|
Tmvr w/prosthetic ring 33426
|
$5,816.80 |
$5,816.80 |
$5,816.80 |
$5,816.80
|
|
Tmvr w/rad reconst w or without ring 33427
|
$5,969.60 |
$5,969.60 |
$5,969.60 |
$5,969.60
|
|
Tnot opn elbw to sho ea tdn
|
$1,161.60 |
$1,161.60 |
$1,161.60 |
$2,564.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$38.32 |
$38.32 |
$38.32 |
$152.36
|
|
Tobramycin non-comp unit
|
$7.68 |
$7.68 |
$7.68 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$66.43 |
$66.43 |
$66.43 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$10.84 |
$10.84 |
$10.84 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$157.15 |
$157.15 |
$157.15 |
$259.50
|
|
Tomosynthesis breast diagnostic left
|
$382.40 |
$382.40 |
$382.40 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$96.80 |
$96.80 |
$96.80 |
$74.10
|
|
Tone decay hearing test
|
$64.80 |
$64.80 |
$64.80 |
$90.37
|
|
Tongue base vol reduction
|
$5,772.00 |
$5,772.00 |
$5,772.00 |
$3,837.72
|
|
Tongue biopsy; posterior one-third 41105
|
$435.20 |
$435.20 |
$435.20 |
$3,592.74
|
|
Tongue mouth jaw surgery
|
$5,428.00 |
$5,428.00 |
$5,428.00 |
$5,428.00
|
|
Tongue suspension
|
$1,622.40 |
$1,622.40 |
$1,622.40 |
$4,082.40
|
|
Tongue to lip surgery
|
$1,097.60 |
$1,097.60 |
$1,097.60 |
$3,837.72
|
|
Tonsillectomy (age 12+)
|
$622.40 |
$622.40 |
$622.40 |
$4,558.89
|
|
Tonsillectomy (child under 12)
|
$650.40 |
$650.40 |
$650.40 |
$6,056.50
|
|
Tot abd hyst/par vag/pelv node sam 58200
|
$3,364.80 |
$3,364.80 |
$3,364.80 |
$3,364.80
|
|
Total hip arthroplasty
|
$8,249.60 |
$8,249.60 |
$8,249.60 |
$7,347.60
|
|
Total Hip Replacement
|
$6,675.20 |
$6,675.20 |
$6,675.20 |
$9,161.60
|
|
Total hysterectomy
|
$2,520.80 |
$2,520.80 |
$2,520.80 |
$3,001.70
|
|
Total Knee Replacement
|
$6,668.80 |
$6,668.80 |
$6,668.80 |
$14,061.89
|
|
Total lung lavage
|
$1,758.40 |
$1,758.40 |
$1,758.40 |
$1,758.40
|
|
Total ob care failed vbac 59618
|
$4,795.20 |
$4,795.20 |
$4,795.20 |
$4,792.80
|
|
Total tau
|
$64.28 |
$64.28 |
$64.28 |
$312.50
|
|
Tot disc arthrp 1ntrspc crv
|
$3,925.60 |
$3,925.60 |
$3,925.60 |
$20,154.40
|
|
Tot disc arthrp 1ntrspc lmbr
|
$4,365.60 |
$4,365.60 |
$4,365.60 |
$4,365.60
|
|
Tot disc arthrp ant appr disc 2nd level cervi 22858
|
$1,230.40 |
$1,230.40 |
$1,230.40 |
$1,230.40
|
|
Tot esophagectomy without thoracotomy 43107
|
$7,284.80 |
$7,284.80 |
$7,284.80 |
$7,284.80
|
|
Tot estradiol response panel
|
$140.80 |
$140.80 |
$140.80 |
$140.80
|
|
Toxoplasma antibody igg
|
$48.57 |
$48.57 |
$48.57 |
$90.00
|
|
Toxoplasma antibody igm
|
$48.57 |
$48.57 |
$48.57 |
$89.05
|
|
Tp53 gene full gene sequence
|
$616.18 |
$616.18 |
