|
Tlso rigid plastic pre one
|
$1,101.05 |
$1,101.05 |
$1,101.05 |
$594.61
|
|
Tlso trnk sj-t9 pre cst
|
$1,839.04 |
$1,839.04 |
$1,839.04 |
$523.94
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$494.34 |
$494.34 |
$494.34 |
$152.36
|
|
Tobramycin non-comp unit
|
$67.68 |
$67.68 |
$67.68 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$151.00 |
$151.00 |
$151.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,405.54 |
$4,405.54 |
$4,405.54 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$23.50 |
$23.50 |
$279.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$18.50 |
$18.50 |
$108.60 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$544.54 |
$544.54 |
$544.54 |
$325.00
|
|
Torsion ank & half solid sti
|
$478.93 |
$478.93 |
$478.93 |
$291.13
|
|
Torsion straight knee joint
|
$96.26 |
$96.26 |
$417.58 |
$253.84
|
|
Total Hip Replacement
|
$57,353.98 |
$57,353.98 |
$57,353.98 |
$9,161.60
|
|
Total Knee Replacement
|
$58,166.92 |
$58,166.92 |
$58,166.92 |
$14,543.50
|
|
Toxoplasma antibody igg
|
$75.60 |
$75.60 |
$76.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$18.00 |
$18.00 |
$112.80 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$823.00 |
$823.00 |
$823.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$373.00 |
$373.00 |
$373.00 |
$371.80
|
|
Trabeculoplasty laser surg
|
$1,093.50 |
$1,093.50 |
$1,093.50 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$628.00 |
$628.00 |
$634.80 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$35.00 |
$35.00 |
$35.00 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$24.00 |
$24.00 |
$24.00 |
$56.38
|
|
Transabdom amnioinfus w/us
|
$271.00 |
$271.00 |
$271.00 |
$678.70
|
|
Transcath biopsy
|
$3,166.00 |
$3,166.00 |
$3,166.00 |
$4,285.93
|
|
Transcath closure of asd
|
$13,795.00 |
$13,795.00 |
$13,795.00 |
$16,741.40
|
|
Transcath closure of vsd
|
$13,795.00 |
$13,795.00 |
$13,795.00 |
$17,115.04
|
|
Transcatheter bx s&i
|
$1,915.00 |
$1,915.00 |
$1,915.00 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$12,922.50 |
$12,922.50 |
$12,922.50 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$25,572.00 |
$25,572.00 |
$25,572.00 |
$12,418.00
|
|
Transcath occlusion cns
|
$3,301.00 |
$3,301.00 |
$3,301.00 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$7,799.00 |
$7,799.00 |
$7,799.00 |
$10,031.28
|
|
Transcath rmvl perm ldss pmkr rv
|
$13,413.00 |
$13,413.00 |
$13,413.00 |
$4,775.16
|
|
Transferrin
|
$82.00 |
$82.00 |
$87.60 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$543.00 |
$543.00 |
$805.50 |
$983.00
|
|
Transparent film >16<=48 in
|
$13.78 |
$13.78 |
$13.78 |
$12.95
|
|
Transparent film <= 16 sq in
|
$2.18 |
$2.18 |
$2.18 |
$4.50
|
|
Transplt autol hct/donor
|
$2,602.00 |
$2,602.00 |
$2,602.00 |
$3,786.00
|
|
Trans shoe caliper plate new
|
$391.08 |
$391.08 |
$391.08 |
$217.22
|
|
Trans shoe calip plate exist
|
$297.01 |
$297.01 |
$297.01 |
$164.98
|
|
Trans shoe solid stirrup exi
|
$297.01 |
$297.01 |
$297.01 |
$141.41
|
|
Trans shoe solid stirrup new
|
$391.08 |
$391.08 |
$391.08 |
$217.22
|
|
Trapezius sling
|
$436.66 |
$436.66 |
$436.66 |
$242.54
|
|
Trastuzumab 150 mg intravenous solution
|
$6,167.42 |
$6,167.42 |
$6,167.42 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$14,966.15 |
$14,966.15 |
$14,966.15 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$13,326.95 |
$13,326.95 |
$13,326.95 |
$5,835.15
|
|
Trauma partial team response w/critical care services level 4
|
$3,598.50 |
$3,598.50 |
$3,598.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$109.71 |
$109.71 |
$14,893.65 |
$940.80
|
|
Trb@ gene rearrange dirprobe
|
$148.80 |
$148.80 |
$148.80 |
$73.46
|
|
Treat ankle dislocation
|
$2,525.00 |
$2,525.00 |
$2,525.00 |
$2,358.40
|
|
Treat ankle dislocation
|
$4,159.00 |
$4,159.00 |
$4,159.00 |
$5,886.74
|
|
Treat clavicle dislocation 23545
|
$1,120.50 |
