|
Tib/per revasc stnt & ather
|
$10,012.80 |
$10,012.80 |
$11,078.70 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$13,263.75 |
$13,263.75 |
$20,598.88 |
$10,165.00
|
|
Tigecycline injection
|
$216.00 |
$216.00 |
$216.00 |
$235.29
|
|
Tilt table study
|
$1,051.80 |
$1,051.80 |
$2,325.16 |
$1,561.82
|
|
Tirofiban 12.5 mg/50 ml
|
$516.15 |
$516.15 |
$516.15 |
$458.85
|
|
Tisagenlecleucel car-pos t
|
$1,382,069.38 |
$1,382,069.38 |
$1,382,069.38 |
$1,780,600.03
|
|
Tis cgen car anomal 1st shnt
|
$7,684.33 |
$7,684.33 |
$7,684.33 |
$8,068.54
|
|
Tis cgen car anomal ea addl
|
$6,546.38 |
$6,546.38 |
$6,546.38 |
$6,546.38
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$12,851.40 |
$12,851.40 |
$12,851.40 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$35.06 |
$35.06 |
$4,201.20 |
$4,201.20
|
|
Tissue culture placenta
|
$585.14 |
$585.14 |
$876.45 |
$440.50
|
|
Tissue culture skin/biopsy
|
$638.40 |
$638.40 |
$687.36 |
$484.00
|
|
Tissue culture tumor
|
$738.00 |
$738.00 |
$772.11 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$51.02 |
$51.02 |
$51.30 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$293.82 |
$293.82 |
$304.84 |
$537.50
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$19,288.03 |
$19,288.03 |
$19,288.03 |
$830.41
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$92.25 |
$92.25 |
$1,403.42 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$36.90 |
$36.90 |
$137.80 |
$44.80
|
|
Tixagev and cilgav inj
|
$180.60 |
$180.60 |
$180.60 |
$241.92
|
|
Tlso 2 piece rigid shell
|
$569.93 |
$569.93 |
$569.93 |
$1,302.50
|
|
Tlso 2 shl symphys-stern cst
|
$1,535.15 |
$1,535.15 |
$2,095.23 |
$1,808.59
|
|
Tlso 3mod sacro-scap pre
|
$2,570.48 |
$2,570.48 |
$2,570.48 |
$2,117.57
|
|
Tlso r fram soft ant pre cst
|
$652.36 |
$652.36 |
$801.11 |
$801.11
|
|
Tlso rigid frame pre subclav
|
$1,193.13 |
$1,193.13 |
$1,461.90 |
$1,382.98
|
|
Tlso rigid lined custom fab
|
$2,547.21 |
$2,547.21 |
$2,831.21 |
$2,831.21
|
|
Tlso rigid lined pre one pie
|
$2,118.31 |
$2,118.31 |
$2,118.31 |
$2,110.02
|
|
Tlso rigid plastic cust fab
|
$2,347.16 |
$2,347.16 |
$5,853.60 |
$2,347.16
|
|
Tlso rigid plastic custom fa
|
$2,788.42 |
$2,788.42 |
$2,788.42 |
$2,788.42
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$175.50 |
$175.50 |
$228.45 |
$152.36
|
|
Tobramycin non-comp unit
|
$143.38 |
$143.38 |
$143.38 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$171.40 |
$171.40 |
$362.70 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,390.24 |
$2,390.24 |
$5,258.52 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$191.86 |
$191.86 |
$313.35 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$71.40 |
$71.40 |
$71.40 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$66.15 |
$66.15 |
$95.23 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$507.60 |
$507.60 |
$664.50 |
$316.84
|
|
Torsion ank & half solid sti
|
$292.47 |
$292.47 |
$292.47 |
$291.13
|
|
Torsion straight knee joint
|
$318.65 |
$318.65 |
$318.65 |
$247.25
|
|
Total hysterectomy
|
$4,189.20 |
$4,189.20 |
$4,189.20 |
$3,001.70
|
|
Total tau
|
$600.00 |
$600.00 |
$600.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$176.55 |
$176.55 |
$315.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$23.85 |
$23.85 |
$252.00 |
$88.00
|
|
Tp53 gene full gene sequence
|
$660.00 |
$660.00 |
$660.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$1,086.00 |
$1,086.00 |
$1,828.50 |
$804.00
|
|
Tpmt gene com vrnts
|
$637.50 |
$637.50 |
$637.50 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$5,980.69 |
$5,980.69 |
$5,980.69 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$6,827.00 |
$6,827.00 |
$6,827.00 |
$6,684.23
|
|
Trabeculoplasty laser surg
|
$1,387.38 |
$1,387.38 |
$1,387.38 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,437.45 |
$1,437.45 |
$1,926.42 |
$1,420.44
|
|
Tracheostoma stent/stud/bttn
|
$452.64 |
