|
Transcath closure of asd
|
$3,076.95 |
$3,076.95 |
$3,076.95 |
$18,034.50
|
|
Transcatheter bx s&i
|
$347.25 |
$347.25 |
$347.25 |
$1,973.01
|
|
Transcath occlusion cns
|
$2,493.45 |
$2,493.45 |
$2,493.45 |
$7,216.32
|
|
Transcath occlusion non-cns
|
$2,110.35 |
$2,110.35 |
$2,110.35 |
$10,452.00
|
|
Transcutaneous carboxyhb
|
$4.80 |
$4.80 |
$4.80 |
$33.57
|
|
Transferrin
|
$22.05 |
$22.05 |
$22.05 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$119.40 |
$119.40 |
$119.40 |
$936.80
|
|
Trauma partial team response w/critical care services level 4
|
$988.65 |
$988.65 |
$988.65 |
$4,063.80
|
|
Tray bonemarrw oncontrol 102mm
|
$583.37 |
$583.37 |
$583.37 |
$940.80
|
|
Treat elbow dislocation
|
$723.45 |
$723.45 |
$723.45 |
$2,223.20
|
|
Treat elbow fracture
|
$723.45 |
$723.45 |
$723.45 |
$1,978.52
|
|
Treat finger fracture each
|
$63.30 |
$63.30 |
$63.30 |
$1,592.00
|
|
Treat foot dislocation
|
$101.55 |
$101.55 |
$101.55 |
$527.28
|
|
Treat fracture of radius
|
$205.50 |
$205.50 |
$205.50 |
$1,790.00
|
|
Treat fracture of ulna
|
$211.95 |
$211.95 |
$211.95 |
$731.04
|
|
Treat hip dislocation
|
$723.45 |
$723.45 |
$723.45 |
$2,192.00
|
|
Treat humerus fracture
|
$283.95 |
$283.95 |
$283.95 |
$1,772.97
|
|
Treat knee dislocation
|
$659.25 |
$659.25 |
$659.25 |
$2,220.89
|
|
Treat knee fracture 27530
|
$109.20 |
$109.20 |
$109.20 |
$550.00
|
|
Treat lower leg dislocation
|
$211.95 |
$211.95 |
$211.95 |
$530.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$834.75 |
$834.75 |
$834.75 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$43.50 |
$43.50 |
$43.50 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$39.60 |
$39.60 |
$39.60 |
$143.75
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$98.55 |
$98.55 |
$98.55 |
$203.49
|
|
Treatment of ankle fracture
|
$3,081.15 |
$3,081.15 |
$3,081.15 |
$8,453.60
|
|
Treatment of ankle fracture 27786
|
$241.50 |
$241.50 |
$241.50 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$221.40 |
$221.40 |
$221.40 |
$491.50
|
|
Treatment of thigh fracture
|
$629.10 |
$629.10 |
$629.10 |
$1,698.58
|
|
Treatment radiation delivery level 2
|
$173.40 |
$173.40 |
$173.40 |
$830.70
|
|
Treat midfoot fracture each
|
$76.05 |
$76.05 |
$76.05 |
$1,848.50
|
|
Treat thigh fx growth plate
|
$96.75 |
$96.75 |
$96.75 |
$475.68
|
|
Treat ulnar fracture
|
$211.95 |
$211.95 |
$211.95 |
$1,662.00
|
|
Treat wrist bone fracture
|
$211.95 |
$211.95 |
$211.95 |
$1,588.95
|
|
Treat wrist dislocation
|
$211.95 |
$211.95 |
$211.95 |
$656.25
|
|
Treponema pallidum antibody
|
$23.10 |
$23.10 |
$23.10 |
$70.40
|
|
Trg gene rearrangement anal
|
$352.80 |
$352.80 |
$352.80 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$20.79 |
$20.79 |
$20.79 |
$43.09
|
|
Triamcinolone a inj prs-free
|
$22.78 |
$22.78 |
$22.78 |
$239.62
|
|
#tricyclicantidprssnt
|
$29.70 |
$29.70 |
$29.70 |
$50.40
|
|
Triglycerides
|
$10.05 |
$10.05 |
$10.05 |
$57.85
|
|
Trimethobenzamide hcl inj
|
$108.77 |
$108.77 |
$108.77 |
$117.49
|
|
Trim nail(s)
|
$12.15 |
$12.15 |
$12.15 |
$78.50
|
|
Trim nondyst nails
|
$12.15 |
$12.15 |
$12.15 |
$115.70
|
|
Trnscath plc stent crv crtd without prtct
|
$2,812.05 |
$2,812.05 |
$2,812.05 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,812.05 |
$2,812.05 |
$2,812.05 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$5,874.15 |
$5,874.15 |
$5,874.15 |
$6,311.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,699.90 |
$3,699.90 |
$3,699.90 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,708.70 |
$2,708.70 |
$2,708.70 |
$8,753.00
|
|
Trnscath plc vas stent w/s&i ini vein
|
$4,660.20 |
$4,660.20 |
$4,660.20 |
$14,819.58
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,487.10 |
$1,487.10 |
$1,487.10 |
$4,735.50
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$5,190.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,401.75 |