$616.18 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$316.33 |
$316.33 |
$316.33 |
$790.68
|
|
Tpmt gene com vrnts
|
$350.40 |
$350.40 |
$350.40 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$7,438.40 |
$7,438.40 |
$7,438.40 |
$7,144.80
|
|
Trabeculoplasty laser surg
|
$1,224.00 |
$1,224.00 |
$1,224.00 |
$1,180.80
|
|
Trachelectomy (cervicectomy) 57530
|
$897.60 |
$897.60 |
$897.60 |
$4,933.66
|
|
Tracheobrnchsc thru est trachs incisn
|
$420.80 |
$420.80 |
$420.80 |
$1,437.45
|
|
Tracheo-esophagoplasty cong
|
$7,181.60 |
$7,181.60 |
$7,181.60 |
$7,181.60
|
|
Tracheostoma revision; simple, without flap rotation
|
$1,069.60 |
$1,069.60 |
$1,069.60 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$124.00 |
$124.00 |
$124.00 |
$101.25
|
|
Transabdom amnioinfus w/us
|
$971.20 |
$971.20 |
$971.20 |
$678.70
|
|
Transab esoph hiat hern repair 43332
|
$2,835.20 |
$2,835.20 |
$2,835.20 |
$2,835.20
|
|
Transab esoph hiat hern rpr
|
$3,096.80 |
$3,096.80 |
$3,096.80 |
$3,096.80
|
|
Transcath biopsy
|
$6,022.87 |
$6,022.87 |
$6,022.87 |
$4,285.93
|
|
Transcath closure of asd
|
$2,110.40 |
$2,110.40 |
$2,110.40 |
$17,352.58
|
|
Transcath closure of vsd
|
$2,861.60 |
$2,861.60 |
$2,861.60 |
$17,458.00
|
|
Transcatheter bx s&i
|
$994.40 |
$994.40 |
$994.40 |
$1,954.55
|
|
Transcath mv repair addl prosthesis
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$4,409.60 |
$4,409.60 |
$4,409.60 |
$13,384.80
|
|
Transcath occlusion non-cns
|
$2,193.60 |
$2,193.60 |
$2,193.60 |
$10,452.00
|
|
Trans cath replace aortic valve 33366
|
$3,853.60 |
$3,853.60 |
$3,853.60 |
$14,593.50
|
|
Transcath rmvl perm ldss pmkr rv
|
$1,304.80 |
$1,304.80 |
$1,304.80 |
$4,822.00
|
|
Transcrv abltj utrn fibrd rf
|
$7,965.60 |
$7,965.60 |
$7,965.60 |
$8,750.72
|
|
Transcutaneous carboxyhb
|
$33.57 |
$33.57 |
$33.57 |
$31.85
|
|
Transcutaneous hgb 88738
|
$12.80 |
$12.80 |
$12.80 |
$13.20
|
|
Transcutaneous methb
|
$19.20 |
$19.20 |
$19.20 |
$19.20
|
|
Transfer of abdominal muscle
|
$4,070.40 |
$4,070.40 |
$4,070.40 |
$5,886.74
|
|
Transfer of embryo
|
$631.20 |
$631.20 |
$631.20 |
$587.60
|
|
Transfer of iliopsoas muscle
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$6,311.00
|
|
Transfer of iliopsoas muscle
|
$4,432.00 |
$4,432.00 |
$4,432.00 |
$4,432.00
|
|
Transfer of spinal muscle
|
$4,268.80 |
$4,268.80 |
$4,268.80 |
$4,268.80
|
|
Transferrin
|
$64.28 |
$64.28 |
$64.28 |
$82.00
|
|
Transfer skin pedicle flap
|
$1,245.60 |
$1,245.60 |
$1,245.60 |
$3,189.12
|
|
Transfer tendon to pelvis
|
$3,412.80 |
$3,412.80 |
$3,412.80 |
$3,839.54
|
|
Transperi needle place pros
|
$1,947.20 |
$1,947.20 |
