|
Surgical pathology level 4 gross & microscopic examination
|
$192.48 |
$192.48 |
$192.48 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$292.80 |
$292.80 |
$292.80 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$636.96 |
$636.96 |
$636.96 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$26.88 |
$26.88 |
$26.88 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$46.08 |
$46.08 |
$46.08 |
$34.48
|
|
Susceptibility mic per plate
|
$86.13 |
$86.13 |
$86.13 |
$94.38
|
|
Svc venogram s&i
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.40 |
$1.40 |
$1.40 |
$44.85
|
|
System cardiomems hosp electronics
|
$54,696.36 |
$54,696.36 |
$54,696.36 |
$41,518.75
|
|
System pacing micra av
|
$32,810.40 |
$32,810.40 |
$32,810.40 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$9,600.00 |
$9,600.00 |
$9,600.00 |
$10,980.00
|
|
System sealant biosentry tract
|
$1,079.57 |
$1,079.57 |
$1,079.57 |
$900.00
|
|
T3 (triiodothyronine) free
|
$100.32 |
$100.32 |
$100.32 |
$89.82
|
|
T3 (triiodothyronine) total
|
$87.36 |
$87.36 |
$87.36 |
$94.90
|
|
T4 (thyroxine) free
|
$80.16 |
$80.16 |
$80.16 |
$81.60
|
|
T4 (thyroxine) total
|
$53.76 |
$53.76 |
$53.76 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$20.98 |
$20.98 |
$20.98 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$785.68 |
$785.68 |
$785.68 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$74.40 |
$74.40 |
$74.40 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$960.00 |
$960.00 |
$960.00 |
$1,928.40
|
|
Tavr perq femoral
|
$12,600.00 |
$12,600.00 |
$12,600.00 |
$16,357.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$115.20 |
$115.20 |
$115.20 |
$166.46
|
|
Tcd emboli detect w/inj
|
$1,245.12 |
$1,245.12 |
$1,245.12 |
$404.68
|
|
T cells absolute cd4/cd8 including ratio
|
$150.55 |
$150.55 |
$150.55 |
$186.00
|
|
T cells absolute cd 4 count
|
$61.27 |
$61.27 |
$61.27 |
$120.25
|
|
T cells total count
|
$45.08 |
$45.08 |
$45.08 |
$124.11
|
|
Telethx isodose plan cplx
|
$2,611.20 |
$2,611.20 |
$2,611.20 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,258.56 |
$1,258.56 |
$1,258.56 |
$848.72
|
|
Temozolomide
|
$105.11 |
$105.11 |
$105.11 |
$374.66
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$14,606.90 |
$14,606.90 |
$14,606.90 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$3,839.54
|
|
Tension based scoliosis orth
|
$3,248.64 |
$3,248.64 |
$3,248.64 |
$2,851.20
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$44.76 |
$44.76 |
$44.76 |
$46.10
|
|
Testicular imaging w/vasc flow
|
$668.64 |
$668.64 |
$668.64 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$949.92 |
$949.92 |
$949.92 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,504.92 |
$1,504.92 |
$1,504.92 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$59.04 |
$59.04 |
$59.04 |
$108.00
|
|
Therapeutic procd strg endur
|
$94.08 |
$94.08 |
$94.08 |
$85.80
|
|
Therapy activity per session >= 45 minutes
|
$180.48 |
$180.48 |
$180.48 |
$158.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$80.64 |
$80.64 |
$80.64 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$80.64 |
$80.64 |
$80.64 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$333.60 |
$333.60 |
$333.60 |
$534.32
|
|
Ther/proph/diag inj ia
|
$307.20 |
$307.20 |
$307.20 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,950.08 |
$2,950.08 |
$2,950.08 |
$1,804.00
|
|
Thoracotomy w/expl
|
$5,543.04 |
$5,543.04 |
$5,543.04 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$8,537.76 |
$8,537.76 |
$8,537.76 |
$2,926.56
|
|
Thrombectmy crnry perq mechanical
|
$3,059.52 |
$3,059.52 |
$3,059.52 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,104.16 |
$6,104.16 |
$6,104.16 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$12,336.48 |
$12,336.48 |
$12,336.48 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$18,698.88 |
