|
Transcath occlusion cns
|
$15,768.00 |
$15,768.00 |
$15,768.00 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$13,417.92 |
$13,417.92 |
$13,417.92 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$20,806.08 |
$20,806.08 |
$20,806.08 |
$4,627.00
|
|
Transferrin
|
$78.24 |
$78.24 |
$78.24 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,454.40 |
$1,454.40 |
$1,454.40 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$2,344.55 |
$2,344.55 |
$2,344.55 |
$3,900.04
|
|
Tray bonemarrw oncontrol 102mm
|
$6,828.00 |
$6,828.00 |
$6,828.00 |
$977.62
|
|
Treat ankle dislocation
|
$1,990.56 |
$1,990.56 |
$1,990.56 |
$2,207.20
|
|
Treat ankle dislocation
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$7,807.24
|
|
Treat big toe fracture
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$3,981.06
|
|
Treat clavicle dislocation 23545
|
$337.92 |
$337.92 |
$337.92 |
$734.00
|
|
Treat elbow dislocation
|
$2,953.92 |
$2,953.92 |
$2,953.92 |
$2,326.40
|
|
Treat elbow fracture
|
$1,496.64 |
$1,496.64 |
$1,496.64 |
$2,125.60
|
|
Treat elbow fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$8,453.60
|
|
Treat eyelid by injection
|
$411.84 |
$411.84 |
$411.84 |
$472.21
|
|
Treat finger fracture each
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$4,108.00
|
|
Treat finger fracture each
|
$1,496.64 |
$1,496.64 |
$1,496.64 |
$1,815.75
|
|
Treat foot dislocation
|
$325.44 |
$325.44 |
$325.44 |
$435.60
|
|
Treat foot dislocation
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$3,935.24
|
|
Treat foot dislocation
|
$273.60 |
$273.60 |
$273.60 |
$527.28
|
|
Treat foot dislocation
|
$390.72 |
$390.72 |
$390.72 |
$478.40
|
|
Treat foot dislocation
|
$337.92 |
$337.92 |
$337.92 |
$404.04
|
|
Treat fracture of radius
|
$2,271.84 |
$2,271.84 |
$2,271.84 |
$2,030.33
|
|
Treat fracture of radius
|
$3,944.16 |
$3,944.16 |
$3,944.16 |
$2,316.75
|
|
Treat fracture of ulna
|
$849.12 |
$849.12 |
$849.12 |
$766.72
|
|
Treat hand dislocation
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$1,893.86
|
|
Treat hip dislocation
|
$5,434.56 |
$5,434.56 |
$5,434.56 |
$2,561.90
|
|
Treat hip dislocation
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$3,152.05
|
|
Treat hip socket fracture
|
$1,285.44 |
$1,285.44 |
$1,285.44 |
$1,340.10
|
|
Treat humerus fracture
|
$9,659.04 |
$9,659.04 |
$9,659.04 |
$11,850.08
|
|
Treat humerus fracture
|
$1,496.64 |
$1,496.64 |
$1,496.64 |
$1,950.60
|
|
Treat humerus fracture
|
$9,659.04 |
$9,659.04 |
$9,659.04 |
$12,653.00
|
|
Treat humerus fracture
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$2,045.35
|
|
Treat kneecap dislocation
|
$2,663.04 |
$2,663.04 |
$2,663.04 |
$1,351.35
|
|
Treat knee dislocation
|
$3,329.28 |
$3,329.28 |
$3,329.28 |
$2,592.08
|
|
Treat knee fracture 27530
|
$373.92 |
$373.92 |
$373.92 |
$580.20
|
|
Treat knee fracture(s)
|
$390.72 |
$390.72 |
$390.72 |
$642.00
|
|
Treat knuckle dislocation
|
$2,453.28 |
$2,453.28 |
$2,453.28 |
$1,893.86
|
|
Treat lower leg dislocation
|
$337.92 |
$337.92 |
$337.92 |
$532.60
|
|
Treat lower leg dislocation
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$4,350.00
|
|
Treat lower leg fracture
|
$9,659.04 |
$9,659.04 |
$9,659.04 |
$12,905.86
|
|
Treat lower leg fracture
|
$9,659.04 |
$9,659.04 |
$9,659.04 |
$12,653.00
|
|
Treat lower leg joint
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$4,044.96 |
$4,044.96 |
$4,044.96 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,796.80 |
$3,796.80 |
$3,796.80 |
$3,806.40
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$154.08 |
$154.08 |
$154.08 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,930.24 |
$3,930.24 |
$3,930.24 |
$3,820.53
|
|
Treatment mouth roof lesion
|
$4,121.76 |
$4,121.76 |
$4,121.76 |
$4,350.00
|
|
Treatment of ankle fracture
