|
Thrombectomy/inf pq dialysis circuit w/pta
|
$7,110.50 |
$7,110.50 |
$7,110.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$9,161.00 |
$9,161.00 |
$9,161.00 |
$21,413.60
|
|
Thrombin time
|
$90.00 |
$90.00 |
$90.00 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$168.00 |
$168.00 |
$168.00 |
$61.52
|
|
Thumb fusion with graft
|
$4,858.00 |
$4,858.00 |
$4,858.00 |
$7,907.11
|
|
Thyroglobulin antibody
|
$61.00 |
$61.00 |
$61.00 |
$82.00
|
|
Thyroid imaging
|
$414.50 |
$414.50 |
$414.50 |
$695.02
|
|
Thyroid (TSH) Test
|
$162.00 |
$162.00 |
$162.00 |
$111.00
|
|
Thyroid Ultrasound
|
$279.50 |
$279.50 |
$279.50 |
$588.50
|
|
Thyroid uptake measurement
|
$414.50 |
$414.50 |
$414.50 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,550.00 |
$4,550.00 |
$4,550.00 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$66.00 |
$66.00 |
$66.00 |
$64.35
|
|
Tissue culture placenta
|
$463.00 |
$463.00 |
$463.00 |
$457.00
|
|
Tissue culture skin/biopsy
|
$464.50 |
$464.50 |
$464.50 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$25.00 |
$25.00 |
$25.00 |
$47.20
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$72.00 |
$72.00 |
$72.00 |
$44.16
|
|
Tixagev and cilgav inj
|
$308.50 |
$308.50 |
$308.50 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$23.50 |
$23.50 |
$23.50 |
$78.40
|
|
Tlh uterus 250 g or less
|
$8,018.00 |
$8,018.00 |
$8,018.00 |
$11,533.76
|
|
Tlh w/t/o 250 g or less
|
$7,615.50 |
$7,615.50 |
$7,615.50 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$5,529.50 |
$5,529.50 |
$5,529.50 |
$12,320.22
|
|
Tobramycin peak therapeutic drug level
|
$103.00 |
$103.00 |
$103.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,975.60 |
$5,975.60 |
$5,975.60 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$198.00 |
$198.00 |
$198.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$109.50 |
$109.50 |
$109.50 |
$72.68
|
|
Tongue base vol reduction
|
$2,172.33 |
$2,172.33 |
$2,172.33 |
$3,986.00
|
|
Tonsillectomy (age 12+)
|
$2,425.00 |
$2,425.00 |
$2,425.00 |
$4,424.11
|
|
Tonsillectomy (child under 12)
|
$1,889.50 |
$1,889.50 |
$1,889.50 |
$5,339.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$57.89 |
$57.89 |
$57.89 |
$325.00
|
|
Total Hip Replacement
|
$15,727.00 |
$15,727.00 |
$15,727.00 |
$9,161.60
|
|
Total hysterectomy
|
$3,842.50 |
$3,842.50 |
$3,842.50 |
$3,001.70
|
|
Total Knee Replacement
|
$16,672.00 |
$16,672.00 |
$16,672.00 |
$14,543.50
|
|
Total tau
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$40.50 |
$40.50 |
$40.50 |
$89.40
|
|
Toxoplasma antibody igm
|
$36.50 |
$36.50 |
$36.50 |
$87.00
|
|
Tp53 gene full gene sequence
|
$126.00 |
$126.00 |
$126.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$955.00 |
$955.00 |
$955.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$175.00 |
$175.00 |
$175.00 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$678.00 |
$678.00 |
$678.00 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$58.00 |
$58.00 |
$58.00 |
$101.25
|
|
Transcutaneous carboxyhb
|
$32.00 |
$32.00 |
$32.00 |
$33.57
|
|
Transferrin
|
$90.00 |
$90.00 |
$90.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$659.00 |
$659.00 |
$659.00 |
$983.00
|
|
Transplant forearm tendon
|
$2,448.75 |
$2,448.75 |
$2,448.75 |
$3,591.33
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$7,948.79 |
$7,948.79 |
$7,948.79 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$1,107.50 |
$1,107.50 |
$1,107.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$298.94 |
$298.94 |
$298.94 |
$940.80
|
|
Treat ankle dislocation
|
$2,650.50 |
$2,650.50 |
$2,650.50 |
$2,358.40
|
|
Treat ectopic pregnancy
|
$4,186.50 |
$4,186.50 |
$4,186.50 |
$6,707.99
|
|
Treat elbow dislocation
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$2,223.20
|
|
Treat elbow fracture
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,919.13
