|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,422.60 |
$1,422.60 |
$1,422.60 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,684.80 |
$1,684.80 |
$1,684.80 |
$1,703.45
|
|
Thrombin time
|
$81.00 |
$81.00 |
$81.00 |
$54.18
|
|
Thromboplastin inhibition
|
$276.00 |
$276.00 |
$276.00 |
$54.18
|
|
Thyroglobulin antibody
|
$210.00 |
$210.00 |
$210.00 |
$82.50
|
|
Thyroid imaging
|
$1,248.60 |
$1,248.60 |
$1,248.60 |
$695.60
|
|
Thyroid met imaging
|
$869.40 |
$869.40 |
$869.40 |
$838.25
|
|
Thyroid mets imag whole body
|
$3,225.60 |
$3,225.60 |
$3,225.60 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$448.80 |
$448.80 |
$448.80 |
$112.70
|
|
Thyroid Ultrasound
|
$646.20 |
$646.20 |
$646.20 |
$588.50
|
|
Thyroid uptake measurement
|
$889.80 |
$889.80 |
$889.80 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$208.20 |
$208.20 |
$208.20 |
$64.51
|
|
Tigecycline injection
|
$724.80 |
$724.80 |
$724.80 |
$235.29
|
|
Tissue culture skin/biopsy
|
$1,299.00 |
$1,299.00 |
$1,299.00 |
$488.74
|
|
Tissue culture tumor
|
$1,980.00 |
$1,980.00 |
$1,980.00 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$70.80 |
$70.80 |
$70.80 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$4,244.40 |
$4,244.40 |
$4,244.40 |
$537.50
|
|
Tissue transglutaminase iga
|
$273.00 |
$273.00 |
$273.00 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$50.40 |
$50.40 |
$50.40 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$180.00 |
$180.00 |
$180.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$9,652.20 |
$9,652.20 |
$9,652.20 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$364.80 |
$364.80 |
$364.80 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$108.00 |
$108.00 |
$108.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$57.00 |
$57.00 |
$57.00 |
$74.10
|
|
Toxoplasma antibody igg
|
$241.20 |
$241.20 |
$241.20 |
$91.65
|
|
Toxoplasma antibody igm
|
$241.20 |
$241.20 |
$241.20 |
$87.75
|
|
Tpmt gene com vrnts
|
$450.00 |
$450.00 |
$450.00 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$13,269.60 |
$13,269.60 |
$13,269.60 |
$6,684.23
|
|
Transferrin
|
$108.00 |
$108.00 |
$108.00 |
$82.00
|
|
Transparent film >16<=48 in
|
$4.20 |
$4.20 |
$4.20 |
$12.95
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$678.60 |
$678.60 |
$678.60 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$678.60 |
$678.60 |
$678.60 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$7,007.40 |
$7,007.40 |
$7,007.40 |
$3,141.85
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$5,910.00 |
$5,910.00 |
$5,910.00 |
$5,846.40
|
|
Trauma partial team response w/critical care services level 4
|
$6,141.60 |
$6,141.60 |
$6,141.60 |
$4,523.04
|
|
Treat ankle dislocation
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,360.00
|
|
Treat clavicle dislocation 23545
|
$825.60 |
$825.60 |
$825.60 |
$692.80
|
|
Treat elbow dislocation
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,272.50
|
|
Treat elbow fracture
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,026.50
|
|
Treat finger fracture each
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$1,592.00
|
|
Treat fracture of radius
|
$825.60 |
$825.60 |
$825.60 |
$1,790.00
|
|
Treat fracture of ulna
|
$499.80 |
$499.80 |
$499.80 |
$731.04
|
|
Treat hip dislocation
|
$3,050.40 |
$3,050.40 |
$3,050.40 |
$2,211.05
|
|
Treat hip dislocation
|
$3,349.80 |
$3,349.80 |
$3,349.80 |
$2,641.60
|
|
Treat humerus fracture
|
$3,250.80 |
$3,250.80 |
$3,250.80 |
$1,790.00
|
|
Treat humerus fracture
|
$3,365.40 |
$3,365.40 |
$3,365.40 |
$1,790.00
|
|
Treat kneecap dislocation
|
$1,931.40 |
$1,931.40 |
$1,931.40 |
$1,068.06
|
|
Treat knee dislocation
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,220.89
|
|
Treat knee fracture 27530
|
$825.60 |
$825.60 |
$825.60 |
$550.73
|
|
