|
Sweat collection by iontophoresis
|
$24.30 |
$24.30 |
$24.30 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$28.65 |
$28.65 |
$28.65 |
$41.60
|
|
T3 (triiodothyronine) free
|
$93.15 |
$93.15 |
$93.15 |
$99.20
|
|
T3 (triiodothyronine) total
|
$35.10 |
$35.10 |
$35.10 |
$93.52
|
|
T4 (thyroxine) free
|
$31.05 |
$31.05 |
$31.05 |
$85.20
|
|
T4 (thyroxine) total
|
$33.30 |
$33.30 |
$33.30 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.96 |
$1.96 |
$1.96 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$143.10 |
$143.10 |
$143.10 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$615.82 |
$615.82 |
$615.82 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$233.10 |
$233.10 |
$233.10 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$862.05 |
$862.05 |
$862.05 |
$3,746.70
|
|
Target gsa panel organ neop
|
$315.00 |
$315.00 |
$315.00 |
$1,655.52
|
|
Tavr perq femoral
|
$3,823.65 |
$3,823.65 |
$3,823.65 |
$15,454.40
|
|
Tbs techl calculation only
|
$37.95 |
$37.95 |
$37.95 |
$153.60
|
|
Tbs techl prep&transmis data
|
$37.95 |
$37.95 |
$37.95 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$28.35 |
$28.35 |
$28.35 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$114.30 |
$114.30 |
$114.30 |
$177.65
|
|
Tc-99m disofenin
|
$67.26 |
$67.26 |
$67.26 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$281.25 |
$281.25 |
$281.25 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$482.85 |
$482.85 |
$482.85 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$46.05 |
$46.05 |
$46.05 |
$302.40
|
|
Tc-99m maa
|
$36.45 |
$36.45 |
$36.45 |
$292.80
|
|
Tc-99m mebrofenin
|
$23.63 |
$23.63 |
$23.63 |
$157.65
|
|
Tc-99m medronate
|
$18.99 |
$18.99 |
$18.99 |
$111.01
|
|
Tc-99m mertiatide
|
$158.40 |
$158.40 |
$158.40 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$1.50 |
$1.50 |
$1.50 |
$6.60
|
|
Tc-99m oxidronate
|
$9.00 |
$9.00 |
$9.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$4.80 |
$4.80 |
$4.80 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$10.80 |
$10.80 |
$10.80 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$0.16 |
$0.16 |
$0.16 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$71.95 |
$71.95 |
$71.95 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$32.41 |
$32.41 |
$32.41 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$76.80 |
$76.80 |
$76.80 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$55.95 |
$55.95 |
$55.95 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$23.55 |
$23.55 |
$23.55 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$234.90 |
$234.90 |
$234.90 |
$955.60
|
|
Tcd emboli detect w/inj
|
$181.05 |
$181.05 |
$181.05 |
$475.80
|
|
Tcd emboli detect without inj
|
$181.05 |
$181.05 |
$181.05 |
$475.28
|
|
Tcd vasoreactivity study
|
$189.90 |
$189.90 |
$189.90 |
$566.88
|
|
T cells absolute cd4/cd8 including ratio
|
$193.80 |
$193.80 |
$193.80 |
$176.40
|
|
T cells absolute cd 4 count
|
$28.05 |
$28.05 |
$28.05 |
$111.20
|
|
T cells total count
|
$155.55 |
$155.55 |
$155.55 |
$126.90
|
|
Telehealth original site facility fee
|
$10.35 |
$10.35 |
$10.35 |
$51.00
|
|
Telethx isodose plan cplx
|
$378.90 |
$378.90 |
$378.90 |
$1,526.85
|
|
Telethx isodose plan simple
|
$304.65 |
$304.65 |
$304.65 |
$873.62
|
|
Temozolomide
|
$87.62 |
$87.62 |
$87.62 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$596.64 |
$596.64 |
$596.64 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$682.80 |
$682.80 |
$682.80 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$5.63 |
$5.63 |
$5.63 |
$39.33
|
|
Test for urine cystines
|
$33.00 |
$33.00 |
$33.00 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$210.45 |
$210.45 |
