|
System cardiomems hosp electronics
|
$111,240.00 |
$111,240.00 |
$111,240.00 |
$39,037.95
|
|
System pacing micra av
|
$22,599.50 |
$22,599.50 |
$22,599.50 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$82,056.00 |
$82,056.00 |
$82,056.00 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$11,183.00 |
$11,183.00 |
$11,183.00 |
$11,183.00
|
|
T3 (triiodothyronine) free
|
$520.00 |
$520.00 |
$520.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$455.00 |
$455.00 |
$455.00 |
$93.52
|
|
T4 (thyroxine) free
|
$407.00 |
$407.00 |
$407.00 |
$85.20
|
|
T4 (thyroxine) total
|
$477.50 |
$477.50 |
$477.50 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$729.00 |
$729.00 |
$729.00 |
$122.40
|
|
Talymed
|
$199.00 |
$199.00 |
$199.00 |
$3,411.49
|
|
Target gsa panel hmtlmph neop
|
$1,606.50 |
$1,606.50 |
$1,606.50 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,837.50 |
$3,837.50 |
$3,837.50 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,979.00 |
$1,979.00 |
$1,979.00 |
$1,655.52
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$169.50 |
$169.50 |
$169.50 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$169.50 |
$169.50 |
$169.50 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$451.00 |
$451.00 |
$451.00 |
$176.40
|
|
T cells absolute cd 4 count
|
$222.00 |
$222.00 |
$222.00 |
$111.20
|
|
T cells total count
|
$496.50 |
$496.50 |
$496.50 |
$126.90
|
|
Telehealth original site facility fee
|
$57.50 |
$57.50 |
$57.50 |
$51.00
|
|
Telethx isodose plan cplx
|
$848.50 |
$848.50 |
$848.50 |
$1,526.85
|
|
Test for urine cystines
|
$16.00 |
$16.00 |
$16.00 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$3,308.00 |
$3,308.00 |
$3,308.00 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,942.50 |
$1,942.50 |
$1,942.50 |
$949.70
|
|
Tgsap so/hl 51/< rna alys
|
$3,879.00 |
$3,879.00 |
$3,879.00 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$283.00 |
$283.00 |
$283.00 |
$108.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,359.50 |
$3,359.50 |
$3,359.50 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$16,483.50 |
$16,483.50 |
$16,483.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$24,983.50 |
$24,983.50 |
$24,983.50 |
$21,413.60
|
|
Thrombin time
|
$275.00 |
$275.00 |
$275.00 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$61.52
|
|
Thyroglobulin antibody
|
$317.50 |
$317.50 |
$317.50 |
$82.00
|
|
Thyroid imaging
|
$1,003.50 |
$1,003.50 |
$1,003.50 |
$695.02
|
|
Thyroid mets imag whole body
|
$1,695.00 |
$1,695.00 |
$1,695.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$594.00 |
$594.00 |
$594.00 |
$111.00
|
|
Thyroid Ultrasound
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$588.50
|
|
Thyroid uptake measurement
|
$1,150.00 |
$1,150.00 |
$1,150.00 |
$591.25
|
|
Tib/per revasc stent & ather 37231
|
$21,954.00 |
$21,954.00 |
$21,954.00 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$14,315.50 |
$14,315.50 |
$14,315.50 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$14,315.50 |
$14,315.50 |
$14,315.50 |
$9,769.65
|
|
Tilt table study
|
$2,562.50 |
$2,562.50 |
$2,562.50 |
$1,507.01
|
|
Tissue culture placenta
|
$498.50 |
$498.50 |
$498.50 |
$457.00
|
|
Tissue culture skin/biopsy
|
$560.50 |
$560.50 |
$560.50 |
$484.00
|
|
Tissue culture tumor
|
$724.00 |
$724.00 |
$724.00 |
$483.36
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$243.50 |
$243.50 |
$243.50 |
$1,134.00
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$57.00 |
$57.00 |
$57.00 |
$18,999.96
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$6,980.00 |
$6,980.00 |
$6,980.00 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$385.00 |
$385.00 |
$385.00 |
$44.16
|
|
Tixagev and cilgav inj
|
$475.00 |
$475.00 |
$475.00 |
$224.55
|
|
Tlso rigid lined custom fab
|
$3,279.00 |
$3,279.00 |
$3,279.00 |
$2,831.21
|
|
Tobramycin peak therapeutic drug level
|
