|
Thrombectomy/inf pq dialysis circuit
|
$26,410.20 |
$26,410.20 |
$26,410.20 |
$7,826.12
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$38,373.60 |
$38,373.60 |
$38,373.60 |
$15,640.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$55,199.40 |
$55,199.40 |
$55,199.40 |
$25,206.69
|
|
Thrombin time
|
$134.40 |
$134.40 |
$134.40 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$189.00 |
$189.00 |
$189.00 |
$56.93
|
|
Thyroglobulin antibody
|
$177.00 |
$177.00 |
$177.00 |
$85.68
|
|
Thyroid imaging
|
$894.00 |
$894.00 |
$894.00 |
$577.80
|
|
Thyroid mets imag whole body
|
$2,743.80 |
$2,743.80 |
$2,743.80 |
$1,320.00
|
|
Thyroid met uptake
|
$709.20 |
$709.20 |
$709.20 |
$380.00
|
|
Thyroid (TSH) Test
|
$301.20 |
$301.20 |
$301.20 |
$101.40
|
|
Thyroid Ultrasound
|
$348.60 |
$348.60 |
$348.60 |
$553.80
|
|
Thyroid uptake measurement
|
$580.20 |
$580.20 |
$580.20 |
$580.20
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,167.70 |
$3,167.70 |
$3,167.70 |
$3,167.70
|
|
Thyrotropin releasing hormone
|
$454.20 |
$454.20 |
$454.20 |
$127.20
|
|
Thyroxine binding globulin (tbg)
|
$162.00 |
$162.00 |
$162.00 |
$75.00
|
|
Tib/per revasc stent & ather 37231
|
$38,692.80 |
$38,692.80 |
$38,692.80 |
$23,525.00
|
|
Tib/per revasc stnt & ather
|
$42,734.40 |
$42,734.40 |
$42,734.40 |
$13,321.00
|
|
Tib/per revasc w/ather add-on 37233
|
$22,282.20 |
$22,282.20 |
$22,282.20 |
$12,568.80
|
|
Tigecycline injection
|
$8.38 |
$8.38 |
$8.38 |
$7.44
|
|
Tilt table study
|
$1,207.20 |
$1,207.20 |
$1,207.20 |
$1,488.24
|
|
Tirofiban 12.5 mg/50 ml
|
$729.20 |
$729.20 |
$729.20 |
$696.08
|
|
Tis cgen car anomal 1st shnt
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
$7,684.33
|
|
Tis cgen car anomal ea addl
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
$5,818.02
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$264.18 |
$264.18 |
$264.18 |
$264.18
|
|
Tissue amnio epifix inj 100mg
|
$6,767.40 |
$6,767.40 |
$6,767.40 |
$42.40
|
|
Tissue culture placenta
|
$825.60 |
$825.60 |
$825.60 |
$470.00
|
|
Tissue culture skin/biopsy
|
$1,047.00 |
$1,047.00 |
$1,047.00 |
$626.77
|
|
Tissue culture tumor
|
$1,562.40 |
$1,562.40 |
$1,562.40 |
$605.52
|
|
Tissue exam koh skin/hair/nails
|
$142.20 |
$142.20 |
$142.20 |
$45.23
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$10,519.80 |
$10,519.80 |
$23,767.20 |
$6,727.80
|
|
Tissue transglutaminase iga
|
$25.20 |
$25.20 |
$25.20 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$24.60 |
$24.60 |
$26.40 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$39.35 |
$66.16 |
$66.16 |
$66.16
|
|
Tobramycin peak therapeutic drug level
|
$300.60 |
$300.60 |
$300.60 |
$118.30
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,669.70 |
$1,669.70 |
$1,669.70 |
$1,669.70
|
|
Tomosynthesis breast screen bilateral
|
$53.40 |
$53.40 |
$53.40 |
$77.46
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$200.93 |
$200.93 |
$200.93 |
$200.93
|
|
Toxoplasma antibody igg
|
$66.60 |
$211.80 |
$211.80 |
$83.20
|
|
Toxoplasma antibody igm
|
$49.20 |
$49.20 |
$49.20 |
$84.80
|
|
Trabectedin 1 mg intravenous solution
|
$6,133.80 |
$6,133.80 |
$6,133.80 |
$2,653.88
|
|
Transcath biopsy
|
$2,869.20 |
$2,869.20 |
$2,869.20 |
$4,285.93
|
|
Transcath closure of asd
|
$36,405.00 |
$36,405.00 |
$36,405.00 |
$19,715.47
|
|
Transcath closure of vsd
|
$36,405.00 |
$36,405.00 |
$36,405.00 |
$18,837.00
|
|
Transcatheter bx s&i
|
$2,151.00 |
$2,151.00 |
$2,151.00 |
$1,795.70
|
|
Transcath mv repair addl prosthesis
|
$20,032.80 |
$20,032.80 |
$20,032.80 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$18,819.00 |
$18,819.00 |
$20,032.80 |
$13,818.35
|
|
Transcath occlusion cns
|
$7,938.60 |
$7,938.60 |
$7,938.60 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$6,071.40 |
$6,071.40 |
$6,071.40 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$3,774.60 |
$3,774.60 |
$3,774.60 |
$4,775.16
|
|
Transferrin
|
$246.00 |
$246.00 |
$246.00 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$1,739.40 |
$5,218.20 |
