|
Tetanus immune globulin inj
|
$2,306.40 |
$2,306.40 |
$2,306.40 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$48.80 |
$48.80 |
$48.80 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$198.40 |
$198.40 |
$198.40 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$157.60 |
$157.60 |
$157.60 |
$101.85
|
|
Therapy Exercise Session (each 15 minutes)
|
$157.60 |
$157.60 |
$157.60 |
$98.58
|
|
Ther nma rdctj intus/obstrcj
|
$1,674.40 |
$1,674.40 |
$1,674.40 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$42.60 |
$42.60 |
$42.60 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$724.80 |
$724.80 |
$724.80 |
$314.50
|
|
Thiotepa injection
|
$2,755.20 |
$2,755.20 |
$2,755.20 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,542.40 |
$1,542.40 |
$1,542.40 |
$1,733.65
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,037.60 |
$2,037.60 |
$2,037.60 |
$1,684.80
|
|
Thrombin time
|
$98.40 |
$98.40 |
$98.40 |
$54.18
|
|
Thromboplastin inhibition
|
$333.60 |
$333.60 |
$333.60 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$128.00 |
$128.00 |
$128.00 |
$61.52
|
|
Thyroglobulin antibody
|
$253.60 |
$253.60 |
$253.60 |
$82.73
|
|
Thyroid imaging
|
$1,510.40 |
$1,510.40 |
$1,510.40 |
$696.75
|
|
Thyroid met imaging
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$838.25
|
|
Thyroid mets imag whole body
|
$3,900.80 |
$3,900.80 |
$3,900.80 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$542.40 |
$542.40 |
$542.40 |
$112.67
|
|
Thyroid Ultrasound
|
$781.60 |
$781.60 |
$781.60 |
$588.50
|
|
Thyroid uptake measurement
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$251.20 |
$251.20 |
$251.20 |
$64.51
|
|
Tigecycline injection
|
$724.80 |
$724.80 |
$724.80 |
$235.29
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$306.00 |
$306.00 |
$306.00 |
$13,339.20
|
|
Tissue culture skin/biopsy
|
$1,571.20 |
$1,571.20 |
$1,571.20 |
$484.00
|
|
Tissue culture tumor
|
$2,394.40 |
$2,394.40 |
$2,394.40 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$85.60 |
$85.60 |
$85.60 |
$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
|
$329.60 |
$329.60 |
$329.60 |
$44.80
|
|
Tixagev and cilgav inj
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$241.92
|
|
Tl-201 thallium diag per mci
|
$61.40 |
$61.40 |
$61.40 |
$80.10
|
|
Tobramycin comp unit
|
$810.40 |
$810.40 |
$810.40 |
$810.40
|
|
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
|
$217.60 |
$217.60 |
$217.60 |
$119.40
|
|
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)
|
$440.80 |
$440.80 |
$440.80 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$136.80 |
$136.80 |
$136.80 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$69.60 |
$69.60 |
$69.60 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$17.40 |
$17.40 |
$17.40 |
$316.84
|
|
Total Hip Replacement
|
$19,440.80 |
$19,440.80 |
$19,440.80 |
$9,161.60
|
|
Toxoplasma antibody igg
|
$292.00 |
$292.00 |
$292.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$292.00 |
$292.00 |
$292.00 |
$88.00
|
|
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
|
|
Transcutaneous hgb 88738
|
$80.80 |
$80.80 |
$80.80 |
$13.20
|
|
Transferrin
|
$130.40 |
$130.40 |
$130.40 |
$82.00
|
|
Transparent film >16<=48 in
|
$5.60 |
$5.60 |
$5.60 |
$12.95
|
|
Transparent film <= 16 sq in
|
$18.60 |
$18.60 |
$18.60 |
$4.50
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$820.80 |
$820.80 |
$820.80 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$820.80 |
$820.80 |
$820.80 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$7,007.40 |
$7,007.40 |
$7,007.40 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$448.80 |
$448.80 |
$448.80 |
$7,540.20
|
|
