|
Treatment of ankle fracture 27786
|
$487.74 |
$487.74 |
$487.74 |
$520.80
|
|
Treatment of penis lesion
|
$6,753.12 |
$6,753.12 |
$6,753.12 |
$3,515.40
|
|
Treatment of thigh fracture
|
$3,742.20 |
$3,742.20 |
$3,742.20 |
$1,748.40
|
|
Treatment of toe fracture 28510
|
$629.64 |
$629.64 |
$629.64 |
$369.70
|
|
Treatment radiation delivery level 2
|
$867.24 |
$867.24 |
$880.00 |
$767.65
|
|
Treat ulnar fracture
|
$3,999.60 |
$3,999.60 |
$3,999.60 |
$1,662.00
|
|
Treat vaginal bleeding
|
$1,052.04 |
$1,052.04 |
$1,052.04 |
$379.60
|
|
Treat wrist dislocation
|
$1,022.34 |
$1,022.34 |
$1,022.34 |
$656.25
|
|
Treponema pallidum antibody
|
$38.28 |
$38.28 |
$52.50 |
$70.40
|
|
Trg gene rearrangement anal
|
$465.30 |
$465.30 |
$610.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$9.16 |
$10.36 |
$11.58 |
$43.21
|
|
Triamcinolone a inj prs-free
|
$202.39 |
$202.39 |
$202.39 |
$223.56
|
|
Trichinella antibody
|
$96.36 |
$96.36 |
$96.36 |
$70.20
|
|
Trichomonas assay w/optic
|
$52.50 |
$52.50 |
$52.50 |
$55.50
|
|
#tricyclicantidprssnt
|
$91.08 |
$91.08 |
$91.08 |
$50.86
|
|
Triglycerides
|
$35.64 |
$35.64 |
$65.00 |
$58.05
|
|
Trim nail(s)
|
$50.00 |
$50.00 |
$108.90 |
$79.00
|
|
Trim nondyst nails
|
$50.00 |
$118.14 |
$118.14 |
$113.40
|
|
Triptorelin pamoate
|
$1,485.25 |
$1,485.25 |
$1,485.25 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$10,145.00 |
$10,145.00 |
$10,145.00 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$7,354.00
|
|
Trnscath plc stent crv crtd without prtct
|
$4,875.00 |
$5,088.60 |
$5,088.60 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$6,570.00 |
$7,128.66 |
$7,128.66 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$823.02 |
$823.02 |
$4,095.00 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,891.26 |
$4,891.26 |
$10,405.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,367.98 |
$3,367.98 |
$10,405.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$13,098.36 |
$13,098.36 |
$16,005.00 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,682.90 |
$2,682.90 |
$2,910.00 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,005.00 |
$6,243.60 |
$6,243.60 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$3,510.00 |
$3,635.28 |
$3,635.28 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$3,510.00 |
$3,635.28 |
$3,635.28 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,005.00 |
$3,635.28 |
$3,635.28 |
$3,866.70
|
|
Troponin quantitative
|
$84.48 |
$84.48 |
$87.50 |
$127.20
|
|
Tte w or without fol w/con,stres
|
$1,657.92 |
$1,657.92 |
$1,657.92 |
$1,632.80
|
|
Tube trach disp innr can 5 xlt
|
$150.00 |
$150.00 |
$150.00 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$10.00 |
$10.00 |
$10.00 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$125.00 |
$125.00 |
$125.00 |
$155.98
|
|
Tx atrial fib pulm vein isol
|
$17,666.22 |
$17,666.22 |
$17,666.22 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$662.64 |
$662.64 |
$662.64 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$6,407.94 |
$6,407.94 |
$6,407.94 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$277.20 |
$277.20 |
$277.20 |
$535.60
|
|
Tx l/r atrial fib addl
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$6,769.00
|
|
Tyms gene com variants
|
$140.00 |
$140.00 |
$140.00 |
$192.29
|
|
Ua w/micro/comp poc
|
$15.00 |
$15.00 |
$15.00 |
$23.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$143.72 |
$143.72 |
$250.83 |
$20,945.01
|
|
Ugt1a1 gene analy common variants
|
$235.00 |
$619.08 |
$619.08 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$380.00 |
$386.76 |
$386.76 |
$394.20
|
|
Ultrasound breast complete
|
$546.48 |
$546.48 |
$1,060.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$392.70 |
$392.70 |
$790.00 |
$449.35
|
|
Ultrasound chest
|
$352.50 |
$405.24 |
$405.24 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$285.00 |