$5,218.20 |
$988.24
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$15.70 |
$15.70 |
$15.70 |
$44.76
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$14.09 |
$14.09 |
$14.09 |
$108.27
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$219.00 |
$219.00 |
$219.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$48.60 |
$48.60 |
$48.60 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$112.80 |
$112.80 |
$112.80 |
$197.60
|
|
Treatment radiation delivery level 2
|
$984.00 |
$984.00 |
$984.00 |
$737.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$200.64 |
$200.64 |
$200.64 |
$200.64
|
|
Treponema pallidum antibody
|
$87.60 |
$87.60 |
$87.60 |
$74.40
|
|
Treprostinil injection
|
$153.47 |
$2,174.58 |
$2,174.58 |
$4,774.98
|
|
Trg gene rearrangement anal
|
$752.40 |
$752.40 |
$752.40 |
$474.50
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.00 |
$177.22 |
$177.22 |
$28.90
|
|
Triamcinolone a inj prs-free
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$696.00
|
|
Trichinella antibody
|
$165.60 |
$165.60 |
$165.60 |
$56.55
|
|
Trichomonas assay w/optic
|
$105.60 |
$105.60 |
$105.60 |
$68.90
|
|
Triglycerides
|
$114.60 |
$114.60 |
$114.60 |
$48.75
|
|
Trimethobenzamide hcl inj
|
$120.73 |
$120.73 |
$120.73 |
$105.89
|
|
Triptorelin pamoate
|
$4,619.39 |
$4,619.39 |
$4,619.39 |
$4,619.39
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,972.40 |
$11,972.40 |
$11,972.40 |
$9,699.95
|
|
Trnscath plc stnt ante carotid art
|
$11,623.20 |
$11,623.20 |
$11,623.20 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$27,933.60 |
$27,933.60 |
$27,933.60 |
$9,418.42
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$27,933.60 |
$27,933.60 |
$27,933.60 |
$9,597.84
|
|
Trnscath plc vas stent w/s&i ini vein
|
$28,789.20 |
$28,789.20 |
$28,789.20 |
$15,873.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$9,810.60 |
$9,810.60 |
$9,810.60 |
$5,555.55
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$23,944.80 |
$23,944.80 |
$23,944.80 |
$6,346.80
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,899.20 |
$5,899.20 |
$5,899.20 |
$4,770.98
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,990.00 |
$6,990.00 |
$6,990.00 |
$5,324.40
|
|
Trnscath tx thromblytc vein ini day
|
$11,972.40 |
$11,972.40 |
$11,972.40 |
$4,201.80
|
|
Troponin quantitative
|
$375.00 |
$375.00 |
$375.00 |
$112.80
|
|
Tube trach disp innr can 5 xlt
|
$29.40 |
$29.40 |
$52.20 |
$416.99
|
|
Tube trach disp innr can 6 xlt
|
$16.80 |
$16.80 |
$16.80 |
$12.89
|
|
Tube trach fen sz 6 uncuffed
|
$133.80 |
$133.80 |
$133.80 |
$132.40
|
|
Tx atrial fib pulm vein isol
|
$62,587.20 |
$62,587.20 |
$62,587.20 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$7,717.80 |
$7,717.80 |
$7,717.80 |
$6,986.85
|
|
Tympanometry & reflex thresh
|
$273.60 |
$273.60 |
$273.60 |
$170.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$331.20 |
$331.20 |
$331.20 |
$394.20
|
|
Ultrasound breast complete
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$513.65
|
|
Ultrasound breast unilateral limited (both sides)
|
$674.40 |
$674.40 |
$674.40 |
$427.00
|
|
Ultrasound chest
|
$235.20 |
$235.20 |
$235.20 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$245.40 |
$245.40 |
$245.40 |
$340.03
|
|
Ultrasound dx ophth b-scan
|
$324.60 |
$324.60 |
$324.60 |
$335.68
|
|
Ultrasound elastography parenchyma
|
$547.20 |
$547.20 |
$547.20 |
$275.98
|
|
Ultrasound encephalogram
|
$324.60 |
$324.60 |
$324.60 |
$463.50
|
|
Ultrasound exam k transpl w/doppler
|
$405.00 |
$405.00 |
$405.00 |
$494.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$306.00 |
$306.00 |
$306.00 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$333.60 |
$333.60 |
$333.60 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$324.60 |
$324.60 |
$324.60 |
$629.64
|
|
Ultrasound guide intraoperative
|
$568.20 |
$568.20 |
$568.20 |
$628.80
|
|
Ultrasound guide tissue ablation
|
$324.60 |
$324.60 |
$324.60 |
$463.50
|
|
Ultrasound hips infant dynamic
|
$143.40 |
$143.40 |
$143.40 |
$395.20
|
