|
Thromboendarterectomy including patch graft; iliac 35351
|
$1,751.04 |
$1,751.04 |
$1,751.04 |
$6,262.40
|
|
Thromboendarterectomy sfa
|
$12,401.28 |
$12,401.28 |
$12,401.28 |
$5,472.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$32.96 |
$32.96 |
$32.96 |
$56.93
|
|
Thyroglobulin antibody
|
$28.78 |
$28.78 |
$28.78 |
$84.00
|
|
Thyroid imaging
|
$630.24 |
$630.24 |
$630.24 |
$670.80
|
|
Thyroid mets imag whole body
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$135.36 |
$135.36 |
$135.36 |
$120.00
|
|
Thyroid Ultrasound
|
$1,044.48 |
$1,044.48 |
$1,044.48 |
$589.96
|
|
Thyroid uptake measurement
|
$266.88 |
$266.88 |
$266.88 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,260.07 |
$4,260.07 |
$4,260.07 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$59.98 |
$59.98 |
$59.98 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$9,089.28 |
$9,089.28 |
$9,089.28 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$7,812.48 |
$7,812.48 |
$7,812.48 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$4,720.80 |
$4,720.80 |
$4,720.80 |
$10,406.14
|
|
Tigecycline injection
|
$142.53 |
$142.53 |
$142.53 |
$277.31
|
|
Tilt table study
|
$2,099.04 |
$2,099.04 |
$2,099.04 |
$1,495.00
|
|
Tissue exam koh skin/hair/nails
|
$43.68 |
$43.68 |
$43.68 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$16,404.48 |
$16,404.48 |
$16,404.48 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$1,867.91 |
$1,867.91 |
$1,867.91 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$58.08 |
$58.08 |
$58.08 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$44.76 |
$44.76 |
$44.76 |
$141.75
|
|
Tobramycin non-comp unit
|
$34.13 |
$34.13 |
$34.13 |
$143.38
|
|
Tobramycin peak therapeutic drug level
|
$191.04 |
$191.04 |
$191.04 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,842.37 |
$5,842.37 |
$5,842.37 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$31.20 |
$31.20 |
$31.20 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$46.08 |
$46.08 |
$46.08 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$209.51 |
$209.51 |
$209.51 |
$404.20
|
|
Toxoplasma antibody igg
|
$42.41 |
$42.41 |
$42.41 |
$84.35
|
|
Toxoplasma antibody igm
|
$34.07 |
$34.07 |
$34.07 |
$83.20
|
|
Tpmt gene com vrnts
|
$151.68 |
$151.68 |
$151.68 |
$381.55
|
|
Tprnl plmt biodegrdabl matrl
|
$8,684.16 |
$8,684.16 |
$8,684.16 |
$6,105.61
|
|
Tracheobrnchsc thru est trachs incisn
|
$2,000.16 |
$2,000.16 |
$2,000.16 |
$1,459.48
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$144.48 |
$144.48 |
$144.48 |
$104.50
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$118.94 |
$118.94 |
$118.94 |
$77.65
|
|
Transcath biopsy
|
$3,422.88 |
$3,422.88 |
$3,422.88 |
$4,298.05
|
|
Transcath closure of asd
|
$9,089.28 |
$9,089.28 |
$9,089.28 |
$18,772.00
|
|
Transcath closure of vsd
|
$9,089.28 |
$9,089.28 |
$9,089.28 |
$18,837.00
|
|
Transcatheter bx s&i
|
$865.44 |
$865.44 |
$865.44 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$10,359.84 |
$10,359.84 |
$10,359.84 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$10,359.84 |
$10,359.84 |
$10,359.84 |
$17,106.18
|
|
Transcath occlusion cns
|
$7,216.32 |
$7,216.32 |
$7,216.32 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$7,216.32 |
$7,216.32 |
$7,216.32 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$19,989.60 |
$19,989.60 |
$19,989.60 |
$4,627.00
|
|
Transferrin
|
$61.44 |
$61.44 |
$61.44 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,628.16 |
$1,628.16 |
$1,628.16 |
$988.24
|
|
Tray bonemarrw oncontrol 102mm
|
$5,880.00 |
$5,880.00 |
$5,880.00 |
$1,013.83
|
|
Treat ankle dislocation
|
$4,501.92 |
$4,501.92 |
$4,501.92 |
$2,207.20
|
|
Treat ankle dislocation
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$7,807.24
