|
Tobramycin peak therapeutic drug level
|
$171.40 |
$171.40 |
$1,024.80 |
$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 |
$231.93 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$66.15 |
$95.23 |
$231.93 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$507.60 |
$664.50 |
$20,523.79 |
$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
|
$209.10 |
$315.00 |
$1,086.57 |
$91.65
|
|
Toxoplasma antibody igm
|
$162.75 |
$252.00 |
$1,086.57 |
$88.00
|
|
Tp53 gene full gene sequence
|
$660.00 |
$660.00 |
$660.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$1,086.00 |
$1,828.50 |
$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 |
$1,926.42 |
$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
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$42.00 |
$42.00 |
$42.00 |
$56.38
|
|
Transabdom amnioinfus w/us
|
$506.35 |
$506.35 |
$506.35 |
$678.70
|
|
Transcath biopsy
|
$3,794.10 |
$4,285.93 |
$4,285.93 |
$4,285.93
|
|
Transcath closure of asd
|
$27,128.00 |
$27,128.00 |
$44,204.81 |
$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 |
$4,511.36 |
$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
|
$7,075.50 |
$8,944.39 |
$8,944.39 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$11,497.65 |
$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 |
$5,057.70 |
$4,822.00
|
|
Transcutaneous hgb 88738
|
$31.12 |
$31.12 |
$31.12 |
$13.20
|
|
Transferrin
|
$119.00 |
$119.00 |
$291.45 |
$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 |
$643.21 |
$643.21 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$509.00 |
$509.00 |
$1,563.68 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$3,085.68 |
$4,220.58 |
$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 |
$8,663.10 |
$4,471.50
|
|
Tray bonemarrw oncontrol 102mm
|
$1,019.25 |
$2,286.90 |
$2,286.90 |
$940.80
|
|
Treat ankle dislocation
|
$1,292.70 |
$3,563.19 |
$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 |
$825.57 |
$825.57 |
$692.80
|
|
Treat elbow dislocation
|
$1,408.80 |
$3,477.41 |
$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 |
$2,687.10 |
$2,687.10 |
$2,027.40
|
|
Treat finger fracture each
|
$1,787.72 |
$1,808.00 |
$1,862.25 |
$1,592.00
|
|
Treat foot dislocation
|
$435.60 |
$435.60 |
$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 |
$807.09 |
$527.28
|
|
Treat foot dislocation
|
$733.69 |
$733.69 |
$733.69 |
$445.80
|
|
Treat foot dislocation
|
$245.81 |
$245.81 |
$245.81 |
$440.04
|
|
Treat fracture of radius
|
$1,862.25 |
$2,116.73 |
$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 |
$1,348.67 |
$1,348.67 |
$726.05
|
|
Treat hip dislocation
|
$1,408.80 |
$3,445.45 |
$3,445.45 |
$2,211.05
|
|
Treat hip dislocation
|
$1,292.70 |
$4,625.34 |
$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 |
$2,413.16 |
$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 |
$2,042.03 |
$2,042.03 |
$1,068.06
|
|
Treat knee dislocation
|
$1,292.70 |
$2,592.08 |
$2,592.08 |
$2,220.89
|
|
Treat knee fracture 27530
|
$256.95 |
$256.95 |
$256.95 |
$550.73
|
|
Treat knee fracture(s)
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$643.26
|
|
Treat knuckle dislocation
|
$1,894.05 |
$1,894.05 |
$1,894.05 |
$1,693.20
|
|
Treat knuckle dislocation
|
$5,611.05 |
$5,611.05 |
$5,611.05 |
$4,332.00
|
|
Treat lower leg dislocation
|
$480.00 |
$480.00 |
$480.00 |
$532.60
|
|
Treat lower leg fracture
|
$12,905.86 |
$12,905.86 |
$12,905.86 |
$12,905.86
|
|
Treat lower leg fracture
|
$12,653.00 |
$12,653.00 |
$12,653.00 |
$12,653.00
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$12,184.35 |
$12,184.35 |
$12,184.35 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$6,865.79 |
$6,865.79 |
$12,184.35 |
$8,590.40
|
|
Treatment incomplete abortion completed surgically any trimester
|
$1,907.85 |
$4,468.97 |
$4,468.97 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$202.80 |
$349.13 |
$892.12 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$154.49 |
$154.65 |
$221.58 |
$147.48
|
|
Treatment missed abortion completed surgically 1st trimester
|
$1,858.95 |
$3,820.53 |
$3,820.53 |
$4,230.80
|
|
Treatment of ankle fracture
|
$6,662.72 |
$6,662.72 |
$6,662.72 |
$7,906.00
|
|
Treatment of ankle fracture 27786
|
$279.90 |
$613.13 |
$613.13 |
$528.00
|
|
Treatment of fibula fracture 27780
|
$256.95 |
$256.95 |
$256.95 |
$515.45
|
|
Treatment of foot infection
|
$3,805.20 |
$3,805.20 |
$3,805.20 |
$3,839.54
|
|
Treatment of heel fracture 28400
|
$279.90 |
$279.90 |
$279.90 |
$473.00
|
|
Treatment of thigh fracture
|
$1,389.72 |
$1,389.72 |
$1,389.72 |
$1,749.06
|
|
Treatment of thigh fracture
|
$380.85 |
$502.76 |
$502.76 |
$548.90
|
|
Treatment of thigh fracture
|
$6,731.17 |
$6,731.17 |
$6,731.17 |
$6,389.60
|
|
Treatment of thigh fracture
|
$2,327.55 |
$2,483.24 |
$2,483.24 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$211.95 |
$380.08 |
$380.08 |
$371.40
|
|
Treatment radiation delivery level 2
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$830.70
|
|
Treatment x10sv retinopathy
|
$1,574.83 |
$1,574.83 |
$1,574.83 |
$1,513.20
|
|
Treat metacarpal fracture
|
$3,409.05 |
$3,409.05 |
$3,409.05 |
$5,741.00
|
|
Treat midfoot fracture each
|
$1,047.87 |
$1,047.87 |
$1,047.87 |
$1,884.74
|
|
Treat spinal cord lesion
|
$1,304.32 |
$1,304.32 |
$1,304.32 |
$1,337.00
|
