|
Thyroglobulin antibody
|
$47.66 |
$47.66 |
$47.66 |
$82.00
|
|
Thyroidectomy inc substrnl split/trans approch 60270
|
$1,448.00 |
$1,448.00 |
$1,448.00 |
$2,616.00
|
|
Thyroid (TSH) Test
|
$94.50 |
$94.50 |
$94.50 |
$111.00
|
|
Thyroid Ultrasound
|
$391.50 |
$391.50 |
$391.50 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,033.50 |
$3,033.50 |
$3,033.50 |
$4,112.43
|
|
Tibial arthroscopy/surgery
|
$857.50 |
$857.50 |
$857.50 |
$5,801.60
|
|
Tissue culture skin/biopsy
|
$110.00 |
$110.00 |
$110.00 |
$484.00
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$129.50 |
$129.50 |
$129.50 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$35.50 |
$35.50 |
$35.50 |
$44.16
|
|
Tlh uterus 250 g or less
|
$895.00 |
$895.00 |
$895.00 |
$11,533.76
|
|
Tlh w/t/o 250 g or less
|
$12,480.00 |
$12,480.00 |
$12,480.00 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$14,976.00 |
$14,976.00 |
$14,976.00 |
$12,320.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$5.74 |
$5.74 |
$5.74 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$74.00 |
$74.00 |
$74.00 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$7,967.46 |
$7,967.46 |
$7,967.46 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$58.00 |
$58.00 |
$58.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$67.00 |
$67.00 |
$67.00 |
$72.68
|
|
Tonsillectomy (age 12+)
|
$266.50 |
$266.50 |
$266.50 |
$4,424.11
|
|
Tonsillectomy (child under 12)
|
$279.50 |
$279.50 |
$279.50 |
$5,339.00
|
|
Total hip arthroplasty
|
$1,845.00 |
$1,845.00 |
$1,845.00 |
$7,347.60
|
|
Total Hip Replacement
|
$12,507.50 |
$12,507.50 |
$12,507.50 |
$9,161.60
|
|
Total hysterectomy
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$3,001.70
|
|
Total Knee Replacement
|
$13,312.00 |
$13,312.00 |
$13,312.00 |
$14,543.50
|
|
Total tau
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$79.50 |
$79.50 |
$79.50 |
$89.40
|
|
Toxoplasma antibody igm
|
$14.50 |
$14.50 |
$14.50 |
$87.00
|
|
Tp53 gene full gene sequence
|
$126.00 |
$126.00 |
$126.00 |
$709.80
|
|
Tpmt gene com vrnts
|
$175.00 |
$175.00 |
$175.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$738.83 |
$738.83 |
$738.83 |
$7,144.80
|
|
Trabeculoplasty laser surg
|
$206.00 |
$206.00 |
$206.00 |
$1,180.80
|
|
Trachelectomy (cervicectomy) 57530
|
$389.50 |
$389.50 |
$389.50 |
$4,933.66
|
|
Tracheostoma revision; simple, without flap rotation
|
$3,175.50 |
$3,175.50 |
$3,175.50 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$46.00 |
$46.00 |
$46.00 |
$101.25
|
|
Transab esoph hiat hern repair 43332
|
$1,234.00 |
$1,234.00 |
$1,234.00 |
$2,835.20
|
|
Transab esoph hiat hern rpr
|
$1,420.50 |
$1,420.50 |
$1,420.50 |
$3,096.80
|
|
Transferrin
|
$58.50 |
$58.50 |
$58.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$608.00 |
$608.00 |
$608.00 |
$983.00
|
|
Transplant forearm tendon
|
$750.00 |
$750.00 |
$750.00 |
$3,591.33
|
|
Transplant forearm tendon
|
$760.50 |
$760.50 |
$760.50 |
$3,821.05
|
|
Trauma partial team response w/critical care services level 4
|
$735.00 |
$735.00 |
$735.00 |
$4,523.04
|
|
Treat ankle dislocation
|
$3,022.50 |
$3,022.50 |
$3,022.50 |
$2,358.40
|
|
Treat ankle fracture
|
$1,100.50 |
$1,100.50 |
$1,100.50 |
$5,488.00
|
|
Treat big toe fracture
|
$540.50 |
$540.50 |
$540.50 |
$4,307.52
|
|
Treat ectopic pregnancy
|
$859.50 |
$859.50 |
$859.50 |
$4,350.00
|
|
Treat ectopic pregnancy
|
$841.00 |
$841.00 |
$841.00 |
$6,707.99
|
|
Treat elbow dislocation
|
$525.50 |
$525.50 |
$525.50 |
$2,223.20
|
|
Treat elbow dislocation
|
$756.00 |
$756.00 |
$756.00 |
$7,292.92
|
|
Treat elbow fracture
|
$1,144.50 |
$1,144.50 |
$1,144.50 |
$11,488.80
|
|
Treat elbow fracture
|
$624.00 |
$624.00 |
$624.00 |
$1,919.13
|
|
Treat eyelid by injection
|
$34.50 |
$34.50 |
$34.50 |
$481.44
|
|
Treat finger fracture each