$1,947.20 |
$6,203.00
|
|
Transplant forearm tendon
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$3,624.06
|
|
Transplant forearm tendon
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$3,839.54
|
|
Transplant/graft hand tendon
|
$2,090.40 |
$2,090.40 |
$2,090.40 |
$3,594.44
|
|
Transplant/graft palm tendon
|
$2,314.40 |
$2,314.40 |
$2,314.40 |
$3,839.54
|
|
Transplant hand tendon
|
$1,872.00 |
$1,872.00 |
$1,872.00 |
$3,839.54
|
|
Transplant of thigh tendon
|
$3,030.40 |
$3,030.40 |
$3,030.40 |
$7,507.19
|
|
Transplant palm tendon
|
$2,003.20 |
$2,003.20 |
$2,003.20 |
$3,839.54
|
|
Transplants of thigh tendons
|
$4,496.00 |
$4,496.00 |
$4,496.00 |
$7,913.97
|
|
Transplant ureter to skin
|
$4,776.00 |
$4,776.00 |
$4,776.00 |
$4,776.00
|
|
Transplj hematopoietic boost
|
$310.40 |
$310.40 |
$310.40 |
$2,667.20
|
|
Transplt allo hct/donor
|
$600.80 |
$600.80 |
$600.80 |
$29,206.10
|
|
Transplt allo lymphocytes
|
$322.40 |
$322.40 |
$322.40 |
$2,751.65
|
|
Transplt autol hct/donor
|
$444.80 |
$444.80 |
$444.80 |
$3,986.00
|
|
Transposition of vein valve
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
$6,366.08
|
|
Transthor cath for stent
|
$2,268.00 |
$2,268.00 |
$2,268.00 |
$3,612.00
|
|
Transthor diaphrag hern repair 43334
|
$3,052.00 |
$3,052.00 |
$3,052.00 |
$3,052.00
|
|
Transurethral rf treatment
|
$5,109.60 |
$5,109.60 |
$5,109.60 |
$3,281.20
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$497.12 |
$497.12 |
$497.12 |
$558.35
|
|
Transvaginal Pregnancy Ultrasound
|
$497.12 |
$497.12 |
$497.12 |
$501.60
|
|
Transvrs a-arch grf hypthrm
|
$7,971.20 |
$7,971.20 |
$7,971.20 |
$6,120.80
|
|
Trastuzumab 150 mg intravenous solution
|
$109.60 |
$109.60 |
$109.60 |
$3,141.85
|
|
Trauma partial team response w/critical care services level 4
|
$2,169.60 |
$2,169.60 |
$2,169.60 |
$4,523.04
|
|
Trb@ gene rearrange dirprobe
|
$112.00 |
$112.00 |
$112.00 |
$73.46
|
|
Treat ankle dislocation
|
$3,185.26 |
$3,185.26 |
$3,185.26 |
$2,358.40
|
|
Treat ankle dislocation
|
$3,531.20 |
$3,531.20 |
$3,531.20 |
$7,913.97
|
|
Treat ankle dislocation
|
$3,950.40 |
$3,950.40 |
$3,950.40 |
$5,741.00
|
|
Treat ankle fracture
|
$5,144.00 |
$5,144.00 |
$5,144.00 |
$5,488.00
|
|
Treat big toe fracture
|
$3,308.80 |
$3,308.80 |
$3,308.80 |
$4,454.10
|
|
Treat cheek bone fracturemalar 21360
|
$2,534.40 |
$2,534.40 |
$2,534.40 |
$6,489.73
|
|
Treat chest lining
|
$3,888.00 |
$3,888.00 |
$3,888.00 |
$3,888.00
|
|
Treat clavicle dislocation 23545
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$692.80
|
|
Treat each add spine fx
|
$675.20 |
$675.20 |
$675.20 |
$603.24
|
