|
Tlso rigid lined custom fab
|
$3,410.30 |
$3,410.30 |
$3,410.30 |
$2,831.21
|
|
Tlso rigid lined pre one pie
|
$2,375.18 |
$2,375.18 |
$2,375.18 |
$2,110.02
|
|
Tlso rigid plastic custom fa
|
$3,573.87 |
$3,573.87 |
$3,573.87 |
$2,788.42
|
|
Tlso rigid plastic pre one
|
$669.31 |
$669.31 |
$669.31 |
$594.61
|
|
Tlso trnk sj-t9 pre cst
|
$1,117.92 |
$1,117.92 |
$1,117.92 |
$523.94
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$6.66 |
$323.40 |
$376.80 |
$152.36
|
|
Tobramycin non-comp unit
|
$34.56 |
$34.56 |
$50.94 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$237.00 |
$237.00 |
$237.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,294.64 |
$2,294.64 |
$11,473.20 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$43.20 |
$45.60 |
$45.60 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$57.60 |
$60.60 |
$60.60 |
$72.68
|
|
Tonsillectomy (age 12+)
|
$12,587.94 |
$13,042.56 |
$17,327.64 |
$4,424.11
|
|
Tonsillectomy (child under 12)
|
$12,992.47 |
$12,992.47 |
$12,992.47 |
$5,339.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$243.72 |
$243.72 |
$243.72 |
$325.00
|
|
Torsion ank & half solid sti
|
$291.13 |
$291.13 |
$291.13 |
$291.13
|
|
Torsion straight knee joint
|
$253.84 |
$253.84 |
$253.84 |
$253.84
|
|
Total hip arthroplasty
|
$65,630.35 |
$65,630.35 |
$96,399.94 |
$7,347.60
|
|
Total Hip Replacement
|
$42,033.16 |
$47,179.75 |
$53,356.69 |
$9,161.60
|
|
Total Knee Replacement
|
$43,071.80 |
$44,878.58 |
$62,575.00 |
$14,543.50
|
|
Total tau
|
$339.00 |
$339.00 |
$339.00 |
$312.50
|
|
Tot disc arthrp 1ntrspc crv
|
$50,088.65 |
$50,088.65 |
$50,088.65 |
$20,154.40
|
|
Toxoplasma antibody igg
|
$156.00 |
$156.00 |
$156.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$87.00 |
$87.00 |
$87.00 |
$87.00
|
|
Tp53 gene full gene sequence
|
$1,708.20 |
$1,708.20 |
$1,708.20 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$548.40 |
$548.40 |
$548.40 |
$790.68
|
|
Tpmt gene com vrnts
|
$367.20 |
$367.20 |
$367.20 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$3,825.60 |
$3,825.60 |
$3,825.60 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$18,815.64 |
$18,815.64 |
$18,815.64 |
$6,827.00
|
|
Trabeculoplasty laser surg
|
$1,292.40 |
$1,292.40 |
$1,292.40 |
$1,180.80
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$18.54 |
$18.54 |
$88.20 |
$56.38
|
|
Transabdom amnioinfus w/us
|
$612.00 |
$612.00 |
$612.00 |
$678.70
|
|
Transcath biopsy
|
$3,995.40 |
$3,995.40 |
$3,995.40 |
$4,285.93
|
|
Transcatheter bx s&i
|
$4,576.20 |
$4,576.20 |
$4,576.20 |
$1,915.00
|
|
Transcath occlusion cns
|
$11,538.00 |
$11,538.00 |
$11,538.00 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$16,026.60 |
$16,026.60 |
$17,716.80 |
$10,031.28
|
|
Transcrv abltj utrn fibrd rf
|
$33,706.14 |
$33,706.14 |
$33,706.14 |
$8,750.72
|
|
Transferrin
|
$96.00 |
$96.00 |
$96.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$983.00
|
|
Transplj hematopoietic boost
|
$2,748.60 |
$2,748.60 |
$2,748.60 |
$2,667.20
|
|
Transplt allo hct/donor
|
$73,761.60 |
$73,761.60 |
$73,761.60 |
$29,206.10
|
|
Transplt allo lymphocytes
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$2,456.00
|
|
Transplt autol hct/donor
|
$1,975.20 |
$1,975.20 |
$1,975.20 |
$3,786.00
|
|
Trans shoe caliper plate new
|
$237.73 |
$237.73 |
$237.73 |
$217.22
|
|
Trans shoe calip plate exist
|
$180.55 |
$180.55 |
$180.55 |
$164.98
|
|
Trans shoe solid stirrup exi
|
$180.55 |
$180.55 |
$180.55 |
$141.41
|
|
Trans shoe solid stirrup new
|
$237.73 |
$237.73 |
$237.73 |
$217.22
|
|
Trapezius sling
|
$265.44 |
$265.44 |
$265.44 |
$242.54
|
|
Trastuzumab 150 mg intravenous solution
|
$8,003.58 |
$8,003.58 |
$8,003.58 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$19,421.76 |
$19,421.76 |
$19,650.24 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$17,294.52 |
$17,294.52 |
$17,497.98 |
$5,835.15
|
|
Tray bonemarrw oncontrol 102mm
|
$9,053.56 |
$9,053.56 |
