|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,710.78 |
$3,710.78 |
$3,710.78 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$10,355.48 |
$12,366.50 |
$21,656.37 |
|
|
Tenolysis extensor tendon hand/finger each
|
$3,210.40 |
$3,210.40 |
$3,210.40 |
|
|
Tenosynovectomy radic 26145
|
$3,613.60 |
$3,613.60 |
$3,613.60 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$61.18 |
$63.10 |
$312.38 |
|
|
Testicular imaging w/vasc flow
|
$1,096.00 |
$1,150.40 |
$1,587.20 |
|
|
Test pathogen(s) for platelets reference
|
$142.40 |
$142.40 |
$142.40 |
|
|
Test stress cardiovascular tracing only
|
$1,025.60 |
$1,103.20 |
$1,808.80 |
|
|
Test urine for porphyrins
|
$104.00 |
$104.00 |
$104.00 |
|
|
Tetanus immune globulin inj
|
$598.64 |
$598.64 |
$899.08 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$11,162.45 |
$11,759.93 |
$12,284.57 |
|
|
Theophylline therapeutic drug level
|
$63.20 |
$88.00 |
$112.80 |
|
|
Therapeutic procd strg endur
|
$123.20 |
$128.80 |
$132.00 |
|
|
Therapy Activity Training (each 15 minutes)
|
$114.40 |
$126.40 |
$138.40 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$117.60 |
$126.40 |
$132.80 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$45.60 |
$50.40 |
$64.00 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$45.60 |
$57.60 |
$62.40 |
|
|
Ther nma rdctj intus/obstrcj
|
$935.20 |
$935.20 |
$935.20 |
|
|
Ther/proph/diag inj ia
|
$173.60 |
$176.00 |
$295.20 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$62.53 |
$63.20 |
$314.53 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$255.20 |
$321.60 |
$455.20 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,148.80 |
$1,804.00 |
$2,495.20 |
|
|
Thoracotomy w/expl
|
$950.40 |
$950.40 |
$950.40 |
|
|
Thoracotomy with cardiac massage
|
$2,599.20 |
$2,599.20 |
$2,599.20 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,726.40 |
$2,036.00 |
$2,588.80 |
|
|
Thrombectmy crnry perq mechanical
|
$4,721.60 |
$4,721.60 |
$5,104.00 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$12,553.60 |
$12,553.60 |
$12,631.20 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$25,091.20 |
$25,091.20 |
$25,907.20 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$39,336.80 |
$39,336.80 |
$39,712.80 |
|
|
Thrombin time
|
$39.20 |
$39.20 |
$60.80 |
|
|
Thromboendarterectomy common femoral
|
$10,087.20 |
$10,087.20 |
$10,087.20 |
|
|
Thromboendarterectomy sfa
|
$10,087.20 |
$10,087.20 |
$10,087.20 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$22.40 |
$69.60 |
$105.60 |
|
|
Thyroglobulin antibody
|
$81.60 |
$87.20 |
$136.00 |
|
|
Thyroid imaging
|
$956.80 |
$1,004.00 |
$1,268.00 |
|
|
Thyroid mets imag whole body
|
$2,220.80 |
$2,220.80 |
$2,408.00 |
|
|
Thyroid met uptake
|
$602.40 |
$602.40 |
$614.40 |
|
|
Thyroid (TSH) Test
|
$81.60 |
$84.00 |
$144.00 |
|
|
Thyroid Ultrasound
|
$680.00 |
$741.60 |
$892.00 |
|
|
Thyroid uptake measurement
|
$857.60 |
$876.80 |
$921.60 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,764.81 |
$2,900.48 |
$4,539.80 |
|
|
Thyroxine binding globulin (tbg)
|
$48.80 |
$48.80 |
$48.80 |
|
|
Tigecycline injection
|
$68.16 |
$271.86 |
$513.06 |
|
|
Tilt table study
|
$2,017.60 |
$2,017.60 |
$2,681.60 |
|
|
Tirofiban 12.5 mg/50 ml
|
$196.76 |
$313.30 |
$501.60 |
|
|
Tissue culture tumor
|
$605.60 |
$605.60 |
$605.60 |
|
|
Tissue exam koh skin/hair/nails
|
$40.80 |
$47.20 |
$72.00 |
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$118.40 |
$118.40 |
$118.40 |
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$98.60 |
$98.60 |
$98.60 |
|
|
Tissue transglutaminase iga