|
$4,044.96 |
$4,044.96 |
$4,044.96 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$7,348.32
|
|
Treatment of ankle fracture 27786
|
$337.92 |
$337.92 |
$337.92 |
$580.00
|
|
Treatment of fibula fracture
|
$4,044.96 |
$4,044.96 |
$4,044.96 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$337.92 |
$337.92 |
$337.92 |
$558.75
|
|
Treatment of heel fracture 28400
|
$337.92 |
$337.92 |
$337.92 |
$494.00
|
|
Treatment of miscarriage
|
$3,930.24 |
$3,930.24 |
$3,930.24 |
$4,146.69
|
|
Treatment of thigh fracture
|
$408.96 |
$408.96 |
$408.96 |
$467.25
|
|
Treatment of thigh fracture
|
$2,103.36 |
$2,103.36 |
$2,103.36 |
$1,893.86
|
|
Treatment of thigh fracture
|
$337.92 |
$337.92 |
$337.92 |
$659.00
|
|
Treatment of thigh fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$6,651.45
|
|
Treatment of thigh fracture
|
$4,536.48 |
$4,536.48 |
$4,536.48 |
$2,055.00
|
|
Treatment of tibia fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$6,183.84
|
|
Treatment of toe fracture 28510
|
$337.92 |
$337.92 |
$337.92 |
$371.40
|
|
Treatment radiation delivery level 2
|
$588.00 |
$588.00 |
$588.00 |
$735.00
|
|
Treat metacarpal fracture
|
$5,214.24 |
$5,214.24 |
$5,214.24 |
$3,958.50
|
|
Treat metacarpal fracture
|
$5,214.24 |
$5,214.24 |
$5,214.24 |
$4,627.00
|
|
Treat metatarsal fracture
|
$4,044.96 |
$4,044.96 |
$4,044.96 |
$7,913.97
|
|
Treat midfoot fracture each
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$1,893.86
|
|
Treat sternum fracture
|
$408.96 |
$408.96 |
$408.96 |
$423.00
|
|
Treat thigh fracture
|
$337.92 |
$337.92 |
$337.92 |
$661.00
|
|
Treat thigh fracture
|
$4,896.96 |
$4,896.96 |
$4,896.96 |
$7,372.60
|
|
Treat thigh fracture
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$2,021.04
|
|
Treat thigh fracture
|
$337.92 |
$337.92 |
$337.92 |
$716.95
|
|
Treat thigh fx growth plate
|
$337.92 |
$337.92 |
$337.92 |
$421.50
|
|
Treat toe dislocation
|
$4,281.60 |
$4,281.60 |
$4,281.60 |
$855.66
|
|
Treat toe fracture
|
$4,307.52 |
$4,307.52 |
$4,307.52 |
$3,981.06
|
|
Treat ulnar fracture
|
$1,496.64 |
$1,496.64 |
$1,496.64 |
$1,861.60
|
|
Treat vaginal bleeding
|
$1,342.56 |
$1,342.56 |
$1,342.56 |
$400.86
|
|
Treat wrist bone fracture
|
$1,496.64 |
$1,496.64 |
$1,496.64 |
$1,907.64
|
|
Treat wrist dislocation
|
$757.44 |
$757.44 |
$757.44 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$49,416.21 |
$49,416.21 |
$49,416.21 |
$101,032.80
|
|
Treponema pallidum antibody
|
$41.28 |
$41.28 |
$41.28 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.76 |
$44.76 |
$44.76 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$67.71 |
$67.71 |
$67.71 |
$1,309.80
|
|
#tricyclicantidprssnt
|
$5.24 |
$5.24 |
$5.24 |
$57.08
|
|
Triglycerides
|
$85.44 |
$85.44 |
$85.44 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$154.09 |
$154.09 |
$154.09 |
$128.00
|
|
Trim nondyst nails
|
$170.88 |
$170.88 |
$170.88 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$337.92 |
$337.92 |
$337.92 |
$777.00
|
|
Trnscath plc stent crv crtd without prtct
|
$28,674.72 |
$28,674.72 |
$28,674.72 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$48,478.08 |
$48,478.08 |
$48,478.08 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$24,934.56 |
$24,934.56 |
$24,934.56 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,558.72 |
$3,558.72 |
$3,558.72 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,203.04 |
$3,203.04 |
$3,203.04 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$6,823.20 |
$6,823.20 |
$6,823.20 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,175.20 |
$6,175.20 |
$6,175.20 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$10,105.44 |
$10,105.44 |
$10,105.44 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$10,105.44 |
$10,105.44 |
$10,105.44 |
$4,505.25
|
