|
Tlh w/t/o 250 g or less
|
$8,357.50 |
$8,357.50 |
$8,357.50 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$18,017.50 |
$18,017.50 |
$18,017.50 |
$12,320.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.78 |
$7.78 |
$7.78 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$83.00 |
$83.00 |
$83.00 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$63.00 |
$63.00 |
$63.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$63.00 |
$63.00 |
$63.00 |
$72.68
|
|
Tongue biopsy; posterior one-third 41105
|
$3,648.50 |
$3,648.50 |
$3,648.50 |
$3,544.29
|
|
Tonsillectomy (age 12+)
|
$2,138.00 |
$2,138.00 |
$2,138.00 |
$4,424.11
|
|
Total Hip Replacement
|
$14,750.50 |
$14,750.50 |
$14,750.50 |
$9,161.60
|
|
Total Knee Replacement
|
$17,782.00 |
$17,782.00 |
$17,782.00 |
$14,543.50
|
|
Total tau
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$83.50 |
$83.50 |
$83.50 |
$89.40
|
|
Toxoplasma antibody igm
|
$18.50 |
$18.50 |
$18.50 |
$87.00
|
|
Tp53 gene full gene sequence
|
$126.00 |
$126.00 |
$126.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$552.60 |
$552.60 |
$552.60 |
$790.68
|
|
Tpmt gene com vrnts
|
$175.00 |
$175.00 |
$175.00 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$620.00 |
$620.00 |
$620.00 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$53.00 |
$53.00 |
$53.00 |
$101.25
|
|
Transcath closure of vsd
|
$9,515.00 |
$9,515.00 |
$9,515.00 |
$17,115.04
|
|
Transferrin
|
$62.00 |
$62.00 |
$62.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$371.50 |
$371.50 |
$371.50 |
$983.00
|
|
Trastuzumab 150 mg intravenous solution
|
$7,854.44 |
$7,854.44 |
$7,854.44 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$10,093.70 |
$10,093.70 |
$10,093.70 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$1,495.50 |
$1,495.50 |
$1,495.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$682.97 |
$682.97 |
$682.97 |
$940.80
|
|
Treat ectopic pregnancy
|
$9,396.50 |
$9,396.50 |
$9,396.50 |
$6,707.99
|
|
Treat elbow dislocation
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$2,223.20
|
|
Treat elbow fracture
|
$3,663.00 |
$3,663.00 |
$3,663.00 |
$1,919.13
|
|
Treat finger fracture each
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$1,536.00
|
|
Treat foot dislocation
|
$283.50 |
$283.50 |
$283.50 |
$527.28
|
|
Treat fracture of radius
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$1,790.00
|
|
Treat fracture of ulna
|
$365.50 |
$365.50 |
$365.50 |
$726.05
|
|
Treat hip socket fracture
|
$311.50 |
$311.50 |
$311.50 |
$1,392.00
|
|
Treat humerus fracture
|
$1,848.50 |
$1,848.50 |
$1,848.50 |
$1,771.43
|
|
Treat kneecap fracture
|
$11,871.50 |
$11,871.50 |
$11,871.50 |
$6,311.00
|
|
Treat lower leg joint
|
$3,725.00 |
$3,725.00 |
$3,725.00 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$7,955.00 |
$7,955.00 |
$7,955.00 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$9,001.50 |
$9,001.50 |
$9,001.50 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$9,645.50 |
$9,645.50 |
$9,645.50 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,577.00 |
$3,577.00 |
$3,577.00 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$181.50 |
$181.50 |
$181.50 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$674.00 |
$674.00 |
$674.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$787.50 |
$787.50 |
$787.50 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$2,651.67 |
$2,651.67 |
$2,651.67 |
$3,982.44
|
|
Treatment of ankle fracture
|
$7,936.24 |
$7,936.24 |
$7,936.24 |
$8,412.89
|
|
Treatment of ankle fracture
|
$8,599.00 |
$8,599.00 |
$8,599.00 |
$8,453.60
|
|
Treatment of ankle fracture
|
$12,785.00 |
$12,785.00 |
$12,785.00 |
$7,907.11
|
|
Treatment of ankle fracture
|
$15,280.50 |
$15,280.50 |
$15,280.50 |
$7,913.97
|
|
Treatment of miscarriage
|
$6,679.50 |
$6,679.50 |
$6,679.50 |
$4,146.69
|
|
Treatment of retinal lesion
|
$632.50 |
$632.50 |
$632.50 |
$1,033.14
|
|
Treatment of thigh fracture
|
$1,848.50 |
