|
Therapy activity per session >= 45 minutes
|
$650.00 |
$650.00 |
$650.00 |
$191.50
|
|
Therapy Activity Training (each 15 minutes)
|
$198.00 |
$198.00 |
$198.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$199.00 |
$199.00 |
$199.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$146.00 |
$146.00 |
$146.00 |
$57.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$7.40 |
$7.40 |
$7.40 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$621.00 |
$621.00 |
$621.00 |
$313.60
|
|
Thiotepa 15 mg solution for injection
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$1,090.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,690.00 |
$2,690.00 |
$2,690.00 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,233.00 |
$2,233.00 |
$2,233.00 |
$1,703.45
|
|
Thrombin time
|
$52.00 |
$52.00 |
$52.00 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$64.00 |
$64.00 |
$64.00 |
$62.01
|
|
Thyroglobulin antibody
|
$188.00 |
$188.00 |
$188.00 |
$82.50
|
|
Thyroid (TSH) Test
|
$898.00 |
$898.00 |
$898.00 |
$112.70
|
|
Thyroid Ultrasound
|
$852.00 |
$852.00 |
$852.00 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$10,828.50 |
$10,828.50 |
$10,828.50 |
$4,152.21
|
|
Tigecycline injection
|
$78.20 |
$78.20 |
$78.20 |
$235.29
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$22,202.40 |
$22,202.40 |
$22,202.40 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$3,932.14 |
$3,932.14 |
$3,932.14 |
$4,201.20
|
|
Tissue dermagraft 2x3in 37.5sqcm-cost per sq cm
|
$104.20 |
$104.20 |
$104.20 |
$67.73
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$417.99 |
$417.99 |
$417.99 |
$537.50
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$75.45 |
$75.45 |
$75.45 |
$830.41
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$59.82 |
$59.82 |
$59.82 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$272.00 |
$272.00 |
$272.00 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$80.10 |
$80.10 |
$80.10 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$3.65 |
$3.65 |
$3.65 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$187.00 |
$187.00 |
$187.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$12,214.20 |
$12,214.20 |
$12,214.20 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$416.00 |
$416.00 |
$416.00 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$341.00 |
$341.00 |
$341.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$120.00 |
$120.00 |
$120.00 |
$74.10
|
|
Tonsillectomy (age 12+)
|
$19,312.60 |
$19,312.60 |
$19,312.60 |
$4,558.89
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$188.75 |
$188.75 |
$188.75 |
$316.84
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$48,786.25 |
$48,786.25 |
$48,786.25 |
$15,383.12
|
|
Total Hip Replacement
|
$21,359.00 |
$21,359.00 |
$21,359.00 |
$9,161.60
|
|
Total Knee Replacement
|
$50,618.79 |
$50,618.79 |
$50,618.79 |
$14,241.77
|
|
Toxoplasma antibody igg
|
$122.00 |
$122.00 |
$122.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$96.00 |
$96.00 |
$96.00 |
$87.75
|
|
Trabectedin 1 mg intravenous solution
|
$11,842.80 |
$11,842.80 |
$11,842.80 |
$6,684.23
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$242.00 |
$242.00 |
$242.00 |
$102.27
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$9.15 |
$9.15 |
$9.15 |
$56.38
|
|
Transferrin
|
$169.00 |
$169.00 |
$169.00 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$859.00 |
$859.00 |
$859.00 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$907.00 |
$907.00 |
$907.00 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$4,708.00 |
$4,708.00 |
$4,708.00 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$10,508.35 |
$10,508.35 |
$10,508.35 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$9,357.40 |
$9,357.40 |
$9,357.40 |
$5,846.40
|
|
Trauma partial team response w/critical care services level 4
|
$4,305.00 |
$4,305.00 |
$4,305.00 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$1,076.23 |
$1,076.23 |
$1,076.23 |
$940.80
|
|
Tray trach basic clean/care ster
|
$0.87 |
$0.87 |
$0.87 |
$0.57
|
|
