|
Transfusion blood/blood component(s)
|
$1,926.27 |
$2,725.77 |
$3,354.65 |
|
|
Trastuzumab 150 mg intravenous solution
|
$2,540.23 |
$3,401.26 |
$4,079.30 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$2,969.36 |
$3,322.98 |
$9,957.93 |
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$7,391.88 |
$7,391.88 |
$8,868.05 |
|
|
Trauma partial team response w/critical care services level 4
|
$9,675.25 |
$9,675.25 |
$9,675.25 |
|
|
Treat clavicle dislocation 23545
|
$795.60 |
$828.75 |
$1,544.40 |
|
|
Treat ectopic pregnancy
|
$16,710.22 |
$16,710.22 |
$16,710.22 |
|
|
Treat elbow dislocation
|
$1,094.60 |
$1,203.15 |
$1,230.45 |
|
|
Treat elbow fracture
|
$1,311.70 |
$1,311.70 |
$1,311.70 |
|
|
Treat eyelid by injection
|
$655.32 |
$655.32 |
$655.32 |
|
|
Treat finger fracture each
|
$707.25 |
$741.65 |
$820.95 |
|
|
Treat foot dislocation
|
$258.70 |
$258.70 |
$592.80 |
|
|
Treat fracture of radius
|
$759.85 |
$841.75 |
$1,081.60 |
|
|
Treat hip dislocation
|
$1,647.75 |
$1,647.75 |
$1,679.60 |
|
|
Treat hip dislocation
|
$895.70 |
$895.70 |
$895.70 |
|
|
Treat hip socket fracture
|
$2,228.20 |
$2,228.20 |
$2,228.20 |
|
|
Treat humerus fracture
|
$1,848.60 |
$1,848.60 |
$1,848.60 |
|
|
Treat kneecap dislocation
|
$993.85 |
$1,063.40 |
$1,108.25 |
|
|
Treat knee fracture 27530
|
$974.35 |
$974.35 |
$974.35 |
|
|
Treat knuckle dislocation
|
$793.65 |
$793.65 |
$949.00 |
|
|
Treatment incomplete abortion completed surgically any trimester
|
$9,960.98 |
$9,960.98 |
$15,166.96 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$70.20 |
$72.80 |
$216.45 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$63.70 |
$134.55 |
$206.05 |
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$18.75 |
$139.75 |
$224.25 |
|
|
Treatment missed abortion completed surgically 1st trimester
|
$5,065.79 |
$5,186.58 |
$15,649.06 |
|
|
Treatment of ankle fracture 27786
|
$213.00 |
$521.30 |
$638.30 |
|
|
Treatment of choroid lesion
|
$1,702.67 |
$1,702.67 |
$1,702.67 |
|
|
Treatment of fibula fracture 27780
|
$531.70 |
$531.70 |
$531.70 |
|
|
Treatment of gum lesion
|
$8,580.06 |
$8,580.06 |
$8,580.06 |
|
|
Treatment of heel fracture 28400
|
$295.50 |
$295.50 |
$660.40 |
|
|
Treatment of miscarriage
|
$8,638.17 |
$8,638.17 |
$8,638.17 |
|
|
Treatment of mouth lesion physical 40820
|
$9,822.53 |
$9,822.53 |
$9,822.53 |
|
|
Treatment of retinal lesion
|
$1,452.42 |
$1,452.42 |
$1,452.42 |
|
|
Treatment of thigh fracture
|
$2,026.05 |
$2,026.05 |
$2,026.05 |
|
|
Treatment of thigh fracture
|
$1,054.30 |
$1,054.30 |
$1,054.30 |
|
|
Treatment of toe fracture 28510
|
$144.00 |
$272.35 |
$289.25 |
|
|
Treatment radiation delivery level 2
|
$21,756.15 |
$21,756.15 |
$36,752.30 |
|
|
Treatment x10sv retinopathy
|
$1,213.91 |
$1,213.91 |
$1,213.91 |
|
|
Treat spinal cord lesion
|
$3,298.10 |
$3,298.10 |
$3,298.10 |
|
|
Treat sternum fracture
|
$327.60 |
$327.60 |
$327.60 |
|
|
Treat thigh fracture
|
$1,090.05 |
$1,090.05 |
$1,090.05 |
|
|
Treat ulnar fracture
|
$1,019.20 |
$1,019.20 |
$1,149.85 |
|
|
Treat vaginal bleeding
|
$335.40 |
$335.40 |
$335.40 |
|
|
Treat wrist dislocation
|
$715.00 |
$715.00 |
$808.60 |
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$9,244.50 |
$9,244.50 |
$68,943.21 |
|
|
Treponema pallidum antibody
|
$68.90 |
$74.10 |
$116.35 |
|
|
Trg gene rearrangement anal
|
$297.70 |
$372.45 |
$569.40 |
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$17.06 |
$25.69 |
$199.26 |
|
|
Triamcinolone a inj prs-free
|
$2,188.29 |
$2,188.29 |
$2,188.29 |
|
|
Trichinella antibody
|
$96.20 |
$96.20 |
$96.20 |
|
|
Trichomonas assay w/optic
|
$73.45 |
$73.45 |
$73.45 |
|
|
#tricyclicantidprssnt
|
$128.05 |
$129.35 |