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
|
$7,799.20 |
$7,799.20 |
$7,799.20 |
$4,471.50
|
|
Treat ankle dislocation
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$2,358.40
|
|
Treat clavicle dislocation 23545
|
$998.40 |
$998.40 |
$998.40 |
$692.80
|
|
Treat elbow dislocation
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$2,311.20
|
|
Treat elbow fracture
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$2,027.40
|
|
Treat finger fracture each
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$1,592.00
|
|
Treat fracture of radius
|
$998.40 |
$998.40 |
$998.40 |
$1,821.60
|
|
Treat fracture of ulna
|
$604.00 |
$604.00 |
$604.00 |
$726.05
|
|
Treat hip dislocation
|
$3,688.80 |
$3,688.80 |
$3,688.80 |
$2,211.05
|
|
Treat hip dislocation
|
$4,051.20 |
$4,051.20 |
$4,051.20 |
$2,612.00
|
|
Treat humerus fracture
|
$3,931.20 |
$3,931.20 |
$3,931.20 |
$1,790.00
|
|
Treat humerus fracture
|
$4,070.40 |
$4,070.40 |
$4,070.40 |
$1,790.00
|
|
Treat kneecap dislocation
|
$2,336.00 |
$2,336.00 |
$2,336.00 |
$1,068.06
|
|
Treat knee dislocation
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$2,220.89
|
|
Treat knee fracture 27530
|
$998.40 |
$998.40 |
$998.40 |
$550.73
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,618.40 |
$8,618.40 |
$8,618.40 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$297.60 |
$297.60 |
$297.60 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$282.40 |
$282.40 |
$282.40 |
$147.48
|
|
Treatment missed abortion completed surgically 1st trimester
|
$10,578.40 |
$10,578.40 |
$10,578.40 |
$4,230.80
|
|
Treatment of ankle fracture
|
$1,622.40 |
$1,622.40 |
$1,622.40 |
$8,453.60
|
|
Treatment of ankle fracture 27786
|
$825.60 |
$825.60 |
$825.60 |
$528.00
|
|
Treatment of fibula fracture 27780
|
$998.40 |
$998.40 |
$998.40 |
$515.45
|
|
Treatment of heel fracture 28400
|
$998.40 |
$998.40 |
$998.40 |
$473.00
|
|
Treatment of thigh fracture
|
$766.40 |
$766.40 |
$766.40 |
$487.50
|
|
Treatment of thigh fracture
|
$6,511.20 |
$6,511.20 |
$6,511.20 |
$1,749.06
|
|
Treatment of thigh fracture
|
$998.40 |
$998.40 |
$998.40 |
$548.90
|
|
Treatment of thigh fracture
|
$3,791.20 |
$3,791.20 |
$3,791.20 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$825.60 |
$825.60 |
$825.60 |
$371.40
|
|
Treat midfoot fracture each
|
$7,873.60 |
$7,873.60 |
$7,873.60 |
$1,884.74
|
|
Treat thigh fracture
|
$4,291.20 |
$4,291.20 |
$4,291.20 |
$1,893.86
|
|
Treat thigh fracture
|
$647.20 |
$647.20 |
$647.20 |
$618.80
|
|
Treat toe fracture
|
$6,191.20 |
$6,191.20 |
$6,191.20 |
$3,839.54
|
|
Treat ulnar fracture
|
$4,070.40 |
$4,070.40 |
$4,070.40 |
$1,678.55
|
|
Treat wrist bone fracture
|
$2,793.60 |
$2,793.60 |
$2,793.60 |
$1,679.04
|
|
Treat wrist dislocation
|
$998.40 |
$998.40 |
$998.40 |
$656.25
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$246.00 |
$246.00 |
$246.00 |
$73,346.25
|
|
Treponema pallidum antibody
|
$176.80 |
$176.80 |
$176.80 |
$72.05
|
|
Trg gene rearrangement anal
|
$636.00 |
$636.00 |
$636.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$43.20 |
$43.20 |
$43.20 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$696.00 |
$696.00 |
$696.00 |
$223.56
|
|
Triglycerides
|
$147.20 |
$147.20 |
$147.20 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$162.60 |
$162.60 |
$162.60 |
$117.49
|
|
Trim nondyst nails
|
$157.60 |
$157.60 |
$157.60 |
$114.48
|
|
Trmt of fracture (femoral shaft) 27500
|
$882.40 |
$882.40 |
$882.40 |
$754.80
|
|
Trnscath tx thromblytc vein ini day
|
$5,236.20 |
$5,236.20 |
$5,236.20 |
$3,866.70
|
|
Troponin quantitative
|
$110.40 |
$110.40 |
$110.40 |
$127.20
|
|
Tte w or without fol w/con,stres
|
$1,171.20 |
$1,171.20 |
$1,171.20 |
$1,632.80
|
