|
Tonsillectomy (child under 12)
|
$2,979.01 |
$2,979.01 |
$2,979.01 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$325.00 |
$325.00 |
$325.00 |
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$22,204.24 |
$22,204.24 |
$22,204.24 |
|
|
Total hysterectomy
|
$8,783.60 |
$8,783.60 |
$8,783.60 |
|
|
Toxoplasma antibody igg
|
$34.45 |
$35.75 |
$73.45 |
|
|
Toxoplasma antibody igm
|
$72.80 |
$75.40 |
$75.40 |
|
|
Tpmt gene com vrnts
|
$381.55 |
$381.55 |
$393.90 |
|
|
Tprnl plmt biodegrdabl matrl
|
$9,652.16 |
$9,652.16 |
$9,652.16 |
|
|
Trabectedin 1 mg intravenous solution
|
$8,987.27 |
$8,987.27 |
$8,987.27 |
|
|
Trabeculoplasty laser surg
|
$828.75 |
$828.75 |
$828.75 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$76.70 |
$76.70 |
$119.60 |
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$64.84 |
$64.84 |
$64.84 |
|
|
Transcatheter bx s&i
|
$1,326.65 |
$1,326.65 |
$1,326.65 |
|
|
Transferrin
|
$28.60 |
$35.75 |
$114.40 |
|
|
Transfusion blood/blood component(s)
|
$283.40 |
$1,136.85 |
$1,874.60 |
|
|
Trastuzumab 150 mg intravenous solution
|
$3,401.26 |
$3,401.26 |
$3,551.91 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$8,300.12 |
$8,300.12 |
$8,670.11 |
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$2,644.97 |
$2,644.97 |
$7,721.21 |
|
|
Trauma partial team response w/critical care services level 4
|
$3,452.80 |
$3,452.80 |
$3,452.80 |
|
|
Treat ankle dislocation
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
|
|
Treat ectopic pregnancy
|
$7,020.05 |
$7,020.05 |
$7,020.05 |
|
|
Treat elbow dislocation
|
$1,180.40 |
$1,180.40 |
$1,180.40 |
|
|
Treat elbow fracture
|
$1,084.85 |
$1,084.85 |
$1,084.85 |
|
|
Treat finger fracture each
|
$666.90 |
$666.90 |
$666.90 |
|
|
Treat fracture of radius
|
$753.35 |
$753.35 |
$809.25 |
|
|
Treat fracture of ulna
|
$897.65 |
$897.65 |
$1,014.00 |
|
|
Treat humerus fracture
|
$1,063.40 |
$1,063.40 |
$1,063.40 |
|
|
Treat kneecap dislocation
|
$950.95 |
$950.95 |
$950.95 |
|
|
Treat knee fracture 27530
|
$847.60 |
$847.60 |
$847.60 |
|
|
Treatment incomplete abortion completed surgically any trimester
|
$4,089.57 |
$4,089.57 |
$4,089.57 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$80.60 |
$86.45 |
$107.25 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$80.60 |
$86.45 |
$107.25 |
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$75.40 |
$75.40 |
$107.25 |
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,975.19 |
$3,975.19 |
$3,975.19 |
|
|
Treatment of ankle fracture 27786
|
$560.95 |
$560.95 |
$625.95 |
|
|
Treatment of fibula fracture 27780
|
$515.45 |
$515.45 |
$757.90 |
|
|
Treatment of foot infection
|
$695.50 |
$695.50 |
$695.50 |
|
|
Treatment of heel fracture 28400
|
$468.65 |
$468.65 |
$468.65 |
|
|
Treatment of thigh fracture
|
$1,663.35 |
$1,663.35 |
$1,663.35 |
|
|
Treatment of toe fracture 28510
|
$226.20 |
$226.20 |
$287.95 |
|
|
Treatment of urethra lesion
|
$4,815.27 |
$4,815.27 |
$4,815.27 |
|
|
Treatment radiation delivery level 2
|
$29,071.90 |
$29,071.90 |
$29,071.90 |
|
|
Treat midfoot fracture each
|
$783.90 |
$783.90 |
$783.90 |
|
|
Treat sternum fracture
|
$263.25 |
$263.25 |
$263.25 |
|
|
Treat thigh fracture
|
$1,174.55 |
$1,174.55 |
$1,174.55 |
|
|
Treat toe fracture
|
$926.90 |
$926.90 |
$926.90 |
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$96,516.06 |
$96,516.06 |
$96,516.06 |
|
|
Treponema pallidum antibody
|
$81.90 |
$84.50 |
$84.50 |
|
|
Trg gene rearrangement anal
|
$111.80 |
$403.00 |
$422.50 |
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$24.98 |
$28.90 |
$28.90 |
|
|
Trichinella antibody
|
$50.70 |
