|
Thoracoscopy w w resect addl 32667
|
$303.00 |
$303.00 |
$303.00 |
$477.00
|
|
Thoracoscopy w w resect diag 32668
|
$304.20 |
$304.20 |
$304.20 |
$304.20
|
|
Thoracostomy w/flap drng 32036
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$3,198.00
|
|
Thoracostomy w/rib resection 32035
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$2,935.40
|
|
Thoracotomy opn free adhesions 32124
|
$1,942.80 |
$1,942.80 |
$1,942.80 |
$2,256.80
|
|
Thoracotomy w/expl
|
$1,591.80 |
$1,591.80 |
$1,591.80 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$1,506.60 |
$1,506.60 |
$1,506.60 |
$2,138.76
|
|
Thorcscpy w/biop pleura
|
$231.00 |
$231.00 |
$231.00 |
$6,904.15
|
|
Thor rib belt custom fabrica
|
$53.40 |
$53.40 |
$53.40 |
$225.50
|
|
Thrcspy w/diag bp lng inf uni
|
$379.20 |
$379.20 |
$379.20 |
$6,792.80
|
|
Thrcspy w/diag bp lng nod uni
|
$361.80 |
$361.80 |
$361.80 |
$6,120.30
|
|
Thrombectomy/inf pq dialysis circuit
|
$633.60 |
$633.60 |
$633.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$796.20 |
$796.20 |
$796.20 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$928.80 |
$928.80 |
$928.80 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$2,095.80 |
$2,095.80 |
$2,095.80 |
$6,422.91
|
|
Thrombin time
|
$82.20 |
$82.20 |
$82.20 |
$54.18
|
|
Thromboendarterectomy common femoral
|
$1,643.40 |
$1,643.40 |
$1,643.40 |
$3,987.20
|
|
Thromboendarterectomy including patch graft if preformed;
|
$1,786.20 |
$1,786.20 |
$1,786.20 |
$5,994.11
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$1,835.40 |
$1,835.40 |
$1,835.40 |
$4,585.00
|
|
Thromboendarterectomy sfa
|
$2,248.20 |
$2,248.20 |
$2,248.20 |
$5,472.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$78.00 |
$78.00 |
$78.00 |
$61.52
|
|
Thymectomy prtl/tot rad medstnl dsj 60522
|
$2,643.00 |
$2,643.00 |
$2,643.00 |
$3,328.80
|
|
Thymectomy prtl/tot transcervical appr 60520
|
$2,205.60 |
$2,205.60 |
$2,205.60 |
$6,465.11
|
|
Thymectomy prtl/tot without rad medstnl dsj 60521
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$2,736.00
|
|
Thyroglobulin antibody
|
$87.00 |
$87.00 |
$87.00 |
$82.73
|
|
Thyroidectomy inc substrnl split/trans approch 60270
|
$2,616.00 |
$2,616.00 |
$2,616.00 |
$2,616.00
|
|
Thyroid (TSH) Test
|
$82.20 |
$82.20 |
$82.20 |
$112.67
|
|
Thyroid Ultrasound
|
$351.00 |
$351.00 |
$351.00 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,594.01 |
$3,594.01 |
$3,594.01 |
$4,152.21
|
|
Thyrotropin releasing hormone
|
$174.00 |
$174.00 |
$174.00 |
$88.35
|
|
Thyroxine binding globulin (tbg)
|
$82.80 |
$82.80 |
$82.80 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$1,274.40 |
$1,274.40 |
$1,274.40 |
$21,249.26
|
|
Tib/per revasc w/ather add-on 37233
|
$690.60 |
$690.60 |
$690.60 |
$10,165.00
|
|
Tigecycline injection
|
$117.25 |
$117.25 |
$117.25 |
$235.29
|
|
Tilt table study
|
$1,339.20 |
$1,339.20 |
$1,339.20 |
$1,561.82
|
|
Tirofiban 12.5 mg/50 ml
|
$452.93 |
$452.93 |
$452.93 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$12,657.66 |
$12,657.66 |
$12,657.66 |
$13,339.20
|
|
Tissue exam koh skin/hair/nails
|
$47.40 |
$47.40 |
$47.40 |
$47.40
|
|
Tissue transglutaminase iga
|
$29.40 |
$29.40 |
$29.40 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$64.20 |
$64.20 |
$64.20 |
$80.10
|
|
Tlh uterus 250 g or less
|
$1,805.40 |
$1,805.40 |
$1,805.40 |
$12,320.22
|
|
Tlh uterus over 250 g
|
$2,249.40 |
$2,249.40 |
$2,249.40 |
$9,363.13
|
|
Tlh w/t/o 250 g or less
|
$2,007.00 |
$2,007.00 |
$2,007.00 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$2,572.20 |
$2,572.20 |
$2,572.20 |
$12,320.22
|
|
Tmvr w/prosthetic ring 33426
|
$4,653.00 |
$4,653.00 |
$4,653.00 |
$5,816.80
|
|
Tmvr w/rad reconst w or without ring 33427
|
$4,785.00 |
$4,785.00 |
$4,785.00 |
$5,969.60
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$33.23 |
$33.23 |
$33.23 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$103.80 |
$103.80 |
$103.80 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,733.60 |
$4,733.60 |
$4,733.60 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$226.20 |
$226.20 |
