|
Thromboplastin inhibition
|
$55.20 |
$55.20 |
$55.20 |
$53.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$58.20 |
$58.20 |
$58.20 |
$61.52
|
|
Th/wght bear nar m-l brim cu
|
$3,002.21 |
$3,002.21 |
$3,002.21 |
$1,515.38
|
|
Th/wght bear nar m-l brim mo
|
$5,342.91 |
$5,342.91 |
$5,342.91 |
$2,395.79
|
|
Th/wght bear quad-lat brim c
|
$2,519.59 |
$2,519.59 |
$2,519.59 |
$1,129.80
|
|
Th/wght bear quad-lat brim m
|
$3,780.61 |
$3,780.61 |
$3,780.61 |
$1,695.23
|
|
Thyroglobulin antibody
|
$84.00 |
$84.00 |
$84.00 |
$82.00
|
|
Thyroid (TSH) Test
|
$250.20 |
$250.20 |
$250.20 |
$111.00
|
|
Thyroid Ultrasound
|
$945.60 |
$945.60 |
$945.60 |
$588.50
|
|
Thyroid uptake measurement
|
$473.40 |
$473.40 |
$473.40 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,154.30 |
$2,154.30 |
$2,154.30 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$135.00 |
$135.00 |
$135.00 |
$64.35
|
|
Tilt table study
|
$2,149.20 |
$2,149.20 |
$2,149.20 |
$1,507.01
|
|
Tissue amnio epifix inj 100mg
|
$15,079.70 |
$15,079.70 |
$15,079.70 |
$4,834.73
|
|
Tissue culture skin/biopsy
|
$300.00 |
$300.00 |
$300.00 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$69.60 |
$69.60 |
$69.60 |
$47.20
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$66,123.28 |
$66,123.28 |
$66,123.28 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$40.20 |
$40.20 |
$40.20 |
$44.16
|
|
Tlh uterus 250 g or less
|
$27,944.37 |
$27,944.37 |
$27,944.37 |
$11,533.76
|
|
Tlh uterus over 250 g
|
$29,749.44 |
$29,749.44 |
$29,749.44 |
$9,363.13
|
|
Tlh w/t/o 250 g or less
|
$30,910.99 |
$30,910.99 |
$30,910.99 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$42,592.99 |
$42,592.99 |
$42,592.99 |
$12,320.22
|
|
Tlso 2mod symphis-xipho pre
|
$4,180.67 |
$4,180.67 |
$4,180.67 |
$1,874.66
|
|
Tlso 2 piece rigid shell
|
$3,600.05 |
$3,600.05 |
$3,600.05 |
$1,302.50
|
|
Tlso 2 shl symphys-stern cst
|
$4,280.23 |
$4,280.23 |
$4,280.23 |
$1,808.59
|
|
Tlso 3mod sacro-scap pre
|
$5,324.09 |
$5,324.09 |
$5,324.09 |
$2,117.57
|
|
Tlso 3 piece rigid shell
|
$2,344.28 |
$2,344.28 |
$2,344.28 |
$1,051.18
|
|
Tlso corset front
|
$500.92 |
$500.92 |
$500.92 |
$244.50
|
|
Tlso flex trnk sj-t9 pre ots
|
$1,625.73 |
$1,625.73 |
$1,625.73 |
$931.57
|
|
Tlso full corset
|
$819.16 |
$819.16 |
$819.16 |
$377.78
|
|
Tlso r fram soft ant pre cst
|
$1,778.53 |
$1,778.53 |
$1,778.53 |
$801.11
|
|
Tlso r fram soft pre ots
|
$1,778.53 |
$1,778.53 |
$1,778.53 |
$910.81
|
|
Tlso rig fram pelvic pre cst
|
$2,228.86 |
$2,228.86 |
$2,228.86 |
$999.43
|
|
Tlso rig fram pelvic pre ots
|
$2,228.86 |
$2,228.86 |
$2,228.86 |
$1,230.29
|
|
Tlso rigid frame pre subclav
|
$3,084.25 |
$3,084.25 |
$3,084.25 |
$1,382.98
|
|
Tlso rigid lined custom fab
|
$6,756.36 |
$6,756.36 |
$6,756.36 |
$2,831.21
|
|
Tlso rigid lined pre one pie
|
$4,705.61 |
$4,705.61 |
$4,705.61 |
$2,110.02
|
|
Tlso rigid plastic custom fa
|
$7,080.41 |
$7,080.41 |
$7,080.41 |
$2,788.42
|
|
Tlso rigid plastic pre one
|
$1,326.01 |
$1,326.01 |
$1,326.01 |
$594.61
|
|
Tlso trnk sj-t9 pre cst
|
$2,214.77 |
$2,214.77 |
$2,214.77 |
$523.94
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$756.00 |
$756.00 |
$756.00 |
$152.36
|
|
Tobramycin non-comp unit
|
$103.64 |
$103.64 |
$103.64 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$120.60 |
$120.60 |
$120.60 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$15,297.53 |
$15,297.53 |
$15,297.53 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$268.80 |
$268.80 |
$268.80 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$107.40 |
$107.40 |
$107.40 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$286.16 |
$286.16 |
$286.16 |
$325.00
|
|
Torsion ank & half solid sti
|
$576.78 |
$576.78 |
$576.78 |
$291.13
|
|
Torsion straight knee joint
|
$502.90 |
$502.90 |
$502.90 |
$253.84
|
|
Total Hip Replacement
|
$52,842.74 |
$52,842.74 |
$52,842.74 |
$9,161.60
|
|
Total hysterectomy