|
$519.00 |
$519.00 |
$519.00 |
$4,132.02
|
|
Treat finger fracture each
|
$2,505.50 |
$2,505.50 |
$2,505.50 |
$1,536.00
|
|
Treat foot bone lesion
|
$594.00 |
$594.00 |
$594.00 |
$3,839.54
|
|
Treat foot dislocation
|
$182.50 |
$182.50 |
$182.50 |
$396.30
|
|
Treat foot dislocation
|
$195.00 |
$195.00 |
$195.00 |
$445.80
|
|
Treat fracture of radius
|
$510.50 |
$510.50 |
$510.50 |
$1,790.00
|
|
Treat fracture of radius
|
$1,262.50 |
$1,262.50 |
$1,262.50 |
$1,849.00
|
|
Treat fracture of ulna
|
$505.00 |
$505.00 |
$505.00 |
$726.05
|
|
Treat hand dislocation
|
$466.50 |
$466.50 |
$466.50 |
$1,749.06
|
|
Treat heel fracture
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$8,269.81
|
|
Treat hip dislocation
|
$792.50 |
$792.50 |
$792.50 |
$2,192.80
|
|
Treat hip dislocation
|
$383.50 |
$383.50 |
$383.50 |
$2,641.60
|
|
Treat hip socket fracture
|
$249.50 |
$249.50 |
$249.50 |
$1,392.00
|
|
Treat humerus fracture
|
$968.00 |
$968.00 |
$968.00 |
$13,278.70
|
|
Treat humerus fracture
|
$14,768.00 |
$14,768.00 |
$14,768.00 |
$12,896.80
|
|
Treat humerus fracture
|
$633.00 |
$633.00 |
$633.00 |
$1,771.43
|
|
Treat humerus fracture
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$12,653.00
|
|
Treat humerus fracture
|
$1,142.50 |
$1,142.50 |
$1,142.50 |
$10,742.40
|
|
Treat humerus fracture
|
$805.50 |
$805.50 |
$805.50 |
$11,250.40
|
|
Treat humerus fracture
|
$918.00 |
$918.00 |
$918.00 |
$10,629.07
|
|
Treat kneecap dislocation
|
$540.00 |
$540.00 |
$540.00 |
$1,068.90
|
|
Treat kneecap fracture
|
$829.50 |
$829.50 |
$829.50 |
$6,311.00
|
|
Treat knee dislocation
|
$1,443.50 |
$1,443.50 |
$1,443.50 |
$2,220.89
|
|
Treat knee fracture
|
$990.50 |
$990.50 |
$990.50 |
$3,486.60
|
|
Treat knee fracture
|
$1,256.50 |
$1,256.50 |
$1,256.50 |
$4,521.40
|
|
Treat knee fracture
|
$896.00 |
$896.00 |
$896.00 |
$2,938.00
|
|
Treat knee fracture 27530
|
$491.50 |
$491.50 |
$491.50 |
$550.00
|
|
Treat knee fracture(s)
|
$494.50 |
$494.50 |
$494.50 |
$642.00
|
|
Treat knuckle dislocation
|
$422.00 |
$422.00 |
$422.00 |
$1,523.90
|
|
Treat knuckle dislocation
|
$605.50 |
$605.50 |
$605.50 |
$4,332.00
|
|
Treat lower leg fracture
|
$1,221.50 |
$1,221.50 |
$1,221.50 |
$14,241.77
|
|
Treat lower leg fracture
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$12,653.00
|
|
Treat lower leg joint
|
$5,211.67 |
$5,211.67 |
$5,211.67 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$6,195.50 |
$6,195.50 |
$6,195.50 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$5,903.50 |
$5,903.50 |
$5,903.50 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$6,715.50 |
$6,715.50 |
$6,715.50 |
$8,370.75
|
|
Treatment incomplete abortion completed surgically any trimester
|
$331.50 |
$331.50 |
$331.50 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$246.50 |
$246.50 |
$246.50 |
$224.90
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$460.00 |
$460.00 |
$460.00 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$410.50 |
$410.50 |
$410.50 |
$3,982.44
|
|
Treatment mouth roof lesion
|
$151.00 |
$151.00 |
$151.00 |
$4,256.70
|
|
Treatment of anal fissure w/dilat 46940
|
$151.50 |
$151.50 |
$151.50 |
$3,245.23
|
|
Treatment of ankle fracture
|
$9,615.50 |
$9,615.50 |
$9,615.50 |
$8,412.89
|
|
Treatment of ankle fracture
|
$5,845.50 |
$5,845.50 |
$5,845.50 |
$8,453.60
|
|
Treatment of ankle fracture
|
$10,853.00 |
$10,853.00 |
$10,853.00 |
$7,907.11
|
|
Treatment of ankle fracture
|
$10,891.50 |
$10,891.50 |
$10,891.50 |
$7,913.97
|
|
Treatment of ankle fracture 27786
|
$491.50 |
$491.50 |
$491.50 |
$520.80
|
|
Treatment of corneal lesion
|
$321.50 |
$321.50 |
$321.50 |
$856.80
|
|
Treatment of fibula fracture
|
$2,287.88 |
$2,287.88 |
$2,287.88 |
$6,311.00
|
|
Treatment of fibula fracture 27780
|
$491.50 |
$491.50 |
$491.50 |
$491.50
|
