|
Trastuzumab 150 mg intravenous solution
|
$257.78 |
$257.78 |
$257.78 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$217.99 |
$217.99 |
$217.99 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$197.59 |
$197.59 |
$197.59 |
$5,846.40
|
|
Tray bonemarrw oncontrol 102mm
|
$1,338.70 |
$1,338.70 |
$1,338.70 |
$940.80
|
|
Treat ankle fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$5,488.00
|
|
Treat big toe fracture
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$4,454.10
|
|
Treat clavicle dislocation 23545
|
$603.00 |
$603.00 |
$603.00 |
$692.80
|
|
Treat elbow dislocation
|
$4,226.00 |
$4,226.00 |
$4,226.00 |
$2,322.40
|
|
Treat elbow fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$9,791.00
|
|
Treat elbow fracture
|
$4,173.00 |
$4,173.00 |
$4,173.00 |
$2,055.00
|
|
Treat elbow fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$6,839.00
|
|
Treat eyelid lesion 67850
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$1,146.13
|
|
Treat finger fracture each
|
$12,994.00 |
$12,994.00 |
$12,994.00 |
$4,192.86
|
|
Treat finger fracture each
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$1,592.00
|
|
Treat foot bone lesion
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Treat foot dislocation
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$5,112.80
|
|
Treat foot dislocation
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$440.04
|
|
Treat foot dislocation
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,839.54
|
|
Treat fracture of radius
|
$4,617.00 |
$4,617.00 |
$4,617.00 |
$1,839.55
|
|
Treat fracture of radius
|
$4,417.00 |
$4,417.00 |
$4,417.00 |
$1,849.00
|
|
Treat hand bone lesion
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,073.20
|
|
Treat hand dislocation
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$1,772.97
|
|
Treat hand dislocation
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Treat hand dislocation
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,986.00
|
|
Treat heel fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$7,907.11
|
|
Treat hip dislocation
|
$5,753.00 |
$5,753.00 |
$5,753.00 |
$2,211.05
|
|
Treat humerus fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$9,803.49
|
|
Treat humerus fracture
|
$8,159.00 |
$8,159.00 |
$8,159.00 |
$12,299.10
|
|
Treat humerus fracture
|
$4,173.00 |
$4,173.00 |
$4,173.00 |
$1,808.80
|
|
Treat humerus fracture
|
$8,159.00 |
$8,159.00 |
$8,159.00 |
$10,902.51
|
|
Treat humerus fracture
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$10,742.40
|
|
Treat humerus fracture
|
$4,173.00 |
$4,173.00 |
$4,173.00 |
$1,790.00
|
|
Treat humerus fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$10,629.07
|
|
Treat humerus fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$7,906.00
|
|
Treat kneecap dislocation
|
$6,070.00 |
$6,070.00 |
$6,070.00 |
$6,070.00
|
|
Treat kneecap fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$6,839.00
|
|
Treat knee fracture
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$3,486.60
|
|
Treat knee fracture
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$3,460.60
|
|
Treat knee fracture(s)
|
$5,252.00 |
$5,252.00 |
$5,252.00 |
$643.26
|
|
Treat knuckle dislocation
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$1,726.01
|
|
Treat lower jaw fracture 21462
|
$9,290.00 |
$9,290.00 |
$9,290.00 |
$7,000.36
|
|
Treat lower leg bone lesion
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$4,092.85
|
|
Treat lower leg dislocation
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$532.60
|
|
Treat lower leg fracture
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$6,475.41
|
|
Treat lower leg fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$12,905.86
|
|
Treat lower leg fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$12,653.00
|
|
Treat lower leg joint
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$9,383.00 |
$9,383.00 |
$9,383.00 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$10,666.00 |
$10,666.00 |
$10,666.00 |
$3,996.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$317.00 |
$317.00 |
$317.00 |
$230.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$317.00 |
$317.00 |
$317.00 |
$148.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$9,383.00 |
$9,383.00 |
$9,383.00 |
$4,230.80
|
|
Treatment of anal fissure w/dilat 46940
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$3,640.00
|
|
Treatment of ankle fracture
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$7,913.97
|
|
Treatment of ankle fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$8,453.60
|
|
Treatment of ankle fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$7,906.00
|
|
Treatment of ankle fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$528.00
|
|
Treatment of fibula fracture
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$6,307.00
|
|
Treatment of fibula fracture 27780
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$528.00
|
|
Treatment of foot infection
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$2,928.60
|
|
Treatment of foot infection
|
$6,318.00 |
$6,318.00 |
$6,318.00 |
$3,839.54
|
|
Treatment of heel fracture 28400
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$478.40
|
|
Treatment of miscarriage
|
$10,666.00 |
$10,666.00 |
$10,666.00 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$8,466.00 |
$8,466.00 |
$8,466.00 |
$3,734.50
|
|
Treatment of penis lesion
|
$8,040.00 |
$8,040.00 |
$8,040.00 |
$3,515.40
|
|
Treatment of rectal prolapse
|
$2,516.00 |
$2,516.00 |
$2,516.00 |
$1,052.80
|
|
Treatment of retinal lesion
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$1,741.60
|
|
Treatment of retinal lesion
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$1,336.20
|
|
Treatment of retinal lesion
|
$7,564.00 |
$7,564.00 |
$7,564.00 |
$5,419.00
|
|
Treatment of thigh fracture
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$6,389.60
|
|
Treatment of tibia fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$6,336.00 |
$6,336.00 |
$6,336.00 |
$371.40
|
|
Treatment of urethra lesion
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$4,061.71
|
|
Treatment radiation delivery level 2
|
$971.00 |
$971.00 |
$971.00 |
$835.20
|
|
Treatment x10sv retinopathy
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$1,513.20
|
|
Treat metacarpal fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$4,289.60
|
|
Treat metacarpal fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$5,741.00
|
|
Treat metatarsal fracture
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$8,241.00
|
|
Treat midfoot fracture each
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$1,893.86
|
|
Treat midfoot fracture each
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$6,445.00
|
|
Treat penis lesion graft
|
$5,753.00 |
$5,753.00 |
$5,753.00 |
$5,986.78
|
|
Treat penis lesion graft
|
$5,753.00 |
$5,753.00 |
$5,753.00 |
$7,976.07
|
|
Treat radius fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$7,907.11
|
|
Treat radius fracture
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$9,791.00
|
|
Treat thumb fracture
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$2,508.80
|
|
Treat thumb fracture
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$3,839.54
|
|
Treat toe dislocation
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$3,839.54
|
|
Treat toe fracture
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Treat ulnar fracture
|
$4,226.00 |
$4,226.00 |
$4,226.00 |
$1,678.55
|
|
Treat ulnar fracture
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$6,653.00
|
|
Treat wrist bone fracture
|
$4,862.00 |
$4,862.00 |
$4,862.00 |
$1,749.06
|
|
Treat wrist dislocation
|
$4,815.00 |
$4,815.00 |
$4,815.00 |
$656.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$301.40 |
$301.40 |
$301.40 |
$73,346.25
|
|
Treponema pallidum antibody
|
$176.00 |
$176.00 |
$176.00 |
$72.05
|
|
Treprostinil injection
|
$245.34 |
$245.34 |
$245.34 |
$19,071.84
|
|
Treprostinil, non-comp unit
|
$20.37 |
$20.37 |
$20.37 |
$2,970.72
|
|
Trg gene rearrangement anal
|
$2,001.00 |
$2,001.00 |
$2,001.00 |
$465.30
|
