|
Trnscath plc vas stent w/s&i ea addl vein
|
$67.10 |
$6,624.75 |
$13,970.70 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$5,442.80 |
$16,005.00 |
$28,889.88 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,461.35 |
$3,625.05 |
$10,243.32 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,902.45 |
$2,889.15 |
$12,930.94 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,018.60 |
$3,510.00 |
$6,662.97 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$747.45 |
$3,510.00 |
$7,530.84 |
|
|
Trnscath tx thromblytc vein ini day
|
$1,725.35 |
$2,005.00 |
$12,999.84 |
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$1,028.28 |
$2,415.09 |
$2,850.40 |
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$510.72 |
$788.88 |
$1,906.40 |
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$3,688.00 |
$3,688.00 |
$3,688.00 |
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,551.20 |
$2,551.20 |
$2,551.20 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$2,202.48 |
$2,202.48 |
$2,461.60 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$1,706.58 |
$1,706.58 |
$2,270.40 |
|
|
Troponin quantitative
|
$59.28 |
$87.50 |
$417.87 |
|
|
Tr retinal les preterm inf
|
$958.17 |
$958.17 |
$958.17 |
|
|
Trurl dstrj prst8 tiss rf wv
|
$2,970.65 |
$2,970.65 |
$2,970.65 |
|
|
Tte w or without contr, cont ecg
|
$2,422.20 |
$2,422.20 |
$2,422.20 |
|
|
Tte w or without fol w/con,stres
|
$851.40 |
$884.40 |
$3,717.84 |
|
|
Tte w or without fol w/cont, com
|
$932.25 |
$1,199.00 |
$1,199.00 |
|
|
Tte w or without fol w/cont, f/u
|
$2,929.28 |
$2,929.28 |
$2,929.28 |
|
|
Tube trach disp innr can 5 xlt
|
$150.00 |
$150.00 |
$150.49 |
|
|
Tube trach disp innr can 6 xlt
|
$10.00 |
$10.00 |
$217.50 |
|
|
Tube trach fen sz 6 uncuffed
|
$87.42 |
$125.00 |
$169.85 |
|
|
Tubular dressing
|
$1.06 |
$1.06 |
$1.06 |
|
|
Twelve volt battery utah/equ
|
$948.59 |
$948.59 |
$948.59 |
|
|
Tx atrial fib pulm vein isol
|
$17,666.22 |
$25,527.15 |
$56,211.80 |
|
|
Tx closed distal humerus fx
|
$398.20 |
$398.20 |
$1,036.91 |
|
|
Tx closed hip disl traumatic without anes
|
$425.15 |
$662.64 |
$3,066.40 |
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$4,955.20 |
$6,407.94 |
$6,407.94 |
|
|
Tx closed tib shaft fx without manip
|
$277.20 |
$1,414.60 |
$2,983.20 |
|
|
Tx contour defects >10.0 cc
|
$200.87 |
$200.87 |
$1,317.60 |
|
|
Tx contour defects 1.1-5.0cc 11951
|
$103.88 |
$103.88 |
$1,144.00 |
|
|
Tx l/r atrial fib addl
|
$1,279.85 |
$8,279.15 |
$28,105.90 |
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$5,497.60 |
$5,497.60 |
$5,497.60 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$643.53 |
$2,857.25 |
$10,622.97 |
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,840.85 |
$6,797.45 |
$6,797.45 |
|
|
Tx open nsl fx uncomp
|
$1,079.08 |
$1,079.08 |
$2,301.60 |
|
|
Tx open nsl sptl fx
|
$2,614.40 |
$2,614.40 |
$2,614.40 |
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$830.49 |
$830.49 |
$9,498.36 |
|
|
Tx tarsal bone fx without manip 28450
|
$944.00 |
$944.00 |
$944.00 |
|
|
Tympanic membrane repair
|
$4,263.20 |
$4,263.20 |
$4,263.20 |
|
|
Tympanometry & reflex thresh
|
$88.00 |
$115.00 |
$116.00 |
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$157.94 |
$910.00 |
$2,177.57 |
|
|
Tympp antrt/mastoidotomy prosthesis torp 69637
|
$8,756.80 |
$8,756.80 |
$8,756.80 |
|
|
Tympp antrt/mastoid without ossic chain recnst 69635
|
$7,840.80 |
$7,840.80 |
$7,840.80 |
|
|
Tyms gene com variants
|
$140.00 |
$140.00 |
$140.00 |
|
|
Typhoid vaccine oral
|
$74.40 |
$74.40 |
$74.40 |
|
|
Ua w/micro/comp poc
