|
Tetanus immune globulin inj
|
$1,395.20 |
$1,395.20 |
$1,395.20 |
|
|
Theophylline therapeutic drug level
|
$107.94 |
$107.94 |
$107.94 |
|
|
Therapeutic procd strg endur
|
$68.93 |
$68.93 |
$68.93 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$28.62 |
$28.62 |
$30.08 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$30.08 |
$30.08 |
$30.08 |
|
|
Ther/proph/diag inj ia
|
$293.46 |
$293.46 |
$293.46 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.54 |
$9.54 |
$9.54 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$633.65 |
$633.65 |
$1,476.80 |
|
|
Thrombectmy crnry perq mechanical
|
$5,183.18 |
$5,183.18 |
$5,183.18 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,864.03 |
$5,864.03 |
$5,864.03 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$16,877.27 |
$16,877.27 |
$16,877.27 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$18,673.44 |
$18,673.44 |
$18,673.44 |
|
|
Thrombin time
|
$58.52 |
$58.52 |
$58.52 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$61.50 |
$61.50 |
$61.52 |
|
|
Thyroglobulin antibody
|
$69.42 |
$69.42 |
$69.42 |
|
|
Thyroid imaging
|
$370.16 |
$370.16 |
$370.16 |
|
|
Thyroid mets imag whole body
|
$436.38 |
$436.38 |
$576.47 |
|
|
Thyroid (TSH) Test
|
$74.27 |
$74.27 |
$74.27 |
|
|
Thyroid Ultrasound
|
$200.28 |
$289.52 |
$289.56 |
|
|
Thyroid uptake measurement
|
$257.97 |
$325.98 |
$325.98 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,249.49 |
$4,249.49 |
$4,249.49 |
|
|
Thyroxine binding globulin (tbg)
|
$90.36 |
$90.36 |
$90.36 |
|
|
Tib/per revasc stent & ather 37231
|
$26,362.29 |
$26,362.29 |
$26,362.29 |
|
|
Tib/per revasc stnt & ather
|
$16,672.49 |
$16,672.49 |
$16,672.49 |
|
|
Tib/per revasc w/ather add-on 37233
|
$11,648.90 |
$11,648.90 |
$11,648.90 |
|
|
Tissue culture tumor
|
$492.41 |
$492.41 |
$492.41 |
|
|
Tissue exam koh skin/hair/nails
|
$45.23 |
$45.23 |
$45.23 |
|
|
Tissue transglutaminase iga
|
$21.09 |
$21.09 |
$21.09 |
|
|
Tl-201 thallium diag per mci
|
$51.23 |
$209.88 |
$209.88 |
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.08 |
$7.08 |
$11.19 |
|
|
Tobramycin peak therapeutic drug level
|
$149.93 |
$149.93 |
$149.93 |
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$14.28 |
$14.28 |
$14.28 |
|
|
Tomosynthesis breast diagnostic left
|
$34.07 |
$34.07 |
$34.07 |
|
|
Tomosynthesis breast screen bilateral
|
$32.45 |
$32.45 |
$32.45 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$3.72 |
$3.72 |
$3.72 |
|
|
Toxoplasma antibody igg
|
$51.12 |
$51.12 |
$51.12 |
|
|
Toxoplasma antibody igm
|
$71.34 |
$71.34 |
$71.34 |
|
|
Tprnl plmt biodegrdabl matrl
|
$3,702.00 |
$3,702.00 |
$3,702.00 |
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,860.63 |
$1,860.63 |
$1,860.63 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$85.11 |
$85.11 |
$85.11 |
|
|
Transabdom amnioinfus w/us
|
$496.26 |
$496.26 |
$557.51 |
|
|
Transcath biopsy
|
$2,038.67 |
$2,038.67 |
$2,038.67 |
|
|
Transcatheter bx s&i
|
$668.48 |
$668.48 |
$668.48 |
|
|
Transcath occlusion cns
|
$3,787.88 |
$3,787.88 |
$3,787.88 |
|
|
Transcath occlusion non-cns
|
$7,822.04 |
$7,822.04 |
$7,822.04 |
|
|
Transferrin
|
$92.46 |
$92.46 |
$92.46 |
|
|
Transfusion blood/blood component(s)
|
$375.00 |
$375.00 |
$375.00 |
|
|
Trastuzumab 150 mg intravenous solution
|
$223.29 |
$223.29 |
$223.29 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$194.88 |
$194.88 |
$194.88 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$62.96 |
$66.14 |
$114.54 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$50.79 |
$50.79 |
$53.34 |
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$75.56 |
