|
Test socket below knee
|
$610.71 |
$610.71 |
$610.71 |
$535.15
|
|
Test urine for porphyrins
|
$158.40 |
$158.40 |
$158.40 |
$50.50
|
|
Tetanus immune globulin inj
|
$2,492.82 |
$2,492.82 |
$2,492.82 |
$1,210.21
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$16,776.84 |
$16,776.84 |
$16,776.84 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$126.00 |
$126.00 |
$126.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$454.80 |
$454.80 |
$454.80 |
$83.16
|
|
Ther nma rdctj intus/obstrcj
|
$513.60 |
$513.60 |
$513.60 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$11.82 |
$11.82 |
$11.82 |
$25.54
|
|
Thigh/wght bear high roll cu
|
$805.06 |
$805.06 |
$805.06 |
$715.23
|
|
Thigh/wght bear lacer molded
|
$1,073.75 |
$1,073.75 |
$1,073.75 |
$873.03
|
|
Thigh/wght bear lacer non-mo
|
$567.44 |
$567.44 |
$567.44 |
$464.92
|
|
Thi/glut/ischia wgt bearing
|
$740.42 |
$740.42 |
$740.42 |
$657.72
|
|
Thorac cont lat support upri
|
$346.21 |
$346.21 |
$346.21 |
$277.16
|
|
Thorac cont paraspinal uprig
|
$377.39 |
$377.39 |
$377.39 |
$344.85
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$1,687.50
|
|
Thoracic control thoracic ba
|
$423.94 |
$423.94 |
$423.94 |
$387.41
|
|
Thoracic pad
|
$256.25 |
$256.25 |
$256.25 |
$234.19
|
|
Thor rib belt custom fabrica
|
$2,720.16 |
$2,720.16 |
$2,720.16 |
$239.38
|
|
Thrombectomy/inf pq dialysis circuit
|
$8,839.20 |
$8,839.20 |
$8,839.20 |
$7,594.40
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$20,564.40 |
$20,564.40 |
$20,564.40 |
$14,227.80
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$35,629.80 |
$35,629.80 |
$35,629.80 |
$21,249.26
|
|
Thrombin time
|
$85.20 |
$85.20 |
$85.20 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$12,808.20 |
$12,808.20 |
$12,808.20 |
$3,666.00
|
|
Thromboendarterectomy sfa
|
$13,308.00 |
$13,308.00 |
$13,308.00 |
$5,472.00
|
|
Thromboplastin inhibition
|
$146.40 |
$146.40 |
$146.40 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$87.60 |
$87.60 |
$87.60 |
$61.50
|
|
Th/wght bear nar m-l brim cu
|
$1,515.38 |
$1,515.38 |
$1,515.38 |
$1,515.38
|
|
Th/wght bear nar m-l brim mo
|
$2,696.86 |
$2,696.86 |
$2,696.86 |
$2,395.79
|
|
Th/wght bear quad-lat brim c
|
$1,271.78 |
$1,271.78 |
$1,271.78 |
$1,129.80
|
|
Th/wght bear quad-lat brim m
|
$1,908.28 |
$1,908.28 |
$1,908.28 |
$1,695.23
|
|
Thyroglobulin antibody
|
$241.80 |
$241.80 |
$241.80 |
$81.90
|
|
Thyroid imaging
|
$570.00 |
$570.00 |
$570.00 |
$695.02
|
|
Thyroid met imaging
|
$1,040.40 |
$1,040.40 |
$1,040.40 |
$838.25
|
|
Thyroid mets imag whole body
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$1,552.00
|
|
Thyroid (TSH) Test
|
$147.00 |
$147.00 |
$147.00 |
$112.00
|
|
Thyroid Ultrasound
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$588.50
|
|
Thyroid uptake measurement
|
$428.40 |
$428.40 |
$428.40 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$93.60 |
$93.60 |
$93.60 |
$64.35
|
|
Tirofiban 12.5 mg/50 ml
|
$1,132.86 |
$1,132.86 |
$1,132.86 |
$456.00
|
|
Tissue amnio epifix inj 100mg
|
$7,611.55 |
$7,611.55 |
$7,611.55 |
$4,201.20
|
|
Tissue culture placenta
|
$573.60 |
$573.60 |
$573.60 |
$462.80
|
|
Tissue culture skin/biopsy
|
$1,904.40 |
$1,904.40 |
$1,904.40 |
$484.00
|
|
Tissue culture tumor
|
$413.40 |
$413.40 |
$413.40 |
$493.43
|
|
Tissue exam koh skin/hair/nails
|
$100.80 |
$100.80 |
$100.80 |
$47.50
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$33,376.04 |
$33,376.04 |
