|
Trim nondyst nails
|
$81.50 |
$81.50 |
$81.50 |
$113.40
|
|
Triptorelin pamoate
|
$1,158.00 |
$1,158.00 |
$1,158.00 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$6,429.00 |
$6,429.00 |
$6,429.00 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$193.50 |
$193.50 |
$193.50 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$522.00 |
$522.00 |
$522.00 |
$754.80
|
|
Trnscath plc stnt ante carotid art
|
$887.00 |
$887.00 |
$887.00 |
$6,069.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$315.50 |
$315.50 |
$315.50 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$407.00 |
$407.00 |
$407.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$243.00 |
$243.00 |
$243.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$129.00 |
$129.00 |
$129.00 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$352.50 |
$352.50 |
$352.50 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$870.00 |
$870.00 |
$870.00 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$214.00 |
$214.00 |
$214.00 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$638.50 |
$638.50 |
$638.50 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$780.00 |
$780.00 |
$780.00 |
$3,078.00
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$761.00 |
$761.00 |
$761.00 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$677.00 |
$677.00 |
$677.00 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$517.50 |
$517.50 |
$517.50 |
$2,406.77
|
|
Troponin quantitative
|
$39.00 |
$39.00 |
$39.00 |
$127.20
|
|
Tubal Ligation (Laparoscopic)
|
$382.00 |
$382.00 |
$382.00 |
$4,323.20
|
|
Tvh w/mmk 58267
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$2,058.60
|
|
Tx closed distal humerus fx
|
$954.50 |
$954.50 |
$954.50 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$212.00 |
$212.00 |
$212.00 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$422.00 |
$422.00 |
$422.00 |
$535.60
|
|
Tx contour defects 1.1-5.0cc 11951
|
$440.00 |
$440.00 |
$440.00 |
$804.23
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$772.00 |
$772.00 |
$772.00 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$537.00 |
$537.00 |
$537.00 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$581.00 |
$581.00 |
$581.00 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$3,109.00 |
$3,109.00 |
$3,109.00 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$236.50 |
$236.50 |
$236.50 |
$416.16
|
|
Ultrasound abdomen aorta screening study aaa
|
$351.50 |
$351.50 |
$351.50 |
$394.20
|
|
Ultrasound breast complete
|
$38.00 |
$38.00 |
$38.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$461.00 |
$461.00 |
$461.00 |
$449.35
|
|
Ultrasound chest
|
$280.00 |
$280.00 |
$280.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$209.00 |
$209.00 |
$209.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$185.50 |
$185.50 |
$185.50 |
$296.80
|
|
Ultrasound encephalogram
|
$280.00 |
$280.00 |
$280.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$511.50 |
$511.50 |
$511.50 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$200.00 |
$200.00 |
$200.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$188.50 |
$188.50 |
$188.50 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$443.50 |
$443.50 |
$443.50 |
$720.15
|
|
Ultrasound guide intraoperative
|
$386.00 |
$386.00 |
$386.00 |
$632.85
|
|
Ultrasound joint complete left
|
$59.00 |
$59.00 |
$59.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$592.00 |
$592.00 |
$592.00 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$500.50 |
$500.50 |
$500.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$156.50 |
$156.50 |
$156.50 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$472.00 |
$472.00 |
$472.00 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$319.00 |
$319.00 |
$319.00 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$280.00 |
