|
Treat knee dislocation
|
$1,292.70 |
$1,292.70 |
$2,592.08 |
$2,220.89
|
|
Treat knee fracture 27530
|
$256.95 |
$256.95 |
$256.95 |
$550.73
|
|
Treat knee fracture(s)
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$643.26
|
|
Treat knuckle dislocation
|
$1,894.05 |
$1,894.05 |
$1,894.05 |
$1,693.20
|
|
Treat knuckle dislocation
|
$5,611.05 |
$5,611.05 |
$5,611.05 |
$4,332.00
|
|
Treat lower leg dislocation
|
$480.00 |
$480.00 |
$480.00 |
$532.60
|
|
Treat lower leg fracture
|
$12,905.86 |
$12,905.86 |
$12,905.86 |
$12,905.86
|
|
Treat lower leg fracture
|
$12,653.00 |
$12,653.00 |
$12,653.00 |
$12,653.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$12,184.35 |
$12,184.35 |
$12,184.35 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$6,865.79 |
$6,865.79 |
$12,184.35 |
$8,590.40
|
|
Treatment incomplete abortion completed surgically any trimester
|
$1,907.85 |
$1,907.85 |
$4,468.97 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$202.80 |
$202.80 |
$349.13 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$154.65 |
$154.65 |
$221.58 |
$147.48
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,858.95 |
$1,858.95 |
$3,820.53 |
$4,230.80
|
|
Treatment of ankle fracture
|
$6,662.72 |
$6,662.72 |
$6,662.72 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$279.90 |
$279.90 |
$613.13 |
$528.00
|
|
Treatment of fibula fracture 27780
|
$256.95 |
$256.95 |
$256.95 |
$515.45
|
|
Treatment of foot infection
|
$3,805.20 |
$3,805.20 |
$3,805.20 |
$3,839.54
|
|
Treatment of heel fracture 28400
|
$279.90 |
$279.90 |
$279.90 |
$473.00
|
|
Treatment of thigh fracture
|
$1,389.72 |
$1,389.72 |
$1,389.72 |
$1,749.06
|
|
Treatment of thigh fracture
|
$380.85 |
$380.85 |
$502.76 |
$548.90
|
|
Treatment of thigh fracture
|
$6,731.17 |
$6,731.17 |
$6,731.17 |
$6,389.60
|
|
Treatment of thigh fracture
|
$2,327.55 |
$2,327.55 |
$2,483.24 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$211.95 |
$211.95 |
$380.08 |
$371.40
|
|
Treatment radiation delivery level 2
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$830.70
|
|
Treatment x10sv retinopathy
|
$1,574.83 |
$1,574.83 |
$1,574.83 |
$1,513.20
|
|
Treat metacarpal fracture
|
$3,409.05 |
$3,409.05 |
$3,409.05 |
$5,741.00
|
|
Treat midfoot fracture each
|
$1,047.87 |
$1,047.87 |
$2,327.55 |
$1,884.74
|
|
Treat spinal cord lesion
|
$1,304.32 |
$1,304.32 |
$1,304.32 |
$1,337.00
|
|
Treat thigh fracture
|
$1,337.47 |
$1,337.47 |
$1,337.47 |
$1,893.86
|
|
Treat thigh fracture
|
$3,548.94 |
$3,548.94 |
$3,548.94 |
$2,008.18
|
|
Treat thigh fx growth plate
|
$1,938.38 |
$1,938.38 |
$1,938.38 |
$1,938.38
|
|
Treat toe dislocation
|
$389.40 |
$389.40 |
$1,863.91 |
$756.00
|
|
Treat toe dislocation
|
$3,098.15 |
$3,098.15 |
$3,098.15 |
$3,839.54
|
|
Treat ulnar fracture
|
$1,678.55 |
$1,678.55 |
$2,327.55 |
$1,678.55
|
|
Treat vaginal bleeding
|
$306.90 |
$306.90 |
$306.90 |
$379.60
|
|
Treat wrist bone fracture
|
$1,481.31 |
$1,481.31 |
$2,327.55 |
$1,679.04
|
|
Treat wrist dislocation
|
$429.45 |
$429.45 |
$901.61 |
$656.25
|
|
Treponema pallidum antibody
|
$98.29 |
$98.29 |
$175.20 |
$72.05
|
|
Treprostinil injection
|
$22,919.76 |
$22,919.76 |
$25,211.74 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$265.20 |
$265.20 |
$606.38 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$25.61 |
$25.61 |
$171.04 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$1,869.12 |
$1,869.12 |
$1,869.12 |
$223.56
|
|
Triamcinolone hexacetonl inj
|
$123.23 |
$123.23 |
$123.23 |
$21.36
|
|
Trichinella antibody
|
$73.06 |
$73.06 |
$73.06 |
$70.65
|
|
#tricyclicantidprssnt
|
$57.44 |
$57.44 |
$57.44 |
$50.54
|
|
Triglycerides
|
$255.15 |
$255.15 |
$265.20 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$117.49 |
$117.49 |
$117.49 |
$117.49
|
|
Trim nondyst nails
|
$84.15 |
$84.15 |
$127.69 |
$114.48
|
|
Triptorelin pamoate
|
$1,706.82 |
$1,706.82 |
$1,706.82 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$15,111.95 |
$15,111.95 |
$15,111.95 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$10,353.85 |