|
$106,343.48 |
$106,343.48 |
$106,343.48 |
$3,001.70
|
|
Total Knee Replacement
|
$51,895.27 |
$51,895.27 |
$51,895.27 |
$14,543.50
|
|
Tot disc arthrp 1ntrspc crv
|
$52,369.82 |
$52,369.82 |
$52,369.82 |
$20,154.40
|
|
Toxoplasma antibody igg
|
$150.60 |
$150.60 |
$150.60 |
$89.40
|
|
Toxoplasma antibody igm
|
$148.20 |
$148.20 |
$148.20 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$833.40 |
$833.40 |
$833.40 |
$790.68
|
|
Trabectedin 1 mg intravenous solution
|
$21,471.96 |
$21,471.96 |
$21,471.96 |
$6,827.00
|
|
Trabeculoplasty laser surg
|
$3,714.68 |
$3,714.68 |
$3,714.68 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$381.00 |
$381.00 |
$381.00 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$113.40 |
$113.40 |
$113.40 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$141.75 |
$141.75 |
$141.75 |
$56.38
|
|
Transcath biopsy
|
$3,312.00 |
$3,312.00 |
$3,312.00 |
$4,285.93
|
|
Transcatheter bx s&i
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$4,336.80 |
$4,336.80 |
$4,336.80 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$8,673.60 |
$8,673.60 |
$8,673.60 |
$12,418.00
|
|
Transferrin
|
$94.80 |
$94.80 |
$94.80 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$983.00
|
|
Trans shoe caliper plate new
|
$470.98 |
$470.98 |
$470.98 |
$217.22
|
|
Trans shoe calip plate exist
|
$357.69 |
$357.69 |
$357.69 |
$164.98
|
|
Trans shoe solid stirrup exi
|
$357.69 |
$357.69 |
$357.69 |
$141.41
|
|
Trans shoe solid stirrup new
|
$470.98 |
$470.98 |
$470.98 |
$217.22
|
|
Trapezius sling
|
$525.88 |
$525.88 |
$525.88 |
$242.54
|
|
Trastuzumab 150 mg intravenous solution
|
$9,133.43 |
$9,133.43 |
$9,133.43 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$22,163.61 |
$22,163.61 |
$22,163.61 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$19,736.09 |
$19,736.09 |
$19,736.09 |
$5,835.15
|
|
Tray bonemarrw oncontrol 102mm
|
$17,936.55 |
$17,936.55 |
$17,936.55 |
$940.80
|
|
Trb@ gene rearrange dirprobe
|
$148.80 |
$148.80 |
$148.80 |
$73.46
|
|
Treat ectopic pregnancy
|
$19,342.01 |
$19,342.01 |
$19,342.01 |
$6,707.99
|
|
Treat elbow dislocation
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,223.20
|
|
Treat elbow fracture
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,919.13
|
|
Treat finger fracture each
|
$12,096.13 |
$12,096.13 |
$12,096.13 |
$4,132.02
|
|
Treat finger fracture each
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,536.00
|
|
Treat foot dislocation
|
$172.80 |
$172.80 |
$172.80 |
$527.28
|
|
Treat foot dislocation
|
$172.80 |
$172.80 |
$172.80 |
$445.80
|
|
Treat fracture of radius
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,790.00
|
|
Treat fracture of ulna
|
$658.20 |
$658.20 |
$658.20 |
$726.05
|
|
Treat humerus fracture
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,771.43
|
|
Treat humerus fracture
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,771.43
|
|
Treat kneecap dislocation
|
$172.80 |
$172.80 |
$172.80 |
$1,068.90
|
|
Treat kneecap fracture
|
$35,266.59 |
$35,266.59 |
$35,266.59 |
$6,311.00
|
|
Treat knee fracture
|
$45,329.35 |
$45,329.35 |
$45,329.35 |
$3,486.60
|
|
Treat lower leg joint
|
$40,982.85 |
$40,982.85 |
$40,982.85 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$25,321.87 |
$25,321.87 |
$25,321.87 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$22,638.45 |
$22,638.45 |
$22,638.45 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$31,334.81 |
$31,334.81 |
$31,334.81 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$7,815.79 |
$7,815.79 |
$7,815.79 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$456.60 |
$456.60 |
$456.60 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$238.20 |
$238.20 |
$238.20 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$172.20 |
$172.20 |
$172.20 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$8,115.04 |
$8,115.04 |
$8,115.04 |
$3,982.44
|
