|
Thrombectomy/inf pq dialysis circuit w/pta
|
$11,155.20 |
$11,155.20 |
$11,155.20 |
$14,227.80
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$28,801.80 |
$28,801.80 |
$28,801.80 |
$21,249.26
|
|
Thrombin time
|
$37.20 |
$37.20 |
$37.20 |
$53.76
|
|
Thromboplastin inhibition
|
$146.40 |
$146.40 |
$146.40 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$39.60 |
$39.60 |
$39.60 |
$61.50
|
|
Th/wght bear nar m-l brim cu
|
$1,720.32 |
$1,720.32 |
$1,720.32 |
$1,515.38
|
|
Th/wght bear nar m-l brim mo
|
$3,061.58 |
$3,061.58 |
$3,061.58 |
$2,395.79
|
|
Th/wght bear quad-lat brim c
|
$1,443.77 |
$1,443.77 |
$1,443.77 |
$1,129.80
|
|
Th/wght bear quad-lat brim m
|
$2,166.35 |
$2,166.35 |
$2,166.35 |
$1,695.23
|
|
Thyroglobulin antibody
|
$243.60 |
$243.60 |
$243.60 |
$81.90
|
|
Thyroid mets imag whole body
|
$2,322.00 |
$2,322.00 |
$2,322.00 |
$1,544.00
|
|
Thyroid (TSH) Test
|
$208.80 |
$208.80 |
$208.80 |
$112.00
|
|
Thyroid Ultrasound
|
$710.40 |
$710.40 |
$710.40 |
$588.50
|
|
Thyroid uptake measurement
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$63.60 |
$63.60 |
$63.60 |
$64.35
|
|
Tirofiban 12.5 mg/50 ml
|
$975.12 |
$975.12 |
$975.12 |
$456.00
|
|
Tissue amnio epifix inj 100mg
|
$8,640.94 |
$8,640.94 |
$8,640.94 |
$4,201.20
|
|
Tissue culture placenta
|
$573.60 |
$573.60 |
$573.60 |
$462.80
|
|
Tissue culture skin/biopsy
|
$450.00 |
$450.00 |
$450.00 |
$488.74
|
|
Tissue culture tumor
|
$573.60 |
$573.60 |
$573.60 |
$493.92
|
|
Tissue exam koh skin/hair/nails
|
$28.20 |
$28.20 |
$28.20 |
$47.50
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$37,889.82 |
$37,889.82 |
$37,889.82 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$20.40 |
$20.40 |
$20.40 |
$44.25
|
|
Tlh uterus 250 g or less
|
$24,296.42 |
$24,296.42 |
$24,296.42 |
$11,523.76
|
|
Tlh w/t/o 250 g or less
|
$27,440.06 |
$27,440.06 |
$27,440.06 |
$11,533.76
|
|
Tlh w/t/o uterus over 250 g
|
$59,004.80 |
$59,004.80 |
$59,004.80 |
$12,320.22
|
|
Tlso 2mod symphis-xipho pre
|
$2,395.60 |
$2,395.60 |
$2,395.60 |
$1,874.50
|
|
Tlso 2 piece rigid shell
|
$2,062.89 |
$2,062.89 |
$2,062.89 |
$1,302.50
|
|
Tlso 2 shl symphys-stern cst
|
$2,452.65 |
$2,452.65 |
$2,452.65 |
$1,808.59
|
|
Tlso 3mod sacro-scap pre
|
$3,050.80 |
$3,050.80 |
$3,050.80 |
$2,117.57
|
|
Tlso 3 piece rigid shell
|
$1,343.32 |
$1,343.32 |
$1,343.32 |
$1,051.18
|
|
Tlso corset front
|
$287.04 |
$287.04 |
$287.04 |
$231.06
|
|
Tlso flex trnk sj-t9 pre ots
|
$931.57 |
$931.57 |
$931.57 |
$931.57
|
|
Tlso full corset
|
$469.39 |
$469.39 |
$469.39 |
$377.78
|
|
Tlso r fram soft ant pre cst
|
$1,019.13 |
$1,019.13 |
$1,019.13 |
$801.11
|
|
Tlso r fram soft pre ots
|
$1,019.13 |
$1,019.13 |
$1,019.13 |
$1,019.13
|
|
Tlso rig fram pelvic pre cst
|
$1,277.18 |
$1,277.18 |
$1,277.18 |
$999.43
|
|
Tlso rig fram pelvic pre ots
|
$1,277.18 |
$1,277.18 |
$1,277.18 |
$1,230.29
|
|
Tlso rigid frame pre subclav
|
$1,767.34 |
$1,767.34 |
$1,767.34 |
$1,382.98
|
|
Tlso rigid lined custom fab
|
$3,871.52 |
$3,871.52 |
$3,871.52 |
$2,831.21
|
|
Tlso rigid lined pre one pie
|
$2,696.40 |
$2,696.40 |
$2,696.40 |
$2,110.02
|
|
Tlso rigid plastic custom fa
|
$4,057.21 |
$4,057.21 |
$4,057.21 |
$2,788.42
|
|
Tlso rigid plastic pre one
|
$759.82 |
$759.82 |
$759.82 |
$594.61
|
|
Tlso trnk sj-t9 pre cst
|
$1,269.11 |
$1,269.11 |
$1,269.11 |
$523.94
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$314.16 |
$314.16 |
$314.16 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$164.40 |
$164.40 |
$164.40 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$7,409.76 |
$7,409.76 |
$7,409.76 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$32.40 |
$32.40 |
$32.40 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$32.40 |
$32.40 |
$32.40 |
$68.43
|
|
Tonsillectomy (age 12+)
|
$8,788.08 |
$8,788.08 |
$8,788.08 |
$3,837.72
|
|
Tonsillectomy (child under 12)
|
$6,193.68 |
$6,193.68 |
$6,193.68 |