$1,401.75 |
$1,401.75 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,401.75 |
$1,401.75 |
$1,401.75 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$1,516.20 |
$1,516.20 |
$1,516.20 |
$3,866.70
|
|
Troponin quantitative
|
$17.10 |
$17.10 |
$17.10 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$4,032.60 |
$4,032.60 |
$4,032.60 |
$29,199.75
|
|
Tx closed hip disl traumatic without anes
|
$245.85 |
$245.85 |
$245.85 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$1,394.10 |
$1,394.10 |
$1,394.10 |
$3,986.00
|
|
Tx closed tib shaft fx without manip
|
$191.10 |
$191.10 |
$191.10 |
$535.60
|
|
Tx l/r atrial fib addl
|
$513.90 |
$513.90 |
$513.90 |
$6,986.85
|
|
Tx tarsal bone fx without manip 28450
|
$63.30 |
$63.30 |
$63.30 |
$419.04
|
|
U2af1 gene common variants
|
$248.10 |
$248.10 |
$248.10 |
$243.34
|
|
Ugt1a1 gene analy common variants
|
$157.80 |
$157.80 |
$157.80 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$101.55 |
$101.55 |
$101.55 |
$394.20
|
|
Ultrasound breast complete
|
$101.55 |
$101.55 |
$101.55 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$96.45 |
$96.45 |
$96.45 |
$452.00
|
|
Ultrasound chest
|
$101.55 |
$101.55 |
$101.55 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$101.55 |
$101.55 |
$101.55 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$101.55 |
$101.55 |
$101.55 |
$302.60
|
|
Ultrasound encephalogram
|
$101.55 |
$101.55 |
$101.55 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$101.55 |
$101.55 |
$101.55 |
$585.15
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$101.55 |
$101.55 |
$101.55 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$101.55 |
$101.55 |
$101.55 |
$388.08
|
|
Ultrasound guided needle placement supervision & interpretation
|
$101.55 |
$101.55 |
$101.55 |
$720.15
|
|
Ultrasound guide intraoperative
|
$101.55 |
$101.55 |
$101.55 |
$625.15
|
|
Ultrasound guide tissue ablation
|
$91.65 |
$91.65 |
$91.65 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$101.55 |
$101.55 |
$101.55 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$96.45 |
$96.45 |
$96.45 |
$311.25
|
|
Ultrasound joint complete left
|
$101.55 |
$101.55 |
$101.55 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$101.55 |
$101.55 |
$101.55 |
$424.00
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$101.55 |
$101.55 |
$101.55 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$50.70 |
$50.70 |
$50.70 |
$393.86
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$50.70 |
$50.70 |
$50.70 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$101.55 |
$101.55 |
$101.55 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$101.55 |
$101.55 |
$101.55 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$101.55 |
$101.55 |
$101.55 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$101.55 |
$101.55 |
$101.55 |
$490.00
|
|
Ultrasound prostate/transrectal
|
$101.55 |
$101.55 |
$101.55 |
$549.95
|
|
Ultrasound retroperitoneal limited
|
$96.45 |
$96.45 |
$96.45 |
$479.60
|
|
Ultrasound scrotum and contents
|
$101.55 |
$101.55 |
$101.55 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$101.55 |
$101.55 |
$101.55 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$50.70 |
$50.70 |
$50.70 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$101.55 |
$101.55 |
$101.55 |
$558.35
|
|
Unlisted chemotherapy px
|
$16.95 |
$16.95 |
$16.95 |
$150.00
|
|
Unlisted CT procedure
|
$559.65 |
$559.65 |
$559.65 |
$700.80
|
|
Unlisted dialysis procedure
|
$301.05 |
$301.05 |
$301.05 |
$1,144.00
|
|
Unlisted procedure microbiology
|
$51.75 |
$51.75 |
$51.75 |
$490.70
|
|
Unlisted px casting/strpg
|
$54.30 |
$54.30 |
$54.30 |
$219.70
|
|
Unlisted px small intestine
|
$1,100.70 |
$1,100.70 |
$1,100.70 |
$1,918.15
|
|
Unlisted spec derm svc/px
|
$86.85 |
$86.85 |
$86.85 |
$223.08
|
