|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.00 |
$17.00 |
$17.00 |
$25.54
|
|
Thorabd diaphr hern repair
|
$1,548.50 |
$1,548.50 |
$1,548.50 |
$3,542.40
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,266.50 |
$1,266.50 |
$1,266.50 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit
|
$383.50 |
$383.50 |
$383.50 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$460.00 |
$460.00 |
$460.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$531.00 |
$531.00 |
$531.00 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$1,206.00 |
$1,206.00 |
$1,206.00 |
$5,520.00
|
|
Thrombin time
|
$74.00 |
$74.00 |
$74.00 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$869.00 |
$869.00 |
$869.00 |
$3,980.60
|
|
Thromboendarterectomy including patch graft if preformed;
|
$968.00 |
$968.00 |
$968.00 |
$5,994.11
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$1,376.50 |
$1,376.50 |
$1,376.50 |
$4,585.00
|
|
Thromboendarterectomy sfa
|
$1,192.50 |
$1,192.50 |
$1,192.50 |
$4,185.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$118.00 |
$118.00 |
$118.00 |
$61.52
|
|
Thyroglobulin antibody
|
$46.50 |
$46.50 |
$46.50 |
$82.00
|
|
Thyroidectomy inc substrnl split/trans approch 60270
|
$1,448.00 |
$1,448.00 |
$1,448.00 |
$2,616.00
|
|
Thyroid (TSH) Test
|
$75.00 |
$75.00 |
$75.00 |
$111.00
|
|
Thyroid Ultrasound
|
$347.00 |
$347.00 |
$347.00 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,033.50 |
$3,033.50 |
$3,033.50 |
$4,112.43
|
|
Tibial arthroscopy/surgery
|
$824.50 |
$824.50 |
$824.50 |
$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
|
$119.50 |
$119.50 |
$119.50 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$116.00 |
$116.00 |
$116.00 |
$44.16
|
|
Tlh uterus 250 g or less
|
$851.00 |
$851.00 |
$851.00 |
$11,533.76
|
|
Tlh w/t/o 250 g or less
|
$955.50 |
$955.50 |
$955.50 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$1,285.00 |
$1,285.00 |
$1,285.00 |
$12,320.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$88.44 |
$88.44 |
$88.44 |
$152.36
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,983.73 |
$3,983.73 |
$3,983.73 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$101.00 |
$101.00 |
$101.00 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$101.00 |
$101.00 |
$101.00 |
$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
|
$5,475.00 |
$5,475.00 |
$5,475.00 |
$7,347.60
|
|
Total Hip Replacement
|
$9,525.00 |
$9,525.00 |
$9,525.00 |
$9,161.60
|
|
Total hysterectomy
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$3,001.70
|
|
Total Knee Replacement
|
$9,750.00 |
$9,750.00 |
$9,750.00 |
$14,543.50
|
|
Total tau
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$47.50 |
$47.50 |
$47.50 |
$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
|
$170.00 |
$170.00 |
$170.00 |
$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
|
$47.50 |
$47.50 |
$47.50 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$6.90 |
$6.90 |
$6.90 |
$56.38
|
|
Transab esoph hiat hern repair 43332
|
$1,234.00 |
$1,234.00 |
$1,234.00 |
$2,835.20
|
|
Transab esoph hiat hern rpr
|
$1,356.00 |
$1,356.00 |
$1,356.00 |
$3,096.80
|
|
Transcutaneous carboxyhb