|
$44.80 |
$50.40 |
$79.20 |
|
|
Tl-201 thallium diag per mci
|
$78.40 |
$78.40 |
$78.40 |
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$60.62 |
$61.32 |
$312.40 |
|
|
Tobramycin non-comp unit
|
$76.63 |
$76.63 |
$76.63 |
|
|
Tobramycin peak therapeutic drug level
|
$84.80 |
$88.00 |
$180.80 |
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,538.50 |
$3,538.50 |
$5,842.76 |
|
|
Toe X-ray (both feet)
|
$231.20 |
$273.60 |
$344.00 |
|
|
Tomosynthesis breast diagnostic left
|
$95.20 |
$95.20 |
$101.60 |
|
|
Tomosynthesis breast screen bilateral
|
$68.00 |
$90.40 |
$126.40 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$546.96 |
$546.96 |
$546.96 |
|
|
Toxoplasma antibody igg
|
$76.00 |
$112.80 |
$148.80 |
|
|
Toxoplasma antibody igm
|
$75.20 |
$122.40 |
$172.80 |
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,857.60 |
$1,857.60 |
$1,857.60 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$88.80 |
$100.00 |
$126.40 |
|
|
Transabdom amnioinfus w/us
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
|
|
Transcath biopsy
|
$6,392.00 |
$6,392.00 |
$6,392.00 |
|
|
Transcath closure of asd
|
$31,254.40 |
$31,254.40 |
$31,254.40 |
|
|
Transcath closure of vsd
|
$22,568.80 |
$22,568.80 |
$22,568.80 |
|
|
Transcatheter bx s&i
|
$3,017.60 |
$3,017.60 |
$3,712.80 |
|
|
Transcath mv repair addl prosthesis
|
$12,006.40 |
$12,006.40 |
$12,006.40 |
|
|
Transcath mv repair init prosthesis
|
$24,160.80 |
$24,160.80 |
$24,160.80 |
|
|
Transcath occlusion cns
|
$12,474.40 |
$12,474.40 |
$15,020.80 |
|
|
Transcath occlusion non-cns
|
$6,179.20 |
$6,179.20 |
$12,907.20 |
|
|
Trans cath replace aortic valve 33366
|
$24,118.40 |
$24,118.40 |
$24,118.40 |
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,784.80 |
$4,784.80 |
$4,784.80 |
|
|
Transferrin
|
$53.60 |
$105.60 |
$148.00 |
|
|
Transplant forearm tendon
|
$4,639.20 |
$4,639.20 |
$4,639.20 |
|
|
Transplant hand tendon
|
$4,377.60 |
$4,377.60 |
$4,377.60 |
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$461.60 |
$743.20 |
$872.00 |
|
|
Transvaginal Pregnancy Ultrasound
|
$450.40 |
$748.00 |
$913.60 |
|
|
Trastuzumab 150 mg intravenous solution
|
$4,312.64 |
$4,312.64 |
$4,312.64 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$10,192.48 |
$10,192.48 |
$10,192.48 |
|
|
Trauma partial team response w/critical care services level 4
|
$1,463.20 |
$2,387.20 |
$7,150.40 |
|
|
Tray bonemarrw oncontrol 102mm
|
$1,493.60 |
$1,493.60 |
$2,988.00 |
|
|
Treat ankle dislocation
|
$1,972.80 |
$1,972.80 |
$2,117.60 |
|
|
Treat clavicle dislocation 23545
|
$432.80 |
$459.20 |
$1,077.60 |
|
|
Treat elbow dislocation
|
$2,223.20 |
$2,500.80 |
$2,606.40 |
|
|
Treat elbow fracture
|
$1,018.40 |
$1,018.40 |
$2,251.20 |
|
|
Treat finger fracture each
|
$904.80 |
$989.60 |
$1,819.20 |
|
|
Treat foot dislocation
|
$246.40 |
$249.60 |
$392.00 |
|
|
Treat foot dislocation
|
$246.40 |
$249.60 |
$464.00 |
|
|
Treat foot dislocation
|
$361.60 |
$362.40 |
$396.00 |
|
|
Treat fracture of radius
|
$1,039.20 |
$1,049.60 |
$1,677.60 |
|
|
Treat fracture of radius
|
$1,025.60 |
$1,025.60 |
$2,558.40 |
|
|
Treat fracture of ulna
|
$424.80 |
$1,512.00 |
$1,832.80 |
|
|
Treat hand bone lesion
|
$4,301.60 |
$4,301.60 |
$4,301.60 |
|
|
Treat hand dislocation
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
|
|
Treat hip dislocation
|
$2,192.80 |
$2,192.80 |
$2,435.20 |
|
|
Treat hip dislocation
|
$1,674.40 |
$1,674.40 |
$2,612.00 |
|
|
Treat hip socket fracture
|
$1,476.00 |
$1,476.00 |
$1,476.00 |
|
|
Treat humerus fracture
|
$1,174.40 |
$1,174.40 |
$1,808.80 |
|