$1,848.50 |
$1,848.50 |
$1,748.40
|
|
Treatment of tibia fracture
|
$10,933.50 |
$10,933.50 |
$10,933.50 |
$8,665.60
|
|
Treatment of tibia fracture
|
$12,456.50 |
$12,456.50 |
$12,456.50 |
$7,087.60
|
|
Treatment radiation delivery level 2
|
$377.00 |
$377.00 |
$377.00 |
$767.65
|
|
Treat metacarpal fracture
|
$7,150.00 |
$7,150.00 |
$7,150.00 |
$3,977.49
|
|
Treat metacarpal fracture
|
$10,450.50 |
$10,450.50 |
$10,450.50 |
$5,464.97
|
|
Treat metatarsal fracture
|
$7,150.00 |
$7,150.00 |
$7,150.00 |
$8,453.60
|
|
Treat thigh fracture
|
$10,264.67 |
$10,264.67 |
$10,264.67 |
$4,083.00
|
|
Treat thigh fracture
|
$4,256.00 |
$4,256.00 |
$4,256.00 |
$2,032.10
|
|
Treat ulnar fracture
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$1,662.00
|
|
Treat ulnar fracture
|
$8,679.50 |
$8,679.50 |
$8,679.50 |
$5,926.25
|
|
Treat wrist bone fracture
|
$2,509.50 |
$2,509.50 |
$2,509.50 |
$1,548.40
|
|
Treat wrist dislocation
|
$369.00 |
$369.00 |
$369.00 |
$656.25
|
|
Treponema pallidum antibody
|
$77.00 |
$77.00 |
$77.00 |
$70.40
|
|
Trg gene rearrangement anal
|
$270.00 |
$270.00 |
$270.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$40.00 |
$40.00 |
$40.00 |
$43.21
|
|
Triamcinolone a inj prs-free
|
$54.00 |
$54.00 |
$54.00 |
$223.56
|
|
Trichinella antibody
|
$39.00 |
$39.00 |
$39.00 |
$70.20
|
|
#tricyclicantidprssnt
|
$5.00 |
$5.00 |
$5.00 |
$50.86
|
|
Triglycerides
|
$51.00 |
$51.00 |
$51.00 |
$58.05
|
|
Trilaciclib 300 mg intravenous solution
|
$6,895.71 |
$6,895.71 |
$6,895.71 |
$4,043.12
|
|
Triptorelin pamoate
|
$1,737.00 |
$1,737.00 |
$1,737.00 |
$4,619.39
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$7,347.50 |
$7,347.50 |
$7,347.50 |
$15,226.08
|
|
Trml dstrj ios bvn ea addl
|
$3,671.50 |
$3,671.50 |
$3,671.50 |
$7,354.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,870.00 |
$2,870.00 |
$2,870.00 |
$4,523.96
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$6,078.00 |
$6,078.00 |
$6,078.00 |
$4,713.66
|
|
Trnsfr/rearrngmnt adjcnt tiss defec ea addl 30sqcm/<
|
$2,192.00 |
$2,192.00 |
$2,192.00 |
$2,357.04
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$4,043.00 |
$4,043.00 |
$4,043.00 |
$2,986.34
|
|
Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm
|
$4,879.00 |
$4,879.00 |
$4,879.00 |
$3,078.00
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$5,563.00 |
$5,563.00 |
$5,563.00 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$7,556.50 |
$7,556.50 |
$7,556.50 |
$2,371.50
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$4,256.33 |
$4,256.33 |
$4,256.33 |
$2,406.77
|
|
Troponin quantitative
|
$150.00 |
$150.00 |
$150.00 |
$127.20
|
|
Tx closed hip disl traumatic without anes
|
$365.50 |
$365.50 |
$365.50 |
$581.07
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$3,761.00 |
$3,761.00 |
$3,761.00 |
$3,977.49
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$4,395.00 |
$4,395.00 |
$4,395.00 |
$4,499.12
|
|
Tympanic membrane repair
|
$4,010.50 |
$4,010.50 |
$4,010.50 |
$2,638.87
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$655.00 |
$655.00 |
$655.00 |
$911.43
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$20,945.01 |
$20,945.01 |
$20,945.01 |
$20,945.01
|
|
Ugt1a1 gene analy common variants
|
$180.00 |
$180.00 |
$180.00 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$600.00 |
$600.00 |
$600.00 |
$394.20
|
|
Ultrasound breast complete
|
$670.00 |
$670.00 |
$670.00 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$670.00 |
$670.00 |
$670.00 |
$449.35
|
|
Ultrasound chest
|
$360.50 |
$360.50 |
$360.50 |
$460.85
|
|
Ultrasound encephalogram
|
$366.00 |
$366.00 |
$366.00 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$558.00 |
$558.00 |
$558.00 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$594.50 |
$594.50 |
$594.50 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$553.00 |
$553.00 |
$553.00 |
$720.15
|
|
Ultrasound guide intraoperative
|
$577.00 |
$577.00 |
$577.00 |
$632.85
|
