|
Thromboxane urine
|
$125.60 |
$125.60 |
$188.50 |
|
|
Thumb tendon transfer
|
$4,179.00 |
$4,179.00 |
$4,179.00 |
|
|
Thyroglobulin antibody
|
$19.50 |
$50.00 |
$556.80 |
|
|
Thyroidectomy inc substrnl split/trans approch 60270
|
$1,436.50 |
$1,436.50 |
$2,298.40 |
|
|
Thyroid imaging
|
$371.50 |
$546.00 |
$821.00 |
|
|
Thyroid mets imag whole body
|
$346.50 |
$1,455.00 |
$2,007.00 |
|
|
Thyroid (TSH) Test
|
$28.00 |
$87.00 |
$184.20 |
|
|
Thyroid Ultrasound
|
$260.00 |
$438.00 |
$1,220.00 |
|
|
Thyroid uptake measurement
|
$196.00 |
$406.00 |
$511.50 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,033.50 |
$4,550.00 |
$4,853.60 |
|
|
Thyroxine binding globulin (tbg)
|
$25.00 |
$48.00 |
$123.50 |
|
|
Tibial arthroscopy/surgery
|
$824.50 |
$825.00 |
$1,320.00 |
|
|
Tigecycline injection
|
$76.90 |
$76.90 |
$1,289.70 |
|
|
Tilt table study
|
$356.50 |
$1,022.00 |
$1,412.50 |
|
|
Tirofiban 12.5 mg/50 ml
|
$48.33 |
$110.25 |
$961.20 |
|
|
Tis cgen car anomal 1st shnt
|
$4,644.00 |
$4,644.00 |
$4,644.00 |
|
|
Tis cgen car anomal ea addl
|
$3,095.50 |
$3,095.50 |
$3,095.50 |
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$44,944.00 |
$44,944.00 |
$47,724.10 |
|
|
Tissue culture placenta
|
$440.50 |
$440.50 |
$862.00 |
|
|
Tissue culture skin/biopsy
|
$110.00 |
$284.00 |
$1,418.00 |
|
|
Tissue culture tumor
|
$186.50 |
$199.50 |
$864.00 |
|
|
Tissue exam koh skin/hair/nails
|
$10.00 |
$24.50 |
$144.50 |
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$119.50 |
$143.50 |
$4,706.12 |
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$830.41 |
$830.41 |
$830.41 |
|
|
Tissue transglutaminase iga
|
$35.00 |
$74.00 |
$416.00 |
|
|
Tixagev and cilgav inj
|
$244.50 |
$244.50 |
$318.00 |
|
|
Tl-201 thallium diag per mci
|
$40.80 |
$62.50 |
$219.00 |
|
|
Tlh uterus 250 g or less
|
$842.00 |
$3,578.69 |
$23,827.00 |
|
|
Tlh uterus over 250 g
|
$12,125.00 |
$13,331.34 |
$24,017.00 |
|
|
Tlh w/t/o 250 g or less
|
$955.50 |
$14,889.00 |
$32,198.50 |
|
|
Tlh w/t/o uterus over 250 g
|
$1,285.00 |
$14,976.00 |
$42,206.50 |
|
|
Tlso 2mod symphis-xipho pre
|
$1,659.50 |
$1,696.00 |
$1,874.50 |
|
|
Tlso 2 piece rigid shell
|
$1,452.00 |
$1,484.00 |
$1,641.00 |
|
|
Tlso 2 shl symphys-stern cst
|
$1,541.50 |
$1,576.00 |
$1,741.00 |
|
|
Tlso 3mod sacro-scap pre
|
$2,104.50 |
$2,151.50 |
$2,377.00 |
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$5.74 |
$13.08 |
$436.14 |
|
|
Tobramycin non-comp unit
|
$19.58 |
$40.98 |
$81.66 |
|
|
Tobramycin peak therapeutic drug level
|
$17.50 |
$111.00 |
$281.00 |
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,983.73 |
$5,975.60 |
$10,623.28 |
|
|
Tomosynthesis breast diagnostic left
|
$43.20 |
$75.50 |
$613.50 |
|
|
Tomosynthesis breast screen bilateral
|
$55.00 |
$73.50 |
$750.00 |
|
|
Tone decay hearing test
|
$135.00 |
$135.00 |
$135.00 |
|
|
Tongue and neck surgery
|
$17,257.50 |
$17,257.50 |
$17,257.50 |
|
|
Tongue base vol reduction
|
$7,184.50 |
$7,184.50 |
$7,184.50 |
|
|
Tongue biopsy; posterior one-third 41105
|
$1,218.00 |
$3,811.00 |
$5,353.00 |
|
|
Tongue removal neck surgery
|
$26,207.13 |
$26,207.13 |
$26,207.13 |
|
|
Tongue suspension
|
$4,309.83 |
$4,309.83 |
$4,309.83 |
|
|
Tonsillectomy (age 12+)
|
$257.50 |
$2,138.00 |
$8,409.69 |
|
|
Tonsillectomy (child under 12)
|
$269.50 |
$431.20 |
$6,056.50 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$32.54 |
$56.80 |
$73.78 |
|
|
Total hip arthroplasty
|
$1,735.50 |
$1,845.00 |
$43,790.00 |