$226.20 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$26.40 |
$26.40 |
$26.40 |
$74.10
|
|
Tongue biopsy; posterior one-third 41105
|
$330.60 |
$330.60 |
$330.60 |
$3,592.74
|
|
Tonsillectomy (age 12+)
|
$499.20 |
$499.20 |
$499.20 |
$4,558.89
|
|
Tonsillectomy (child under 12)
|
$481.80 |
$481.80 |
$481.80 |
$6,056.50
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$570.18 |
$570.18 |
$570.18 |
$316.84
|
|
Tot abd hyst/par vag/pelv node sam 58200
|
$2,560.80 |
$2,560.80 |
$2,560.80 |
$3,364.80
|
|
Total Hip Replacement
|
$1,771.80 |
$1,771.80 |
$1,771.80 |
$9,161.60
|
|
Total hysterectomy
|
$1,941.00 |
$1,941.00 |
$1,941.00 |
$3,001.70
|
|
Total Knee Replacement
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$14,061.89
|
|
Total ob care failed vbac 59618
|
$4,792.80 |
$4,792.80 |
$4,792.80 |
$4,792.80
|
|
Tot disc arthrp ant appr disc 2nd level cervi 22858
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$1,230.40
|
|
Tot esophagectomy without thoracotomy 43107
|
$4,865.40 |
$4,865.40 |
$4,865.40 |
$7,284.80
|
|
Toxoplasma antibody igg
|
$54.60 |
$54.60 |
$54.60 |
$91.65
|
|
Toxoplasma antibody igm
|
$55.20 |
$55.20 |
$55.20 |
$88.00
|
|
Tpmt gene com vrnts
|
$467.40 |
$467.40 |
$467.40 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$6,148.46 |
$6,148.46 |
$6,148.46 |
$6,684.23
|
|
Trachelectomy (cervicectomy) 57530
|
$669.60 |
$669.60 |
$669.60 |
$4,933.66
|
|
Tracheobrnchsc thru est trachs incisn
|
$357.00 |
$357.00 |
$357.00 |
$1,420.44
|
|
Tracheostoma revision; simple, without flap rotation
|
$878.40 |
$878.40 |
$878.40 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$82.80 |
$82.80 |
$82.80 |
$103.20
|
|
Transab esoph hiat hern repair 43332
|
$1,930.20 |
$1,930.20 |
$1,930.20 |
$2,835.20
|
|
Transcath mv repair addl prosthesis
|
$949.20 |
$949.20 |
$949.20 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$4,020.60 |
$4,020.60 |
$4,020.60 |
$13,093.20
|
|
Trans cath replace aortic valve 33366
|
$4,079.40 |
$4,079.40 |
$4,079.40 |
$14,593.50
|
|
Transcutaneous hgb 88738
|
$13.80 |
$13.80 |
$13.80 |
$13.20
|
|
Transferrin
|
$81.60 |
$81.60 |
$81.60 |
$82.00
|
|
Transparent film <= 16 sq in
|
$3.00 |
$3.00 |
$3.00 |
$4.50
|
|
Transthor diaphrag hern repair 43334
|
$2,356.80 |
$2,356.80 |
$2,356.80 |
$3,052.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$368.40 |
$368.40 |
$368.40 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$384.00 |
$384.00 |
$384.00 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$2,801.66 |
$2,801.66 |
$2,801.66 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$6,786.46 |
$6,786.46 |
$6,786.46 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$6,047.69 |
$6,047.69 |
$6,047.69 |
$5,846.40
|
|
Trauma partial team response w/critical care services level 4
|
$4,063.80 |
$4,063.80 |
$4,063.80 |
$4,471.50
|
|
Tray bonemarrw oncontrol 102mm
|
$832.80 |
$832.80 |
$832.80 |
$940.80
|
|
Treat ankle fracture
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$5,488.00
|
|
Treat big toe fracture
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$4,454.10
|
|
Treat cheek bone fracturemalar 21360
|
$1,033.80 |
$1,033.80 |
$1,033.80 |
$6,489.73
|
|
Treat clavicle dislocation 23545
|
$531.60 |
$531.60 |
$531.60 |
$692.80
|
|
Treat ectopic pregnancy
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$3,986.00
|
|
Treat ectopic pregnancy
|
$1,538.40 |
$1,538.40 |
$1,538.40 |
$6,707.99
|
|
Treat elbow dislocation
|
$881.40 |
$881.40 |
$881.40 |
$2,311.20
|
|
Treat eyelid lesion 67850
|
$531.00 |
$531.00 |
$531.00 |
$1,146.13
|
|
Treat foot bone lesion
|
$809.40 |
$809.40 |
$809.40 |
$3,839.54
|
|
Treat heel fracture
|
$1,572.00 |
$1,572.00 |
$1,572.00 |
$7,907.11
|
|
Treat hip dislocation
|
$637.20 |
$637.20 |
$637.20 |
$2,612.00
|
|
Treat knee fracture 27530
|
$580.20 |
$580.20 |
$580.20 |
$550.73
|
|
Treat lower jaw fracture 21462
|
$3,153.00 |
$3,153.00 |
$3,153.00 |
$7,000.36
|
|
Treat lower leg fracture
|
$1,559.40 |
$1,559.40 |
$1,559.40 |
$12,905.86
|
|
Treat lower leg fracture
|
$1,843.80 |
$1,843.80 |
$1,843.80 |
$12,653.00
|
