|
Susceptibility enzyme detection per enzyme
|
$16.80 |
$16.80 |
$16.80 |
$35.70
|
|
Susceptibility mic per plate
|
$122.20 |
$122.20 |
$122.20 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$4.48 |
$4.48 |
$4.48 |
$59.28
|
|
Svc venogram s&i
|
$1,775.80 |
$1,775.80 |
$1,775.80 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$49.60 |
$49.60 |
$49.60 |
$41.60
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$11,161.40 |
$11,161.40 |
$11,161.40 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$76.60 |
$76.60 |
$76.60 |
$99.20
|
|
T3 (triiodothyronine) total
|
$46.20 |
$46.20 |
$46.20 |
$93.52
|
|
T4 (thyroxine) free
|
$129.80 |
$129.80 |
$129.80 |
$85.20
|
|
T4 (thyroxine) total
|
$93.40 |
$93.40 |
$93.40 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.48 |
$3.48 |
$3.48 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$42.60 |
$42.60 |
$42.60 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$490.00 |
$490.00 |
$490.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$583.92 |
$583.92 |
$583.92 |
$3,746.70
|
|
Target gsa panel organ neop
|
$143.50 |
$143.50 |
$143.50 |
$1,655.52
|
|
Tbs techl prep&transmis data
|
$53.00 |
$53.00 |
$53.00 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$189.60 |
$189.60 |
$189.60 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$26.80 |
$26.80 |
$26.80 |
$177.65
|
|
Tc-99m disofenin
|
$11.00 |
$11.00 |
$11.00 |
$124.32
|
|
Tc-99m exametazime diag
|
$433.00 |
$433.00 |
$433.00 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$66.60 |
$66.60 |
$66.60 |
$302.40
|
|
Tc-99m maa
|
$11.60 |
$11.60 |
$11.60 |
$292.80
|
|
Tc-99m mebrofenin
|
$59.40 |
$59.40 |
$59.40 |
$157.65
|
|
Tc-99m medronate
|
$118.00 |
$118.00 |
$118.00 |
$111.01
|
|
Tc-99m mertiatide
|
$137.00 |
$137.00 |
$137.00 |
$756.00
|
|
Tc-99m oxidronate
|
$2.20 |
$2.20 |
$2.20 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$53.20 |
$53.20 |
$53.20 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$28.40 |
$28.40 |
$28.40 |
$190.80
|
|
Tc-99m sestamibi p study dose
|
$178.09 |
$178.09 |
$178.09 |
$274.45
|
|
Tc-99m sulfur colloid
|
$10.00 |
$10.00 |
$10.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$81.00 |
$81.00 |
$81.00 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$124.40 |
$124.40 |
$124.40 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$8.31 |
$8.31 |
$8.31 |
$176.40
|
|
T cells absolute cd 4 count
|
$4.76 |
$4.76 |
$4.76 |
$111.20
|
|
T cells total count
|
$6.75 |
$6.75 |
$6.75 |
$126.90
|
|
Telehealth original site facility fee
|
$16.00 |
$16.00 |
$16.00 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$4,265.25 |
$4,265.25 |
$4,265.25 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$12.15 |
$12.15 |
$12.15 |
$39.33
|
|
Test for chlorohydrocarbons
|
$24.40 |
$24.40 |
$24.40 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$148.20 |
$148.20 |
$148.20 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$210.60 |
$210.60 |
$210.60 |
$949.70
|
|
Theophylline therapeutic drug level
|
$122.60 |
$122.60 |
$122.60 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$21.80 |
$21.80 |
$21.80 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$11.60 |
$11.60 |
$11.60 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$100.20 |
$100.20 |
$100.20 |
$529.08
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.77 |
$9.77 |
$9.77 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$245.00 |
$245.00 |
$245.00 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,082.60 |
$5,082.60 |
$5,082.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$8,694.40 |
$8,694.40 |
$8,694.40 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$12,336.60 |
