|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$28,655.86 |
$28,655.86 |
$28,655.86 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$9,068.27 |
$9,068.27 |
$9,068.27 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$175.80 |
$175.80 |
$175.80 |
$224.90
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$159.00 |
$159.00 |
$159.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$8,794.21 |
$8,794.21 |
$8,794.21 |
$3,982.44
|
|
Treatment of ankle fracture
|
$54,022.34 |
$54,022.34 |
$54,022.34 |
$8,412.89
|
|
Treatment of ankle fracture
|
$36,117.92 |
$36,117.92 |
$36,117.92 |
$8,453.60
|
|
Treatment of fibula fracture
|
$61,153.76 |
$61,153.76 |
$61,153.76 |
$6,311.00
|
|
Treatment of thigh fracture
|
$1,507.80 |
$1,507.80 |
$1,507.80 |
$1,748.40
|
|
Treatment of thigh fracture
|
$1,507.80 |
$1,507.80 |
$1,507.80 |
$1,772.97
|
|
Treatment of tibia fracture
|
$49,512.28 |
$49,512.28 |
$49,512.28 |
$7,087.60
|
|
Treat metatarsal fracture
|
$40,038.97 |
$40,038.97 |
$40,038.97 |
$8,453.60
|
|
Treat thigh fracture
|
$445.80 |
$445.80 |
$445.80 |
$618.80
|
|
Treat ulnar fracture
|
$1,507.80 |
$1,507.80 |
$1,507.80 |
$1,662.00
|
|
Treat ulnar fracture
|
$47,636.29 |
$47,636.29 |
$47,636.29 |
$5,926.25
|
|
Treat wrist dislocation
|
$445.80 |
$445.80 |
$445.80 |
$656.25
|
|
Treponema pallidum antibody
|
$84.60 |
$84.60 |
$84.60 |
$70.40
|
|
Treprostinil injection
|
$45,648.52 |
$45,648.52 |
$45,648.52 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$929.40 |
$929.40 |
$929.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$67.12 |
$67.12 |
$67.12 |
$43.21
|
|
Trichinella antibody
|
$27.00 |
$27.00 |
$27.00 |
$70.20
|
|
#tricyclicantidprssnt
|
$111.60 |
$111.60 |
$111.60 |
$50.86
|
|
Triglycerides
|
$61.20 |
$61.20 |
$61.20 |
$58.05
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,109.00 |
$11,109.00 |
$11,109.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ini vein
|
$16,630.20 |
$16,630.20 |
$16,630.20 |
$15,330.11
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,245.00 |
$4,245.00 |
$4,245.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,221.00 |
$4,221.00 |
$4,221.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,444.80 |
$4,444.80 |
$4,444.80 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$6,027.00 |
$6,027.00 |
$6,027.00 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$32,796.47 |
$32,796.47 |
$32,796.47 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$32,796.47 |
$32,796.47 |
$32,796.47 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$7,398.28 |
$7,398.28 |
$7,398.28 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$15,801.06 |
$15,801.06 |
$15,801.06 |
$2,406.77
|
|
Troponin quantitative
|
$54.60 |
$54.60 |
$54.60 |
$127.20
|
|
Trurl dstrj prst8 tiss rf wv
|
$15,761.83 |
$15,761.83 |
$15,761.83 |
$4,228.00
|
|
Tte w or without contr, cont ecg
|
$1,617.00 |
$1,617.00 |
$1,617.00 |
$2,012.40
|
|
Tte w or without fol w/con,stres
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$1,632.80
|
|
Tube trach disp innr can 5 xlt
|
$787.21 |
$787.21 |
$787.21 |
$445.99
|
|
Tx atrial fib pulm vein isol
|
$25,746.00 |
$25,746.00 |
$25,746.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$445.80 |
$445.80 |
$445.80 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,135.80 |
$4,135.80 |
$4,135.80 |
$3,977.49
|
|
Ugt1a1 gene analy common variants
|
$243.60 |
$243.60 |
$243.60 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$829.20 |
$829.20 |
$829.20 |
$394.20
|
|
Ultrasound chest
|
$554.40 |
$554.40 |
$554.40 |
$460.85
|
|
Ultrasound elastography parenchyma
|
$455.40 |
$455.40 |
$455.40 |
$307.00
|
|
Ultrasound encephalogram
|
$736.20 |
$736.20 |
$736.20 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$280.80 |
$280.80 |
$280.80 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$223.20 |
$223.20 |
$223.20 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$914.40 |
$914.40 |
$914.40 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$878.40 |
