|
Tib/per revasc stnt & ather
|
$5,198.70 |
$5,198.70 |
$5,198.70 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$4,610.25 |
$4,610.25 |
$4,610.25 |
$10,406.14
|
|
Tigecycline injection
|
$5,431.18 |
$5,431.18 |
$5,431.18 |
$308.75
|
|
Tilt table study
|
$1,094.10 |
$1,094.10 |
$1,094.10 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$7.19 |
$7.19 |
$7.19 |
$360.60
|
|
Tissue culture placenta
|
$141.15 |
$141.15 |
$141.15 |
$520.91
|
|
Tissue culture tumor
|
$189.65 |
$189.65 |
$189.65 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$19.05 |
$19.05 |
$19.05 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$7,473.38 |
$7,473.38 |
$7,473.38 |
$4,293.26
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$1,429.79 |
$1,429.79 |
$1,429.79 |
$2,114.68
|
|
Tissue transglutaminase iga
|
$64.72 |
$64.72 |
$64.72 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$171.90 |
$171.90 |
$171.90 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$1,074.15 |
$1,074.15 |
$1,074.15 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$36.60 |
$36.60 |
$36.60 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$400.11 |
$400.11 |
$400.11 |
$5,790.85
|
|
Tomosynthesis breast diagnostic left
|
$31.80 |
$31.80 |
$31.80 |
$63.70
|
|
Tomosynthesis breast screen bilateral
|
$36.60 |
$36.60 |
$36.60 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$3,900.01 |
$3,900.01 |
$3,900.01 |
$303.88
|
|
Toxoplasma antibody igg
|
$42.00 |
$42.00 |
$42.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$49.35 |
$49.35 |
$49.35 |
$83.20
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$36.15 |
$36.15 |
$36.15 |
$93.75
|
|
Transcath biopsy
|
$2,221.35 |
$2,221.35 |
$2,221.35 |
$4,298.05
|
|
Transcath closure of asd
|
$5,798.40 |
$5,798.40 |
$5,798.40 |
$18,772.00
|
|
Transcatheter bx s&i
|
$448.80 |
$448.80 |
$448.80 |
$1,875.96
|
|
Transferrin
|
$49.83 |
$49.83 |
$49.83 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$409.95 |
$409.95 |
$409.95 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$15,864.48 |
$15,864.48 |
$15,864.48 |
$3,401.26
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$13,215.92 |
$13,215.92 |
$13,215.92 |
$7,620.16
|
|
Trauma partial team response w/critical care services level 4
|
$531.00 |
$531.00 |
$531.00 |
$5,941.07
|
|
Treat clavicle dislocation 23545
|
$78.00 |
$78.00 |
$78.00 |
$734.00
|
|
Treat elbow fracture
|
$853.51 |
$853.51 |
$853.51 |
$2,125.60
|
|
Treat finger fracture each
|
$903.32 |
$903.32 |
$903.32 |
$1,815.75
|
|
Treat foot bone lesion
|
$912.60 |
$912.60 |
$912.60 |
$3,839.54
|
|
Treat fracture of radius
|
$852.06 |
$852.06 |
$852.06 |
$2,030.33
|
|
Treat fracture of ulna
|
$123.75 |
$123.75 |
$123.75 |
$766.72
|
|
Treat hip socket fracture
|
$582.17 |
$582.17 |
$582.17 |
$1,340.10
|
|
Treat humerus fracture
|
$790.14 |
$790.14 |
$790.14 |
$1,950.60
|
|
Treat humerus fracture
|
$531.45 |
$531.45 |
$531.45 |
$2,045.35
|
|
Treat knee fracture(s)
|
$94.65 |
$94.65 |
$94.65 |
$642.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$52.18 |
$52.18 |
$52.18 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$48.30 |
$48.30 |
$48.30 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$72.62 |
$72.62 |
$72.62 |
$210.00
|
|
Treatment of thigh fracture
|
$835.35 |
$835.35 |
$835.35 |
$2,055.00
|
|
Treatment radiation delivery level 2
|
$107.40 |
$107.40 |
$107.40 |
$735.00
|
|
Treat ulnar fracture
|
$531.45 |
$531.45 |
$531.45 |
$1,861.60
|
|
Treponema pallidum antibody
|
$47.74 |
$47.74 |
$47.74 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$32.40 |
$32.40 |
$32.40 |
$48.22
|
|
Triglycerides
|
$31.83 |
$31.83 |
$31.83 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$1,837.68 |
$1,837.68 |
$1,837.68 |
$154.09
|
|
Trim nondyst nails
|
$28.05 |
$28.05 |
$28.05 |
$124.22
|
|
Trnscath plc stent crv crtd without prtct