|
|
Treat big toe fracture
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$3,981.06
|
|
Treat clavicle dislocation 23545
|
$425.76 |
$425.76 |
$425.76 |
$734.00
|
|
Treat elbow dislocation
|
$4,092.00 |
$4,092.00 |
$4,092.00 |
$2,326.40
|
|
Treat elbow fracture
|
$2,225.76 |
$2,225.76 |
$2,225.76 |
$2,125.60
|
|
Treat elbow fracture
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$8,453.60
|
|
Treat eyelid by injection
|
$411.84 |
$411.84 |
$411.84 |
$472.21
|
|
Treat finger fracture each
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$4,108.00
|
|
Treat finger fracture each
|
$1,073.76 |
$1,073.76 |
$1,073.76 |
$1,815.75
|
|
Treat foot dislocation
|
$574.56 |
$574.56 |
$574.56 |
$435.60
|
|
Treat foot dislocation
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$3,935.24
|
|
Treat foot dislocation
|
$462.24 |
$462.24 |
$462.24 |
$527.28
|
|
Treat foot dislocation
|
$489.60 |
$489.60 |
$489.60 |
$478.40
|
|
Treat foot dislocation
|
$425.76 |
$425.76 |
$425.76 |
$404.04
|
|
Treat fracture of radius
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$2,030.33
|
|
Treat fracture of radius
|
$2,669.28 |
$2,669.28 |
$2,669.28 |
$2,316.75
|
|
Treat fracture of ulna
|
$489.60 |
$489.60 |
$489.60 |
$766.72
|
|
Treat hand dislocation
|
$1,720.32 |
$1,720.32 |
$1,720.32 |
$1,893.86
|
|
Treat hip dislocation
|
$4,135.68 |
$4,135.68 |
$4,135.68 |
$2,561.90
|
|
Treat hip dislocation
|
$3,490.08 |
$3,490.08 |
$3,490.08 |
$3,152.05
|
|
Treat hip socket fracture
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$1,340.10
|
|
Treat humerus fracture
|
$8,457.12 |
$8,457.12 |
$8,457.12 |
$11,850.08
|
|
Treat humerus fracture
|
$1,073.76 |
$1,073.76 |
$1,073.76 |
$1,950.60
|
|
Treat humerus fracture
|
$8,457.12 |
$8,457.12 |
$8,457.12 |
$12,653.00
|
|
Treat humerus fracture
|
$1,720.32 |
$1,720.32 |
$1,720.32 |
$2,045.35
|
|
Treat kneecap dislocation
|
$4,501.92 |
$4,501.92 |
$4,501.92 |
$1,351.35
|
|
Treat knee dislocation
|
$2,669.28 |
$2,669.28 |
$2,669.28 |
$2,592.08
|
|
Treat knee fracture 27530
|
$465.60 |
$465.60 |
$465.60 |
$580.20
|
|
Treat knee fracture(s)
|
$489.60 |
$489.60 |
$489.60 |
$642.00
|
|
Treat knuckle dislocation
|
$3,490.56 |
$3,490.56 |
$3,490.56 |
$1,893.86
|
|
Treat lower leg dislocation
|
$425.76 |
$425.76 |
$425.76 |
$532.60
|
|
Treat lower leg dislocation
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$4,350.00
|
|
Treat lower leg fracture
|
$8,457.12 |
$8,457.12 |
$8,457.12 |
$12,905.86
|
|
Treat lower leg fracture
|
$8,457.12 |
$8,457.12 |
$8,457.12 |
$12,653.00
|
|
Treat lower leg joint
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,282.24 |
$3,282.24 |
$3,282.24 |
$3,806.40
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$277.44 |
$277.44 |
$277.44 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$3,902.88 |
$3,902.88 |
$3,902.88 |
$3,820.53
|
|
Treatment mouth roof lesion
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$4,350.00
|
|
Treatment of ankle fracture
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$7,907.11
|
|
Treatment of ankle fracture
|
$4,287.36 |
$4,287.36 |
$4,287.36 |
$7,348.32
|
|
Treatment of ankle fracture 27786
|
$425.76 |
$425.76 |
$425.76 |
$580.00
|
|
Treatment of fibula fracture
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$7,069.90
|
|
Treatment of fibula fracture 27780
|
$425.76 |
$425.76 |
$425.76 |
$558.75
|
|
Treatment of heel fracture 28400
|
$425.76 |
$425.76 |
$425.76 |
$494.00
|
|
Treatment of miscarriage
|
$3,902.88 |
$3,902.88 |
$3,902.88 |
$4,146.69
|
|
Treatment of thigh fracture
|
$456.00 |
$456.00 |
$456.00 |
$467.25
|
|
Treatment of thigh fracture
|
$1,841.28 |
$1,841.28 |
$1,841.28 |
$1,893.86
|
|
Treatment of thigh fracture
|
$425.76 |
$425.76 |
$425.76 |
$659.00
|