|
$14.84 |
$15.00 |
$43.20 |
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$111.14 |
$143.72 |
$259.31 |
|
|
Ugt1a1 gene analy common variants
|
$235.00 |
$618.20 |
$911.90 |
|
|
Ultrasound bone density measure
|
$138.86 |
$138.86 |
$138.86 |
|
|
Ultrasound breast complete
|
$436.70 |
$639.10 |
$2,434.60 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$371.07 |
$660.00 |
$2,012.34 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$284.08 |
$292.38 |
$836.00 |
|
|
Ultrasound dx ophth b-scan
|
$222.42 |
$288.75 |
$870.69 |
|
|
Ultrasound elastography ea l target les
|
$52.25 |
$180.00 |
$180.00 |
|
|
Ultrasound elastography parenchyma
|
$207.35 |
$362.50 |
$362.50 |
|
|
Ultrasound encephalogram
|
$160.74 |
$570.00 |
$919.47 |
|
|
Ultrasound exam k transpl w/doppler
|
$205.20 |
$670.00 |
$1,045.55 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$98.61 |
$450.00 |
$1,415.87 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$374.18 |
$720.00 |
$2,735.15 |
|
|
Ultrasound guidance for vascular access
|
$134.52 |
$370.26 |
$1,091.16 |
|
|
Ultrasound guide intraoperative
|
$292.50 |
$385.84 |
$1,834.23 |
|
|
Ultrasound guide tissue ablation
|
$287.85 |
$420.00 |
$1,300.75 |
|
|
Ultrasound hips infant dynamic
|
$194.94 |
$370.00 |
$1,290.30 |
|
|
Ultrasound infant hips ltd without stress
|
$150.48 |
$247.50 |
$1,012.55 |
|
|
Ultrasound joint complete left
|
$156.18 |
$572.82 |
$1,415.87 |
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$38.69 |
$355.00 |
$355.00 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$90.63 |
$330.00 |
$1,415.87 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$73.53 |
$267.50 |
$579.15 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$400.95 |
$535.00 |
$2,205.77 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$135.66 |
$387.50 |
$919.47 |
|
|
Ultrasound prostate/transrectal
|
$228.36 |
$741.47 |
$794.75 |
|
|
Ultrasound spinal canal and contents
|
$141.93 |
$405.00 |
$1,415.87 |
|
|
Ultrasound transabd ea addl gest
|
$202.46 |
$297.00 |
$919.47 |
|
|
Ultrasound trgt dyn mbubb 1st les
|
$685.00 |
$685.00 |
$685.00 |
|
|
Ultrasound trgt dyn mbubb ea addl
|
$342.50 |
$342.50 |
$342.50 |
|
|
Ultraviolet therapy
|
$22.26 |
$52.44 |
$54.15 |
|
|
Umbilical artery cath newborn 36660
|
$53.35 |
$347.50 |
$575.20 |
|
|
Unit mobile power mpu
|
$21,229.60 |
$21,229.60 |
$21,229.60 |
|
|
Unlistd noninvas vasc dx std
|
$37.95 |
$427.50 |
$427.50 |
|
|
Unlisted chemotherapy px
|
$127.50 |
$127.50 |
$127.50 |
|
|
Unlisted CT procedure
|
$136.95 |
$747.40 |
$1,540.00 |
|
|
Unlisted cv px dx nuc med
|
$951.06 |
$951.06 |
$1,482.88 |
|
|
Unlisted cytogenetic study
|
$137.27 |
$372.90 |
$372.90 |
|
|
Unlisted dialysis procedure
|
$508.20 |
$729.30 |
$5,370.00 |
|
|
Unlisted dx gi procedure
|
$940.00 |
$940.00 |
$940.00 |
|
|
Unlisted endocrine px dx nuc
|
$1,226.96 |
$1,226.96 |
$1,226.96 |
|
|
Unlisted fluoroscopic px
|
$364.10 |
$460.00 |
$704.22 |
|
|
Unlisted gi px dx nuc med
|
$995.00 |
$1,482.88 |
$1,818.30 |
|
|
Unlisted gu px dx nuc med
|
$1,482.88 |
$1,482.88 |
$1,482.88 |
|
|
Unlisted hematology&coagj px
|
$83.55 |
$83.55 |
$83.55 |
|
|
Unlisted laparoscopic procedure 49659
|
$5,832.00 |
$5,832.00 |
$5,832.00 |
|
|
Unlisted laps px spleen
|
$2,667.20 |
$2,667.20 |
$2,667.20 |
|
|
Unlisted maaa
|
$109.60 |
$109.60 |
$109.60 |
|
|
Unlisted misc path test
|
$12.50 |
$12.50 |
$12.50 |
|
|
Unlisted mr procedure
|
$789.45 |
$1,385.00 |
$2,706.00 |
|
|
Unlisted neurological dx px
|
$242.50 |
$242.50 |
$394.02 |
|
|
Unlisted orl service/px
|
$52.80 |
$80.00 |
$80.00 |
|
