|
Synvisc or synvisc-one
|
$4,922.75 |
$4,922.75 |
$4,922.75 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$17.28 |
$17.28 |
$17.28 |
$41.60
|
|
T3 (triiodothyronine) free
|
$47.04 |
$47.04 |
$47.04 |
$99.20
|
|
T3 (triiodothyronine) total
|
$41.60 |
$41.60 |
$41.60 |
$93.52
|
|
T4 (thyroxine) free
|
$28.80 |
$28.80 |
$28.80 |
$85.20
|
|
T4 (thyroxine) total
|
$57.60 |
$57.60 |
$57.60 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$76.80 |
$76.80 |
$76.80 |
$122.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$61.44 |
$61.44 |
$61.44 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$96.00 |
$96.00 |
$96.00 |
$176.40
|
|
T cells total count
|
$93.95 |
$93.95 |
$93.95 |
$126.90
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$20,709.96 |
$20,709.96 |
$20,709.96 |
$15,245.38
|
|
Testicular imaging w/vasc flow
|
$398.72 |
$398.72 |
$398.72 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$560.32 |
$560.32 |
$560.32 |
$949.70
|
|
Tetanus immune globulin inj
|
$1,657.98 |
$1,657.98 |
$1,657.98 |
$1,285.36
|
|
Therapeutic procd strg endur
|
$92.90 |
$92.90 |
$92.90 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$19.20 |
$19.20 |
$19.20 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$16.64 |
$16.64 |
$16.64 |
$50.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,039.04 |
$2,039.04 |
$2,039.04 |
$1,687.50
|
|
Thyroglobulin antibody
|
$28.16 |
$28.16 |
$28.16 |
$82.00
|
|
Thyroid imaging
|
$418.88 |
$418.88 |
$418.88 |
$695.02
|
|
Thyroid (TSH) Test
|
$80.64 |
$80.64 |
$80.64 |
$111.00
|
|
Thyroid Ultrasound
|
$266.88 |
$266.88 |
$266.88 |
$588.50
|
|
Thyroid uptake measurement
|
$202.88 |
$202.88 |
$202.88 |
$591.25
|
|
Tigecycline injection
|
$304.13 |
$304.13 |
$304.13 |
$234.00
|
|
Tissue transglutaminase iga
|
$14.72 |
$14.72 |
$14.72 |
$44.16
|
|
Tobramycin peak therapeutic drug level
|
$50.43 |
$50.43 |
$50.43 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$32.00 |
$32.00 |
$32.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$32.00 |
$32.00 |
$32.00 |
$72.68
|
|
Total hip arthroplasty
|
$2,711.20 |
$2,711.20 |
$2,711.20 |
$7,347.60
|
|
Total Hip Replacement
|
$2,682.40 |
$2,682.40 |
$2,682.40 |
$9,161.60
|
|
Total Knee Replacement
|
$2,867.84 |
$2,867.84 |
$2,867.84 |
$14,543.50
|
|
Total ob care failed vbac 59618
|
$82.75 |
$82.75 |
$82.75 |
$4,564.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$35.20 |
$35.20 |
$35.20 |
$101.25
|
|
Transferrin
|
$32.00 |
$32.00 |
$32.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$444.16 |
$444.16 |
$444.16 |
$983.00
|
|
Transplant hand tendon
|
$814.40 |
$814.40 |
$814.40 |
$3,821.05
|
|
Trauma partial team response w/critical care services level 4
|
$1,740.80 |
$1,740.80 |
$1,740.80 |
$4,523.04
|
|
Treat ankle dislocation
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$2,358.40
|
|
Treat big toe fracture
|
$464.64 |
$464.64 |
$464.64 |
$4,307.52
|
|
Treat ectopic pregnancy
|
$988.80 |
$988.80 |
$988.80 |
$6,707.99
|
|
Treat elbow dislocation
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$2,223.20
|
|
Treat elbow fracture
|
$1,798.40 |
$1,798.40 |
$1,798.40 |
$11,488.80
|
|
Treat elbow fracture
|
$873.60 |
$873.60 |
$873.60 |
$1,919.13
|
|
Treat finger fracture each
|
$860.16 |
$860.16 |
$860.16 |
$4,132.02
|
|
Treat finger fracture each
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$1,536.00
|
|
Treat foot dislocation
|
$174.40 |
$174.40 |
$174.40 |
$396.30
|
|
Treat fracture of radius
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$1,790.00
|
|
Treat fracture of radius
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$1,849.00
|
|
Treat heel fracture
|
$1,931.20 |
$1,931.20 |
$1,931.20 |
$8,269.81
|
|
Treat hip dislocation
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$2,192.80
|
|
Treat hip dislocation
