|
Surgical pathology level 1 gross examination only
|
$14.95 |
$14.95 |
$27.88 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$34.44 |
$34.44 |
$293.20 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$88.91 |
$88.91 |
$416.21 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$135.64 |
$135.64 |
$1,092.64 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$303.31 |
$303.31 |
$411.12 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$457.10 |
$457.10 |
$933.45 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$22.18 |
$22.18 |
$127.04 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$14.48 |
$14.48 |
$18.82 |
$35.75
|
|
Susceptibility mic per plate
|
$72.58 |
$72.58 |
$683.67 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$38.64 |
$38.64 |
$48.12 |
$59.28
|
|
Svc venogram s&i
|
$397.42 |
$397.42 |
$1,269.79 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$135.78 |
$135.78 |
$135.78 |
$316.55
|
|
Swallowing Therapy Session
|
$78.21 |
$78.21 |
$78.21 |
$240.31
|
|
Sweat collection by iontophoresis
|
$38.42 |
$38.42 |
$38.42 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$18.04 |
$18.04 |
$25.73 |
$41.60
|
|
System pacing micra av
|
$9,426.84 |
$9,426.84 |
$32,710.48 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$29,456.58 |
$29,456.58 |
$32,710.48 |
$12,003.00
|
|
System sealant biosentry tract
|
$884.40 |
$884.40 |
$884.40 |
$889.35
|
|
T3 (triiodothyronine) free
|
$13.92 |
$13.92 |
$43.42 |
$100.32
|
|
T3 (triiodothyronine) total
|
$8.43 |
$8.43 |
$87.91 |
$93.52
|
|
T4 (thyroxine) free
|
$41.55 |
$41.55 |
$112.03 |
$88.44
|
|
T4 (thyroxine) total
|
$10.98 |
$10.98 |
$77.46 |
$69.58
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$50.92 |
$50.92 |
$50.92 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$12.54 |
$12.54 |
$69.95 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$112.53 |
$112.53 |
$273.63 |
$289.90
|
|
Target gsa panel hmtlmph neop
|
$814.22 |
$814.22 |
$1,116.30 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,129.82 |
$3,129.82 |
$4,290.43 |
$3,746.70
|
|
Target gsa panel organ neop
|
$640.96 |
$640.96 |
$878.70 |
$1,681.28
|
|
Tas congenital car anomal
|
$1,964.18 |
$1,964.18 |
$1,964.18 |
$6,003.27
|
|
Tavr perq femoral
|
$8,705.18 |
$8,705.18 |
$8,705.18 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$104.10 |
$104.10 |
$104.10 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$64.54 |
$64.54 |
$66.47 |
$180.80
|
|
Tc-99m bicisate
|
$788.89 |
$788.89 |
$1,148.92 |
$2,070.00
|
|
Tc-99m exame autol wbc diag per dose
|
$1,490.35 |
$1,490.35 |
$1,781.30 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$648.56 |
$648.56 |
$648.56 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$237.34 |
$237.34 |
$348.14 |
$306.00
|
|
Tc-99m maa
|
$17.69 |
$17.69 |
$43.06 |
$312.06
|
|
Tc-99m mebrofenin
|
$83.58 |
$83.58 |
$101.04 |
$157.65
|
|
Tc-99m medronate
|
$68.08 |
$68.08 |
$113.02 |
$111.01
|
|
Tc-99m mertiatide
|
$352.18 |
$352.18 |
$795.96 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$216.82 |
$216.82 |
$216.82 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$682.87 |
$682.87 |
$682.87 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$36.18 |
$36.18 |
$45.62 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$155.18 |
$155.18 |
$155.18 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$88.65 |
$88.65 |
$128.38 |
$287.20
|
|
Tc-99m sulfur colloid
|
$80.71 |
$80.71 |
$248.17 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$336.23 |
$336.23 |
$336.23 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$333.13 |
$333.13 |
$765.44 |
$985.60
|
|
Tcd emboli detect w/inj
|
$404.68 |
$404.68 |
$404.68 |
$475.80
|
|
T cells absolute cd4/cd8 including ratio
|
$48.93 |
$48.93 |
$50.37 |
$185.28
|
|
T cells absolute cd 4 count
|
$28.11 |
$28.11 |
$28.71 |
$111.20
|