$280.00 |
$280.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$239.00 |
$239.00 |
$239.00 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$124.00 |
$124.00 |
$124.00 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$467.50 |
$467.50 |
$467.50 |
$486.50
|
|
Ultrasound scrotum and contents
|
$325.00 |
$325.00 |
$325.00 |
$608.90
|
|
Ultrasound transabd ea addl gest
|
$214.00 |
$214.00 |
$214.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$494.50 |
$494.50 |
$494.50 |
$558.35
|
|
Unlisted chemotherapy px
|
$60.00 |
$60.00 |
$60.00 |
$150.00
|
|
Unlisted hematology&coagj px
|
$52.00 |
$52.00 |
$52.00 |
$39.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$2,758.66 |
$2,758.66 |
$2,758.66 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$1,670.50 |
$1,670.50 |
$1,670.50 |
$5,419.00
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$1,228.00 |
$1,228.00 |
$1,228.00 |
$6,463.42
|
|
Unlisted laps px appendix
|
$825.00 |
$825.00 |
$825.00 |
$3,617.40
|
|
Unlisted laps px bladder
|
$19,383.00 |
$19,383.00 |
$19,383.00 |
$5,082.74
|
|
Unlisted laps px lymphtc sys
|
$21.50 |
$21.50 |
$21.50 |
$6,870.89
|
|
Unlisted laps px uterus
|
$1,081.00 |
$1,081.00 |
$1,081.00 |
$4,627.00
|
|
Unlisted maaa
|
$587.00 |
$587.00 |
$587.00 |
$235.20
|
|
Unlisted muscskel px head
|
$109.50 |
$109.50 |
$109.50 |
$478.46
|
|
Unlisted procedure colon
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$1,702.50
|
|
Unlisted procedure esophagus
|
$1,358.50 |
$1,358.50 |
$1,358.50 |
$1,998.88
|
|
Unlisted procedure larynx
|
$137.00 |
$137.00 |
$137.00 |
$924.00
|
|
Unlisted procedure microbiology
|
$6.00 |
$6.00 |
$6.00 |
$523.50
|
|
Unlisted procedure rectum
|
$348.50 |
$348.50 |
$348.50 |
$1,220.35
|
|
Unlisted procedure spine
|
$106.50 |
$106.50 |
$106.50 |
$4,659.85
|
|
Unlisted px abdomen muscskel
|
$133.50 |
$133.50 |
$133.50 |
$1,848.60
|
|
Unlisted px arthroscopy
|
$598.50 |
$598.50 |
$598.50 |
$2,765.60
|
|
Unlisted px biliary tract
|
$886.50 |
$886.50 |
$886.50 |
$2,718.10
|
|
Unlisted px conjunctiva
|
$387.00 |
$387.00 |
$387.00 |
$479.62
|
|
Unlisted px diaphragm
|
$118.50 |
$118.50 |
$118.50 |
$6,547.57
|
|
Unlisted px external ear
|
$20.50 |
$20.50 |
$20.50 |
$325.68
|
|
Unlisted px foot/toes
|
$792.00 |
$792.00 |
$792.00 |
$1,225.50
|
|
Unlisted px forearm/wrist
|
$876.50 |
$876.50 |
$876.50 |
$593.60
|
|
Unlisted px hands/fingers
|
$229.00 |
$229.00 |
$229.00 |
$354.20
|
|
Unlisted px lacrimal system
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$416.50
|
|
Unlisted px leg/ankle
|
$285.00 |
$285.00 |
$285.00 |
$811.00
|
|
Unlisted px male genital sys
|
$307.50 |
$307.50 |
$307.50 |
$343.55
|
|
Unlisted px mediastinum
|
$118.50 |
$118.50 |
$118.50 |
$397.60
|
|
Unlisted px neck/thorax
|
$453.50 |
$453.50 |
$453.50 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$584.50 |
$584.50 |
$584.50 |
$3,118.44
|
|
Unlisted px small intestine
|
$615.50 |
$615.50 |
$615.50 |
$2,102.10
|
|
Unlisted spec derm svc/px
|
$113.00 |
$113.00 |
$113.00 |
$223.08
|
|
Unlisted urinalysis px
|
$85.50 |
$85.50 |
$85.50 |
$25.72
|
|
Upgrade pm system
|
$4,469.00 |
$4,469.00 |
$4,469.00 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,415.50 |
$2,415.50 |
$2,415.50 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,544.50 |
$1,544.50 |
$1,544.50 |
$2,034.41
|
|
Upper Endoscopy (EGD, diagnostic)
|
$792.67 |
$792.67 |
$792.67 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,978.00 |
$1,978.00 |
$1,978.00 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$140.50 |
$140.50 |
$140.50 |
$1,872.00
|
|
Urachal cyst/sinus excision 51500
|
$660.50 |
$660.50 |
$660.50 |
$6,082.67
|
|
Urea nitrogen
|
$26.00 |
$26.00 |
$26.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$42.00 |
$42.00 |
$42.00 |
$51.75
|