$210.45 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$16.65 |
$16.65 |
$16.65 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$220.05 |
$220.05 |
$220.05 |
$949.70
|
|
Tgsap hl neo 5-50 rna alys
|
$369.75 |
$369.75 |
$369.75 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$1,420.95 |
$1,420.95 |
$1,420.95 |
$4,347.00
|
|
Tgsap so neo 5-50 rna alys
|
$291.15 |
$291.15 |
$291.15 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$58.05 |
$58.05 |
$58.05 |
$108.00
|
|
Therapy activation ipnss
|
$39.00 |
$39.00 |
$39.00 |
$226.24
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$15.00 |
$15.00 |
$15.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$13.50 |
$13.50 |
$13.50 |
$50.00
|
|
Ther/proph/diag inj ia
|
$55.20 |
$55.20 |
$55.20 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$10.35 |
$10.35 |
$10.35 |
$25.54
|
|
Thiotepa injection
|
$978.30 |
$978.30 |
$978.30 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$458.40 |
$458.40 |
$458.40 |
$1,687.50
|
|
Thoracotomy w/expl
|
$435.90 |
$435.90 |
$435.90 |
$2,045.17
|
|
Throat x-ray & fluoroscopy
|
$84.90 |
$84.90 |
$84.90 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$1,553.55 |
$1,553.55 |
$1,553.55 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,595.85 |
$1,595.85 |
$1,595.85 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$3,226.05 |
$3,226.05 |
$3,226.05 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$4,792.50 |
$4,792.50 |
$4,792.50 |
$21,413.60
|
|
Thrombin time
|
$43.50 |
$43.50 |
$43.50 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$23.85 |
$23.85 |
$23.85 |
$61.52
|
|
Thyroglobulin antibody
|
$49.95 |
$49.95 |
$49.95 |
$82.00
|
|
Thyroid imaging
|
$220.80 |
$220.80 |
$220.80 |
$695.02
|
|
Thyroid mets imag whole body
|
$283.20 |
$283.20 |
$283.20 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$33.30 |
$33.30 |
$33.30 |
$111.00
|
|
Thyroid Ultrasound
|
$117.30 |
$117.30 |
$117.30 |
$588.50
|
|
Thyroid uptake measurement
|
$190.65 |
$190.65 |
$190.65 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$60.75 |
$60.75 |
$60.75 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$11,474.70 |
$11,474.70 |
$11,474.70 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$10,064.85 |
$10,064.85 |
$10,064.85 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$6,294.60 |
$6,294.60 |
$6,294.60 |
$9,769.65
|
|
Tigecycline injection
|
$109.33 |
$109.33 |
$109.33 |
$234.00
|
|
Tilt table study
|
$291.45 |
$291.45 |
$291.45 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$94.50 |
$94.50 |
$94.50 |
$458.85
|
|
Tissue culture placenta
|
$82.35 |
$82.35 |
$82.35 |
$457.00
|
|
Tissue culture skin/biopsy
|
$373.80 |
$373.80 |
$373.80 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$13.80 |
$13.80 |
$13.80 |
$47.20
|
|
Tissue transglutaminase iga
|
$5.70 |
$5.70 |
$5.70 |
$44.16
|
|
Tixagev and cilgav inj
|
$76.35 |
$76.35 |
$76.35 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$51.72 |
$51.72 |
$51.72 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$80.14 |
$80.14 |
$80.14 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$83.70 |
$83.70 |
$83.70 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$15.75 |
$15.75 |
$15.75 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$15.75 |
$15.75 |
$15.75 |
$72.68
|
|
Tone decay hearing test
|
$22.95 |
$22.95 |
$22.95 |
$90.37
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$194.25 |
$194.25 |
$194.25 |
$325.00
|
|
Toxoplasma antibody igg
|
$71.10 |
$71.10 |
$71.10 |
$89.40
|
|
Toxoplasma antibody igm
|
$45.30 |
$45.30 |
$45.30 |
$87.00
|
|
Tp53 gene full gene sequence
|
$324.90 |
$324.90 |
$324.90 |
$709.80
|