$5,110.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$132.78 |
$132.78 |
$132.78 |
$310.80
|
|
Torsion ank & half solid sti
|
$330.50 |
$330.50 |
$330.50 |
$291.13
|
|
Torsion straight knee joint
|
$288.17 |
$288.17 |
$288.17 |
$253.84
|
|
Total Hip Replacement
|
$41,396.90 |
$41,396.90 |
$41,396.90 |
$9,161.60
|
|
Total Knee Replacement
|
$37,510.75 |
$37,510.75 |
$37,510.75 |
$14,254.12
|
|
Total tau
|
$339.00 |
$339.00 |
$339.00 |
$312.00
|
|
Toxoplasma antibody igg
|
$154.80 |
$154.80 |
$154.80 |
$89.24
|
|
Toxoplasma antibody igm
|
$126.60 |
$126.60 |
$126.60 |
$87.00
|
|
Tpmt gene com vrnts
|
$376.20 |
$376.20 |
$376.20 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$20,824.66 |
$20,824.66 |
$20,824.66 |
$7,144.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$9,313.40 |
$9,313.40 |
$9,313.40 |
$1,404.29
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$16.74 |
$16.74 |
$16.74 |
$55.69
|
|
Transcath biopsy
|
$3,703.20 |
$3,703.20 |
$3,703.20 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,731.00 |
$1,731.00 |
$1,731.00 |
$1,958.00
|
|
Transcath occlusion cns
|
$5,239.80 |
$5,239.80 |
$5,239.80 |
$7,125.60
|
|
Transcath occlusion non-cns
|
$12,279.00 |
$12,279.00 |
$12,279.00 |
$10,454.34
|
|
Transferrin
|
$96.60 |
$96.60 |
$96.60 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$1,491.60 |
$1,491.60 |
$1,491.60 |
$936.80
|
|
Transperi needle place pros
|
$5,114.40 |
$5,114.40 |
$5,114.40 |
$6,015.75
|
|
Trans shoe caliper plate new
|
$269.88 |
$269.88 |
$269.88 |
$217.22
|
|
Trans shoe calip plate exist
|
$204.97 |
$204.97 |
$204.97 |
$164.98
|
|
Trans shoe solid stirrup exi
|
$204.97 |
$204.97 |
$204.97 |
$141.41
|
|
Trans shoe solid stirrup new
|
$269.88 |
$269.88 |
$269.88 |
$217.22
|
|
Trapezius sling
|
$301.34 |
$301.34 |
$301.34 |
$242.54
|
|
Trastuzumab 150 mg intravenous solution
|
$4,359.60 |
$4,359.60 |
$4,359.60 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$10,579.14 |
$10,579.14 |
$10,579.14 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$9,420.48 |
$9,420.48 |
$9,420.48 |
$5,525.09
|
|
Tray bonemarrw oncontrol 102mm
|
$10,277.96 |
$10,277.96 |
$10,277.96 |
$940.80
|
|
Treat ectopic pregnancy
|
$16,958.28 |
$16,958.28 |
$16,958.28 |
$6,707.99
|
|
Treat finger fracture each
|
$5,815.44 |
$5,815.44 |
$5,815.44 |
$4,192.86
|
|
Treat heel fracture
|
$20,399.99 |
$20,399.99 |
$20,399.99 |
$8,269.81
|
|
Treat humerus fracture
|
$31,848.21 |
$31,848.21 |
$31,848.21 |
$12,653.00
|
|
Treat humerus fracture
|
$24,834.82 |
$24,834.82 |
$24,834.82 |
$10,629.07
|
|
Treat knee fracture
|
$18,669.75 |
$18,669.75 |
$18,669.75 |
$3,486.60
|
|
Treat knee fracture
|
$65,593.04 |
$65,593.04 |
$65,593.04 |
$4,521.40
|
|
Treat lower leg joint
|
$69,109.38 |
$69,109.38 |
$69,109.38 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$15,576.88 |
$15,576.88 |
$15,576.88 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$18,802.81 |
$18,802.81 |
$18,802.81 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$23,456.11 |
$23,456.11 |
$23,456.11 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$7,188.36 |
$7,188.36 |
$7,188.36 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$218.40 |
$218.40 |
$218.40 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$200.40 |
$200.40 |
$200.40 |
$143.48
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$174.00 |
$174.00 |
$174.00 |
$203.49
|
|
Treatment missed abortion completed surgically 1st trimester
|
$6,694.14 |
$6,694.14 |
$6,694.14 |
$3,982.44
|
|
Treatment of ankle fracture
|
$17,169.84 |
$17,169.84 |
$17,169.84 |
$8,412.89
|
|
Treatment of ankle fracture
|
$29,064.47 |
$29,064.47 |
$29,064.47 |
$8,453.60
|
|
Treatment of ankle fracture
|
$69,109.38 |
$69,109.38 |
$69,109.38 |
$7,907.11
|
|
Treatment radiation delivery level 2
|
$2,645.40 |
$2,645.40 |
$2,645.40 |
$787.80
|
|
Treat metacarpal fracture
|
$18,304.90 |
$18,304.90 |
$18,304.90 |
$5,464.97
|