|
$27.50 |
$27.50 |
$27.50 |
$33.57
|
|
Transferrin
|
$75.50 |
$75.50 |
$75.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$664.00 |
$664.00 |
$664.00 |
$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
|
$1,380.50 |
$1,380.50 |
$1,380.50 |
$4,523.04
|
|
Treat ankle dislocation
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$2,358.40
|
|
Treat ankle fracture
|
$1,100.50 |
$1,100.50 |
$1,100.50 |
$5,488.00
|
|
Treat big toe fracture
|
$517.00 |
$517.00 |
$517.00 |
$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
|
$504.50 |
$504.50 |
$504.50 |
$2,223.20
|
|
Treat elbow dislocation
|
$756.00 |
$756.00 |
$756.00 |
$7,292.92
|
|
Treat elbow fracture
|
$1,197.00 |
$1,197.00 |
$1,197.00 |
$11,488.80
|
|
Treat elbow fracture
|
$2,330.50 |
$2,330.50 |
$2,330.50 |
$1,919.13
|
|
Treat eyelid by injection
|
$34.50 |
$34.50 |
$34.50 |
$481.44
|
|
Treat finger fracture each
|
$6,380.00 |
$6,380.00 |
$6,380.00 |
$4,132.02
|
|
Treat finger fracture each
|
$358.50 |
$358.50 |
$358.50 |
$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
|
$491.00 |
$491.00 |
$491.00 |
$1,790.00
|
|
Treat fracture of radius
|
$580.50 |
$580.50 |
$580.50 |
$1,849.00
|
|
Treat fracture of ulna
|
$505.00 |
$505.00 |
$505.00 |
$726.05
|
|
Treat hand dislocation
|
$450.50 |
$450.50 |
$450.50 |
$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
|
$2,182.00 |
$2,182.00 |
$2,182.00 |
$2,641.60
|
|
Treat hip socket fracture
|
$286.00 |
$286.00 |
$286.00 |
$1,392.00
|
|
Treat humerus fracture
|
$930.00 |
$930.00 |
$930.00 |
$13,278.70
|
|
Treat humerus fracture
|
$25,665.00 |
$25,665.00 |
$25,665.00 |
$12,896.80
|
|
Treat humerus fracture
|
$1,621.00 |
$1,621.00 |
$1,621.00 |
$1,771.43
|
|
Treat humerus fracture
|
$983.50 |
$983.50 |
$983.50 |
$12,653.00
|
|
Treat humerus fracture
|
$1,098.50 |
$1,098.50 |
$1,098.50 |
$10,742.40
|
|
Treat humerus fracture
|
$776.00 |
$776.00 |
$776.00 |
$11,250.40
|
|
Treat humerus fracture
|
$883.50 |
$883.50 |
$883.50 |
$10,629.07
|
|
Treat kneecap dislocation
|
$521.50 |
$521.50 |
$521.50 |
$1,068.90
|
|
Treat kneecap fracture
|
$829.50 |
$829.50 |
$829.50 |
$6,311.00
|
|
Treat knee dislocation
|
$1,621.00 |
$1,621.00 |
$1,621.00 |
$2,220.89
|
|
Treat knee fracture
|
$949.50 |
$949.50 |
$949.50 |
$3,486.60
|
|
Treat knee fracture
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$4,521.40
|
|
Treat knee fracture
|
$896.00 |
$896.00 |
$896.00 |
$2,938.00
|
|
Treat knee fracture 27530
|
$341.00 |
$341.00 |
$341.00 |
$550.00
|
|
Treat knee fracture(s)
|
$477.00 |
$477.00 |
$477.00 |
$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
|
$14,355.00 |
$14,355.00 |
$14,355.00 |
$12,653.00
|
|
Treat lower leg joint
|
$768.00 |
$768.00 |
$768.00 |
$7,807.24
|
|
Treatment fx radial distal open w/internal fixation 2 frag left (restricted method ii cah)
|
$15,915.50 |
$15,915.50 |
$15,915.50 |
$8,370.75
|
|
Treatment fx radial distal open w/internal fixation 3+ frag left (restricted method ii cah)
|
$10,150.00 |
$10,150.00 |
$10,150.00 |
$8,590.40
|
|
Treatment fx radial distal open w/internal fixation left (restricted method ii cah)
|
$9,715.00 |
$9,715.00 |
$9,715.00 |
$8,370.75
|
