|
Tonsillectomy (age 12+)
|
$11,477.23 |
$11,477.23 |
$11,477.23 |
$4,424.11
|
|
Tonsillectomy (child under 12)
|
$11,910.70 |
$11,910.70 |
$11,910.70 |
$5,339.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$694.20 |
$694.20 |
$694.20 |
$325.00
|
|
Torsion ank & half solid sti
|
$440.84 |
$440.84 |
$440.84 |
$291.13
|
|
Torsion straight knee joint
|
$384.37 |
$384.37 |
$384.37 |
$253.84
|
|
Total hip arthroplasty
|
$89,516.00 |
$89,516.00 |
$89,516.00 |
$7,347.60
|
|
Total Hip Replacement
|
$52,502.42 |
$52,502.42 |
$52,502.42 |
$9,161.60
|
|
Total Knee Replacement
|
$47,568.95 |
$47,568.95 |
$47,568.95 |
$14,543.50
|
|
Total tau
|
$339.00 |
$339.00 |
$339.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$198.60 |
$198.60 |
$198.60 |
$89.40
|
|
Toxoplasma antibody igm
|
$198.60 |
$198.60 |
$198.60 |
$87.00
|
|
Tp53 gene full gene sequence
|
$1,617.60 |
$1,617.60 |
$1,617.60 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$628.80 |
$628.80 |
$628.80 |
$790.68
|
|
Tpmt gene com vrnts
|
$347.40 |
$347.40 |
$347.40 |
$371.80
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$102.00 |
$102.00 |
$102.00 |
$56.38
|
|
Transcath biopsy
|
$8,924.40 |
$8,924.40 |
$8,924.40 |
$4,285.93
|
|
Transcatheter bx s&i
|
$6,559.20 |
$6,559.20 |
$6,559.20 |
$1,915.00
|
|
Transferrin
|
$67.20 |
$67.20 |
$67.20 |
$82.00
|
|
Transplant forearm tendon
|
$23,154.33 |
$23,154.33 |
$23,154.33 |
$3,591.33
|
|
Trans shoe caliper plate new
|
$359.98 |
$359.98 |
$359.98 |
$217.22
|
|
Trans shoe calip plate exist
|
$273.39 |
$273.39 |
$273.39 |
$164.98
|
|
Trans shoe solid stirrup exi
|
$273.39 |
$273.39 |
$273.39 |
$141.41
|
|
Trans shoe solid stirrup new
|
$359.98 |
$359.98 |
$359.98 |
$217.22
|
|
Trapezius sling
|
$401.94 |
$401.94 |
$401.94 |
$242.54
|
|
Trastuzumab 150 mg intravenous solution
|
$7,862.34 |
$7,862.34 |
$7,862.34 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$19,079.04 |
$19,079.04 |
$19,079.04 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$16,989.36 |
$16,989.36 |
$16,989.36 |
$5,835.15
|
|
Tray bonemarrw oncontrol 102mm
|
$9,053.56 |
$9,053.56 |
$9,053.56 |
$940.80
|
|
Treat ectopic pregnancy
|
$20,343.61 |
$20,343.61 |
$20,343.61 |
$6,707.99
|
|
Treat heel fracture
|
$38,300.26 |
$38,300.26 |
$38,300.26 |
$8,269.81
|
|
Treat humerus fracture
|
$59,014.25 |
$59,014.25 |
$59,014.25 |
$13,278.70
|
|
Treat kneecap fracture
|
$22,980.51 |
$22,980.51 |
$22,980.51 |
$6,311.00
|
|
Treat lower leg fracture
|
$52,595.35 |
$52,595.35 |
$52,595.35 |
$14,241.77
|
|
Treat lower leg joint
|
$32,289.90 |
$32,289.90 |
$32,289.90 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$37,042.68 |
$37,042.68 |
$37,042.68 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$27,244.40 |
$27,244.40 |
$27,244.40 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$24,238.80 |
$24,238.80 |
$24,238.80 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,034.12 |
$8,034.12 |
$8,034.12 |
$3,916.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$42,678.12 |
$42,678.12 |
$42,678.12 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$8,757.84 |
$8,757.84 |
$8,757.84 |
$3,982.44
|
|
Treatment of ankle fracture
|
$30,967.57 |
$30,967.57 |
$30,967.57 |
$8,412.89
|
|
Treatment of ankle fracture
|
$33,281.05 |
$33,281.05 |
$33,281.05 |
$8,453.60
|
|
Treatment of ankle fracture
|
$32,795.75 |
$32,795.75 |
$32,795.75 |
$7,907.11
|
|
Treatment of ankle fracture
|
$67,852.91 |
$67,852.91 |
$67,852.91 |
$7,913.97
|
|
Treatment radiation delivery level 2
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$767.65
|
|
Treat metatarsal fracture
|
$62,223.22 |
$62,223.22 |
$62,223.22 |
$8,453.60
|
|
Treat ulnar fracture
|
$30,982.13 |
$30,982.13 |
$30,982.13 |
$5,926.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$31,454.22 |
$31,454.22 |
$31,454.22 |
$73,346.25
|
|
Treponema pallidum antibody
|
$67.80 |
$67.80 |
$67.80 |
$70.40
|
|
Trg gene rearrangement anal
|
$347.40 |
$347.40 |
