|
Stent iliac/open or perc/uni/init 37221
|
$5,540.15 |
$5,540.15 |
$5,540.15 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$1,994.30 |
$1,994.30 |
$1,994.30 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$11,476.50 |
$11,476.50 |
$11,476.50 |
$19,765.20
|
|
St evaluate speech sound production
|
$162.75 |
$162.75 |
$162.75 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$245.00 |
$245.00 |
$245.00 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$285.60 |
$285.60 |
$285.60 |
$406.40
|
|
St evaluation swallow function
|
$254.80 |
$254.80 |
$254.80 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$156.80 |
$156.80 |
$156.80 |
$248.05
|
|
Strapping of chest
|
$140.00 |
$140.00 |
$140.00 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$109.55 |
$109.55 |
$109.55 |
$171.00
|
|
Strapping of hand or finger
|
$109.55 |
$109.55 |
$109.55 |
$194.40
|
|
Strapping of hip
|
$140.00 |
$140.00 |
$140.00 |
$170.08
|
|
Strapping of knee
|
$156.80 |
$156.80 |
$156.80 |
$224.80
|
|
Strapping of toes 29550
|
$156.80 |
$156.80 |
$156.80 |
$185.36
|
|
Streptomycin injection
|
$272.51 |
$272.51 |
$272.51 |
$138.30
|
|
Stress test pulmonary
|
$91.00 |
$91.00 |
$91.00 |
$327.20
|
|
St treatment speech individual
|
$130.20 |
$130.20 |
$130.20 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$130.20 |
$130.20 |
$130.20 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$33.19 |
$33.19 |
$33.19 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$34.62 |
$34.62 |
$34.62 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$34.57 |
$34.57 |
$34.57 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$23.75 |
$23.75 |
$23.75 |
$94.19
|
|
Susceptibility agar dilution per agent
|
$145.95 |
$145.95 |
$145.95 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$37.45 |
$37.45 |
$37.45 |
$34.48
|
|
Susceptibility mic per plate
|
$369.25 |
$369.25 |
$369.25 |
$94.38
|
|
Svc venogram s&i
|
$1,582.00 |
$1,582.00 |
$1,582.00 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$2,460.59 |
$2,460.59 |
$2,460.59 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$113.05 |
$113.05 |
$113.05 |
$44.85
|
|
System cardiomems hosp electronics
|
$33,334.88 |
$33,334.88 |
$33,334.88 |
$41,518.75
|
|
System pacing micra av
|
$20,408.85 |
$20,408.85 |
$20,408.85 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,908.00 |
$5,908.00 |
$5,908.00 |
$10,980.00
|
|
System sealant biosentry tract
|
$630.26 |
$630.26 |
$630.26 |
$900.00
|
|
T3 (triiodothyronine) free
|
$122.85 |
$122.85 |
$122.85 |
$89.82
|
|
T3 (triiodothyronine) total
|
$97.65 |
$97.65 |
$97.65 |
$94.90
|
|
T4 (thyroxine) free
|
$122.85 |
$122.85 |
$122.85 |
$81.60
|
|
T4 (thyroxine) total
|
$122.85 |
$122.85 |
$122.85 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.81 |
$4.81 |
$4.81 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$916.63 |
$916.63 |
$916.63 |
$612.11
|
|
Tc-99m diag per dose
|
$198.45 |
$198.45 |
$198.45 |
$279.95
|
|
T cells absolute cd4/cd8 including ratio
|
$38.52 |
$38.52 |
$38.52 |
$186.00
|
|
T cells total count
|
$30.99 |
$30.99 |
$30.99 |
$124.11
|
|
Telethx isodose plan cplx
|
$671.30 |
$671.30 |
$671.30 |
$1,617.00
|
|
Telethx isodose plan simple
|
$321.30 |
$321.30 |
$321.30 |
$848.72
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$6,647.82 |
$6,647.82 |
$6,647.82 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$29,822.42 |
$29,822.42 |
$29,822.42 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$3,839.54
|
|
Tension based scoliosis orth
|
$1,953.00 |
$1,953.00 |
$1,953.00 |
$2,851.20
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$33.14 |
$33.14 |
$33.14 |
$46.10
|
|
Testicular imaging w/vasc flow
|
$546.00 |
$546.00 |
$546.00 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$63.00 |
$63.00 |
$63.00 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$701.40 |
$701.40 |