$143.65 |
|
|
Triglycerides
|
$21.75 |
$90.35 |
$229.45 |
|
|
Trimethobenzamide hcl inj
|
$19.93 |
$19.93 |
$199.74 |
|
|
Trim nondyst nails
|
$14.25 |
$14.25 |
$14.25 |
|
|
Trluml dil aq o/f can without st
|
$13,556.11 |
$13,556.11 |
$13,556.11 |
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$27,032.67 |
$27,032.67 |
$34,200.77 |
|
|
Trml dstrj ios bvn ea addl
|
$27,032.67 |
$27,032.67 |
$27,032.67 |
|
|
Trmt of fracture (femoral shaft) 27500
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
|
|
Trnscath plc stent crv crtd without prtct
|
$4,344.60 |
$4,344.60 |
$4,344.60 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$5,411.90 |
$5,411.90 |
$5,411.90 |
|
|
Trnscath plc stnt ante carotid art
|
$18,408.00 |
$18,408.00 |
$18,408.00 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,254.90 |
$4,254.90 |
$4,254.90 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$14,143.35 |
$14,143.35 |
$101,048.09 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$37,805.40 |
$37,805.40 |
$101,048.09 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$12,669.21 |
$12,669.21 |
$53,213.79 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,817.10 |
$2,817.10 |
$2,817.10 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,390.05 |
$2,390.05 |
$2,390.05 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,252.25 |
$2,252.25 |
$2,252.25 |
|
|
Trnscath tx thromblytc vein ini day
|
$2,287.35 |
$2,287.35 |
$2,287.35 |
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,065.70 |
$2,065.70 |
$2,065.70 |
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,621.75 |
$1,621.75 |
$1,621.75 |
|
|
Troponin quantitative
|
$38.25 |
$135.85 |
$303.55 |
|
|
Tte w or without contr, cont ecg
|
$1,970.80 |
$2,002.00 |
$2,067.00 |
|
|
Tte w or without fol w/con,stres
|
$2,107.30 |
$2,107.30 |
$2,728.70 |
|
|
Tvh >250 gms 58290
|
$22,259.52 |
$22,259.52 |
$22,259.52 |
|
|
Tx atrial fib pulm vein isol
|
$17,609.15 |
$17,609.15 |
$34,519.55 |
|
|
Tx closed hip disl traumatic without anes
|
$395.25 |
$929.50 |
$1,079.65 |
|
|
Tx closed tib shaft fx without manip
|
$901.55 |
$901.55 |
$901.55 |
|
|
Tx l/r atrial fib addl
|
$7,837.05 |
$7,837.05 |
$7,837.05 |
|
|
Tx open art fx mcp/iphlngl jnt incl int fixtn ea
|
$2,714.40 |
$2,714.40 |
$2,714.40 |
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$1,695.85 |
$1,695.85 |
$1,695.85 |
|
|
Tx open iphlngl jt disl internal fixation sngl
|
$1,810.90 |
$1,810.90 |
$1,810.90 |
|
|
Tx tarsal bone fx without manip 28450
|
$620.10 |
$620.10 |
$620.10 |
|
|
Tympanic membrane repair
|
$5,622.59 |
$5,622.59 |
$5,622.59 |
|
|
Tympanolysis transcanal 69450
|
$14,075.85 |
$14,075.85 |
$14,075.85 |
|
|
Ua w/micro/comp poc
|
$12.00 |
$43.55 |
$46.15 |
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$24,387.95 |
$25,772.31 |
$30,924.56 |
|
|
Ugt1a1 gene analy common variants
|
$607.10 |
$668.85 |
$1,182.35 |
|
|
Ultrasound abdomen aorta screening study aaa
|
$33.00 |
$257.40 |
$401.70 |
|
|
Ultrasound breast complete
|
$139.75 |
$603.20 |
$1,007.50 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$285.35 |
$499.85 |
$809.25 |
|
|
Ultrasound chest
|
$273.75 |
$477.75 |
$529.75 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$241.80 |
$312.65 |
$564.20 |
|
|
Ultrasound dx ophth b-scan
|
$395.85 |
$395.85 |
$395.85 |
|
|
Ultrasound elastography ea l target les
|
$321.75 |
$321.75 |
$321.75 |
|
|
Ultrasound elastography parenchyma
|
$377.00 |
$377.00 |
$377.00 |
|
|
Ultrasound encephalogram
|
$314.60 |
$571.35 |
$584.35 |
|
|
Ultrasound exam k transpl w/doppler
|
$475.80 |
$648.70 |
$716.95 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$433.55 |
$451.75 |
$652.60 |
|
