|
Transplj hematopoietic boost
|
$1,600.42 |
$1,600.42 |
$1,600.42 |
$2,667.20
|
|
Transplt allo hct/donor
|
$7,185.31 |
$7,185.31 |
$7,185.31 |
$29,206.10
|
|
Transplt autol hct/donor
|
$9,000.00 |
$9,000.00 |
$9,000.00 |
$3,986.00
|
|
Transurethral rf treatment
|
$2,906.29 |
$2,906.29 |
$2,906.29 |
$3,281.20
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$543.02 |
$543.02 |
$543.02 |
$558.35
|
|
Transvaginal Pregnancy Ultrasound
|
$509.00 |
$509.00 |
$509.00 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$8,258.47 |
$8,258.47 |
$8,258.47 |
$3,141.85
|
|
Trauma partial team response w/critical care services level 4
|
$8,026.96 |
$8,026.96 |
$8,026.96 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$2,286.90 |
$2,286.90 |
$2,286.90 |
$940.80
|
|
Trb@ gene rearrange dirprobe
|
$73.46 |
$73.46 |
$73.46 |
$73.46
|
|
Treat ankle dislocation
|
$2,821.75 |
$2,821.75 |
$2,821.75 |
$2,358.40
|
|
Treat ankle dislocation
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$7,913.97
|
|
Treat ankle dislocation
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$5,741.00
|
|
Treat ankle fracture
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$5,488.00
|
|
Treat big toe fracture
|
$4,962.95 |
$4,962.95 |
$4,962.95 |
$4,454.10
|
|
Treat cheek bone fracturemalar 21360
|
$6,814.22 |
$6,814.22 |
$6,814.22 |
$6,489.73
|
|
Treat clavicle dislocation 23545
|
$825.57 |
$825.57 |
$825.57 |
$692.80
|
|
Treat ectopic pregnancy
|
$6,515.57 |
$6,515.57 |
$6,515.57 |
$3,986.00
|
|
Treat ectopic pregnancy
|
$6,707.99 |
$6,707.99 |
$6,707.99 |
$6,707.99
|
|
Treat elbow dislocation
|
$2,184.47 |
$2,184.47 |
$2,184.47 |
$2,322.40
|
|
Treat elbow dislocation
|
$6,629.92 |
$6,629.92 |
$6,629.92 |
$7,292.92
|
|
Treat elbow fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$9,791.00
|
|
Treat elbow fracture
|
$1,978.52 |
$1,978.52 |
$1,978.52 |
$2,055.00
|
|
Treat elbow fracture
|
$10,443.23 |
$10,443.23 |
$10,443.23 |
$6,839.00
|
|
Treat eyelid by injection
|
$176.04 |
$176.04 |
$176.04 |
$472.21
|
|
Treat eyelid lesion 67850
|
$1,465.04 |
$1,465.04 |
$1,465.04 |
$1,146.13
|
|
Treat finger fracture each
|
$3,714.93 |
$3,714.93 |
$3,714.93 |
$4,192.86
|
|
Treat finger fracture each
|
$2,226.01 |
$2,226.01 |
$2,226.01 |
$1,592.00
|
|
Treat foot bone lesion
|
$3,700.57 |
$3,700.57 |
$3,700.57 |
$3,839.54
|
|
Treat foot dislocation
|
$396.30 |
$396.30 |
$396.30 |
$410.00
|
|
Treat foot dislocation
|
$3,935.24 |
$3,935.24 |
$3,935.24 |
$4,192.86
|
|
Treat foot dislocation
|
$3,935.24 |
$3,935.24 |
$3,935.24 |
$2,856.00
|
|
Treat foot dislocation
|
$421.50 |
$421.50 |
$421.50 |
$535.60
|
|
Treat foot dislocation
|
$3,079.75 |
$3,079.75 |
$3,079.75 |
$5,112.80
|
|
Treat foot dislocation
|
$394.75 |
$394.75 |
$394.75 |
$445.80
|
|
Treat foot dislocation
|
$276.31 |
$276.31 |
$276.31 |
$440.04
|
|
Treat foot dislocation
|
$3,778.28 |
$3,778.28 |
$3,778.28 |
$3,839.54
|
|
Treat fracture of radius
|
$1,839.55 |
$1,839.55 |
$1,839.55 |
$1,839.55
|
|
Treat fracture of radius
|
$1,417.44 |
$1,417.44 |
$1,417.44 |
$1,849.00
|
|
Treat fracture of ulna
|
$551.53 |
$551.53 |
$551.53 |
$731.04
|
|
Treat/graft heel fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$10,629.07
|
|
Treat hand bone lesion
|
$4,149.29 |
$4,149.29 |
$4,149.29 |
$3,073.20
|
|
Treat hand dislocation
|
$1,417.44 |
$1,417.44 |
$1,417.44 |
$1,772.97
|
|
Treat hand dislocation
|
$3,565.60 |
$3,565.60 |
$3,565.60 |
$3,839.54
|
|
Treat hand dislocation
|
$7,492.98 |
$7,492.98 |
$7,492.98 |
$3,986.00
|
|
Treat heel fracture
|
$8,683.23 |
$8,683.23 |
$8,683.23 |
$7,907.11
|
|
Treat hip dislocation
|
$2,465.82 |
$2,465.82 |
$2,465.82 |
$2,211.05
|
|
Treat hip dislocation
|
$2,743.15 |
$2,743.15 |
$2,743.15 |
$2,643.60
|
|
Treat hip socket fracture
|
$1,903.18 |
$1,903.18 |
$1,903.18 |
$1,340.10
|
|
Treat humerus fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$9,803.49
|
|
Treat humerus fracture
|
$11,850.08 |