$9,053.56 |
$940.80
|
|
Treat ankle fracture
|
$70,854.74 |
$70,854.74 |
$70,854.74 |
$5,488.00
|
|
Treat ectopic pregnancy
|
$22,035.50 |
$22,035.50 |
$22,035.50 |
$6,707.99
|
|
Treat elbow fracture
|
$44,791.58 |
$44,791.58 |
$44,791.58 |
$11,488.80
|
|
Treat finger fracture each
|
$17,001.39 |
$17,001.39 |
$19,073.15 |
$4,132.02
|
|
Treat foot bone lesion
|
$21,435.59 |
$21,435.59 |
$21,435.59 |
$3,839.54
|
|
Treat foot dislocation
|
$714.60 |
$714.60 |
$714.60 |
$396.30
|
|
Treat foot dislocation
|
$4,263.60 |
$4,263.60 |
$4,263.60 |
$4,192.86
|
|
Treat foot dislocation
|
$714.60 |
$714.60 |
$714.60 |
$527.28
|
|
Treat foot dislocation
|
$714.60 |
$714.60 |
$714.60 |
$445.80
|
|
Treat heel fracture
|
$14,777.70 |
$14,777.70 |
$50,643.26 |
$8,269.81
|
|
Treat humerus fracture
|
$34,078.83 |
$34,078.83 |
$52,498.10 |
$13,278.70
|
|
Treat kneecap dislocation
|
$39,979.52 |
$39,979.52 |
$39,979.52 |
$7,807.24
|
|
Treat kneecap fracture
|
$24,089.75 |
$24,089.75 |
$51,352.65 |
$6,311.00
|
|
Treat lower leg fracture
|
$40,416.72 |
$40,416.72 |
$45,540.80 |
$14,241.77
|
|
Treat lower leg joint
|
$37,581.98 |
$37,980.94 |
$44,057.63 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$27,819.86 |
$27,819.86 |
$32,061.34 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$26,406.46 |
$38,383.46 |
$40,212.61 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$19,611.30 |
$19,611.30 |
$27,136.36 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$13,497.18 |
$13,497.18 |
$13,497.18 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$126.00 |
$126.00 |
$126.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$117.60 |
$117.60 |
$117.60 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$136.80 |
$136.80 |
$136.80 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$13,934.34 |
$13,934.34 |
$13,934.34 |
$3,982.44
|
|
Treatment of ankle fracture
|
$35,468.12 |
$35,511.50 |
$36,226.01 |
$8,412.89
|
|
Treatment of ankle fracture
|
$23,036.59 |
$36,973.13 |
$38,606.73 |
$8,453.60
|
|
Treatment of ankle fracture
|
$31,471.00 |
$31,471.00 |
$47,503.46 |
$7,907.11
|
|
Treatment of ankle fracture
|
$55,838.09 |
$55,838.09 |
$55,838.09 |
$7,913.97
|
|
Treatment of fibula fracture 27780
|
$44,057.63 |
$44,057.63 |
$44,057.63 |
$491.50
|
|
Treatment of heel fracture 28400
|
$856.80 |
$856.80 |
$856.80 |
$473.00
|
|
Treatment of penis lesion
|
$86,075.68 |
$86,075.68 |
$86,075.68 |
$4,081.37
|
|
Treatment of retinal lesion
|
$1,292.40 |
$1,292.40 |
$1,292.40 |
$1,033.14
|
|
Treatment of thigh fracture
|
$51,352.65 |
$51,352.65 |
$51,352.65 |
$548.90
|
|
Treatment of tibia fracture
|
$30,826.72 |
$30,826.72 |
$30,826.72 |
$8,665.60
|
|
Treatment of toe fracture 28510
|
$760.80 |
$760.80 |
$760.80 |
$369.70
|
|
Treatment radiation delivery level 2
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$767.65
|
|
Treatment x10sv retinopathy
|
$1,292.40 |
$1,292.40 |
$1,292.40 |
$1,513.20
|
|
Treat metacarpal fracture
|
$14,489.40 |
$14,489.40 |
$14,489.40 |
$3,977.49
|
|
Treat metacarpal fracture
|
$22,152.55 |
$28,545.25 |
$31,896.80 |
$5,464.97
|
|
Treat metatarsal fracture
|
$27,249.04 |
$29,624.51 |
$33,600.92 |
$8,453.60
|
|
Treat radius fracture
|
$22,938.10 |
$22,938.10 |
$22,938.10 |
$7,807.24
|
|
Treat radius fracture
|
$31,246.88 |
$31,246.88 |
$40,604.73 |
$14,061.89
|
|
Treat thigh fracture
|
$64,580.50 |
$64,580.50 |
$64,580.50 |
$2,802.80
|
|
Treat ulnar fracture
|
$25,128.91 |
$36,190.76 |
$43,060.78 |
$5,926.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$54,101.28 |
$54,101.28 |
$54,101.28 |
$73,346.25
|
|
Treponema pallidum antibody
|
$76.20 |
$76.20 |
$76.20 |
$70.40
|
|
Trg gene rearrangement anal
|
$522.00 |
$522.00 |
$522.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$37.38 |
$42.24 |
$44.94 |
$43.21
|
|
Trichinella antibody
|
$106.20 |
$106.20 |
$106.20 |
$70.20
|
|
Trichomonas assay w/optic
|
$63.00 |
$63.00 |
$63.00 |
$55.50
|