|
Thrombectomy/inf pq dialysis circuit
|
$9,465.93 |
$9,465.93 |
$9,465.93 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$10,412.37 |
$10,412.37 |
$10,412.37 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$9,655.37 |
$9,655.37 |
$9,655.37 |
$24,605.30
|
|
Thrombin time
|
$18.87 |
$18.87 |
$18.87 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$76.25 |
$76.25 |
$76.25 |
$56.93
|
|
Thyroglobulin antibody
|
$2.53 |
$2.53 |
$2.53 |
$84.00
|
|
Thyroid mets imag whole body
|
$2,158.95 |
$2,158.95 |
$2,158.95 |
$1,524.99
|
|
Thyroid met uptake
|
$366.83 |
$366.83 |
$366.83 |
$380.00
|
|
Thyroid (TSH) Test
|
$98.03 |
$98.03 |
$98.03 |
$120.00
|
|
Thyroid Ultrasound
|
$728.99 |
$728.99 |
$728.99 |
$589.96
|
|
Thyroid uptake measurement
|
$1,974.57 |
$1,974.57 |
$1,974.57 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$5.56 |
$5.56 |
$5.56 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$14,829.46 |
$14,829.46 |
$14,829.46 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$1,830.25 |
$1,830.25 |
$1,830.25 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$11,403.93 |
$11,403.93 |
$11,403.93 |
$10,406.14
|
|
Tigecycline injection
|
$291.37 |
$291.37 |
$291.37 |
$277.31
|
|
Tilt table study
|
$1,597.24 |
$1,597.24 |
$1,597.24 |
$1,495.00
|
|
Tissue amnio epifix inj 100mg
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$3,846.61
|
|
Tissue culture placenta
|
$36.96 |
$36.96 |
$36.96 |
$520.91
|
|
Tissue culture skin/biopsy
|
$77.03 |
$77.03 |
$77.03 |
$558.87
|
|
Tissue culture tumor
|
$36.96 |
$36.96 |
$36.96 |
$529.23
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$8,923.66 |
$8,923.66 |
$8,923.66 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$4.67 |
$4.67 |
$4.67 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$33.46 |
$33.46 |
$33.46 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$340.38 |
$340.38 |
$340.38 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$153.27 |
$153.27 |
$153.27 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,949.28 |
$1,949.28 |
$1,949.28 |
$4,711.84
|
|
Toxoplasma antibody igg
|
$3.89 |
$3.89 |
$3.89 |
$84.35
|
|
Toxoplasma antibody igm
|
$3.89 |
$3.89 |
$3.89 |
$83.20
|
|
Tp53 gene trgt sequence alys
|
$315.09 |
$315.09 |
$315.09 |
$919.10
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$63.41 |
$63.41 |
$63.41 |
$104.50
|
|
Transcath biopsy
|
$7,133.49 |
$7,133.49 |
$7,133.49 |
$4,298.05
|
|
Transcath closure of asd
|
$18,638.55 |
$18,638.55 |
$18,638.55 |
$18,772.00
|
|
Transcatheter bx s&i
|
$1,368.51 |
$1,368.51 |
$1,368.51 |
$1,875.96
|
|
Transcath occlusion cns
|
$5,099.41 |
$5,099.41 |
$5,099.41 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$1,988.57 |
$1,988.57 |
$1,988.57 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$3,291.33 |
$3,291.33 |
$3,291.33 |
$4,627.00
|
|
Transferrin
|
$134.21 |
$134.21 |
$134.21 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,205.90 |
$1,205.90 |
$1,205.90 |
$988.24
|
|
Trauma partial team response w/critical care services level 4
|
$8,793.35 |
$8,793.35 |
$8,793.35 |
$5,455.00
|
|
Tray bonemarrw oncontrol 102mm
|
$1,091.15 |
$1,091.15 |
$1,091.15 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$437.24 |
$437.24 |
$437.24 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$310.43 |
$310.43 |
$310.43 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$551.61 |
$551.61 |
$551.61 |
$210.00
|
|
Treponema pallidum antibody
|
$36.18 |
$36.18 |
$36.18 |
$72.80
|
|
Trg gene rearrangement anal
|
$101.14 |
$101.14 |
$101.14 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$84.81 |
$84.81 |
$84.81 |
$55.80
|
|
Triglycerides
|
$59.13 |
$59.13 |
$59.13 |
$54.60
|
|
Trnscath plc stent crv crtd without prtct
|
$1,876.93 |
$1,876.93 |
$1,876.93 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$17,063.10 |
$17,063.10 |
$17,063.10 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,525.78 |
