|
Thiotepa injection
|
$1,562.08 |
$1,562.08 |
$1,562.08 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,131.00 |
$3,131.00 |
$3,131.00 |
$1,733.65
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,391.00 |
$2,391.00 |
$2,391.00 |
$1,684.80
|
|
Thrombectmy crnry perq mechanical
|
$6,236.00 |
$6,236.00 |
$6,236.00 |
$3,836.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$7,233.00 |
$7,233.00 |
$7,233.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$8,875.00 |
$8,875.00 |
$8,875.00 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$13,451.00 |
$13,451.00 |
$13,451.00 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$24,750.00 |
$24,750.00 |
$24,750.00 |
$6,422.91
|
|
Thrombin time
|
$112.00 |
$112.00 |
$112.00 |
$54.18
|
|
Thromboendarterectomy common femoral
|
$29,700.00 |
$29,700.00 |
$29,700.00 |
$3,987.20
|
|
Thromboendarterectomy sfa
|
$34,155.00 |
$34,155.00 |
$34,155.00 |
$5,472.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$104.00 |
$104.00 |
$104.00 |
$61.52
|
|
Thromboxane urine
|
$153.00 |
$153.00 |
$153.00 |
$119.40
|
|
Thumb tendon transfer
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Thyroglobulin antibody
|
$407.00 |
$407.00 |
$407.00 |
$82.73
|
|
Thyroid imaging
|
$1,109.00 |
$1,109.00 |
$1,109.00 |
$696.75
|
|
Thyroid mets imag whole body
|
$2,607.00 |
$2,607.00 |
$2,607.00 |
$1,524.99
|
|
Thyroid met uptake
|
$462.00 |
$462.00 |
$462.00 |
$407.40
|
|
Thyroid (TSH) Test
|
$218.00 |
$218.00 |
$218.00 |
$112.67
|
|
Thyroid Ultrasound
|
$1,679.00 |
$1,679.00 |
$1,679.00 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,887.35 |
$4,887.35 |
$4,887.35 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$285.00 |
$285.00 |
$285.00 |
$64.51
|
|
Tibial arthroscopy/surgery
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
$5,801.60
|
|
Tib/per revasc stent & ather 37231
|
$11,919.00 |
$11,919.00 |
$11,919.00 |
$21,249.26
|
|
Tib/per revasc w/ather add-on 37233
|
$14,797.00 |
$14,797.00 |
$14,797.00 |
$10,165.00
|
|
Tic-brn enceph vac 0.5ml im
|
$1,160.81 |
$1,160.81 |
$1,160.81 |
$560.33
|
|
Tigecycline injection
|
$11.28 |
$11.28 |
$11.28 |
$235.29
|
|
Tilt table study
|
$2,019.00 |
$2,019.00 |
$2,019.00 |
$1,561.82
|
|
Tirofiban 12.5 mg/50 ml
|
$31.67 |
$31.67 |
$31.67 |
$458.85
|
|
Tisagenlecleucel car-pos t
|
$2,240,569.30 |
$2,240,569.30 |
$2,240,569.30 |
$1,780,600.03
|
|
Tis cgen car anomal 1st shnt
|
$37,485.00 |
$37,485.00 |
$37,485.00 |
$8,068.54
|
|
Tis cgen car anomal ea addl
|
$9,371.00 |
$9,371.00 |
$9,371.00 |
$6,546.38
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$228.95 |
$228.95 |
$228.95 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$362.74 |
$362.74 |
$362.74 |
$4,201.20
|
|
Tissue culture skin/biopsy
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
$484.00
|
|
Tissue culture tumor
|
$4,143.00 |
$4,143.00 |
$4,143.00 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$71.00 |
$71.00 |
$71.00 |
$47.40
|
|
Tissue transglutaminase iga
|
$53.00 |
$53.00 |
$53.00 |
$44.80
|
|
Tixagev and cilgav inj
|
$398.00 |
$398.00 |
$398.00 |
$241.92
|
|
Tl-201 thallium diag per mci
|
$402.00 |
$402.00 |
$402.00 |
$80.10
|
|
Tlh uterus 250 g or less
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$12,320.22
|
|
Tlh uterus over 250 g
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$9,363.13
|
|
Tlh w/t/o 250 g or less
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$13,654.00 |
$13,654.00 |
$13,654.00 |
$12,320.22
|
|
Tmvr w/prosthetic ring 33426
|
$41,040.00 |
$41,040.00 |
$41,040.00 |
$5,816.80
|
|
Tnot opn elbw to sho ea tdn
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$2,564.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$22.55 |
$22.55 |
$22.55 |
$152.36
|
|
Tobramycin non-comp unit
|
$578.25 |
$578.25 |
$578.25 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$447.00 |
$447.00 |
$447.00 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$18.27 |
$18.27 |
$18.27 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$304.00 |
$304.00 |
