|
Treatment radiation delivery level 2
|
$377.00 |
$1,198.50 |
$2,694.00 |
|
|
Treatment x10sv retinopathy
|
$632.50 |
$632.50 |
$8,232.00 |
|
|
Treat metacarpal fracture
|
$511.50 |
$4,618.50 |
$12,528.00 |
|
|
Treat metacarpal fracture
|
$608.00 |
$3,799.50 |
$16,526.00 |
|
|
Treat metatarsal fracture
|
$400.50 |
$415.50 |
$10,645.00 |
|
|
Treat metatarsal fracture
|
$582.50 |
$6,995.00 |
$17,908.00 |
|
|
Treat midfoot fracture each
|
$1,848.50 |
$1,867.50 |
$2,117.00 |
|
|
Treat midfoot fracture each
|
$671.50 |
$688.50 |
$16,132.00 |
|
|
Treat pelvic ring fracture
|
$29,720.00 |
$29,720.00 |
$29,720.00 |
|
|
Treat penis lesion graft
|
$15,364.50 |
$15,364.50 |
$15,364.50 |
|
|
Treat penis lesion graft
|
$14,835.00 |
$14,835.00 |
$14,835.00 |
|
|
Treat radius fracture
|
$5,921.00 |
$5,921.00 |
$8,627.50 |
|
|
Treat radius fracture
|
$771.50 |
$1,234.40 |
$24,263.76 |
|
|
Treat slipped epiphysis
|
$9,951.50 |
$9,951.50 |
$9,951.50 |
|
|
Treat spinal cord lesion
|
$341.00 |
$341.00 |
$341.00 |
|
|
Treat thigh fracture
|
$185.50 |
$284.00 |
$284.00 |
|
|
Treat thigh fracture
|
$953.00 |
$959.00 |
$13,752.50 |
|
|
Treat thigh fracture
|
$1,248.00 |
$1,316.50 |
$10,264.67 |
|
|
Treat thigh fracture
|
$1,848.50 |
$1,867.50 |
$2,054.00 |
|
|
Treat thigh fracture
|
$1,281.50 |
$7,759.50 |
$25,665.00 |
|
|
Treat thigh fracture
|
$270.50 |
$412.00 |
$788.50 |
|
|
Treat thigh fracture
|
$782.50 |
$822.50 |
$10,744.00 |
|
|
Treat thigh fracture
|
$1,013.00 |
$1,024.50 |
$4,420.00 |
|
|
Treat thigh fracture
|
$1,285.00 |
$1,354.00 |
$14,024.00 |
|
|
Treat thumb fracture
|
$7,148.00 |
$7,148.00 |
$11,279.00 |
|
|
Treat thumb fracture
|
$642.00 |
$660.50 |
$9,114.13 |
|
|
Treat toe dislocation
|
$242.00 |
$242.00 |
$387.20 |
|
|
Treat toe dislocation
|
$130.50 |
$133.00 |
$357.50 |
|
|
Treat toe fracture
|
$418.00 |
$426.50 |
$8,049.00 |
|
|
Treat ulnar fracture
|
$444.00 |
$1,848.50 |
$2,763.00 |
|
|
Treat ulnar fracture
|
$696.00 |
$8,679.50 |
$47,271.50 |
|
|
Treat vaginal bleeding
|
$270.50 |
$270.50 |
$270.50 |
|
|
Treat wrist bone fracture
|
$464.00 |
$742.40 |
$2,509.50 |
|
|
Treat wrist dislocation
|
$284.00 |
$443.00 |
$856.00 |
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$20,693.58 |
$72,427.45 |
$95,472.00 |
|
|
Treponema pallidum antibody
|
$32.50 |
$73.50 |
$192.60 |
|
|
Trg gene rearrangement anal
|
$152.50 |
$608.00 |
$1,332.50 |
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$3.50 |
$31.80 |
$116.10 |
|
|
Triamcinolone a inj prs-free
|
$25.00 |
$40.00 |
$1,756.19 |
|
|
Trichinella antibody
|
$39.00 |
$39.00 |
$62.40 |
|
|
Trichomonas assay w/optic
|
$85.00 |
$85.00 |
$85.00 |
|
|
#tricyclicantidprssnt
|
$5.00 |
$5.00 |
$18.50 |
|
|
Triglycerides
|
$51.00 |
$51.00 |
$177.50 |
|
|
Trilaciclib 300 mg intravenous solution
|
$4,926.60 |
$4,926.60 |
$6,895.71 |
|
|
Trimethobenzamide hcl inj
|
$100.15 |
$100.15 |
$100.15 |
|
|
Trim nail(s)
|
$7.50 |
$68.00 |
$133.50 |
|
|
Trim nondyst nails
|
$7.50 |
$92.00 |
$139.00 |
|
|
Triptorelin pamoate
|
$1,158.00 |
$1,737.00 |
$44,595.34 |
|
|
Trluml dil aq o/f can without st
|
$1,799.83 |
$1,799.83 |
$3,843.50 |
|
|
Trluml dil aq o/f can w/st
|
$4,522.67 |
$4,522.67 |
$4,522.67 |
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$6,180.00 |
$7,347.50 |
$19,739.00 |
|
|
Trml dstrj ios bvn ea addl
|
$193.50 |
$217.00 |
$10,598.00 |
|
|
Trmt of fracture (femoral shaft) 27500
|
$284.00 |
$510.00 |
$835.20 |
|
|
Trnscath plc stent crv crtd without prtct
|
$6,208.50 |
$6,208.50 |