$33,376.04 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$29.40 |
$29.40 |
$29.40 |
$44.25
|
|
Tlh uterus 250 g or less
|
$39,237.94 |
$39,237.94 |
$39,237.94 |
$11,378.21
|
|
Tlh w/t/o 250 g or less
|
$35,231.16 |
$35,231.16 |
$35,231.16 |
$11,533.76
|
|
Tlh w/t/o uterus over 250 g
|
$30,147.18 |
$30,147.18 |
$30,147.18 |
$12,320.22
|
|
Tlso 2mod symphis-xipho pre
|
$2,110.21 |
$2,110.21 |
$2,110.21 |
$1,874.50
|
|
Tlso 2 piece rigid shell
|
$1,817.14 |
$1,817.14 |
$1,817.14 |
$1,302.50
|
|
Tlso 2 shl symphys-stern cst
|
$2,160.47 |
$2,160.47 |
$2,160.47 |
$1,808.59
|
|
Tlso 3mod sacro-scap pre
|
$2,687.36 |
$2,687.36 |
$2,687.36 |
$2,117.57
|
|
Tlso 3 piece rigid shell
|
$1,183.29 |
$1,183.29 |
$1,183.29 |
$1,051.18
|
|
Tlso corset front
|
$252.85 |
$252.85 |
$252.85 |
$231.06
|
|
Tlso flex trnk sj-t9 pre ots
|
$820.60 |
$820.60 |
$820.60 |
$931.57
|
|
Tlso full corset
|
$413.47 |
$413.47 |
$413.47 |
$377.78
|
|
Tlso r fram soft ant pre cst
|
$897.72 |
$897.72 |
$897.72 |
$801.11
|
|
Tlso r fram soft pre ots
|
$897.72 |
$897.72 |
$897.72 |
$1,019.13
|
|
Tlso rig fram pelvic pre cst
|
$1,125.03 |
$1,125.03 |
$1,125.03 |
$999.43
|
|
Tlso rig fram pelvic pre ots
|
$1,125.03 |
$1,125.03 |
$1,125.03 |
$1,230.29
|
|
Tlso rigid frame pre subclav
|
$1,556.79 |
$1,556.79 |
$1,556.79 |
$1,382.98
|
|
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
|
$355.50 |
$355.50 |
$355.50 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$126.00 |
$126.00 |
$126.00 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$10,198.38 |
$10,198.38 |
$10,198.38 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$26.40 |
$26.40 |
$26.40 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$25.20 |
$25.20 |
$25.20 |
$68.43
|
|
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 Replacement
|
$52,235.59 |
$52,235.59 |
$52,235.59 |
$9,161.60
|
|
Total Knee Replacement
|
$65,643.48 |
$65,643.48 |
$65,643.48 |
$14,254.12
|
|
Tot disc arthrp 1ntrspc crv
|
$54,757.03 |
$54,757.03 |
$54,757.03 |
$20,154.40
|
|
Tot disc arthrp 1ntrspc lmbr
|
$84,678.69 |
$84,678.69 |
$84,678.69 |
$4,365.60
|
|
Toxoplasma antibody igg
|
$142.80 |
$142.80 |
$142.80 |
$89.24
|
|
Toxoplasma antibody igm
|
$223.20 |
$223.20 |
$223.20 |
$87.00
|
|
Tpmt gene com vrnts
|
$323.40 |
$323.40 |
$323.40 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$8,505.60 |
$8,505.60 |
$8,505.60 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$14,543.40 |
$14,543.40 |
$14,543.40 |
$6,684.23
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$96.72 |
$96.72 |
$96.72 |
$55.69
|
|
Transcath biopsy
|
$4,093.80 |
$4,093.80 |
$4,093.80 |
$4,285.93
|
|
Transcatheter bx s&i
|
$3,713.40 |
$3,713.40 |
$3,713.40 |
$1,958.00
|
|
Transcath mv repair addl prosthesis
|
$5,318.40 |
$5,318.40 |
$5,318.40 |
$4,415.21
|
|
Transcath mv repair init prosthesis
|
$10,077.00 |
$10,077.00 |
$10,077.00 |
$12,421.44
|
|
Transcath occlusion cns
|
$10,167.60 |
$10,167.60 |
$10,167.60 |
$7,125.60
|
|
Transcath occlusion non-cns
|
$17,929.20 |
$17,929.20 |
$17,929.20 |
$10,454.34
|
|
Transferrin
|
$140.40 |
$140.40 |
$140.40 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$936.80
|
|
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
|
$6,186.30 |
$6,186.30 |
$6,186.30 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$15,011.88 |
$15,011.88 |
$15,011.88 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$13,367.64 |
$13,367.64 |
$13,367.64 |
$5,525.09
|