|
T cells total count
|
$39.56 |
$39.56 |
$40.45 |
$130.35
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$8,305.06 |
$8,305.06 |
$8,305.06 |
$14,951.87
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,162.76 |
$2,162.76 |
$2,162.76 |
$2,175.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$71.29 |
$71.29 |
$71.29 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$485.09 |
$485.09 |
$504.92 |
$953.40
|
|
Tetanus immune globulin inj
|
$1,032.34 |
$1,032.34 |
$1,032.34 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$4,089.42 |
$4,089.42 |
$4,089.42 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$8.43 |
$8.43 |
$138.29 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$31.56 |
$31.56 |
$31.56 |
$101.85
|
|
Therapy Exercise Session (each 15 minutes)
|
$28.03 |
$28.03 |
$28.03 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$41.54 |
$41.54 |
$41.54 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$45.56 |
$45.56 |
$45.56 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$416.02 |
$416.02 |
$416.02 |
$538.88
|
|
Ther/proph/diag inj ia
|
$273.90 |
$273.90 |
$273.90 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$27.34 |
$27.34 |
$27.34 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$114.70 |
$114.70 |
$114.70 |
$314.50
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$945.65 |
$945.65 |
$945.65 |
$1,733.65
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,082.72 |
$1,082.72 |
$1,334.08 |
$1,684.80
|
|
Thrombectmy crnry perq mechanical
|
$2,137.80 |
$2,137.80 |
$2,709.48 |
$3,836.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$7,565.98 |
$7,565.98 |
$7,565.98 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$11,348.51 |
$11,348.51 |
$11,348.51 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$17,101.08 |
$17,101.08 |
$18,271.36 |
$21,413.60
|
|
Thrombin time
|
$6.19 |
$6.19 |
$15.51 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$13.94 |
$13.94 |
$28.53 |
$61.52
|
|
Thyroglobulin antibody
|
$33.31 |
$33.31 |
$122.75 |
$82.73
|
|
Thyroid imaging
|
$339.52 |
$339.52 |
$339.52 |
$696.75
|
|
Thyroid met imaging
|
$476.80 |
$476.80 |
$476.80 |
$838.25
|
|
Thyroid mets imag whole body
|
$610.78 |
$610.78 |
$827.52 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$64.29 |
$64.29 |
$122.75 |
$112.67
|
|
Thyroid Ultrasound
|
$231.67 |
$231.67 |
$287.84 |
$588.50
|
|
Thyroid uptake measurement
|
$196.16 |
$196.16 |
$196.16 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,852.41 |
$4,852.41 |
$4,852.41 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$8.82 |
$8.82 |
$15.85 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$8,800.32 |
$8,800.32 |
$8,800.32 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$3,639.98 |
$3,639.98 |
$10,758.60 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$7,510.17 |
$7,510.17 |
$8,722.79 |
$10,165.00
|
|
Tigecycline injection
|
$378.69 |
$378.69 |
$378.69 |
$235.29
|
|
Tilt table study
|
$714.49 |
$714.49 |
$1,118.53 |
$1,561.82
|
|
Tissue culture placenta
|
$152.98 |
$152.98 |
$161.13 |
$440.50
|
|
Tissue culture skin/biopsy
|
$143.27 |
$143.27 |
$288.10 |
$484.00
|
|
Tissue culture tumor
|
$150.02 |
$150.02 |
$288.10 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$70.22 |
$70.22 |
$72.24 |
$47.40
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$15,925.64 |
$15,925.64 |
$15,925.64 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$20.47 |
$20.47 |
$180.10 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$133.20 |
$133.20 |
$133.20 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$227.80 |
$227.80 |
$227.80 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$9.60 |
$9.60 |
$96.48 |
$119.40
|
|
Toe X-ray (both feet)
|
$77.81 |
$77.81 |
$77.81 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$40.20 |
$40.20 |
$40.20 |
$74.10
|