|
Tee w or without fol w/cont,cong
|
$1,886.08 |
$1,886.08 |
$1,886.08 |
|
|
Tee w or without fol w/cont, mon
|
$1,692.44 |
$1,692.44 |
$1,692.44 |
|
|
Telavancin injection
|
$22.07 |
$5,138.57 |
$5,138.57 |
|
|
Telehealth original site facility fee
|
$25.20 |
$52.80 |
$99.36 |
|
|
Telethx isodose plan cplx
|
$500.00 |
$1,760.40 |
$36,183.70 |
|
|
Telethx isodose plan simple
|
$228.36 |
$1,145.00 |
$18,704.00 |
|
|
Temozolomide
|
$95.55 |
$438.51 |
$4,671.14 |
|
|
Temozolomide 100 mg intravenous solution
|
$71.35 |
$1,818.11 |
$8,657.77 |
|
|
Temperature gradient studies
|
$19.20 |
$614.60 |
$614.60 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$77.60 |
$2,861.96 |
$16,710.92 |
|
|
Tendon lengthening
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
|
|
Tendon lngth upr a/e ea tdn
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
|
|
Tendon shortening
|
$1,460.80 |
$1,460.80 |
$1,460.80 |
|
|
Tendon transfer with graft
|
$2,200.80 |
$2,200.80 |
$2,200.80 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$268.32 |
$573.51 |
$48,155.10 |
|
|
Teniposide, 50 mg
|
$849.48 |
$849.48 |
$849.48 |
|
|
Tenodesis biceps tdn at elbw
|
$3,020.80 |
$3,020.80 |
$3,020.80 |
|
|
Tenolysis extensor tendon hand/finger each
|
$1,086.60 |
$1,086.60 |
$1,436.00 |
|
|
Tenolysis triceps
|
$3,012.80 |
$3,012.80 |
$3,012.80 |
|
|
Tenoplasty elbow to sho 1
|
$1,919.20 |
$1,919.20 |
$1,919.20 |
|
|
Tenosynovectomy radic 26145
|
$1,110.00 |
$1,110.00 |
$1,266.40 |
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$840.00 |
$840.00 |
$2,243.20 |
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$744.00 |
$3,664.50 |
$4,211.40 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$5.95 |
$44.39 |
$86.10 |
|
|
Teriparatide injection
|
$65.60 |
$306.41 |
$3,175.78 |
|
|
Tert gene targeted seq alys
|
$115.00 |
$428.40 |
$3,325.60 |
|
|
Test for chlorohydrocarbons
|
$8.91 |
$95.00 |
$244.30 |
|
|
Test for porphobilinogen
|
$33.57 |
$33.57 |
$82.08 |
|
|
Test for urine cystines
|
$23.20 |
$25.20 |
$25.20 |
|
|
Testicular imaging w/vasc flow
|
$459.20 |
$1,180.00 |
$1,711.44 |
|
|
Testosterone pellet 75 mg
|
$102.40 |
$102.40 |
$102.40 |
|
|
Testosterone response panel
|
$129.60 |
$129.60 |
$129.60 |
|
|
Testosterone undecanoate 1mg
|
$2.40 |
$216.33 |
$216.33 |
|
|
Test pathogen(s) for platelets reference
|
$60.00 |
$117.50 |
$1,036.70 |
|
|
Test stress cardiovascular tracing only
|
$385.00 |
$970.00 |
$2,060.40 |
|
|
Test urine for lactose
|
$23.20 |
$23.20 |
$23.20 |
|
|
Test urine for porphyrins
|
$27.20 |
$27.20 |
$27.20 |
|
|
Test urine urobilinogen
|
$9.60 |
$9.60 |
$27.36 |
|
|
Tetanus ig im
|
$624.00 |
$624.00 |
$624.00 |
|
|
Tetanus immune globulin inj
|
$410.17 |
$1,578.42 |
$4,977.17 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$32.37 |
$1,856.59 |
$27,353.37 |
|
|
Tgsap hl neo 5-50 rna alys
|
$729.16 |
$729.16 |
$729.16 |
|
|
Tgsap so/hl 51/< rna alys
|
$2,802.82 |
$6,744.50 |
$9,375.20 |
|
|
Tgsap so neo 5-50 rna alys
|
$792.10 |
$2,255.04 |
$2,255.04 |
|
|
Thaw cryoprsvrd reprod tiss
|
$419.20 |
$419.20 |
$419.20 |
|
|
Thawing cryopresrved embryo
|
$419.20 |
$419.20 |
$419.20 |
|
|
Thawing cryopresrved oocyte
|
$419.20 |
$419.20 |
$419.20 |
|
|
Thawing cryopresrved sperm
|
$419.20 |
$419.20 |
$419.20 |
|
|
Thaw preserved stem cells
|
$790.00 |
$790.00 |
$6,462.57 |
|
|
Theophylline therapeutic drug level
|
$25.60 |
$135.60 |
$727.20 |
|
|
Therapeutic procd strg endur
|
$30.10 |
$69.00 |
$142.40 |
|
|
Therapy activation ipnss
|
$195.00 |
$195.00 |