|
|
Total Hip Replacement
|
$1,338.50 |
$12,507.50 |
$35,695.00 |
|
|
Total hysterectomy
|
$1,075.00 |
$1,974.00 |
$23,709.50 |
|
|
Total Knee Replacement
|
$1,336.00 |
$14,543.50 |
$31,715.00 |
|
|
Total tau
|
$431.00 |
$431.00 |
$689.60 |
|
|
Tot disc arthrp 1ntrspc crv
|
$16,830.00 |
$21,711.00 |
$41,238.00 |
|
|
Tot disc arthrp ant appr disc 2nd level cervi 22858
|
$11,745.00 |
$11,745.00 |
$11,745.00 |
|
|
Toxoplasma antibody igg
|
$14.00 |
$61.00 |
$216.60 |
|
|
Toxoplasma antibody igm
|
$14.50 |
$46.00 |
$505.80 |
|
|
Tp53 gene full gene sequence
|
$126.00 |
$126.00 |
$126.00 |
|
|
Tp53 gene trgt sequence alys
|
$552.60 |
$871.00 |
$993.00 |
|
|
Tpmt gene com vrnts
|
$175.00 |
$175.00 |
$619.20 |
|
|
Tprnl plmt biodegrdabl matrl
|
$164.00 |
$262.40 |
$6,030.00 |
|
|
Trabectedin 1 mg intravenous solution
|
$14,757.36 |
$18,446.70 |
$26,563.25 |
|
|
Trabeculoplasty laser surg
|
$190.00 |
$304.00 |
$2,004.00 |
|
|
Trachelectomy (cervicectomy) 57530
|
$383.50 |
$389.50 |
$7,776.66 |
|
|
Tracheobrnchsc thru est trachs incisn
|
$600.00 |
$620.00 |
$863.50 |
|
|
Tracheostoma revision; simple, without flap rotation
|
$3,175.50 |
$3,175.50 |
$8,309.50 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$46.00 |
$53.00 |
$199.50 |
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$6.90 |
$10.35 |
$33.48 |
|
|
Transab esoph hiat hern repair 43332
|
$1,234.00 |
$1,273.00 |
$2,036.80 |
|
|
Transab esoph hiat hern rpr
|
$1,356.00 |
$1,391.00 |
$2,225.60 |
|
|
Transcath biopsy
|
$1,622.00 |
$5,039.50 |
$5,039.50 |
|
|
Transcath closure of asd
|
$10,784.00 |
$10,784.00 |
$10,784.00 |
|
|
Transcath closure of vsd
|
$9,158.50 |
$9,158.50 |
$9,515.00 |
|
|
Transcatheter bx s&i
|
$2,063.50 |
$4,047.50 |
$4,047.50 |
|
|
Transcath mv repair addl prosthesis
|
$2,998.00 |
$2,998.00 |
$2,998.00 |
|
|
Transcath mv repair init prosthesis
|
$6,662.00 |
$6,662.00 |
$6,662.00 |
|
|
Transcath occlusion cns
|
$11,102.00 |
$11,647.00 |
$16,755.00 |
|
|
Transcath occlusion non-cns
|
$3,982.00 |
$7,466.50 |
$7,644.00 |
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,980.50 |
$2,980.50 |
$3,428.00 |
|
|
Transcutaneous carboxyhb
|
$21.00 |
$26.50 |
$31.00 |
|
|
Transferrin
|
$27.20 |
$73.50 |
$120.60 |
|
|
Transfer skin pedicle flap
|
$3,152.50 |
$3,152.50 |
$3,152.50 |
|
|
Transfusion blood/blood component(s)
|
$360.80 |
$664.00 |
$1,733.00 |
|
|
Transorl lwr esophgl myotomy
|
$7,000.50 |
$7,000.50 |
$10,439.00 |
|
|
Transparent film >16<=48 in
|
$2.50 |
$2.50 |
$2.50 |
|
|
Transperi needle place pros
|
$652.88 |
$871.63 |
$4,929.00 |
|
|
Transplant forearm tendon
|
$745.00 |
$750.00 |
$6,541.75 |
|
|
Transplant forearm tendon
|
$749.00 |
$749.00 |
$1,198.40 |
|
|
Transplant/graft hand tendon
|
$12,486.67 |
$12,486.67 |
$12,486.67 |
|
|
Transplant hand tendon
|
$4,529.60 |
$4,803.67 |
$7,539.50 |
|
|
Transplant palm tendon
|
$4,179.00 |
$4,179.00 |
$4,179.00 |
|
|
Transplt allo hct/donor
|
$79,473.00 |
$79,473.00 |
$79,473.00 |
|
|
Transplt autol hct/donor
|
$2,203.00 |
$2,203.00 |
$2,203.00 |
|
|
Transposition ovary(s)
|
$4,633.50 |
$4,633.50 |
$4,633.50 |
|
|
Trastuzumab 150 mg intravenous solution
|
$5,196.60 |
$7,854.44 |
$17,017.95 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$3,406.62 |
$9,841.25 |
$13,574.40 |
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$4,397.18 |
$4,397.18 |
$4,397.18 |
|
|
Trauma partial team response w/critical care services level 4
|
$684.00 |
$1,517.50 |
$2,352.00 |
|