$304.00 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$342.00 |
$342.00 |
$342.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$220.00 |
$220.00 |
$220.00 |
$74.10
|
|
Tongue biopsy; posterior one-third 41105
|
$9,715.00 |
$9,715.00 |
$9,715.00 |
$3,592.74
|
|
Tonsillectomy (age 12+)
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$4,558.89
|
|
Tonsillectomy (child under 12)
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$6,056.50
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$25.49 |
$25.49 |
$25.49 |
$316.84
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$93.88 |
$93.88 |
$93.88 |
$15,383.12
|
|
Total hip arthroplasty
|
$12,866.00 |
$12,866.00 |
$12,866.00 |
$7,347.60
|
|
Total Hip Replacement
|
$12,866.00 |
$12,866.00 |
$12,866.00 |
$9,161.60
|
|
Total Knee Replacement
|
$12,866.00 |
$12,866.00 |
$12,866.00 |
$14,061.89
|
|
Total lung lavage
|
$5,641.00 |
$5,641.00 |
$5,641.00 |
$1,758.40
|
|
Total ob care failed vbac 59618
|
$13,752.00 |
$13,752.00 |
$13,752.00 |
$4,792.80
|
|
Total tau
|
$458.00 |
$458.00 |
$458.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$304.00 |
$304.00 |
$304.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$374.00 |
$374.00 |
$374.00 |
$88.00
|
|
Tp53 gene trgt sequence alys
|
$989.00 |
$989.00 |
$989.00 |
$804.00
|
|
Tpmt gene com vrnts
|
$1,057.00 |
$1,057.00 |
$1,057.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$10,228.00 |
$10,228.00 |
$10,228.00 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$863.81 |
$863.81 |
$863.81 |
$6,684.23
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,999.00 |
$1,999.00 |
$1,999.00 |
$1,420.44
|
|
Tracheostoma revision; simple, without flap rotation
|
$9,715.00 |
$9,715.00 |
$9,715.00 |
$3,837.72
|
|
Tracheostoma stent/stud/bttn
|
$7,692.30 |
$7,692.30 |
$7,692.30 |
$333.29
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$225.00 |
$225.00 |
$225.00 |
$103.20
|
|
Transcath biopsy
|
$11,000.00 |
$11,000.00 |
$11,000.00 |
$4,285.93
|
|
Transcath closure of asd
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$17,088.00
|
|
Transcath closure of vsd
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$17,115.04
|
|
Transcatheter bx s&i
|
$7,810.00 |
$7,810.00 |
$7,810.00 |
$1,950.85
|
|
Transcath mv repair addl prosthesis
|
$9,132.00 |
$9,132.00 |
$9,132.00 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$36,525.00 |
$36,525.00 |
$36,525.00 |
$13,093.20
|
|
Transcath occlusion cns
|
$12,165.00 |
$12,165.00 |
$12,165.00 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$11,753.00 |
$11,753.00 |
$11,753.00 |
$10,270.00
|
|
Trans cath replace aortic valve 33366
|
$31,476.00 |
$31,476.00 |
$31,476.00 |
$14,593.50
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,822.00 |
$4,822.00 |
$4,822.00 |
$4,822.00
|
|
Transcrv abltj utrn fibrd rf
|
$20,968.00 |
$20,968.00 |
$20,968.00 |
$8,750.72
|
|
Transferrin
|
$294.00 |
$294.00 |
$294.00 |
$82.00
|
|
Transorl lwr esophgl myotomy
|
$9,131.00 |
$9,131.00 |
$9,131.00 |
$6,594.64
|
|
Transperi needle place pros
|
$16,385.00 |
$16,385.00 |
$16,385.00 |
$6,015.75
|
|
Transplant forearm tendon
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,624.06
|
|
Transplant forearm tendon
|
$9,791.00 |
$9,791.00 |
$9,791.00 |
$3,839.54
|
|
Transplant/graft hand tendon
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$3,594.44
|
|
Transplant/graft palm tendon
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,839.54
|
|
Transplant hand tendon
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Transplant palm tendon
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,839.54
|
|
Transplj hematopoietic boost
|
$4,832.00 |
$4,832.00 |
$4,832.00 |
$2,667.20
|
|
Transplt allo hct/donor
|
$8,738.00 |
$8,738.00 |
$8,738.00 |
$29,206.10
|
|
Transplt allo lymphocytes
|
$6,110.00 |
$6,110.00 |
$6,110.00 |
$2,751.65
|
|
Transplt autol hct/donor
|
$8,738.00 |
$8,738.00 |
$8,738.00 |
$3,986.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$947.00 |
$947.00 |
$947.00 |
$501.60
|