$292.38 |
$292.38 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$222.42 |
$222.42 |
$222.42 |
$296.80
|
|
Ultrasound elastography ea l target les
|
$180.00 |
$180.00 |
$180.00 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$362.50 |
$362.50 |
$362.50 |
$307.00
|
|
Ultrasound encephalogram
|
$570.00 |
$629.64 |
$629.64 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$573.54 |
$573.54 |
$670.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$398.64 |
$398.64 |
$402.50 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$370.26 |
$370.26 |
$392.50 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$699.60 |
$699.60 |
$720.00 |
$720.15
|
|
Ultrasound guide intraoperative
|
$292.50 |
$839.52 |
$839.52 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$420.00 |
$420.00 |
$552.42 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$370.00 |
$377.52 |
$377.52 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$247.50 |
$247.50 |
$247.50 |
$311.25
|
|
Ultrasound joint complete left
|
$566.28 |
$566.28 |
$750.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$384.78 |
$384.78 |
$565.00 |
$425.45
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$355.00 |
$355.00 |
$355.00 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$307.56 |
$307.56 |
$330.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$251.46 |
$251.46 |
$267.50 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$535.00 |
$650.10 |
$650.10 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$321.42 |
$321.42 |
$387.50 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$335.28 |
$335.28 |
$387.50 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$440.22 |
$440.22 |
$452.50 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$228.36 |
$228.36 |
$790.00 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$347.50 |
$517.44 |
$517.44 |
$486.50
|
|
Ultrasound scrotum and contents
|
$578.16 |
$578.16 |
$595.00 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$349.80 |
$349.80 |
$405.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$267.50 |
$297.00 |
$297.00 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$397.50 |
$531.30 |
$531.30 |
$558.35
|
|
Ultrasound trgt dyn mbubb 1st les
|
$685.00 |
$685.00 |
$685.00 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$342.50 |
$342.50 |
$342.50 |
$348.00
|
|
Umbilical artery cath newborn 36660
|
$129.36 |
$129.36 |
$347.50 |
$206.64
|
|
Unlistd noninvas vasc dx std
|
$427.50 |
$427.50 |
$427.50 |
$528.80
|
|
Unlisted chemotherapy px
|
$127.50 |
$127.50 |
$127.50 |
$150.00
|
|
Unlisted CT procedure
|
$331.98 |
$331.98 |
$1,540.00 |
$732.70
|
|
Unlisted cytogenetic study
|
$372.90 |
$372.90 |
$372.90 |
$160.18
|
|
Unlisted dialysis procedure
|
$510.18 |
$510.18 |
$510.18 |
$1,144.00
|
|
Unlisted fluoroscopic px
|
$460.00 |
$460.00 |
$704.22 |
$305.76
|
|
Unlisted mr procedure
|
$1,385.00 |
$2,233.44 |
$2,233.44 |
$1,163.00
|
|
Unlisted procedure larynx
|
$570.90 |
$570.90 |
$570.90 |
$924.00
|
|
Unlisted procedure liver
|
$2,475.00 |
$2,475.00 |
$2,475.00 |
$2,287.20
|
|
Unlisted procedure microbiology
|
$530.00 |
$530.00 |
$530.00 |
$523.50
|
|
Unlisted procedure pancreas
|
$147.50 |
$147.50 |
$8,257.26 |
$3,986.00
|
|
Unlisted procedure spine
|
$3,010.00 |
$3,010.00 |
$3,010.00 |
$4,659.85
|
|
Unlisted px biliary tract
|
$2,246.64 |
$2,246.64 |
$3,055.00 |
$2,718.10
|
|
Unlisted px casting/strpg
|
$110.00 |
$285.78 |
$285.78 |
$219.70
|
|
Unlisted px foot/toes
|
$545.82 |
$545.82 |
$545.82 |
$1,225.50
|
|
Unlisted px med radj physics
|
$196.02 |
$196.02 |
$495.00 |
$462.35
|
|
Unlisted px neck/thorax
|
$429.66 |
$429.66 |
$429.66 |
$571.20
|
|
Unlisted px pelvis/hip joint
|
$5,088.60 |
$5,088.60 |
$5,088.60 |
$3,118.44
|
|
Unlisted px small intestine
|
$1,083.06 |
$1,083.06 |
$1,083.06 |
$2,102.10
|