$701.40 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$2,048.35 |
$2,048.35 |
$2,048.35 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$401.80 |
$401.80 |
$401.80 |
$108.00
|
|
Ther nma rdctj intus/obstrcj
|
$198.45 |
$198.45 |
$198.45 |
$534.32
|
|
Ther/proph/diag inj ia
|
$376.60 |
$376.60 |
$376.60 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$34.02 |
$34.02 |
$34.02 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$745.85 |
$745.85 |
$745.85 |
$1,804.00
|
|
Thoracotomy w/expl
|
$3,668.70 |
$3,668.70 |
$3,668.70 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$3,668.70 |
$3,668.70 |
$3,668.70 |
$2,926.56
|
|
Thrombectmy crnry perq mechanical
|
$799.75 |
$799.75 |
$799.75 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$4,144.70 |
$4,144.70 |
$4,144.70 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$8,399.65 |
$8,399.65 |
$8,399.65 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$7,463.40 |
$7,463.40 |
$7,463.40 |
$24,605.30
|
|
Thrombin time
|
$179.20 |
$179.20 |
$179.20 |
$48.75
|
|
Thyroid imaging
|
$344.75 |
$344.75 |
$344.75 |
$670.80
|
|
Thyroid mets imag whole body
|
$659.40 |
$659.40 |
$659.40 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$206.50 |
$206.50 |
$206.50 |
$120.00
|
|
Thyroid Ultrasound
|
$866.25 |
$866.25 |
$866.25 |
$589.96
|
|
Thyroid uptake measurement
|
$386.75 |
$386.75 |
$386.75 |
$653.60
|
|
Tib/per revasc stent & ather 37231
|
$11,476.50 |
$11,476.50 |
$11,476.50 |
$21,900.00
|
|
Tib/per revasc w/ather add-on 37233
|
$1,994.30 |
$1,994.30 |
$1,994.30 |
$10,406.14
|
|
Tigecycline injection
|
$283.14 |
$283.14 |
$283.14 |
$277.31
|
|
Tilt table study
|
$4,195.10 |
$4,195.10 |
$4,195.10 |
$1,495.00
|
|
Tissue culture tumor
|
$32.81 |
$32.81 |
$32.81 |
$529.23
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$3,655.64 |
$3,655.64 |
$3,655.64 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$913.66 |
$913.66 |
$913.66 |
$1,525.91
|
|
Tlso 3mod sacro-scap pre
|
$433.13 |
$433.13 |
$433.13 |
$975.00
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$44.33 |
$44.33 |
$44.33 |
$141.75
|
|
Tobramycin non-comp unit
|
$8.28 |
$8.28 |
$8.28 |
$143.38
|
|
Tobramycin peak therapeutic drug level
|
$393.75 |
$393.75 |
$393.75 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$9,542.53 |
$9,542.53 |
$9,542.53 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$18.90 |
$18.90 |
$18.90 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$18.90 |
$18.90 |
$18.90 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$241.05 |
$241.05 |
$241.05 |
$404.20
|
|
Trabeculoplasty laser surg
|
$500.85 |
$500.85 |
$500.85 |
$1,224.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$386.40 |
$386.40 |
$386.40 |
$1,459.48
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$91.00 |
$91.00 |
$91.00 |
$104.50
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$313.51 |
$313.51 |
$313.51 |
$77.65
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,364.15 |
$4,364.15 |
$4,364.15 |
$4,627.00
|
|
Transferrin
|
$33.50 |
$33.50 |
$33.50 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$453.95 |
$453.95 |
$453.95 |
$988.24
|
|
Tray bonemarrw oncontrol 102mm
|
$3,762.50 |
$3,762.50 |
$3,762.50 |
$977.62
|
|
Treat ankle dislocation
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$2,207.20
|
|
Treat ankle dislocation
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$7,807.24
|
|
Treat big toe fracture
|
$2,718.45 |
$2,718.45 |
$2,718.45 |
$3,981.06
|
|
Treat clavicle dislocation 23545
|
$156.80 |
$156.80 |
$156.80 |
$734.00
|
|
Treat elbow dislocation
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$2,326.40
|
|
Treat elbow fracture
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$2,125.60
|
|
Treat elbow fracture
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$8,453.60
|
|
Treat eyelid by injection
|
$211.40 |
$211.40 |
$211.40 |
$472.21
|
