|
Tx contour defects 1.1-5.0cc 11951
|
$804.23 |
$804.23 |
$804.23 |
$849.50
|
|
Tx l/r atrial fib addl
|
$10,871.82 |
$10,871.82 |
$10,871.82 |
$6,986.85
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$4,521.61 |
$4,521.61 |
$4,521.61 |
$4,521.61
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$4,301.50 |
$4,301.50 |
$4,301.50 |
$4,537.59
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$4,416.30 |
$4,416.30 |
$4,416.30 |
$4,595.50
|
|
Tx open nsl fx uncomp
|
$4,173.52 |
$4,173.52 |
$4,173.52 |
$3,837.72
|
|
Tx open nsl sptl fx
|
$4,308.40 |
$4,308.40 |
$4,308.40 |
$4,308.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$5,317.77 |
$5,317.77 |
$5,317.77 |
$4,529.60
|
|
Tx tarsal bone fx without manip 28450
|
$380.44 |
$380.44 |
$380.44 |
$423.15
|
|
Tympanic membrane repair
|
$2,638.87 |
$2,638.87 |
$2,638.87 |
$2,133.48
|
|
Tympanolysis transcanal 69450
|
$5,550.20 |
$5,550.20 |
$5,550.20 |
$3,837.72
|
|
Tympanometry & reflex thresh
|
$168.62 |
$168.62 |
$168.62 |
$173.18
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$1,047.93 |
$1,047.93 |
$1,047.93 |
$911.43
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$11,063.54 |
$11,063.54 |
$11,063.54 |
$6,740.80
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$9,481.40 |
$9,481.40 |
$9,481.40 |
$7,000.36
|
|
Tyms gene com variants
|
$1,192.80 |
$1,192.80 |
$1,192.80 |
$192.29
|
|
Ua w/micro/comp poc
|
$33.17 |
$33.17 |
$33.17 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$1,476.60 |
$1,476.60 |
$1,476.60 |
$438.75
|
|
Ultrasound breast complete
|
$386.64 |
$386.64 |
$386.64 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$346.09 |
$346.09 |
$346.09 |
$452.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$303.43 |
$303.43 |
$303.43 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$380.47 |
$380.47 |
$380.47 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$353.09 |
$353.09 |
$353.09 |
$307.00
|
|
Ultrasound encephalogram
|
$444.58 |
$444.58 |
$444.58 |
$485.48
|
|
Ultrasound exam follow-up
|
$267.44 |
$267.44 |
$267.44 |
$226.38
|
|
Ultrasound exam k transpl w/doppler
|
$601.20 |
$601.20 |
$601.20 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$421.33 |
$421.33 |
$421.33 |
$477.10
|
|
Ultrasound Guidance for a Needle Procedure
|
$906.04 |
$906.04 |
$906.04 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$605.63 |
$605.63 |
$605.63 |
$388.08
|
|
Ultrasound guide intraoperative
|
$488.56 |
$488.56 |
$488.56 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$400.79 |
$400.79 |
$400.79 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$462.36 |
$462.36 |
$462.36 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$321.35 |
$321.35 |
$321.35 |
$304.00
|
|
Ultrasound joint complete left
|
$499.95 |
$499.95 |
$499.95 |
$560.92
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$388.47 |
$388.47 |
$388.47 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$459.43 |
$459.43 |
$459.43 |
$406.44
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$326.54 |
$326.54 |
$326.54 |
$333.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$631.20 |
$631.20 |
$631.20 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$352.11 |
$352.11 |
$352.11 |
$428.25
|
|
Ultrasound prostate/transrectal
|
$515.63 |
$515.63 |
$515.63 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$491.43 |
$491.43 |
$491.43 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$375.38 |
$375.38 |
$375.38 |
$417.15
|
|
Ultrasound trgt dyn mbubb 1st les
|
$237.74 |
$237.74 |
$237.74 |
$568.32
|
|
Ultraviolet therapy
|
$45.05 |
$45.05 |
$45.05 |
$39.76
|
|
Umbilical artery cath newborn 36660
|
$534.45 |
$534.45 |
$534.45 |
$223.80
|
|
Umbilical cord occlud w/us
|
$374.48 |
$374.48 |
$374.48 |
$754.00
|
|
Umbilicoplasty 15847
|
$4,172.97 |
$4,172.97 |
$4,172.97 |
$4,172.97
|
|
Unit mobile power mpu
|
$18,528.00 |
$18,528.00 |
$18,528.00 |
$14,359.52
|
|
Unlistd noninvas vasc dx std
|
$844.07 |
$844.07 |