$228.80 |
|
|
Therapy activity per session >= 45 minutes
|
$77.50 |
$77.50 |
$192.50 |
|
|
Therapy Activity Training (each 15 minutes)
|
$32.50 |
$107.25 |
$258.48 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$32.50 |
$105.00 |
$225.36 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$18.75 |
$55.00 |
$106.56 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$16.25 |
$47.50 |
$100.80 |
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$283.20 |
$755.40 |
$755.40 |
|
|
Ther fx nasal inf turbinate
|
$240.00 |
$20,210.41 |
$59,328.04 |
|
|
Ther nma rdctj intus/obstrcj
|
$483.84 |
$519.40 |
$1,325.40 |
|
|
Ther/proph/diag inj ia
|
$110.60 |
$236.50 |
$455.04 |
|
|
Ther radiology tx plng cplx
|
$332.00 |
$1,108.80 |
$1,613.40 |
|
|
Ther radiology tx plng intrm
|
$220.80 |
$849.00 |
$1,249.80 |
|
|
Ther radiology tx plng smpl
|
$148.80 |
$431.40 |
$883.20 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$8.22 |
$30.03 |
$100.80 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$99.00 |
$400.40 |
$985.80 |
|
|
Thiotepa injection
|
$984.24 |
$2,306.89 |
$2,306.89 |
|
|
Thorabd diaphr hern repair
|
$3,542.40 |
$3,542.40 |
$3,542.40 |
|
|
Thorabd diaphr hern repair
|
$3,777.60 |
$3,777.60 |
$3,777.60 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$375.00 |
$1,588.32 |
$7,558.96 |
|
|
Thoracic aortic graft 33875
|
$3,898.20 |
$5,329.20 |
$6,691.20 |
|
|
Thoracic duct procedure
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
|
|
Thoracic duct procedure
|
$1,958.40 |
$1,958.40 |
$1,958.40 |
|
|
Thoracic duct procedure
|
$1,656.80 |
$1,656.80 |
$1,656.80 |
|
|
Thoracic lymphadenect/thoracotomy 38746
|
$441.00 |
$499.80 |
$126,843.69 |
|
|
Thoracoabdominal graft 33877
|
$5,187.60 |
$6,070.20 |
$8,824.00 |
|
|
Thoracoscop w/esoph musc exc
|
$2,999.20 |
$2,999.20 |
$2,999.20 |
|
|
Thoracoscopy bilobectomy 32670
|
$3,288.00 |
$3,288.00 |
$3,910.40 |
|
|
Thoracoscopy diagnostic 32601
|
$600.60 |
$11,188.10 |
$32,474.73 |
|
|
Thoracoscopy for lvrs
|
$3,711.20 |
$3,711.20 |
$3,711.20 |
|
|
Thoracoscopy lymph node exc
|
$414.00 |
$69,108.18 |
$116,166.62 |
|
|
Thoracoscopy pneumonectomy
|
$4,325.60 |
$4,325.60 |
$76,636.19 |
|
|
Thoracoscopy remove cortex
|
$1,672.80 |
$1,672.80 |
$5,332.80 |
|
|
Thoracoscopy remove segment
|
$2,670.00 |
$3,271.20 |
$115,000.28 |
|
|
Thoracoscopy remov fb/fibrin 32653
|
$2,034.00 |
$2,091.00 |
$137,966.95 |
|
|
Thoracoscopy resect bullae 32655
|
$1,843.20 |
$1,843.20 |
$74,416.43 |
|
|
Thoracoscopy surgical 32650
|
$1,291.80 |
$1,317.60 |
$62,870.64 |
|
|
Thoracoscopy surgical with control of traumatic hemorrhage
|
$2,301.60 |
$2,301.60 |
$5,707.20 |
|
|
Thoracoscopy/thoracic sympathectomy32664
|
$1,818.60 |
$1,818.60 |
$73,675.87 |
|
|
Thoracoscopy/tot pulm decortication32652
|
$3,192.00 |
$3,294.00 |
$137,966.95 |
|
|
Thoracoscopy w/bx med space
|
$895.80 |
$1,128.00 |
$99,100.69 |
|
|
Thoracoscopy wbx sac
|
$1,169.60 |
$1,169.60 |
$1,169.60 |
|
|
Thoracoscopy w/lobectomy
|
$2,710.80 |
$3,408.80 |
$152,066.12 |
|
|
Thoracoscopy w/mediast exc
|
$2,172.00 |
$2,291.40 |
$76,741.49 |
|
|
Thoracoscopy w/pericard exc
|
$1,942.40 |
$1,942.40 |
$63,120.25 |
|
|
Thoracoscopy w/pleurectomy 32656
|
$1,299.60 |
$1,299.60 |
$72,734.50 |
|
|
Thoracoscopy w/sac drng 32659
|
$1,044.60 |
$1,905.00 |
$84,555.77 |
|
|
Thoracoscopy w/sac fb remove
|
$1,024.20 |
$1,024.20 |
$1,736.80 |
|
|
Thoracoscopy w/thymus resect
|
$2,319.60 |
$2,319.60 |
$87,776.98 |
|
|
Thoracoscopy w/wedge resect
|
$1,675.80 |
$69,108.18 |
$116,166.62 |
|
