|
Treatment of tibia fracture
|
$1,009.60 |
$1,009.60 |
$1,009.60 |
$6,183.84
|
|
Treatment of tibia fracture
|
$1,512.80 |
$1,512.80 |
$1,512.80 |
$8,665.60
|
|
Treatment of tibia fracture
|
$9,297.60 |
$9,297.60 |
$9,297.60 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$378.40 |
$378.40 |
$378.40 |
$369.70
|
|
Treatment of urethra lesion
|
$312.00 |
$312.00 |
$312.00 |
$2,874.36
|
|
Treat metacarpal fracture
|
$5,483.20 |
$5,483.20 |
$5,483.20 |
$3,977.49
|
|
Treat metacarpal fracture
|
$5,354.40 |
$5,354.40 |
$5,354.40 |
$5,464.97
|
|
Treat metatarsal fracture
|
$664.80 |
$664.80 |
$664.80 |
$3,839.54
|
|
Treat metatarsal fracture
|
$8,197.60 |
$8,197.60 |
$8,197.60 |
$8,453.60
|
|
Treat midfoot fracture each
|
$1,101.60 |
$1,101.60 |
$1,101.60 |
$6,192.78
|
|
Treat radius fracture
|
$1,234.40 |
$1,234.40 |
$1,234.40 |
$14,061.89
|
|
Treat thigh fracture
|
$1,524.80 |
$1,524.80 |
$1,524.80 |
$6,510.40
|
|
Treat thigh fracture
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$4,083.00
|
|
Treat thigh fracture
|
$8,582.40 |
$8,582.40 |
$8,582.40 |
$4,726.80
|
|
Treat thigh fracture
|
$673.60 |
$673.60 |
$673.60 |
$618.80
|
|
Treat thigh fracture
|
$1,252.00 |
$1,252.00 |
$1,252.00 |
$2,802.80
|
|
Treat thigh fracture
|
$1,639.20 |
$1,639.20 |
$1,639.20 |
$2,032.10
|
|
Treat thigh fracture
|
$2,056.00 |
$2,056.00 |
$2,056.00 |
$3,580.50
|
|
Treat thumb fracture
|
$4,291.20 |
$4,291.20 |
$4,291.20 |
$3,786.00
|
|
Treat toe dislocation
|
$387.20 |
$387.20 |
$387.20 |
$3,839.54
|
|
Treat toe dislocation
|
$212.80 |
$212.80 |
$212.80 |
$756.39
|
|
Treat toe fracture
|
$682.40 |
$682.40 |
$682.40 |
$3,839.54
|
|
Treat ulnar fracture
|
$748.00 |
$748.00 |
$748.00 |
$1,662.00
|
|
Treat ulnar fracture
|
$1,113.60 |
$1,113.60 |
$1,113.60 |
$5,926.25
|
|
Treat wrist bone fracture
|
$742.40 |
$742.40 |
$742.40 |
$1,548.40
|
|
Treat wrist dislocation
|
$856.00 |
$856.00 |
$856.00 |
$656.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$95,472.00 |
$95,472.00 |
$95,472.00 |
$73,346.25
|
|
Treponema pallidum antibody
|
$74.40 |
$74.40 |
$74.40 |
$70.40
|
|
Trg gene rearrangement anal
|
$432.00 |
$432.00 |
$432.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.80 |
$44.80 |
$44.80 |
$43.21
|
|
Triamcinolone a inj prs-free
|
$40.00 |
$40.00 |
$40.00 |
$223.56
|
|
Trichinella antibody
|
$62.40 |
$62.40 |
$62.40 |
$70.20
|
|
Triglycerides
|
$81.60 |
$81.60 |
$81.60 |
$58.05
|
|
Trim nail(s)
|
$92.00 |
$92.00 |
$92.00 |
$79.00
|
|
Trim nondyst nails
|
$91.20 |
$91.20 |
$91.20 |
$113.40
|
|
Triptorelin pamoate
|
$1,852.80 |
$1,852.80 |
$1,852.80 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$10,131.20 |
$10,131.20 |
$10,131.20 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$309.60 |
$309.60 |
$309.60 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$835.20 |
$835.20 |
$835.20 |
$754.80
|
|
Trnscath plc stnt ante carotid art
|
$1,419.20 |
$1,419.20 |
$1,419.20 |
$6,069.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$504.80 |
$504.80 |
$504.80 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$651.20 |
$651.20 |
$651.20 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$388.80 |
$388.80 |
$388.80 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$206.40 |
$206.40 |
$206.40 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$564.00 |
$564.00 |
$564.00 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$1,392.00 |
$1,392.00 |
$1,392.00 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$342.40 |
$342.40 |
$342.40 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,021.60 |
$1,021.60 |
$1,021.60 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$3,078.00
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$1,109.60 |
$1,109.60 |
$1,109.60 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$828.00 |