$471.00 |
$471.00 |
$471.00 |
$120.60
|
|
Tomosynthesis breast screen bilateral
|
$358.00 |
$358.00 |
$358.00 |
$72.68
|
|
Toxoplasma antibody igg
|
$382.00 |
$382.00 |
$382.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$563.00 |
$563.00 |
$563.00 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$306.50 |
$306.50 |
$306.50 |
$790.68
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,095.50 |
$1,095.50 |
$1,095.50 |
$1,420.44
|
|
Transcath biopsy
|
$1,871.00 |
$1,871.00 |
$1,871.00 |
$4,285.93
|
|
Transcatheter bx s&i
|
$3,067.00 |
$3,067.00 |
$3,067.00 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$750.00 |
$750.00 |
$750.00 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$1,995.00 |
$1,995.00 |
$1,995.00 |
$12,418.00
|
|
Transcutaneous hgb 88738
|
$17.00 |
$17.00 |
$17.00 |
$13.80
|
|
Transferrin
|
$224.50 |
$224.50 |
$224.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$3,060.50 |
$3,060.50 |
$3,060.50 |
$983.00
|
|
Transparent film >16<=48 in
|
$124.50 |
$124.50 |
$124.50 |
$12.95
|
|
Trauma partial team response w/critical care services level 4
|
$4,927.00 |
$4,927.00 |
$4,927.00 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$940.80
|
|
Treat ankle dislocation
|
$2,857.00 |
$2,857.00 |
$2,857.00 |
$2,358.40
|
|
Treat finger fracture each
|
$1,668.50 |
$1,668.50 |
$1,668.50 |
$1,536.00
|
|
Treat foot dislocation
|
$222.50 |
$222.50 |
$222.50 |
$527.28
|
|
Treat hip dislocation
|
$3,323.00 |
$3,323.00 |
$3,323.00 |
$2,192.80
|
|
Treat hip dislocation
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$2,641.60
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,070.00 |
$3,070.00 |
$3,070.00 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$204.00 |
$204.00 |
$204.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$152.00 |
$152.00 |
$152.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$386.50 |
$386.50 |
$386.50 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$2,979.00 |
$2,979.00 |
$2,979.00 |
$3,982.44
|
|
Treatment of ankle fracture 27786
|
$271.00 |
$271.00 |
$271.00 |
$520.80
|
|
Treponema pallidum antibody
|
$350.50 |
$350.50 |
$350.50 |
$70.40
|
|
Trg gene rearrangement anal
|
$290.50 |
$290.50 |
$290.50 |
$455.70
|
|
Triglycerides
|
$311.50 |
$311.50 |
$311.50 |
$58.05
|
|
Trim nondyst nails
|
$543.00 |
$543.00 |
$543.00 |
$113.40
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$7,840.00 |
$7,840.00 |
$7,840.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$7,840.00 |
$7,840.00 |
$7,840.00 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$7,840.00 |
$7,840.00 |
$7,840.00 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,723.00 |
$2,723.00 |
$2,723.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,723.00 |
$2,723.00 |
$2,723.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,723.00 |
$2,723.00 |
$2,723.00 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,723.00 |
$2,723.00 |
$2,723.00 |
$3,866.70
|
|
Troponin quantitative
|
$340.00 |
$340.00 |
$340.00 |
$127.20
|
|
Tube trach fen sz 6 uncuffed
|
$101.00 |
$101.00 |
$101.00 |
$155.98
|
|
Tx closed hip disl traumatic without anes
|
$463.50 |
$463.50 |
$463.50 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$2,004.00 |
$2,004.00 |
$2,004.00 |
$3,977.49
|
|
Ugt1a1 gene analy common variants
|
$1,131.00 |
$1,131.00 |
$1,131.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$218.00 |
$218.00 |
$218.00 |
$394.20
|
|
Ultrasound breast complete
|
$852.50 |
$852.50 |
$852.50 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$745.00 |
$745.00 |
$745.00 |
$449.35
|
|
Ultrasound chest
|
$366.50 |
$366.50 |
$366.50 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$170.00 |
$170.00 |
$170.00 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$92.50 |
$92.50 |
$92.50 |
$307.00
|
|
Ultrasound exam k transpl w/doppler
|
$192.50 |
$192.50 |
$192.50 |
$573.54
|