$452.64 |
$452.64 |
$333.29
|
|
Trach/laryn tube plug/stop
|
$9.18 |
$9.18 |
$9.18 |
$9.18
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$100.98 |
$100.98 |
$144.60 |
$103.20
|
|
Transabdom amnioinfus w/us
|
$506.35 |
$506.35 |
$506.35 |
$678.70
|
|
Transcath biopsy
|
$3,794.10 |
$3,794.10 |
$4,285.93 |
$4,285.93
|
|
Transcath closure of asd
|
$27,128.00 |
$27,128.00 |
$27,128.00 |
$17,088.00
|
|
Transcath closure of vsd
|
$24,215.41 |
$24,215.41 |
$24,215.41 |
$17,115.04
|
|
Transcatheter bx s&i
|
$1,774.94 |
$1,774.94 |
$3,961.95 |
$1,950.85
|
|
Transcath mv repair addl prosthesis
|
$17,969.54 |
$17,969.54 |
$17,969.54 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$27,199.84 |
$27,199.84 |
$27,199.84 |
$13,093.20
|
|
Transcath occlusion cns
|
$8,944.39 |
$8,944.39 |
$8,944.39 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$12,427.79 |
$12,427.79 |
$12,427.79 |
$10,270.00
|
|
Trans cath replace aortic valve 33366
|
$25,539.49 |
$25,539.49 |
$25,539.49 |
$14,593.50
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,127.40 |
$4,127.40 |
$4,127.40 |
$4,822.00
|
|
Transcutaneous hgb 88738
|
$31.12 |
$31.12 |
$31.12 |
$13.20
|
|
Transferrin
|
$119.00 |
$119.00 |
$243.00 |
$82.00
|
|
Transorl lwr esophgl myotomy
|
$4,229.53 |
$4,229.53 |
$4,229.53 |
$6,594.64
|
|
Transparent film >16<=48 in
|
$18.02 |
$18.02 |
$18.02 |
$12.95
|
|
Transparent film <= 16 sq in
|
$14.78 |
$14.78 |
$14.78 |
$4.50
|
|
Transplt allo hct/donor
|
$28,236.60 |
$28,236.60 |
$28,236.60 |
$29,206.10
|
|
Transplt allo lymphocytes
|
$3,388.64 |
$3,388.64 |
$3,388.64 |
$2,751.65
|
|
Transplt autol hct/donor
|
$9,000.00 |
$9,000.00 |
$9,000.00 |
$3,986.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$589.80 |
$589.80 |
$643.21 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$509.00 |
$509.00 |
$589.80 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$3,085.68 |
$3,085.68 |
$8,258.47 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$7,540.20 |
$7,540.20 |
$7,540.20 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$8,026.96 |
$8,026.96 |
$8,026.96 |
$4,471.50
|
|
Tray bonemarrw oncontrol 102mm
|
$1,019.25 |
$1,019.25 |
$2,286.90 |
$940.80
|
|
Treat ankle dislocation
|
$1,292.70 |
$1,292.70 |
$3,563.19 |
$2,358.40
|
|
Treat big toe fracture
|
$3,478.12 |
$3,478.12 |
$3,478.12 |
$4,454.10
|
|
Treat clavicle dislocation 23545
|
$520.80 |
$520.80 |
$825.57 |
$692.80
|
|
Treat elbow dislocation
|
$1,408.80 |
$1,408.80 |
$3,477.41 |
$2,311.20
|
|
Treat elbow dislocation
|
$7,292.92 |
$7,292.92 |
$7,292.92 |
$7,292.92
|
|
Treat elbow fracture
|
$13,908.81 |
$13,908.81 |
$13,908.81 |
$9,791.00
|
|
Treat elbow fracture
|
$1,650.90 |
$1,650.90 |
$2,687.10 |
$2,027.40
|
|
Treat finger fracture each
|
$1,808.00 |
$1,808.00 |
$1,862.25 |
$1,592.00
|
|
Treat foot dislocation
|
$345.75 |
$345.75 |
$435.60 |
$405.60
|
|
Treat foot dislocation
|
$3,160.37 |
$3,160.37 |
$3,160.37 |
$4,192.86
|
|
Treat foot dislocation
|
$807.09 |
$807.09 |
$1,267.50 |
$527.28
|
|
Treat foot dislocation
|
$314.85 |
$314.85 |
$733.69 |
$445.80
|
|
Treat foot dislocation
|
$245.81 |
$245.81 |
$424.50 |
$440.04
|
|
Treat fracture of radius
|
$1,862.25 |
$1,862.25 |
$2,116.73 |
$1,821.60
|
|
Treat fracture of radius
|
$1,849.00 |
$1,849.00 |
$1,849.00 |
$1,849.00
|
|
Treat fracture of ulna
|
$343.95 |
$343.95 |
$1,348.67 |
$726.05
|
|
Treat hip dislocation
|
$1,408.80 |
$1,408.80 |
$3,445.45 |
$2,211.05
|
|
Treat hip dislocation
|
$1,292.70 |
$1,292.70 |
$4,625.34 |
$2,612.00
|
|
Treat hip socket fracture
|
$3,424.29 |
$3,424.29 |
$3,424.29 |
$1,344.00
|
|
Treat humerus fracture
|
$2,327.55 |
$2,327.55 |
$2,413.16 |
$1,790.00
|
|
Treat humerus fracture
|
$12,653.00 |
$12,653.00 |
$12,653.00 |
$10,902.51
|
|
Treat humerus fracture
|
$2,045.35 |
$2,045.35 |
$2,327.55 |
$1,790.00
|
|
Treat kneecap dislocation
|
$1,440.30 |
$1,440.30 |
$2,042.03 |
$1,068.06
|