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$2,641.60
|
|
Treat humerus fracture
|
$1,575.20 |
$1,575.20 |
$1,575.20 |
$13,278.70
|
|
Treat humerus fracture
|
$2,199.68 |
$2,199.68 |
$2,199.68 |
$1,771.43
|
|
Treat humerus fracture
|
$1,807.20 |
$1,807.20 |
$1,807.20 |
$10,742.40
|
|
Treat humerus fracture
|
$600.80 |
$600.80 |
$600.80 |
$1,771.43
|
|
Treat kneecap fracture
|
$1,295.36 |
$1,295.36 |
$1,295.36 |
$6,311.00
|
|
Treat knee fracture
|
$1,605.76 |
$1,605.76 |
$1,605.76 |
$3,486.60
|
|
Treat knee fracture
|
$1,896.32 |
$1,896.32 |
$1,896.32 |
$4,521.40
|
|
Treat knee fracture 27530
|
$638.72 |
$638.72 |
$638.72 |
$550.00
|
|
Treat knuckle dislocation
|
$707.20 |
$707.20 |
$707.20 |
$4,332.00
|
|
Treat lower leg fracture
|
$1,979.52 |
$1,979.52 |
$1,979.52 |
$14,241.77
|
|
Treat lower leg joint
|
$961.60 |
$961.60 |
$961.60 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$1,203.84 |
$1,203.84 |
$1,203.84 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$1,539.20 |
$1,539.20 |
$1,539.20 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$1,052.16 |
$1,052.16 |
$1,052.16 |
$8,370.75
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$203.52 |
$203.52 |
$203.52 |
$224.90
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$225.92 |
$225.92 |
$225.92 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$457.60 |
$457.60 |
$457.60 |
$3,982.44
|
|
Treatment of ankle fracture
|
$1,086.40 |
$1,086.40 |
$1,086.40 |
$8,412.89
|
|
Treatment of ankle fracture
|
$1,331.84 |
$1,331.84 |
$1,331.84 |
$8,453.60
|
|
Treatment of ankle fracture
|
$1,469.44 |
$1,469.44 |
$1,469.44 |
$7,907.11
|
|
Treatment of ankle fracture 27786
|
$562.56 |
$562.56 |
$562.56 |
$520.80
|
|
Treatment of fibula fracture
|
$824.96 |
$824.96 |
$824.96 |
$6,311.00
|
|
Treatment of fibula fracture 27780
|
$544.00 |
$544.00 |
$544.00 |
$491.50
|
|
Treatment of thigh fracture
|
$2,176.00 |
$2,176.00 |
$2,176.00 |
$5,109.00
|
|
Treatment of thigh fracture
|
$660.00 |
$660.00 |
$660.00 |
$548.90
|
|
Treatment of thigh fracture
|
$9,544.96 |
$9,544.96 |
$9,544.96 |
$6,389.60
|
|
Treatment of thigh fracture
|
$1,140.48 |
$1,140.48 |
$1,140.48 |
$1,772.97
|
|
Treatment of thigh fracture
|
$1,600.00 |
$1,600.00 |
$1,600.00 |
$3,409.00
|
|
Treatment of thigh fracture
|
$1,634.40 |
$1,634.40 |
$1,634.40 |
$3,764.80
|
|
Treatment of thigh fracture
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$5,505.50
|
|
Treatment of thigh fracture
|
$1,664.00 |
$1,664.00 |
$1,664.00 |
$3,796.00
|
|
Treatment of tibia fracture
|
$1,677.60 |
$1,677.60 |
$1,677.60 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$291.71 |
$291.71 |
$291.71 |
$369.70
|
|
Treat metacarpal fracture
|
$864.00 |
$864.00 |
$864.00 |
$3,977.49
|
|
Treat metacarpal fracture
|
$919.20 |
$919.20 |
$919.20 |
$5,464.97
|
|
Treat metatarsal fracture
|
$459.20 |
$459.20 |
$459.20 |
$3,839.54
|
|
Treat metatarsal fracture
|
$930.40 |
$930.40 |
$930.40 |
$8,453.60
|
|
Treat radius fracture
|
$1,203.20 |
$1,203.20 |
$1,203.20 |
$7,807.24
|
|
Treat thigh fracture
|
$1,597.60 |
$1,597.60 |
$1,597.60 |
$6,510.40
|
|
Treat thigh fracture
|
$1,840.64 |
$1,840.64 |
$1,840.64 |
$4,083.00
|
|
Treat thigh fracture
|
$629.76 |
$629.76 |
$629.76 |
$1,893.86
|
|
Treat thigh fracture
|
$2,457.60 |
$2,457.60 |
$2,457.60 |
$4,726.80
|
|
Treat thigh fracture
|
$1,989.76 |
$1,989.76 |
$1,989.76 |
$3,580.50
|
|
Treat toe fracture
|
$715.20 |
$715.20 |
$715.20 |
$3,839.54
|
|
Treat ulnar fracture
|
$1,145.60 |
$1,145.60 |
$1,145.60 |
$5,926.25
|
|
Treponema pallidum antibody
|
$35.84 |
$35.84 |
$35.84 |
$70.40
|
|
Triglycerides
|
$26.88 |
$26.88 |
$26.88 |
$58.05
|
|
Trim nondyst nails
|
$99.84 |
$99.84 |
$99.84 |
$113.40
|
|
Trmt of fracture (femoral shaft) 27500
|
$713.60 |
$713.60 |
$713.60 |
$754.80
|