$878.40 |
$878.40 |
$720.15
|
|
Ultrasound joint/nonvascular extremity limited left
|
$426.00 |
$426.00 |
$426.00 |
$425.45
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$541.20 |
$541.20 |
$541.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$624.00 |
$624.00 |
$624.00 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$332.40 |
$332.40 |
$332.40 |
$486.50
|
|
Ultrasound scrotum and contents
|
$743.40 |
$743.40 |
$743.40 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$361.80 |
$361.80 |
$361.80 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$714.60 |
$714.60 |
$714.60 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$487.80 |
$487.80 |
$487.80 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$487.80 |
$487.80 |
$487.80 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$3,831.60 |
$3,831.60 |
$3,831.60 |
$206.64
|
|
Umbilicoplasty 15847
|
$36,500.75 |
$36,500.75 |
$36,500.75 |
$4,172.97
|
|
Unlisted fluoroscopic px
|
$181.20 |
$181.20 |
$181.20 |
$305.76
|
|
Unlisted laparoscopic liver biopy 47379
|
$42,481.00 |
$42,481.00 |
$42,481.00 |
$5,419.00
|
|
Unlisted laparoscopic reduction intestine 44238
|
$17,576.56 |
$17,576.56 |
$17,576.56 |
$5,419.00
|
|
Unlisted maaa
|
$141.60 |
$141.60 |
$141.60 |
$235.20
|
|
Unlisted procedure larynx
|
$11,204.38 |
$11,204.38 |
$11,204.38 |
$924.00
|
|
Unlisted procedure microbiology
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$523.50
|
|
Unlisted px arthroscopy
|
$14,661.32 |
$14,661.32 |
$14,661.32 |
$2,765.60
|
|
Unlisted px foot/toes
|
$35,578.20 |
$35,578.20 |
$35,578.20 |
$1,225.50
|
|
Unlisted px hands/fingers
|
$453.60 |
$453.60 |
$453.60 |
$354.20
|
|
Unlisted px tongue flr mouth
|
$289.20 |
$289.20 |
$289.20 |
$282.50
|
|
Unlisted px vestibule mouth
|
$461.40 |
$461.40 |
$461.40 |
$456.96
|
|
Unlstd laps px sprmatic cord
|
$23,260.70 |
$23,260.70 |
$23,260.70 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$1,174.80 |
$1,174.80 |
$1,174.80 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,152.20 |
$5,152.20 |
$5,152.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,602.40 |
$3,602.40 |
$3,602.40 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$7,798.85 |
$7,798.85 |
$7,798.85 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$4,701.12 |
$4,701.12 |
$4,701.12 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$5,782.99 |
$5,782.99 |
$5,782.99 |
$1,872.00
|
|
Urea nitrogen
|
$52.20 |
$52.20 |
$52.20 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$60.60 |
$60.60 |
$60.60 |
$51.75
|
|
Urea nitrogen clearance
|
$67.20 |
$67.20 |
$67.20 |
$42.25
|
|
Urethrcystgrphy rtrgrde s&i
|
$886.80 |
$886.80 |
$886.80 |
$579.73
|
|
Uric acid blood
|
$70.20 |
$70.20 |
$70.20 |
$48.75
|
|
Uric acid urine
|
$63.60 |
$63.60 |
$63.60 |
$44.33
|
|
Urinalysis (with microscopy)
|
$68.40 |
$68.40 |
$68.40 |
$55.00
|
|
Urinalysis (without microscopy)
|
$40.80 |
$40.80 |
$40.80 |
$35.75
|
|
Urine Culture Test
|
$75.60 |
$75.60 |
$75.60 |
$81.50
|
|
Urine pregnancy test
|
$91.80 |
$91.80 |
$91.80 |
$67.20
|
|
Vaccine dtap < 7 years im
|
$146.48 |
$146.48 |
$146.48 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$512.92 |
$512.92 |
$512.92 |
$164.63
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$66.36 |
$66.36 |
$66.36 |
$43.12
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.01 |
$0.01 |
$0.01 |
$75.39
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$58.78 |
$58.78 |
$58.78 |
$76.50
|
|
Vaccine mmr live subcutaneous
|
$485.05 |
$485.05 |
$485.05 |
$211.68
|
|
Vaccine tdap >=7 years im
|
$241.30 |
$241.30 |
$241.30 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$209.12 |
$209.12 |
$209.12 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$950.97 |
$950.97 |
$950.97 |
$365.17
|
|
Vad univ batt charger hm 1440
|
$28,255.20 |
$28,255.20 |
$28,255.20 |
$14,827.28
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$48.04 |
$48.04 |
$48.04 |
$24.12
|