|
$1,794.15 |
$1,794.15 |
$1,794.15 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,454.98 |
$2,454.98 |
$2,454.98 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$2,719.58 |
$2,719.58 |
$2,719.58 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,944.40 |
$3,944.40 |
$3,944.40 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$4,062.90 |
$4,062.90 |
$4,062.90 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$4,279.35 |
$4,279.35 |
$4,279.35 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,382.60 |
$2,382.60 |
$2,382.60 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,479.80 |
$2,479.80 |
$2,479.80 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$794.10 |
$794.10 |
$794.10 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,382.60 |
$2,382.60 |
$2,382.60 |
$4,329.36
|
|
Troponin quantitative
|
$76.50 |
$76.50 |
$76.50 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$392.40 |
$392.40 |
$392.40 |
$1,446.48
|
|
Tube trach disp innr can 5 xlt
|
$91.04 |
$91.04 |
$91.04 |
$460.58
|
|
Tube trach fen sz 6 uncuffed
|
$91.04 |
$91.04 |
$91.04 |
$132.40
|
|
Tx atrial fib pulm vein isol
|
$7,908.45 |
$7,908.45 |
$7,908.45 |
$32,426.20
|
|
Tx closed distal humerus fx
|
$126.30 |
$126.30 |
$126.30 |
$786.00
|
|
Tx closed hip disl traumatic without anes
|
$117.99 |
$117.99 |
$117.99 |
$657.28
|
|
Tx l/r atrial fib addl
|
$2,609.85 |
$2,609.85 |
$2,609.85 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$91.80 |
$91.80 |
$91.80 |
$403.26
|
|
Ultrasound breast complete
|
$375.30 |
$375.30 |
$375.30 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$312.75 |
$312.75 |
$312.75 |
$449.35
|
|
Ultrasound chest
|
$414.56 |
$414.56 |
$414.56 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$96.70 |
$96.70 |
$96.70 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$37.51 |
$37.51 |
$37.51 |
$284.25
|
|
Ultrasound encephalogram
|
$182.40 |
$182.40 |
$182.40 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$184.65 |
$184.65 |
$184.65 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$384.45 |
$384.45 |
$384.45 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$382.05 |
$382.05 |
$382.05 |
$701.35
|
|
Ultrasound guide intraoperative
|
$105.30 |
$105.30 |
$105.30 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$217.11 |
$217.11 |
$217.11 |
$403.00
|
|
Ultrasound joint complete left
|
$130.20 |
$130.20 |
$130.20 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$154.95 |
$154.95 |
$154.95 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$358.35 |
$358.35 |
$358.35 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$247.05 |
$247.05 |
$247.05 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$184.80 |
$184.80 |
$184.80 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$324.00 |
$324.00 |
$324.00 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$285.15 |
$285.15 |
$285.15 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$324.00 |
$324.00 |
$324.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$298.50 |
$298.50 |
$298.50 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$300.30 |
$300.30 |
$300.30 |
$498.00
|
|
Ultrasound scrotum and contents
|
$546.75 |
$546.75 |
$546.75 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$62.40 |
$62.40 |
$62.40 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$199.50 |
$199.50 |
$199.50 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$311.70 |
$311.70 |
$311.70 |
$567.44
|
|
Unlisted procedure rectum
|
$476.10 |
$476.10 |
$476.10 |
$1,278.72
|
|
Unlisted px med radj physics
|
$61.80 |
$61.80 |
$61.80 |
$376.03
|
|
Unlisted px tongue flr mouth
|
$80.70 |
$80.70 |
$80.70 |
$274.80
|
|
Unsched dialysis esrd pt hos
|
$543.90 |
$543.90 |
$543.90 |
$1,505.29
|
|
Upgrade pm system
|
$1,932.66 |
$1,932.66 |
$1,932.66 |
$12,324.60
|