$75.56 |
$128.94 |
|
|
Treatment radiation delivery level 2
|
$155.90 |
$155.90 |
$155.90 |
|
|
Treponema pallidum antibody
|
$119.52 |
$119.52 |
$119.52 |
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$4.56 |
$4.56 |
$5.19 |
|
|
Triglycerides
|
$42.81 |
$42.81 |
$42.81 |
|
|
Trim nondyst nails
|
$277.29 |
$277.29 |
$277.29 |
|
|
Trnscath plc stent crv crtd without prtct
|
$776.69 |
$776.69 |
$776.69 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$3,938.67 |
$3,938.67 |
$3,938.67 |
|
|
Trnscath plc stnt ante carotid art
|
$3,938.67 |
$3,938.67 |
$3,938.67 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,764.29 |
$11,764.29 |
$11,764.29 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$11,764.29 |
$11,764.29 |
$11,764.29 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,764.29 |
$11,764.29 |
$11,764.29 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,358.24 |
$4,358.24 |
$4,358.24 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,905.24 |
$4,905.24 |
$4,905.24 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,485.86 |
$4,485.86 |
$4,485.86 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,496.04 |
$4,496.04 |
$4,496.04 |
|
|
Trnscath tx thromblytc vein ini day
|
$4,905.24 |
$4,905.24 |
$4,905.24 |
|
|
Troponin quantitative
|
$74.66 |
$77.15 |
$77.15 |
|
|
Tte w or without fol w/con,stres
|
$1,108.76 |
$1,108.76 |
$1,108.76 |
|
|
Tx atrial fib pulm vein isol
|
$22,914.50 |
$22,914.50 |
$22,914.50 |
|
|
Tx l/r atrial fib addl
|
$686.31 |
$686.31 |
$686.31 |
|
|
Ultrasound abdomen aorta screening study aaa
|
$170.31 |
$170.31 |
$178.85 |
|
|
Ultrasound breast complete
|
$346.94 |
$346.94 |
$346.94 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$330.39 |
$330.39 |
$330.39 |
|
|
Ultrasound chest
|
$188.24 |
$207.68 |
$218.07 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$228.42 |
$228.42 |
$228.42 |
|
|
Ultrasound elastography ea l target les
|
$178.70 |
$178.70 |
$178.70 |
|
|
Ultrasound encephalogram
|
$190.37 |
$190.37 |
$199.89 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$125.04 |
$131.31 |
$308.31 |
|
|
Ultrasound guidance for vascular access
|
$211.65 |
$222.23 |
$222.23 |
|
|
Ultrasound guided needle placement supervision & interpretation
|
$228.23 |
$228.23 |
$228.23 |
|
|
Ultrasound guide intraoperative
|
$282.24 |
$282.24 |
$282.24 |
|
|
Ultrasound guide tissue ablation
|
$628.43 |
$628.43 |
$628.43 |
|
|
Ultrasound infant hips ltd without stress
|
$120.57 |
$126.59 |
$206.69 |
|
|
Ultrasound joint complete left
|
$209.33 |
$287.31 |
$301.68 |
|
|
Ultrasound joint/nonvascular extremity limited left
|
$209.33 |
$261.99 |
$275.09 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$156.15 |
$156.15 |
$163.98 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$190.31 |
$190.31 |
$199.83 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$322.76 |
$338.91 |
$338.91 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$201.17 |
$211.22 |
$211.22 |
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$82.56 |
$86.70 |
$163.02 |
|
|
Ultrasound pregnant uterus transvaginal
|
$304.01 |
$354.47 |
$372.18 |
|
|
Ultrasound prostate/transrectal
|
$181.01 |
$181.01 |
$190.08 |
|
|
Ultrasound retroperitoneal limited
|
$252.51 |
$252.51 |
$252.51 |
|
|
Ultrasound scrotum and contents
|
$264.11 |
$317.94 |
$333.84 |
|
|
Ultrasound spinal canal and contents
|
$207.26 |
$217.62 |
$376.25 |
|
|
Ultrasound transabd ea addl gest
|
$199.88 |
$199.88 |
$209.88 |
|
|
Ultrasound transvaginal non obstetric
|
$195.29 |
$352.61 |
$370.23 |
|
|
Unlisted mr procedure
|
$542.21 |
$542.21 |
$736.64 |
|