$347.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$43.38 |
$43.38 |
$43.38 |
$43.21
|
|
Trichinella antibody
|
$169.20 |
$169.20 |
$169.20 |
$70.20
|
|
Triglycerides
|
$60.00 |
$60.00 |
$60.00 |
$58.05
|
|
Trilaciclib 300 mg intravenous solution
|
$7,597.38 |
$7,597.38 |
$7,597.38 |
$4,043.12
|
|
Trim nondyst nails
|
$96.60 |
$96.60 |
$96.60 |
$113.40
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$32,494.39 |
$32,494.39 |
$32,494.39 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$32,494.39 |
$32,494.39 |
$32,494.39 |
$7,354.00
|
|
Trnscath plc stent crv crtd without prtct
|
$26,708.40 |
$26,708.40 |
$26,708.40 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$26,708.40 |
$26,708.40 |
$26,708.40 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$23,121.00 |
$23,121.00 |
$23,121.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$23,121.00 |
$23,121.00 |
$23,121.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$23,121.00 |
$23,121.00 |
$23,121.00 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,398.20 |
$5,398.20 |
$5,398.20 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,850.40 |
$4,850.40 |
$4,850.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$6,949.20 |
$6,949.20 |
$6,949.20 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$6,112.80 |
$6,112.80 |
$6,112.80 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$4,370.40 |
$4,370.40 |
$4,370.40 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$8,088.66 |
$8,088.66 |
$8,088.66 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$7,101.78 |
$7,101.78 |
$7,101.78 |
$2,371.50
|
|
Troponin quantitative
|
$70.20 |
$70.20 |
$70.20 |
$127.20
|
|
Tube trach disp innr can 5 xlt
|
$675.32 |
$675.32 |
$675.32 |
$445.99
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$9,177.90 |
$9,177.90 |
$9,177.90 |
$4,499.12
|
|
Tympanic membrane repair
|
$7,176.11 |
$7,176.11 |
$7,176.11 |
$2,638.87
|
|
Ugt1a1 gene analy common variants
|
$298.20 |
$298.20 |
$298.20 |
$438.75
|
|
Ultrasound guidance for vascular access
|
$8,884.80 |
$8,884.80 |
$8,884.80 |
$400.20
|
|
Ultrasound infant hips ltd without stress
|
$554.40 |
$554.40 |
$554.40 |
$311.25
|
|
Umbilicoplasty 15847
|
$45,117.02 |
$45,117.02 |
$45,117.02 |
$4,172.97
|
|
Unlisted chemotherapy px
|
$57.60 |
$57.60 |
$57.60 |
$150.00
|
|
Unlisted hematology&coagj px
|
$162.60 |
$162.60 |
$162.60 |
$39.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$20,883.28 |
$20,883.28 |
$20,883.28 |
$5,419.00
|
|
Unlisted laparoscopic procedure 49659
|
$39,376.04 |
$39,376.04 |
$39,376.04 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$14,594.04 |
$14,594.04 |
$14,594.04 |
$5,419.00
|
|
Unlisted laps px esoph
|
$24,478.31 |
$24,478.31 |
$24,478.31 |
$5,741.00
|
|
Unlisted misc path test
|
$38.40 |
$38.40 |
$38.40 |
$89.40
|
|
Unlisted procedure microbiology
|
$1,984.80 |
$1,984.80 |
$1,984.80 |
$523.50
|
|
Unlisted px foot/toes
|
$39,543.50 |
$39,543.50 |
$39,543.50 |
$1,225.50
|
|
Unlisted px med radj physics
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$462.35
|
|
Unlisted px temporal bone
|
$7,863.30 |
$7,863.30 |
$7,863.30 |
$571.20
|
|
Unlisted transfusion med px
|
$192.00 |
$192.00 |
$192.00 |
$147.50
|
|
Upper Endoscopy (EGD, diagnostic)
|
$6,322.20 |
$6,322.20 |
$6,322.20 |
$1,751.66
|
|
Upper Endoscopy (EGD, with biopsy)
|
$7,044.00 |
$7,044.00 |
$7,044.00 |
$1,768.00
|
|
Uppr gi scope w/submuc inj
|
$14,845.92 |
$14,845.92 |
$14,845.92 |
$1,872.00
|
|
Urea nitrogen
|
$54.00 |
$54.00 |
$54.00 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$36.60 |
$36.60 |
$36.60 |
$51.75
|
|
Urea nitrogen clearance
|
$16.20 |
$16.20 |
$16.20 |
$42.25
|
|
Ureteral reflux study
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$579.73
|
|
Urethrocystography void s&i
|
$1,337.40 |
$1,337.40 |
$1,337.40 |
$622.35
|
|
Uric acid blood
|
$77.40 |
$77.40 |
$77.40 |
$48.75
|
|
Uric acid urine
|
$26.40 |
$26.40 |
$26.40 |
$44.33
|
