|
Tlso r fram soft ant pre cst
|
$801.11 |
$801.11 |
$801.11 |
$801.11
|
|
Tlso rigid frame pre subclav
|
$1,193.13 |
$1,193.13 |
$1,193.13 |
$1,382.98
|
|
Tlso rigid lined custom fab
|
$2,831.21 |
$2,831.21 |
$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
|
$5,853.60 |
$5,853.60 |
$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 |
$175.50 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$362.70 |
$362.70 |
$362.70 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,258.52 |
$5,258.52 |
$5,258.52 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$71.40 |
$71.40 |
$71.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$66.15 |
$66.15 |
$66.15 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$507.60 |
$507.60 |
$507.60 |
$325.00
|
|
Torsion ank & half solid sti
|
$292.47 |
$292.47 |
$292.47 |
$291.13
|
|
Torsion straight knee joint
|
$318.65 |
$318.65 |
$318.65 |
$253.84
|
|
Toxoplasma antibody igg
|
$176.55 |
$176.55 |
$176.55 |
$89.40
|
|
Toxoplasma antibody igm
|
$209.10 |
$209.10 |
$209.10 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$790.68
|
|
Trabectedin 1 mg intravenous solution
|
$6,827.00 |
$6,827.00 |
$6,827.00 |
$6,827.00
|
|
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
|
|
Transabdom amnioinfus w/us
|
$313.95 |
$313.95 |
$313.95 |
$678.70
|
|
Transcath biopsy
|
$3,794.10 |
$3,794.10 |
$3,794.10 |
$4,285.93
|
|
Transcath closure of asd
|
$12,669.30 |
$12,669.30 |
$12,669.30 |
$16,741.40
|
|
Transcath closure of vsd
|
$12,181.95 |
$12,181.95 |
$12,181.95 |
$17,115.04
|
|
Transcatheter bx s&i
|
$3,961.95 |
$3,961.95 |
$3,961.95 |
$1,915.00
|
|
Transcath occlusion cns
|
$7,075.50 |
$7,075.50 |
$7,075.50 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$11,497.65 |
$11,497.65 |
$11,497.65 |
$10,031.28
|
|
Transferrin
|
$243.00 |
$243.00 |
$243.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$2,352.15 |
$2,352.15 |
$2,352.15 |
$983.00
|
|
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
|
|
Trastuzumab 150 mg intravenous solution
|
$3,085.68 |
$3,085.68 |
$3,085.68 |
$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
|
$7,235.25 |
$7,235.25 |
$7,235.25 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$1,019.25 |
$1,019.25 |
$1,019.25 |
$940.80
|
|
Treat elbow dislocation
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$2,223.20
|
|
Treat elbow fracture
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$1,919.13
|
|
Treat finger fracture each
|
$1,862.25 |
$1,862.25 |
$1,862.25 |
$1,536.00
|
|
Treat fracture of radius
|
$1,862.25 |
$1,862.25 |
$1,862.25 |
$1,790.00
|
|
Treat fracture of ulna
|
$343.95 |
$343.95 |
$343.95 |
$726.05
|
|
Treat hip dislocation
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$2,192.80
|
|
Treat humerus fracture
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$1,771.43
|
|
Treat knee dislocation
|
$1,292.70 |
$1,292.70 |
$1,292.70 |
$2,220.89
|
|
Treat lower leg dislocation
|
$408.15 |
$408.15 |
$408.15 |
$530.75
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$202.80 |
$202.80 |
$202.80 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$154.65 |
$154.65 |
$154.65 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$310.80 |
$310.80 |
$310.80 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,858.95 |
$1,858.95 |
$1,858.95 |
$3,982.44
|
|
Treatment of ankle fracture 27786
|
$279.90 |
$279.90 |
$279.90 |
$520.80
|
|
Treat toe dislocation
|
$389.40 |
$389.40 |
$389.40 |
$756.39
|
|
Treat ulnar fracture
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$1,662.00
|
|
Treat vaginal bleeding
|
$306.90 |
$306.90 |
$306.90 |
$379.60
|
|
Treat wrist dislocation
|
$429.45 |
$429.45 |
$429.45 |
$656.25
|
|
Treponema pallidum antibody
|