Treat hip dislocation
|
$2,886.00 |
$2,886.00 |
$2,886.00 |
$2,211.05
|
|
Treat kneecap fracture
|
$2,597.00 |
$2,597.00 |
$2,597.00 |
$7,635.41
|
|
Treat lower leg joint
|
$2,450.00 |
$2,450.00 |
$2,450.00 |
$6,905.00
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$4,718.00 |
$4,718.00 |
$4,718.00 |
$8,797.32
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$16,196.00 |
$16,196.00 |
$16,196.00 |
$8,370.75
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$371.00 |
$371.00 |
$371.00 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$244.00 |
$244.00 |
$244.00 |
$147.48
|
|
Treatment of ankle fracture
|
$36,757.66 |
$36,757.66 |
$36,757.66 |
$7,913.97
|
|
Treatment of ankle fracture
|
$2,595.00 |
$2,595.00 |
$2,595.00 |
$8,453.60
|
|
Treatment of ankle fracture
|
$5,096.00 |
$5,096.00 |
$5,096.00 |
$7,907.11
|
|
Treatment of ankle fracture 27786
|
$3,707.00 |
$3,707.00 |
$3,707.00 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$3,707.00 |
$3,707.00 |
$3,707.00 |
$501.20
|
|
Treatment of thigh fracture
|
$4,785.00 |
$4,785.00 |
$4,785.00 |
$5,109.00
|
|
Treatment of thigh fracture
|
$3,707.00 |
$3,707.00 |
$3,707.00 |
$549.00
|
|
Treatment of thigh fracture
|
$4,380.00 |
$4,380.00 |
$4,380.00 |
$5,505.50
|
|
Treat thigh fracture
|
$4,845.00 |
$4,845.00 |
$4,845.00 |
$4,083.00
|
|
Treat thigh fracture
|
$4,197.00 |
$4,197.00 |
$4,197.00 |
$4,726.80
|
|
Treat ulnar fracture
|
$1,818.00 |
$1,818.00 |
$1,818.00 |
$6,653.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$127,265.40 |
$127,265.40 |
$127,265.40 |
$73,346.25
|
|
Treponema pallidum antibody
|
$200.00 |
$200.00 |
$200.00 |
$72.05
|
|
Trg gene rearrangement anal
|
$605.00 |
$605.00 |
$605.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$39.90 |
$39.90 |
$39.90 |
$43.09
|
|
Triglycerides
|
$77.00 |
$77.00 |
$77.00 |
$58.50
|
|
Trilaciclib 300 mg intravenous solution
|
$8,065.15 |
$8,065.15 |
$8,065.15 |
$4,043.12
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$10,415.88 |
$10,415.88 |
$10,415.88 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$9,436.38 |
$9,436.38 |
$9,436.38 |
$2,551.20
|
|
Troponin quantitative
|
$192.00 |
$192.00 |
$192.00 |
$127.60
|
|
Tube drain vert dev st 5-40f
|
$27.20 |
$27.20 |
$27.20 |
$27.60
|
|
Tube trach disp innr can 5 xlt
|
$641.52 |
$641.52 |
$641.52 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$4.27 |
$4.27 |
$4.27 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$197.11 |
$197.11 |
$197.11 |
$160.88
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$35,496.45 |
$35,496.45 |
$35,496.45 |
$21,992.26
|
|
Ultrasound breast unilateral limited (both sides)
|
$2,149.00 |
$2,149.00 |
$2,149.00 |
$452.40
|
|
Unit mobile power mpu
|
$18,187.20 |
$18,187.20 |
$18,187.20 |
$14,359.52
|
|
Unlisted procedure microbiology
|
$3,675.00 |
$3,675.00 |
$3,675.00 |
$530.00
|
|
Unlisted px male genital sys
|
$730.00 |
$730.00 |
$730.00 |
$387.84
|
|
Upper Arm (Humerus) X-ray (left side)
|
$310.00 |
$310.00 |
$310.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,047.00 |
$2,047.00 |
$2,047.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$7,130.00 |
$7,130.00 |
$7,130.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,926.00 |
$3,926.00 |
$3,926.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$402.00 |
$402.00 |
$402.00 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$513.00 |
$513.00 |
$513.00 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$446.00 |
$446.00 |
$446.00 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$13,998.80 |
$13,998.80 |
$13,998.80 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$706.00 |
$706.00 |
$706.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$510.00 |
$510.00 |
$510.00 |
$607.20
|
|
Urea nitrogen
|
$65.00 |
$65.00 |
$65.00 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$84.00 |
$84.00 |
$84.00 |
$52.00
|
|
Uric acid blood
|
$89.00 |
$89.00 |
$89.00 |
$49.44
|
|
Uric acid urine
|
$102.00 |
$102.00 |
$102.00 |
$45.36
|
|
Urinalysis microscopic only
|
$49.00 |
$49.00 |
$49.00 |
$26.46
|