$844.07 |
$564.60
|
|
Unlisted chemotherapy px
|
$475.70 |
$475.70 |
$475.70 |
$149.15
|
|
Unlisted cranfcl&maxlfcl px
|
$6,289.53 |
$6,289.53 |
$6,289.53 |
$571.20
|
|
Unlisted CT procedure
|
$4,603.28 |
$4,603.28 |
$4,603.28 |
$740.43
|
|
Unlisted dialysis procedure
|
$3,467.73 |
$3,467.73 |
$3,467.73 |
$1,144.00
|
|
Unlisted dx gi procedure
|
$1,256.74 |
$1,256.74 |
$1,256.74 |
$649.22
|
|
Unlisted fetal invas px w/us
|
$694.58 |
$694.58 |
$694.58 |
$498.40
|
|
Unlisted fluoroscopic px
|
$3,433.99 |
$3,433.99 |
$3,433.99 |
$305.76
|
|
Unlisted hystsc px uterus
|
$2,803.60 |
$2,803.60 |
$2,803.60 |
$3,027.89
|
|
Unlisted laparoscopic liver biopy 47379
|
$6,307.38 |
$6,307.38 |
$6,307.38 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$6,838.32 |
$6,838.32 |
$6,838.32 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$4,981.62 |
$4,981.62 |
$4,981.62 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$9,492.80 |
$9,492.80 |
$9,492.80 |
$6,463.42
|
|
Unlisted laps px appendix
|
$3,617.40 |
$3,617.40 |
$3,617.40 |
$3,617.40
|
|
Unlisted laps px bladder
|
$5,082.74 |
$5,082.74 |
$5,082.74 |
$5,082.74
|
|
Unlisted laps px endoc sys
|
$5,631.01 |
$5,631.01 |
$5,631.01 |
$5,855.00
|
|
Unlisted laps px esoph
|
$5,042.16 |
$5,042.16 |
$5,042.16 |
$5,741.00
|
|
Unlisted laps px lymphtc sys
|
$10,635.94 |
$10,635.94 |
$10,635.94 |
$6,870.89
|
|
Unlisted laps px ovidct ovry
|
$4,713.11 |
$4,713.11 |
$4,713.11 |
$6,904.15
|
|
Unlisted laps px renal
|
$8,914.07 |
$8,914.07 |
$8,914.07 |
$5,110.00
|
|
Unlisted laps px testis
|
$5,628.67 |
$5,628.67 |
$5,628.67 |
$5,628.67
|
|
Unlisted laps px ureter
|
$5,787.59 |
$5,787.59 |
$5,787.59 |
$6,376.26
|
|
Unlisted laps px uterus
|
$8,151.73 |
$8,151.73 |
$8,151.73 |
$4,627.00
|
|
Unlisted maxlfcl prosth px
|
$1,432.65 |
$1,432.65 |
$1,432.65 |
$571.20
|
|
Unlisted misc path test
|
$89.40 |
$89.40 |
$89.40 |
$89.40
|
|
Unlisted mr procedure
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$1,165.00
|
|
Unlisted muscskel px head
|
$187.43 |
$187.43 |
$187.43 |
$1,224.08
|
|
Unlisted oph svc/procedure
|
$213.51 |
$213.51 |
$213.51 |
$40.26
|
|
Unlisted orl service/px
|
$334.27 |
$334.27 |
$334.27 |
$132.60
|
|
Unlisted procedure colon
|
$1,839.55 |
$1,839.55 |
$1,839.55 |
$1,839.55
|
|
Unlisted procedure esophagus
|
$5,817.32 |
$5,817.32 |
$5,817.32 |
$1,998.88
|
|
Unlisted procedure eyelids
|
$479.62 |
$479.62 |
$479.62 |
$2,174.90
|
|
Unlisted procedure larynx
|
$5,107.38 |
$5,107.38 |
$5,107.38 |
$924.00
|
|
Unlisted procedure liver
|
$3,950.78 |
$3,950.78 |
$3,950.78 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$2,221.36 |
$2,221.36 |
$2,221.36 |
$530.00
|
|
Unlisted procedure orbit
|
$479.62 |
$479.62 |
$479.62 |
$437.00
|
|
Unlisted procedure pancreas
|
$7,194.87 |
$7,194.87 |
$7,194.87 |
$4,810.00
|
|
Unlisted procedure rectum
|
$745.48 |
$745.48 |
$745.48 |
$1,278.72
|
|
Unlisted procedure spine
|
$9,362.69 |
$9,362.69 |
$9,362.69 |
$4,706.35
|
|
Unlisted px abdomen muscskel
|
$11,582.59 |
$11,582.59 |
$11,582.59 |
$2,053.50
|
|
Unlisted px accessory sinus
|
$235.82 |
$235.82 |
$235.82 |
$3,335.28
|
|
Unlisted px ant segment eye
|
$3,110.31 |
$3,110.31 |
$3,110.31 |
$2,698.92
|
|
Unlisted px arthroscopy
|
$13,708.47 |
$13,708.47 |
$13,708.47 |
$2,765.60
|
|
Unlisted px biliary tract
|
$11,636.44 |
$11,636.44 |
$11,636.44 |
$3,055.00
|
|
Unlisted px casting/strpg
|
$224.93 |
$224.93 |
$224.93 |
$222.00
|
|
Unlisted px conjunctiva
|
$479.62 |
$479.62 |
$479.62 |
$479.62
|
|
Unlisted px diaphragm
|
$6,547.57 |
$6,547.57 |
$6,547.57 |
$6,325.20
|
|
Unlisted px exc pressure ulc
|
$626.83 |
$626.83 |
$626.83 |
$973.71
|
|
Unlisted px external ear
|
$7,359.08 |
$7,359.08 |
$7,359.08 |
$325.68
|
|
Unlisted px extraocular musc
|
$3,718.79 |
$3,718.79 |
$3,718.79 |
$739.20
|
|
Unlisted px foot/toes
|
$7,763.00 |
$7,763.00 |
$7,763.00 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$6,515.57 |
$6,515.57 |
$6,515.57 |
$859.50
|
