|
Thrombectomy/inf pq dialysis circuit
|
$12,315.60 |
$12,315.60 |
$12,315.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$24,495.84 |
$24,495.84 |
$24,495.84 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$38,786.40 |
$38,786.40 |
$38,786.40 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$7,192.80 |
$7,192.80 |
$7,192.80 |
$5,520.00
|
|
Thrombin time
|
$74.16 |
$74.16 |
$74.16 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$10,018.08 |
$10,018.08 |
$10,018.08 |
$3,980.60
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$4,824.00 |
$4,824.00 |
$4,824.00 |
$4,585.00
|
|
Thromboendarterectomy sfa
|
$470.88 |
$470.88 |
$470.88 |
$4,185.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$134.64 |
$134.64 |
$134.64 |
$61.52
|
|
Thyroglobulin antibody
|
$133.92 |
$133.92 |
$133.92 |
$82.00
|
|
Thyroid imaging
|
$867.60 |
$867.60 |
$867.60 |
$695.02
|
|
Thyroid (TSH) Test
|
$254.88 |
$254.88 |
$254.88 |
$111.00
|
|
Thyroid Ultrasound
|
$894.96 |
$894.96 |
$894.96 |
$588.50
|
|
Thyroid uptake measurement
|
$867.60 |
$867.60 |
$867.60 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$149.04 |
$149.04 |
$149.04 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$38,786.40 |
$38,786.40 |
$38,786.40 |
$21,249.26
|
|
Tib/per revasc w/ather add-on 37233
|
$7,431.12 |
$7,431.12 |
$7,431.12 |
$9,769.65
|
|
Tigecycline injection
|
$8.56 |
$8.56 |
$8.56 |
$234.00
|
|
Tilt table study
|
$3,406.32 |
$3,406.32 |
$3,406.32 |
$1,507.01
|
|
Tissue culture placenta
|
$1,059.12 |
$1,059.12 |
$1,059.12 |
$457.00
|
|
Tissue culture skin/biopsy
|
$673.20 |
$673.20 |
$673.20 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$77.76 |
$77.76 |
$77.76 |
$47.20
|
|
Tissue transglutaminase iga
|
$95.76 |
$95.76 |
$95.76 |
$44.16
|
|
Tixagev and cilgav inj
|
$325.44 |
$325.44 |
$325.44 |
$224.55
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$27.00 |
$27.00 |
$27.00 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$348.48 |
$348.48 |
$348.48 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$14.34 |
$14.34 |
$14.34 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$154.80 |
$154.80 |
$154.80 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$142.56 |
$142.56 |
$142.56 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$17.26 |
$17.26 |
$17.26 |
$325.00
|
|
Total tau
|
$511.20 |
$511.20 |
$511.20 |
$312.50
|
|
Toxoplasma antibody igg
|
$109.44 |
$109.44 |
$109.44 |
$89.40
|
|
Toxoplasma antibody igm
|
$152.64 |
$152.64 |
$152.64 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$1,349.28 |
$1,349.28 |
$1,349.28 |
$790.68
|
|
Tpmt gene com vrnts
|
$220.32 |
$220.32 |
$220.32 |
$371.80
|
|
Transferrin
|
$92.88 |
$92.88 |
$92.88 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,624.32 |
$1,624.32 |
$1,624.32 |
$983.00
|
|
Transparent film >16<=48 in
|
$7.92 |
$7.92 |
$7.92 |
$12.95
|
|
Transparent film <= 16 sq in
|
$7.92 |
$7.92 |
$7.92 |
$4.50
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$122.07 |
$122.07 |
$122.07 |
$5,835.15
|
|
Treat elbow dislocation
|
$3,237.12 |
$3,237.12 |
$3,237.12 |
$2,223.20
|
|
Treat elbow fracture
|
$4,273.92 |
$4,273.92 |
$4,273.92 |
$1,919.13
|
|
Treat fracture of radius
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,790.00
|
|
Treat fracture of radius
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,849.00
|
|
Treat fracture of ulna
|
$4,890.24 |
$4,890.24 |
$4,890.24 |
$726.05
|
|
Treat kneecap dislocation
|
$518.40 |
$518.40 |
$518.40 |
$1,068.90
|
|
Treat knee fracture 27530
|
$538.56 |
$538.56 |
$538.56 |
$550.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$330.48 |
$330.48 |
$330.48 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$261.36 |
$261.36 |
$261.36 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$469.44 |
$469.44 |
$469.44 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$518.40 |