$50.70 |
$59.15 |
|
|
Trichomonas assay w/optic
|
$42.25 |
$42.25 |
$42.25 |
|
|
#tricyclicantidprssnt
|
$96.85 |
$115.05 |
$130.65 |
|
|
Triglycerides
|
$48.75 |
$48.75 |
$64.35 |
|
|
Trilaciclib 300 mg intravenous solution
|
$4,043.12 |
$4,043.12 |
$4,043.12 |
|
|
Trimethobenzamide hcl inj
|
$204.03 |
$204.03 |
$204.03 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$30,686.66 |
$30,686.66 |
$30,686.66 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$19,390.58 |
$19,390.58 |
$19,390.58 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,455.75 |
$4,455.75 |
$4,455.75 |
|
|
Troponin quantitative
|
$117.00 |
$143.65 |
$170.30 |
|
|
Tte w or without contr, cont ecg
|
$1,669.20 |
$1,669.20 |
$1,669.20 |
|
|
Tx atrial fib pulm vein isol
|
$34,596.25 |
$34,596.25 |
$34,596.25 |
|
|
Tx closed hip disl traumatic without anes
|
$958.10 |
$958.10 |
$958.10 |
|
|
Tx closed tib shaft fx without manip
|
$799.50 |
$799.50 |
$799.50 |
|
|
Tx l/r atrial fib addl
|
$6,028.75 |
$6,028.75 |
$6,028.75 |
|
|
Tx tarsal bone fx without manip 28450
|
$471.90 |
$471.90 |
$471.90 |
|
|
Tympanic membrane repair
|
$2,303.49 |
$2,303.49 |
$2,303.49 |
|
|
Ua w/micro/comp poc
|
$53.95 |
$53.95 |
$55.25 |
|
|
Ugt1a1 gene analy common variants
|
$645.45 |
$740.35 |
$740.35 |
|
|
Ultrasound abdomen aorta screening study aaa
|
$286.65 |
$325.00 |
$330.20 |
|
|
Ultrasound bone density measure
|
$100.75 |
$100.75 |
$100.75 |
|
|
Ultrasound breast complete
|
$460.20 |
$460.20 |
$460.20 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$265.85 |
$265.85 |
$312.00 |
|
|
Ultrasound chest
|
$401.05 |
$401.05 |
$430.30 |
|
|
Ultrasound encephalogram
|
$440.05 |
$440.05 |
$440.05 |
|
|
Ultrasound exam k transpl w/doppler
|
$478.40 |
$478.40 |
$478.40 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$245.05 |
$245.05 |
$428.35 |
|
|
Ultrasound guidance for vascular access
|
$258.05 |
$258.05 |
$269.10 |
|
|
Ultrasound guided needle placement supervision & interpretation
|
$497.25 |
$533.65 |
$538.85 |
|
|
Ultrasound guide intraoperative
|
$514.15 |
$514.15 |
$606.45 |
|
|
Ultrasound guide tissue ablation
|
$377.00 |
$377.00 |
$377.00 |
|
|
Ultrasound hips infant dynamic
|
$247.65 |
$247.65 |
$247.65 |
|
|
Ultrasound infant hips ltd without stress
|
$161.20 |
$161.20 |
$161.20 |
|
|
Ultrasound joint complete left
|
$464.10 |
$557.05 |
$657.15 |
|
|
Ultrasound joint/nonvascular extremity limited left
|
$379.60 |
$596.05 |
$612.30 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$325.00 |
$325.00 |
$523.25 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$209.30 |
$263.90 |
$362.70 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$413.40 |
$413.40 |
$413.40 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$228.15 |
$228.15 |
$228.15 |
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$310.70 |
$332.80 |
$391.30 |
|
|
Ultrasound pregnant uterus transvaginal
|
$356.20 |
$449.15 |
$449.80 |
|
|
Ultrasound prostate/transrectal
|
$278.20 |
$351.00 |
$462.15 |
|
|
Ultrasound retroperitoneal limited
|
$193.70 |
$211.90 |
$447.85 |
|
|
Ultrasound scrotum and contents
|
$411.45 |
$508.30 |
$538.20 |
|
|
Ultrasound spinal canal and contents
|
$414.70 |
$414.70 |
$414.70 |
|
|
Ultrasound transabd ea addl gest
|
$340.60 |
$340.60 |
$340.60 |
|
|
Ultrasound transvaginal non obstetric
|
$312.65 |
$359.45 |
$494.00 |
|
|
Unlisted laparoscopic liver biopy 47379
|
$8,603.64 |
$8,603.64 |
$8,603.64 |
|
|
Unlisted laparoscopic reduction intestine 44238
|
$6,658.92 |
$6,658.92 |
$6,658.92 |
|
|
Unlisted laparoscopy procedure biliary tract 47579
|
$10,057.79 |
$10,057.79 |
$10,057.79 |
|