$1,120.50 |
$1,120.50 |
$705.60
|
|
Treat elbow dislocation
|
$1,507.80 |
$1,507.80 |
$2,044.00 |
$2,223.20
|
|
Treat elbow fracture
|
$1,507.80 |
$1,507.80 |
$2,218.50 |
$1,919.13
|
|
Treat eyelid by injection
|
$447.00 |
$447.00 |
$447.00 |
$481.44
|
|
Treat eyelid lesion 67850
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$1,146.13
|
|
Treat finger fracture each
|
$838.50 |
$838.50 |
$1,507.80 |
$1,536.00
|
|
Treat foot dislocation
|
$263.00 |
$263.00 |
$263.00 |
$396.30
|
|
Treat foot dislocation
|
$4,419.00 |
$4,419.00 |
$4,419.00 |
$4,192.86
|
|
Treat foot dislocation
|
$377.00 |
$377.00 |
$445.80 |
$527.28
|
|
Treat foot dislocation
|
$445.00 |
$445.00 |
$445.80 |
$445.80
|
|
Treat fracture of radius
|
$1,507.80 |
$1,507.80 |
$1,551.00 |
$1,790.00
|
|
Treat fracture of radius
|
$835.50 |
$835.50 |
$835.50 |
$1,849.00
|
|
Treat fracture of ulna
|
$445.80 |
$445.80 |
$1,450.50 |
$726.05
|
|
Treat hand bone lesion
|
$4,137.50 |
$4,137.50 |
$4,137.50 |
$3,073.20
|
|
Treat hip dislocation
|
$1,846.50 |
$1,846.50 |
$3,039.00 |
$2,192.80
|
|
Treat hip dislocation
|
$2,461.50 |
$2,461.50 |
$2,461.50 |
$2,641.60
|
|
Treat hip socket fracture
|
$1,991.50 |
$1,991.50 |
$1,991.50 |
$1,392.00
|
|
Treat humerus fracture
|
$838.50 |
$838.50 |
$1,507.80 |
$1,771.43
|
|
Treat humerus fracture
|
$838.50 |
$838.50 |
$1,507.80 |
$1,771.43
|
|
Treat kneecap dislocation
|
$445.80 |
$445.80 |
$445.80 |
$1,068.90
|
|
Treat knee dislocation
|
$1,378.50 |
$1,378.50 |
$1,378.50 |
$2,220.89
|
|
Treat knee fracture
|
$61,833.72 |
$61,833.72 |
$61,833.72 |
$4,521.40
|
|
Treat knee fracture 27530
|
$380.00 |
$380.00 |
$380.00 |
$550.00
|
|
Treat knee fracture(s)
|
$401.00 |
$401.00 |
$401.00 |
$642.00
|
|
Treat knuckle dislocation
|
$838.50 |
$838.50 |
$838.50 |
$1,523.90
|
|
Treat lower leg joint
|
$39,125.06 |
$39,125.06 |
$39,125.06 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$41,014.49 |
$41,014.49 |
$41,014.49 |
$8,590.40
|
|
Treatment incomplete abortion completed surgically any trimester
|
$2,258.50 |
$2,258.50 |
$3,928.20 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$175.80 |
$175.80 |
$243.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$89.00 |
$89.00 |
$142.80 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$158.50 |
$158.50 |
$159.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$2,258.50 |
$2,258.50 |
$3,928.20 |
$3,982.44
|
|
Treatment of ankle fracture
|
$39,125.06 |
$39,125.06 |
$39,125.06 |
$8,412.89
|
|
Treatment of ankle fracture
|
$35,002.90 |
$35,002.90 |
$35,002.90 |
$7,907.11
|
|
Treatment of ankle fracture
|
$47,144.10 |
$47,144.10 |
$47,144.10 |
$7,913.97
|
|
Treatment of ankle fracture 27786
|
$203.00 |
$203.00 |
$203.00 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$264.00 |
$264.00 |
$264.00 |
$491.50
|
|
Treatment of heel fracture 28400
|
$263.00 |
$263.00 |
$263.00 |
$473.00
|
|
Treatment of miscarriage
|
$2,258.50 |
$2,258.50 |
$2,258.50 |
$4,146.69
|
|
Treatment of retinal lesion
|
$899.50 |
$899.50 |
$899.50 |
$1,033.14
|
|
Treatment of thigh fracture
|
$343.50 |
$343.50 |
$343.50 |
$476.16
|
|
Treatment of thigh fracture
|
$1,507.80 |
$1,507.80 |
$2,303.00 |
$1,748.40
|
|
Treatment of thigh fracture
|
$401.00 |
$401.00 |
$401.00 |
$548.90
|
|
Treatment of thigh fracture
|
$1,125.00 |
$1,125.00 |
$1,507.80 |
$1,772.97
|
|
Treatment of toe fracture 28510
|
$321.00 |
$321.00 |
$321.00 |
$369.70
|
|
Treatment radiation delivery level 2
|
$371.00 |
$371.00 |
$3,387.60 |
$767.65
|
|
Treatment x10sv retinopathy
|
$899.50 |
$899.50 |
$899.50 |
$1,513.20
|
|
Treat midfoot fracture each
|
$1,824.50 |
$1,824.50 |
$1,824.50 |
$1,851.78
|
|
Treat spinal cord lesion
|
$1,142.50 |
$1,142.50 |
$1,142.50 |
$1,142.50
|
|
Treat spinal cord lesion
|
$1,337.00 |
$1,337.00 |
$1,337.00 |
$1,337.00
|
|
Treat thigh fracture
|
$434.50 |
$434.50 |
$434.50 |
$661.00
|