$828.00 |
$828.00 |
$2,406.77
|
|
Troponin quantitative
|
$43.20 |
$43.20 |
$43.20 |
$127.20
|
|
Tubal Ligation (Laparoscopic)
|
$5,840.80 |
$5,840.80 |
$5,840.80 |
$4,323.20
|
|
Tubular dressing
|
$39.20 |
$39.20 |
$39.20 |
$28.46
|
|
Tvh w/mmk 58267
|
$1,747.20 |
$1,747.20 |
$1,747.20 |
$2,058.60
|
|
Tx closed hip disl traumatic without anes
|
$339.20 |
$339.20 |
$339.20 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$580.80 |
$580.80 |
$580.80 |
$535.60
|
|
Tx contour defects 1.1-5.0cc 11951
|
$115.20 |
$115.20 |
$115.20 |
$804.23
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$6,079.20 |
$6,079.20 |
$6,079.20 |
$4,499.12
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$859.20 |
$859.20 |
$859.20 |
$4,468.55
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$929.60 |
$929.60 |
$929.60 |
$4,421.00
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$4,529.60 |
$4,529.60 |
$4,529.60 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$378.40 |
$378.40 |
$378.40 |
$416.16
|
|
Ua w/micro/comp poc
|
$8.80 |
$8.80 |
$8.80 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$366.40 |
$366.40 |
$366.40 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$260.00 |
$260.00 |
$260.00 |
$394.20
|
|
Ultrasound breast complete
|
$494.40 |
$494.40 |
$494.40 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$452.00 |
$452.00 |
$452.00 |
$449.35
|
|
Ultrasound chest
|
$247.20 |
$247.20 |
$247.20 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$43.20 |
$43.20 |
$43.20 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$324.80 |
$324.80 |
$324.80 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$257.60 |
$257.60 |
$257.60 |
$307.00
|
|
Ultrasound encephalogram
|
$52.80 |
$52.80 |
$52.80 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$260.00 |
$260.00 |
$260.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$65.60 |
$65.60 |
$65.60 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$43.20 |
$43.20 |
$43.20 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$120.00 |
$120.00 |
$120.00 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$176.00 |
$176.00 |
$176.00 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$184.80 |
$184.80 |
$184.80 |
$311.25
|
|
Ultrasound joint complete left
|
$76.80 |
$76.80 |
$76.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$260.00 |
$260.00 |
$260.00 |
$425.45
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$161.60 |
$161.60 |
$161.60 |
$707.20
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$448.00 |
$448.00 |
$448.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$63.20 |
$63.20 |
$63.20 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$247.20 |
$247.20 |
$247.20 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$260.00 |
$260.00 |
$260.00 |
$486.50
|
|
Ultrasound scrotum and contents
|
$260.00 |
$260.00 |
$260.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$260.00 |
$260.00 |
$260.00 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$260.00 |
$260.00 |
$260.00 |
$558.35
|
|
Unlisted hematology&coagj px
|
$12.00 |
$12.00 |
$12.00 |
$39.52
|
|
Unlisted hystsc px uterus
|
$1,913.60 |
$1,913.60 |
$1,913.60 |
$2,803.60
|
|
Unlisted laparoscopic liver biopy 47379
|
$8,344.00 |
$8,344.00 |
$8,344.00 |
$5,419.00
|
|
Unlisted maaa
|
$939.20 |
$939.20 |
$939.20 |
$235.20
|
|
Unlisted procedure colon
|
$1,425.60 |
$1,425.60 |
$1,425.60 |
$1,702.50
|
|
Unlisted procedure microbiology
|
$9.60 |
$9.60 |
$9.60 |
$523.50
|
|
Unlisted procedure rectum
|
$3,078.40 |
$3,078.40 |
$3,078.40 |
$1,220.35
|
|
Unlisted px arthroscopy
|
$2,582.66 |
$2,582.66 |
$2,582.66 |
$2,765.60
|
|
Unlisted px conjunctiva
|
$619.20 |
$619.20 |
$619.20 |
$479.62
|
|
Unlisted px hands/fingers
|
$2,246.40 |
$2,246.40 |
$2,246.40 |
$354.20
|