$2,525.78 |
$2,525.78 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,310.01 |
$3,310.01 |
$3,310.01 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$13,334.92 |
$13,334.92 |
$13,334.92 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,825.40 |
$6,825.40 |
$6,825.40 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,316.50 |
$2,316.50 |
$2,316.50 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,402.35 |
$1,402.35 |
$1,402.35 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,321.05 |
$1,321.05 |
$1,321.05 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,032.14 |
$2,032.14 |
$2,032.14 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$2,787.97 |
$2,787.97 |
$2,787.97 |
$2,986.34
|
|
Troponin quantitative
|
$242.74 |
$242.74 |
$242.74 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$25,694.62 |
$25,694.62 |
$25,694.62 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$4,625.21 |
$4,625.21 |
$4,625.21 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$692.42 |
$692.42 |
$692.42 |
$403.26
|
|
Ultrasound chest
|
$728.99 |
$728.99 |
$728.99 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$765.56 |
$765.56 |
$765.56 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$239.63 |
$239.63 |
$239.63 |
$330.40
|
|
Ultrasound encephalogram
|
$838.30 |
$838.30 |
$838.30 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$748.44 |
$748.44 |
$748.44 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$838.30 |
$838.30 |
$838.30 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$542.66 |
$542.66 |
$542.66 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$727.05 |
$727.05 |
$727.05 |
$701.35
|
|
Ultrasound guide intraoperative
|
$411.57 |
$411.57 |
$411.57 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$576.11 |
$576.11 |
$576.11 |
$403.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$459.02 |
$459.02 |
$459.02 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$313.54 |
$313.54 |
$313.54 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,086.48 |
$1,086.48 |
$1,086.48 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$728.99 |
$728.99 |
$728.99 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$728.99 |
$728.99 |
$728.99 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$728.99 |
$728.99 |
$728.99 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$728.99 |
$728.99 |
$728.99 |
$498.00
|
|
Ultrasound scrotum and contents
|
$728.99 |
$728.99 |
$728.99 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$838.30 |
$838.30 |
$838.30 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$347.77 |
$347.77 |
$347.77 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$728.99 |
$728.99 |
$728.99 |
$567.44
|
|
Unit mobile power mpu
|
$19,609.49 |
$19,609.49 |
$19,609.49 |
$16,315.20
|
|
Unlisted CT procedure
|
$1,307.43 |
$1,307.43 |
$1,307.43 |
$1,043.00
|
|
Unlisted cytogenetic study
|
$178.94 |
$178.94 |
$178.94 |
$132.48
|
|
Unlisted procedure microbiology
|
$1,039.10 |
$1,039.10 |
$1,039.10 |
$487.50
|
|
Unlisted procedure spine
|
$10,937.91 |
$10,937.91 |
$10,937.91 |
$4,706.35
|
|
Unlisted psychiatric service/proc 90899
|
$130.32 |
$130.32 |
$130.32 |
$96.48
|
|
Unlisted transfusion med px
|
$126.43 |
$126.43 |
$126.43 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$1,099.71 |
$1,099.71 |
$1,099.71 |
$1,480.70
|
|
Upgrade pm system
|
$4,989.32 |
$4,989.32 |
$4,989.32 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,259.05 |
$3,259.05 |
$3,259.05 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,356.69 |
$3,356.69 |
$3,356.69 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,118.50 |
$2,118.50 |
$2,118.50 |
$2,013.08
|
|
Urea nitrogen
|
$38.90 |
$38.90 |
$38.90 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$82.86 |
$82.86 |
$82.86 |
$50.00
|
|
Ureteral embolization/occl
|
$848.41 |
$848.41 |
$848.41 |
$3,041.22
|