$518.40 |
$518.40 |
$520.80
|
|
Treat wrist dislocation
|
$824.40 |
$824.40 |
$824.40 |
$656.25
|
|
Treponema pallidum antibody
|
$105.12 |
$105.12 |
$105.12 |
$70.40
|
|
Trg gene rearrangement anal
|
$1,074.24 |
$1,074.24 |
$1,074.24 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$21.85 |
$21.85 |
$21.85 |
$43.21
|
|
Trichinella antibody
|
$144.72 |
$144.72 |
$144.72 |
$70.20
|
|
#tricyclicantidprssnt
|
$94.32 |
$94.32 |
$94.32 |
$50.86
|
|
Triglycerides
|
$210.24 |
$210.24 |
$210.24 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$324.11 |
$324.11 |
$324.11 |
$117.49
|
|
Trim nail(s)
|
$246.96 |
$246.96 |
$246.96 |
$79.00
|
|
Trim nondyst nails
|
$160.56 |
$160.56 |
$160.56 |
$113.40
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,002.96 |
$1,002.96 |
$1,002.96 |
$754.80
|
|
Trnscath plc stent crv crtd without prtct
|
$7,924.32 |
$7,924.32 |
$7,924.32 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$10,895.04 |
$10,895.04 |
$10,895.04 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$7,793.28 |
$7,793.28 |
$7,793.28 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,289.36 |
$8,289.36 |
$8,289.36 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$22,908.24 |
$22,908.24 |
$22,908.24 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$11,676.24 |
$11,676.24 |
$11,676.24 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$8,334.00 |
$8,334.00 |
$8,334.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,280.64 |
$7,280.64 |
$7,280.64 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$6,798.24 |
$6,798.24 |
$6,798.24 |
$3,866.70
|
|
Troponin quantitative
|
$168.48 |
$168.48 |
$168.48 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,482.56 |
$2,482.56 |
$2,482.56 |
$2,012.40
|
|
Tte w or without fol w/con,stres
|
$2,291.04 |
$2,291.04 |
$2,291.04 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$1,864.08 |
$1,864.08 |
$1,864.08 |
$1,220.31
|
|
Tx closed hip disl traumatic without anes
|
$1,448.64 |
$1,448.64 |
$1,448.64 |
$581.07
|
|
Ultrasound abdomen aorta screening study aaa
|
$676.80 |
$676.80 |
$676.80 |
$394.20
|
|
Ultrasound breast complete
|
$897.84 |
$897.84 |
$897.84 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$660.24 |
$660.24 |
$660.24 |
$449.35
|
|
Ultrasound chest
|
$619.20 |
$619.20 |
$619.20 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$405.36 |
$405.36 |
$405.36 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$229.68 |
$229.68 |
$229.68 |
$307.00
|
|
Ultrasound encephalogram
|
$385.20 |
$385.20 |
$385.20 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$1,146.24 |
$1,146.24 |
$1,146.24 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$865.44 |
$865.44 |
$865.44 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$846.00 |
$846.00 |
$846.00 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,137.60 |
$1,137.60 |
$1,137.60 |
$720.15
|
|
Ultrasound guide intraoperative
|
$593.28 |
$593.28 |
$593.28 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$221.04 |
$221.04 |
$221.04 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$221.04 |
$221.04 |
$221.04 |
$311.25
|
|
Ultrasound joint complete left
|
$979.20 |
$979.20 |
$979.20 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$682.56 |
$682.56 |
$682.56 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$532.80 |
$532.80 |
$532.80 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$532.80 |
$532.80 |
$532.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,157.04 |
$1,157.04 |
$1,157.04 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,110.24 |
$1,110.24 |
$1,110.24 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$698.40 |
$698.40 |
$698.40 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$532.80 |
$532.80 |
$532.80 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$1,102.32 |
$1,102.32 |
$1,102.32 |
$486.50
|