$175.20 |
$175.20 |
$175.20 |
$70.40
|
|
Treprostinil injection
|
$25,211.74 |
$25,211.74 |
$25,211.74 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$265.20 |
$265.20 |
$265.20 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$25.61 |
$25.61 |
$25.61 |
$43.21
|
|
Triamcinolone a inj prs-free
|
$1,869.12 |
$1,869.12 |
$1,869.12 |
$223.56
|
|
Triglycerides
|
$265.20 |
$265.20 |
$265.20 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$117.49 |
$117.49 |
$117.49 |
$117.49
|
|
Trim nondyst nails
|
$84.15 |
$84.15 |
$84.15 |
$113.40
|
|
Triptorelin pamoate
|
$1,706.82 |
$1,706.82 |
$1,706.82 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$21,248.85 |
$21,248.85 |
$21,248.85 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$10,624.65 |
$10,624.65 |
$10,624.65 |
$7,354.00
|
|
Trmt of fracture (femoral shaft) 27500
|
$520.80 |
$520.80 |
$520.80 |
$754.80
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$11,631.90 |
$11,631.90 |
$11,631.90 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$11,631.90 |
$11,631.90 |
$11,631.90 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$11,631.90 |
$11,631.90 |
$11,631.90 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$5,398.35 |
$5,398.35 |
$5,398.35 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,267.30 |
$3,267.30 |
$3,267.30 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,250.25 |
$4,250.25 |
$4,250.25 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$3,866.70 |
$3,866.70 |
$3,866.70 |
$3,866.70
|
|
Troponin quantitative
|
$353.40 |
$353.40 |
$353.40 |
$127.20
|
|
Truskin, per sq centimeter
|
$230.63 |
$230.63 |
$230.63 |
$230.63
|
|
Tube drain vert dev st 5-40f
|
$27.60 |
$27.60 |
$27.60 |
$29.40
|
|
Tube trach disp innr can 5 xlt
|
$1,217.70 |
$1,217.70 |
$1,217.70 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$329.64 |
$329.64 |
$329.64 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$846.24 |
$846.24 |
$846.24 |
$155.98
|
|
Tubular dressing
|
$139.53 |
$139.53 |
$139.53 |
$28.46
|
|
Tx closed hip disl traumatic without anes
|
$279.90 |
$279.90 |
$279.90 |
$581.07
|
|
Tx closed tib shaft fx without manip
|
$256.95 |
$256.95 |
$256.95 |
$535.60
|
|
Ultrasound abdomen aorta screening study aaa
|
$356.70 |
$356.70 |
$356.70 |
$394.20
|
|
Ultrasound breast complete
|
$766.05 |
$766.05 |
$766.05 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$766.05 |
$766.05 |
$766.05 |
$449.35
|
|
Ultrasound chest
|
$484.95 |
$484.95 |
$484.95 |
$460.85
|
|
Ultrasound encephalogram
|
$762.60 |
$762.60 |
$762.60 |
$488.80
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$469.50 |
$469.50 |
$469.50 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$532.95 |
$532.95 |
$532.95 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$720.15 |
$720.15 |
$720.15 |
$720.15
|
|
Ultrasound guide intraoperative
|
$632.85 |
$632.85 |
$632.85 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$484.95 |
$484.95 |
$484.95 |
$403.88
|
|
Ultrasound joint/nonvascular extremity limited left
|
$277.80 |
$277.80 |
$277.80 |
$425.45
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$277.80 |
$277.80 |
$277.80 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$317.85 |
$317.85 |
$317.85 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$317.85 |
$317.85 |
$317.85 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$641.40 |
$641.40 |
$641.40 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$254.70 |
$254.70 |
$254.70 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$381.75 |
$381.75 |
$381.75 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$589.80 |
$589.80 |
$589.80 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$557.40 |
$557.40 |
$557.40 |
$557.40
|