$10,353.85 |
$10,353.85 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$520.80 |
$520.80 |
$1,322.09 |
$754.80
|
|
Trnscath plc stent crv crtd without prtct
|
$9,687.14 |
$9,687.14 |
$19,103.10 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$13,302.73 |
$13,302.73 |
$19,103.10 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$10,132.11 |
$10,132.11 |
$19,103.10 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$9,418.42 |
$9,418.42 |
$11,631.90 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$10,946.25 |
$10,946.25 |
$11,631.90 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,631.90 |
$11,631.90 |
$16,687.70 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,398.35 |
$5,398.35 |
$5,602.90 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,267.30 |
$3,267.30 |
$5,361.72 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,250.25 |
$4,250.25 |
$4,960.05 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,250.25 |
$4,250.25 |
$5,428.93 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$3,866.70 |
$3,866.70 |
$4,522.76 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$5,938.20 |
$5,938.20 |
$5,938.20 |
$4,727.52
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$3,110.10 |
$3,110.10 |
$3,110.10 |
$2,377.62
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,626.30 |
$1,626.30 |
$2,986.34 |
$2,986.34
|
|
Troponin quantitative
|
$241.65 |
$241.65 |
$353.40 |
$127.20
|
|
Tr retinal les preterm inf
|
$1,736.63 |
$1,736.63 |
$1,736.63 |
$1,794.00
|
|
Truskin, per sq centimeter
|
$230.63 |
$230.63 |
$230.63 |
$1.00
|
|
Tte w or without contr, cont ecg
|
$2,198.34 |
$2,198.34 |
$2,198.34 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$1,375.35 |
$1,375.35 |
$1,375.35 |
$1,632.80
|
|
Tube drain vert dev st 5-40f
|
$27.60 |
$27.60 |
$27.60 |
$27.60
|
|
Tube trach disp innr can 5 xlt
|
$667.76 |
$667.76 |
$1,217.70 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$329.64 |
$329.64 |
$329.64 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$846.24 |
$846.24 |
$846.24 |
$155.98
|
|
Tubular dressing
|
$139.53 |
$139.53 |
$139.53 |
$28.46
|
|
Tx atrial fib pulm vein isol
|
$14,791.50 |
$14,791.50 |
$36,478.99 |
$29,030.54
|
|
Tx closed distal humerus fx
|
$4,298.11 |
$4,298.11 |
$4,298.11 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$279.90 |
$279.90 |
$649.67 |
$586.80
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,406.82 |
$3,406.82 |
$4,829.55 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$256.95 |
$256.95 |
$757.39 |
$535.60
|
|
Tx l/r atrial fib addl
|
$7,396.05 |
$7,396.05 |
$12,204.38 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$3,331.35 |
$3,331.35 |
$5,003.40 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$3,331.35 |
$3,331.35 |
$5,737.64 |
$4,499.12
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$3,476.21 |
$3,476.21 |
$3,476.21 |
$4,499.12
|
|
Tx open nsl fx uncomp
|
$5,143.95 |
$5,143.95 |
$5,143.95 |
$3,837.72
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$2,911.20 |
$2,911.20 |
$5,175.49 |
$4,529.60
|
|
Tx tarsal bone fx without manip 28450
|
$256.95 |
$256.95 |
$256.95 |
$419.73
|
|
Ua w/micro/comp poc
|
$39.33 |
$39.33 |
$39.33 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$1,476.60 |
$1,476.60 |
$1,476.60 |
$438.75
|
|
Ultrasound breast complete
|
$442.26 |
$442.26 |
$766.05 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$346.19 |
$346.19 |
$766.05 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$340.14 |
$340.14 |
$340.14 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$305.10 |
$305.10 |
$366.50 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$232.30 |
$232.30 |
$545.55 |
$313.95
|
|
Ultrasound encephalogram
|
$496.36 |
$496.36 |
$762.60 |
$494.92
|
|
Ultrasound exam follow-up
|
$189.00 |
$189.00 |
$189.00 |
$226.38
|
|
Ultrasound exam k transpl w/doppler
|
$684.31 |
$684.31 |
$684.31 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$404.98 |
$404.98 |
$469.50 |
$476.94
|