$11,850.08 |
$11,850.08 |
$12,299.10
|
|
Treat humerus fracture
|
$1,417.44 |
$1,417.44 |
$1,417.44 |
$1,808.80
|
|
Treat humerus fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$10,902.51
|
|
Treat humerus fracture
|
$16,139.55 |
$16,139.55 |
$16,139.55 |
$10,742.40
|
|
Treat humerus fracture
|
$1,488.31 |
$1,488.31 |
$1,488.31 |
$1,790.00
|
|
Treat humerus fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$10,629.07
|
|
Treat humerus fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$7,906.00
|
|
Treat humerus fracture
|
$3,079.75 |
$3,079.75 |
$3,079.75 |
$6,311.00
|
|
Treat kneecap dislocation
|
$1,792.16 |
$1,792.16 |
$1,792.16 |
$1,063.40
|
|
Treat kneecap dislocation
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$6,070.00
|
|
Treat kneecap fracture
|
$11,051.25 |
$11,051.25 |
$11,051.25 |
$6,839.00
|
|
Treat knee dislocation
|
$2,220.89 |
$2,220.89 |
$2,220.89 |
$2,211.05
|
|
Treat knee fracture 27530
|
$452.81 |
$452.81 |
$452.81 |
$550.73
|
|
Treat knee fracture(s)
|
$381.15 |
$381.15 |
$381.15 |
$643.26
|
|
Treat knuckle dislocation
|
$1,417.44 |
$1,417.44 |
$1,417.44 |
$1,726.01
|
|
Treat knuckle dislocation
|
$5,036.85 |
$5,036.85 |
$5,036.85 |
$4,332.00
|
|
Treat lower jaw fracture 21462
|
$8,803.45 |
$8,803.45 |
$8,803.45 |
$7,000.36
|
|
Treat lower leg bone lesion
|
$4,092.85 |
$4,092.85 |
$4,092.85 |
$4,092.85
|
|
Treat lower leg dislocation
|
$616.97 |
$616.97 |
$616.97 |
$532.60
|
|
Treat lower leg dislocation
|
$6,072.59 |
$6,072.59 |
$6,072.59 |
$6,072.59
|
|
Treat lower leg fracture
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$6,475.41
|
|
Treat lower leg fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$12,905.86
|
|
Treat lower leg fracture
|
$10,629.07 |
$10,629.07 |
$10,629.07 |
$12,653.00
|
|
Treat lower leg joint
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$8,280.41 |
$8,280.41 |
$8,280.41 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$9,217.75 |
$9,217.75 |
$9,217.75 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$7,218.81 |
$7,218.81 |
$7,218.81 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,916.04 |
$3,916.04 |
$3,916.04 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$420.58 |
$420.58 |
$420.58 |
$226.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$218.32 |
$218.32 |
$218.32 |
$148.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,638.60 |
$3,638.60 |
$3,638.60 |
$4,230.80
|
|
Treatment mouth roof lesion
|
$2,424.47 |
$2,424.47 |
$2,424.47 |
$4,256.70
|
|
Treatment of anal fissure w/dilat 46940
|
$2,943.60 |
$2,943.60 |
$2,943.60 |
$3,640.00
|
|
Treatment of ankle fracture
|
$7,141.80 |
$7,141.80 |
$7,141.80 |
$7,913.97
|
|
Treatment of ankle fracture
|
$8,789.77 |
$8,789.77 |
$8,789.77 |
$8,453.60
|
|
Treatment of ankle fracture
|
$7,348.32 |
$7,348.32 |
$7,348.32 |
$7,906.00
|
|
Treatment of ankle fracture
|
$8,647.07 |
$8,647.07 |
$8,647.07 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$466.22 |
$466.22 |
$466.22 |
$528.00
|
|
Treatment of choroid lesion
|
$1,242.48 |
$1,242.48 |
$1,242.48 |
$1,253.20
|
|
Treatment of corneal lesion
|
$431.53 |
$431.53 |
$431.53 |
$856.80
|
|
Treatment of eyelid lesions
|
$281.05 |
$281.05 |
$281.05 |
$352.04
|
|
Treatment of fibula fracture
|
$7,069.90 |
$7,069.90 |
$7,069.90 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$404.29 |
$404.29 |
$404.29 |
$528.00
|
|
Treatment of foot infection
|
$2,614.25 |
$2,614.25 |
$2,614.25 |
$2,928.60
|
|
Treatment of foot infection
|
$2,777.50 |
$2,777.50 |
$2,777.50 |
$3,839.54
|
|
Treatment of gum lesion
|
$3,164.85 |
$3,164.85 |
$3,164.85 |
$3,164.85
|
|
Treatment of heel fracture 28400
|
$412.37 |
$412.37 |
$412.37 |
$478.40
|
|
Treatment of miscarriage
|
$3,958.20 |
$3,958.20 |
$3,958.20 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$2,641.78 |
$2,641.78 |
$2,641.78 |
$3,734.50
|
|
Treatment of penis lesion
|
$5,528.58 |
$5,528.58 |
$5,528.58 |
$4,081.37
|