$12,336.60 |
$12,336.60 |
$21,413.60
|
|
Thrombin time
|
$1.93 |
$1.93 |
$1.93 |
$53.76
|
|
Thromboplastin inhibition
|
$26.00 |
$26.00 |
$26.00 |
$53.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$180.80 |
$180.80 |
$180.80 |
$61.52
|
|
Thyroglobulin antibody
|
$42.60 |
$42.60 |
$42.60 |
$82.00
|
|
Thyroid met imaging
|
$130.60 |
$130.60 |
$130.60 |
$838.25
|
|
Thyroid mets imag whole body
|
$264.40 |
$264.40 |
$264.40 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$128.20 |
$128.20 |
$128.20 |
$111.00
|
|
Thyroid Ultrasound
|
$660.60 |
$660.60 |
$660.60 |
$588.50
|
|
Thyroid uptake measurement
|
$188.40 |
$188.40 |
$188.40 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$2.63 |
$2.63 |
$2.63 |
$64.35
|
|
Tissue culture placenta
|
$35.10 |
$35.10 |
$35.10 |
$457.00
|
|
Tissue culture skin/biopsy
|
$47.73 |
$47.73 |
$47.73 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$36.60 |
$36.60 |
$36.60 |
$47.20
|
|
Tissue transglutaminase iga
|
$2.40 |
$2.40 |
$2.40 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$45.00 |
$45.00 |
$45.00 |
$78.40
|
|
Tobramycin peak therapeutic drug level
|
$141.40 |
$141.40 |
$141.40 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$107.40 |
$107.40 |
$107.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$28.20 |
$28.20 |
$28.20 |
$72.68
|
|
Total tau
|
$60.00 |
$60.00 |
$60.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$42.00 |
$42.00 |
$42.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$3.00 |
$3.00 |
$3.00 |
$87.00
|
|
Tp53 gene full gene sequence
|
$128.00 |
$128.00 |
$128.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$66.00 |
$66.00 |
$66.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$37.00 |
$37.00 |
$37.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$20,192.00 |
$20,192.00 |
$20,192.00 |
$7,144.80
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$6.67 |
$6.67 |
$6.67 |
$56.38
|
|
Transferrin
|
$74.80 |
$74.80 |
$74.80 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$116.60 |
$116.60 |
$116.60 |
$983.00
|
|
Treat foot bone lesion
|
$1,030.60 |
$1,030.60 |
$1,030.60 |
$3,839.54
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$54.00 |
$54.00 |
$54.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$54.00 |
$54.00 |
$54.00 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$56.60 |
$56.60 |
$56.60 |
$203.35
|
|
Treatment of foot infection
|
$508.40 |
$508.40 |
$508.40 |
$2,614.25
|
|
Treatment of foot infection
|
$1,030.60 |
$1,030.60 |
$1,030.60 |
$3,821.05
|
|
Treponema pallidum antibody
|
$39.40 |
$39.40 |
$39.40 |
$70.40
|
|
Trg gene rearrangement anal
|
$40.30 |
$40.30 |
$40.30 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$9.90 |
$9.90 |
$9.90 |
$43.21
|
|
Trichinella antibody
|
$18.98 |
$18.98 |
$18.98 |
$70.20
|
|
#tricyclicantidprssnt
|
$11.60 |
$11.60 |
$11.60 |
$50.86
|
|
Triglycerides
|
$116.40 |
$116.40 |
$116.40 |
$58.05
|
|
Trim nondyst nails
|
$42.80 |
$42.80 |
$42.80 |
$113.40
|
|
Trnscath plc vas stent w/s&i ini vein
|
$7,546.20 |
$7,546.20 |
$7,546.20 |
$15,330.11
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,904.00 |
$2,904.00 |
$2,904.00 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,495.40 |
$1,495.40 |
$1,495.40 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$4,250.25
|
|
Troponin quantitative
|
$198.80 |
$198.80 |
$198.80 |
$127.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$361.80 |
$361.80 |
$361.80 |
$394.20
|
|
Ultrasound breast complete
|
$455.60 |
$455.60 |
$455.60 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$683.40 |
$683.40 |
$683.40 |
$449.35
|
|
Ultrasound chest
|
$557.00 |
$557.00 |
$557.00 |
$460.85
|