$11,958.50 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$4,564.50 |
$6,497.50 |
$15,945.00 |
|
|
Trnscath plc stnt ante carotid art
|
$880.00 |
$1,419.20 |
$19,677.00 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$915.00 |
$4,280.00 |
$17,764.20 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$652.00 |
$3,222.50 |
$11,544.00 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$7,254.00 |
$11,000.00 |
$39,818.00 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$315.00 |
$504.80 |
$6,261.50 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$407.00 |
$3,538.20 |
$11,016.50 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$243.00 |
$2,803.00 |
$7,513.50 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$129.00 |
$2,196.00 |
$7,654.50 |
|
|
Trnscath tx thromblytc vein ini day
|
$352.50 |
$1,884.60 |
$7,533.50 |
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$870.00 |
$4,073.50 |
$9,691.67 |
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$214.00 |
$1,740.50 |
$4,845.83 |
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$638.50 |
$1,976.50 |
$15,895.00 |
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$780.00 |
$2,161.00 |
$9,422.76 |
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$693.50 |
$2,265.50 |
$14,325.50 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$677.00 |
$1,137.92 |
$7,556.50 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$517.50 |
$1,557.33 |
$4,256.33 |
|
|
Troponin quantitative
|
$39.00 |
$109.50 |
$284.00 |
|
|
Tr retinal les preterm inf
|
$9,137.00 |
$9,137.00 |
$9,137.00 |
|
|
Trurl dstrj prst8 tiss rf wv
|
$2,092.67 |
$2,126.00 |
$3,492.00 |
|
|
Tte w or without contr, cont ecg
|
$1,004.50 |
$1,484.50 |
$1,903.00 |
|
|
Tte w or without fol w/con,stres
|
$1,391.00 |
$1,391.00 |
$1,538.50 |
|
|
Tte w or without fol w/cont, com
|
$956.00 |
$1,254.50 |
$1,266.50 |
|
|
Tte w or without fol w/cont, f/u
|
$556.00 |
$556.00 |
$956.00 |
|
|
Tubal Ligation (Laparoscopic)
|
$382.00 |
$390.50 |
$5,840.80 |
|
|
Tube trach disp innr can 5 xlt
|
$92.01 |
$130.50 |
$472.00 |
|
|
Tube trach fen sz 6 uncuffed
|
$396.91 |
$396.91 |
$396.91 |
|
|
Tubular dressing
|
$25.50 |
$25.50 |
$39.20 |
|
|
Tvh w/mmk 58267
|
$1,092.00 |
$1,092.00 |
$1,747.20 |
|
|
Tx atrial fib pulm vein isol
|
$13,551.00 |
$18,906.50 |
$19,113.00 |
|
|
Tx closed distal humerus fx
|
$496.00 |
$954.50 |
$10,752.00 |
|
|
Tx closed hip disl traumatic without anes
|
$189.00 |
$293.00 |
$1,384.00 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,643.00 |
$3,761.00 |
$4,725.00 |
|
|
Tx closed tib shaft fx without manip
|
$189.00 |
$363.00 |
$2,772.50 |
|
|
Tx contour defects >10.0 cc
|
$762.50 |
$849.50 |
$1,097.50 |
|
|
Tx contour defects 1.1-5.0cc 11951
|
$72.00 |
$708.00 |
$1,097.50 |
|
|
Tx ectopic pregnancy abdl pregnancy 59130
|
$4,382.50 |
$4,382.50 |
$4,382.50 |
|
|
Tx l/r atrial fib addl
|
$5,867.50 |
$5,867.50 |
$6,510.00 |
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$772.00 |
$812.50 |
$11,761.50 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$530.00 |
$859.20 |
$8,504.67 |
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$579.50 |
$3,799.50 |
$14,007.50 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$628.00 |
$4,372.00 |
$19,426.50 |
|
|
Tx tarsal bone fx without manip 28450
|
$204.50 |
$341.00 |
$4,332.50 |
|
|
Tympanic membrane repair
|
$1,320.00 |
$1,822.00 |
$4,666.50 |
|
|
Tympanolysis transcanal 69450
|
$13,209.50 |
$13,209.50 |
$13,209.50 |
|
|
Tympanometry & reflex thresh
|
$158.50 |
$205.00 |
$227.50 |
|
