
|
Tx atrial fib pulm vein isol
|
$6,520.14 |
$6,520.14 |
$6,520.14 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$621.72 |
$621.72 |
$621.72 |
$547.20
|
|
Tx closed tib shaft fx without manip
|
$240.57 |
$240.57 |
$240.57 |
$535.60
|
|
Tx l/r atrial fib addl
|
$3,834.93 |
$3,834.93 |
$3,834.93 |
$7,005.00
|
|
Tx tarsal bone fx without manip 28450
|
$144.21 |
$144.21 |
$144.21 |
$414.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$133.65 |
$133.65 |
$133.65 |
$394.20
|
|
Ultrasound breast complete
|
$416.13 |
$416.13 |
$416.13 |
$533.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$277.86 |
$277.86 |
$277.86 |
$455.26
|
|
Ultrasound chest
|
$527.34 |
$527.34 |
$527.34 |
$451.52
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$164.01 |
$164.01 |
$164.01 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$215.49 |
$215.49 |
$215.49 |
$284.25
|
|
Ultrasound encephalogram
|
$491.37 |
$491.37 |
$491.37 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$543.84 |
$543.84 |
$543.84 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$698.61 |
$698.61 |
$698.61 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$532.95 |
$532.95 |
$532.95 |
$379.36
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,489.29 |
$1,489.29 |
$1,489.29 |
$720.00
|
|
Ultrasound guide intraoperative
|
$305.25 |
$305.25 |
$305.25 |
$625.15
|
|
Ultrasound guide tissue ablation
|
$829.95 |
$829.95 |
$829.95 |
$552.42
|
|
Ultrasound hips infant dynamic
|
$491.37 |
$491.37 |
$491.37 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$356.40 |
$356.40 |
$356.40 |
$295.50
|
|
Ultrasound joint complete left
|
$758.34 |
$758.34 |
$758.34 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$543.84 |
$543.84 |
$543.84 |
$418.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$387.75 |
$387.75 |
$387.75 |
$397.15
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$491.37 |
$491.37 |
$491.37 |
$323.40
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,037.85 |
$1,037.85 |
$1,037.85 |
$693.00
|
|
Ultrasound pregnant uterus follow up per fetus
|
$425.04 |
$425.04 |
$425.04 |
$420.80
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$707.85 |
$707.85 |
$707.85 |
$442.80
|
|
Ultrasound pregnant uterus transvaginal
|
$559.02 |
$559.02 |
$559.02 |
$484.52
|
|
Ultrasound prostate/transrectal
|
$655.71 |
$655.71 |
$655.71 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$906.18 |
$906.18 |
$906.18 |
$477.10
|
|
Ultrasound scrotum and contents
|
$1,360.59 |
$1,360.59 |
$1,360.59 |
$606.60
|
|
Ultrasound spinal canal and contents
|
$681.78 |
$681.78 |
$681.78 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$357.72 |
$357.72 |
$357.72 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$758.34 |
$758.34 |
$758.34 |
$549.75
|
|
Umbilical artery cath newborn 36660
|
$436.92 |
$436.92 |
$436.92 |
$196.03
|
|
Unlisted CT procedure
|
$220.77 |
$220.77 |
$220.77 |
$676.12
|
|
Unlisted dx gi procedure
|
$441.54 |
$441.54 |
$441.54 |
$613.20
|
|
Unlisted fluoroscopic px
|
$349.14 |
$349.14 |
$349.14 |
$305.76
|
|
Unlisted gi px dx nuc med
|
$1,732.50 |
$1,732.50 |
$1,732.50 |
$1,150.80
|
|
Unlisted nrvs sys px dx nuc
|
$1,215.72 |
$1,215.72 |
$1,215.72 |
$891.41
|
|
Unlisted orl service/px
|
$148.50 |
$148.50 |
$148.50 |
$121.50
|
|
Unlisted px ant segment eye
|
$1,773.42 |
$1,773.42 |
$1,773.42 |
$2,698.92
|
|
Unlisted px small intestine
|
$967.56 |
$967.56 |
$967.56 |
$2,025.36
|
|
Unsched dialysis esrd pt hos
|
$1,931.16 |
$1,931.16 |
$1,931.16 |
$1,248.00
|
|
Upgrade pm system
|
$4,038.54 |
$4,038.54 |
$4,038.54 |
$12,087.24
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,233.67 |
$3,233.67 |
$3,233.67 |
$3,039.60
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,971.98 |
$2,971.98 |
$2,971.98 |
$2,412.60
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,641.32 |
$2,641.32 |
$2,641.32 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$396.33 |
$396.33 |
$396.33 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$495.66 |
$495.66 |
$495.66 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$515.46 |
$515.46 |
$515.46 |
$1,872.00
|
|
Urea nitrogen
|
$123.09 |
$123.09 |
$123.09 |
$39.90
|
|
Urea nitrogen 24 hour urine
|
$101.97 |
$101.97 |
$101.97 |
$52.00
|
|
Ureteral reflux study
|
$1,352.67 |
$1,352.67 |
$1,352.67 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$905.85 |
$905.85 |
$905.85 |
$584.00
|
|
Urethrocystography void s&i
|
$774.51 |
$774.51 |
$774.51 |
$622.35
|
|
Uric acid blood
|
$104.61 |
$104.61 |
$104.61 |
$49.32
|