$18,698.88 |
$18,698.88 |
$24,605.30
|
|
Thrombin time
|
$19.90 |
$19.90 |
$19.90 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$32.96 |
$32.96 |
$32.96 |
$56.93
|
|
Thyroglobulin antibody
|
$28.78 |
$28.78 |
$28.78 |
$84.00
|
|
Thyroid mets imag whole body
|
$1,087.68 |
$1,087.68 |
$1,087.68 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$90.24 |
$90.24 |
$90.24 |
$120.00
|
|
Thyroid Ultrasound
|
$708.00 |
$708.00 |
$708.00 |
$589.96
|
|
Thyroid uptake measurement
|
$421.44 |
$421.44 |
$421.44 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$59.98 |
$59.98 |
$59.98 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$22,244.64 |
$22,244.64 |
$22,244.64 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$12,844.80 |
$12,844.80 |
$12,844.80 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$12,844.80 |
$12,844.80 |
$12,844.80 |
$10,406.14
|
|
Tigecycline injection
|
$300.30 |
$300.30 |
$300.30 |
$277.31
|
|
Tilt table study
|
$1,345.92 |
$1,345.92 |
$1,345.92 |
$1,495.00
|
|
Tissue exam koh skin/hair/nails
|
$68.64 |
$68.64 |
$68.64 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$6,004.62 |
$6,004.62 |
$6,004.62 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$1,550.13 |
$1,550.13 |
$1,550.13 |
$1,525.91
|
|
Tissue transglutaminase iga
|
$58.08 |
$58.08 |
$58.08 |
$48.57
|
|
Tlso 3mod sacro-scap pre
|
$748.80 |
$748.80 |
$748.80 |
$975.00
|
|
Tlso rigid plastic cust fab
|
$3,049.58 |
$3,049.58 |
$3,049.58 |
$2,347.16
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$72.95 |
$72.95 |
$72.95 |
$141.75
|
|
Tobramycin non-comp unit
|
$56.74 |
$56.74 |
$56.74 |
$143.38
|
|
Tobramycin peak therapeutic drug level
|
$114.24 |
$114.24 |
$114.24 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,842.37 |
$5,842.37 |
$5,842.37 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$217.92 |
$217.92 |
$217.92 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$217.92 |
$217.92 |
$217.92 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$200.02 |
$200.02 |
$200.02 |
$404.20
|
|
Toxoplasma antibody igg
|
$42.41 |
$42.41 |
$42.41 |
$84.35
|
|
Toxoplasma antibody igm
|
$34.07 |
$34.07 |
$34.07 |
$83.20
|
|
Tpmt gene com vrnts
|
$151.68 |
$151.68 |
$151.68 |
$381.55
|
|
Tracheobrnchsc thru est trachs incisn
|
$2,128.32 |
$2,128.32 |
$2,128.32 |
$1,459.48
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$44.76 |
$44.76 |
$44.76 |
$77.65
|
|
Transcath biopsy
|
$3,576.96 |
$3,576.96 |
$3,576.96 |
$4,298.05
|
|
Transcath closure of asd
|
$6,242.88 |
$6,242.88 |
$6,242.88 |
$18,772.00
|
|
Transcath closure of vsd
|
$6,242.88 |
$6,242.88 |
$6,242.88 |
$18,837.00
|
|
Transcatheter bx s&i
|
$2,649.12 |
$2,649.12 |
$2,649.12 |
$1,875.96
|
|
Transcath occlusion cns
|
$7,157.76 |
$7,157.76 |
$7,157.76 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$7,329.60 |
$7,329.60 |
$7,329.60 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$13,258.56 |
$13,258.56 |
$13,258.56 |
$4,627.00
|
|
Transferrin
|
$63.84 |
$63.84 |
$63.84 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$898.08 |
$898.08 |
$898.08 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$2,344.55 |
$2,344.55 |
$2,344.55 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$5,172.20 |
$5,172.20 |
$5,172.20 |
$7,191.23
|
|
Trauma partial team response w/critical care services level 4
|
$32,602.56 |
$32,602.56 |
$32,602.56 |
$5,104.55
|
|
Tray bonemarrw oncontrol 102mm
|
$6,180.00 |
$6,180.00 |
$6,180.00 |
$977.62
|
|
Treat ankle dislocation
|
$5,325.12 |
$5,325.12 |
$5,325.12 |
$2,207.20
|
|
Treat ankle dislocation
|
$4,265.28 |
$4,265.28 |
$4,265.28 |
$7,807.24
|
|
Treat big toe fracture
|
$4,885.44 |
$4,885.44 |
$4,885.44 |
$3,981.06
|
|
Treat clavicle dislocation 23545
|
$475.68 |
$475.68 |
$475.68 |
$734.00
|
|
Treat elbow dislocation
|
$5,325.12 |
$5,325.12 |
$5,325.12 |
$2,326.40
|