Treatment incomplete abortion completed surgically any trimester
|
$7,126.80 |
$7,126.80 |
$7,126.80 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$246.60 |
$246.60 |
$246.60 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$234.00 |
$234.00 |
$234.00 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$825.60 |
$825.60 |
$825.60 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$825.60 |
$825.60 |
$825.60 |
$501.20
|
|
Treatment of heel fracture 28400
|
$825.60 |
$825.60 |
$825.60 |
$473.00
|
|
Treatment of thigh fracture
|
$633.60 |
$633.60 |
$633.60 |
$477.75
|
|
Treatment of thigh fracture
|
$825.60 |
$825.60 |
$825.60 |
$549.00
|
|
Treatment of thigh fracture
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$825.60 |
$825.60 |
$825.60 |
$371.40
|
|
Treat midfoot fracture each
|
$6,510.60 |
$6,510.60 |
$6,510.60 |
$1,884.74
|
|
Treat thigh fracture
|
$534.60 |
$534.60 |
$534.60 |
$618.80
|
|
Treat toe dislocation
|
$3,505.20 |
$3,505.20 |
$3,505.20 |
$756.39
|
|
Treat ulnar fracture
|
$3,365.40 |
$3,365.40 |
$3,365.40 |
$1,677.20
|
|
Treat wrist bone fracture
|
$2,310.00 |
$2,310.00 |
$2,310.00 |
$1,703.20
|
|
Treat wrist dislocation
|
$825.60 |
$825.60 |
$825.60 |
$656.25
|
|
Treponema pallidum antibody
|
$146.40 |
$146.40 |
$146.40 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$55.80 |
$55.80 |
$55.80 |
$43.09
|
|
Triamcinolone a inj prs-free
|
$696.00 |
$696.00 |
$696.00 |
$223.56
|
|
Triglycerides
|
$121.80 |
$121.80 |
$121.80 |
$58.50
|
|
Trimethobenzamide hcl inj
|
$162.60 |
$162.60 |
$162.60 |
$117.49
|
|
Trim nondyst nails
|
$130.20 |
$130.20 |
$130.20 |
$113.88
|
|
Trmt of fracture (femoral shaft) 27500
|
$729.60 |
$729.60 |
$729.60 |
$754.80
|
|
Troponin quantitative
|
$91.20 |
$91.20 |
$91.20 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$968.40 |
$968.40 |
$968.40 |
$1,632.80
|
|
Tube trach disp innr can 5 xlt
|
$220.80 |
$220.80 |
$220.80 |
$445.99
|
|
Tubular dressing
|
$4.80 |
$4.80 |
$4.80 |
$28.46
|
|
Tx closed distal humerus fx
|
$114.60 |
$114.60 |
$114.60 |
$594.88
|
|
Tx closed hip disl traumatic without anes
|
$825.60 |
$825.60 |
$825.60 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$718.20 |
$718.20 |
$718.20 |
$535.60
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$6,510.60 |
$6,510.60 |
$6,510.60 |
$4,499.12
|
|
Tx open nsl fx uncomp
|
$5,368.20 |
$5,368.20 |
$5,368.20 |
$3,926.40
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$6,497.40 |
$6,497.40 |
$6,497.40 |
$4,637.36
|
|
Tx tarsal bone fx without manip 28450
|
$825.60 |
$825.60 |
$825.60 |
$419.04
|
|
Ultrasound breast complete
|
$546.60 |
$546.60 |
$546.60 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$479.40 |
$479.40 |
$479.40 |
$452.40
|
|
Ultrasound encephalogram
|
$610.20 |
$610.20 |
$610.20 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$718.80 |
$718.80 |
$718.80 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$540.00 |
$540.00 |
$540.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,009.80 |
$1,009.80 |
$1,009.80 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$400.20 |
$400.20 |
$400.20 |
$388.08
|
|
Ultrasound guide intraoperative
|
$628.80 |
$628.80 |
$628.80 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$1,000.20 |
$1,000.20 |
$1,000.20 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$658.80 |
$658.80 |
$658.80 |
$311.25
|
|
Ultrasound joint complete left
|
$847.80 |
$847.80 |
$847.80 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$309.00 |
$309.00 |
$309.00 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$309.00 |
$309.00 |
$309.00 |
$334.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$690.60 |
$690.60 |
$690.60 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$695.40 |
$695.40 |
$695.40 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$571.80 |
$571.80 |
$571.80 |
$463.00
|