|
|
Treat eyelid by injection
|
$513.50 |
$513.50 |
$513.50 |
$481.44
|
|
Treat eyelid lesion 67850
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$1,146.13
|
|
Treat finger fracture each
|
$2,775.50 |
$2,775.50 |
$2,775.50 |
$4,132.02
|
|
Treat finger fracture each
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,536.00
|
|
Treat foot dislocation
|
$302.50 |
$302.50 |
$302.50 |
$396.30
|
|
Treat foot dislocation
|
$283.50 |
$283.50 |
$283.50 |
$527.28
|
|
Treat fracture of radius
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,790.00
|
|
Treat fracture of ulna
|
$364.00 |
$364.00 |
$364.00 |
$726.05
|
|
Treat hip socket fracture
|
$274.00 |
$274.00 |
$274.00 |
$1,392.00
|
|
Treat humerus fracture
|
$8,808.00 |
$8,808.00 |
$8,808.00 |
$12,896.80
|
|
Treat humerus fracture
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,771.43
|
|
Treat humerus fracture
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,771.43
|
|
Treat kneecap dislocation
|
$324.00 |
$324.00 |
$324.00 |
$1,068.90
|
|
Treat kneecap fracture
|
$8,531.50 |
$8,531.50 |
$8,531.50 |
$6,311.00
|
|
Treat knee fracture 27530
|
$283.50 |
$283.50 |
$283.50 |
$550.00
|
|
Treat lower leg dislocation
|
$308.00 |
$308.00 |
$308.00 |
$530.75
|
|
Treat lower leg fracture
|
$7,598.00 |
$7,598.00 |
$7,598.00 |
$14,241.77
|
|
Treat lower leg fracture
|
$6,346.00 |
$6,346.00 |
$6,346.00 |
$12,653.00
|
|
Treat lower leg joint
|
$3,423.00 |
$3,423.00 |
$3,423.00 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$7,307.00 |
$7,307.00 |
$7,307.00 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$6,018.50 |
$6,018.50 |
$6,018.50 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$5,490.00 |
$5,490.00 |
$5,490.00 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$4,006.00 |
$4,006.00 |
$4,006.00 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$149.00 |
$149.00 |
$149.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$80.00 |
$80.00 |
$80.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$2,130.00 |
$2,130.00 |
$2,130.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$698.50 |
$698.50 |
$698.50 |
$3,982.44
|
|
Treatment of ankle fracture
|
$5,411.00 |
$5,411.00 |
$5,411.00 |
$8,412.89
|
|
Treatment of ankle fracture
|
$3,727.67 |
$3,727.67 |
$3,727.67 |
$8,453.60
|
|
Treatment of ankle fracture
|
$2,843.50 |
$2,843.50 |
$2,843.50 |
$7,907.11
|
|
Treatment of ankle fracture
|
$11,138.50 |
$11,138.50 |
$11,138.50 |
$7,913.97
|
|
Treatment of ankle fracture 27786
|
$378.00 |
$378.00 |
$378.00 |
$520.80
|
|
Treatment of corneal lesion
|
$365.00 |
$365.00 |
$365.00 |
$856.80
|
|
Treatment of fibula fracture
|
$1,184.83 |
$1,184.83 |
$1,184.83 |
$6,311.00
|
|
Treatment of fibula fracture 27780
|
$337.50 |
$337.50 |
$337.50 |
$491.50
|
|
Treatment of heel fracture 28400
|
$308.00 |
$308.00 |
$308.00 |
$473.00
|
|
Treatment of miscarriage
|
$938.50 |
$938.50 |
$938.50 |
$4,146.69
|
|
Treatment of mouth lesion physical 40820
|
$3,810.50 |
$3,810.50 |
$3,810.50 |
$3,589.62
|
|
Treatment of retinal lesion
|
$632.00 |
$632.00 |
$632.00 |
$1,033.14
|
|
Treatment of thigh fracture
|
$283.50 |
$283.50 |
$283.50 |
$476.16
|
|
Treatment of thigh fracture
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,748.40
|
|
Treatment of thigh fracture
|
$375.00 |
$375.00 |
$375.00 |
$548.90
|
|
Treatment of thigh fracture
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,772.97
|
|
Treatment of tibia fracture
|
$7,386.00 |
$7,386.00 |
$7,386.00 |
$7,087.60
|
|
Treatment of toe fracture 28510
|
$283.50 |
$283.50 |
$283.50 |
$369.70
|
|
Treatment radiation delivery level 2
|
$481.50 |
$481.50 |
$481.50 |
$767.65
|
|
Treat metacarpal fracture
|
$4,447.00 |
$4,447.00 |
$4,447.00 |
$3,977.49
|
|
Treat metatarsal fracture
|
$3,554.50 |
$3,554.50 |
$3,554.50 |
$3,839.54
|
