|
Telehealth original site facility fee
|
$33.32 |
$33.32 |
$33.32 |
$60.80
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$14,700.00 |
$14,700.00 |
$14,700.00 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$84.68 |
$84.68 |
$84.68 |
$46.10
|
|
Test stress cardiovascular tracing only
|
$911.40 |
$911.40 |
$911.40 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,776.55 |
$1,776.55 |
$1,776.55 |
$1,204.50
|
|
Tgsap so/hl 51/< rna alys
|
$1,234.80 |
$1,234.80 |
$1,234.80 |
$4,563.00
|
|
Theophylline therapeutic drug level
|
$185.03 |
$185.03 |
$185.03 |
$108.00
|
|
Ther/proph/diag inj ia
|
$429.64 |
$429.64 |
$429.64 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$49.00 |
$49.00 |
$49.00 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,918.84 |
$1,918.84 |
$1,918.84 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$4,361.40 |
$4,361.40 |
$4,361.40 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$12,655.72 |
$12,655.72 |
$12,655.72 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$13,640.43 |
$13,640.43 |
$13,640.43 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$15,046.53 |
$15,046.53 |
$15,046.53 |
$24,605.30
|
|
Thrombin time
|
$46.83 |
$46.83 |
$46.83 |
$48.75
|
|
Thromboplastin inhibition
|
$37.19 |
$37.19 |
$37.19 |
$52.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$71.25 |
$71.25 |
$71.25 |
$56.93
|
|
Thyroglobulin antibody
|
$30.69 |
$30.69 |
$30.69 |
$84.00
|
|
Thyroid imaging
|
$1,110.54 |
$1,110.54 |
$1,110.54 |
$670.80
|
|
Thyroid mets imag whole body
|
$1,110.54 |
$1,110.54 |
$1,110.54 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$106.63 |
$106.63 |
$106.63 |
$120.00
|
|
Thyroid Ultrasound
|
$589.96 |
$589.96 |
$589.96 |
$589.96
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$8,350.00 |
$8,350.00 |
$8,350.00 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$5.60 |
$5.60 |
$5.60 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$23,626.24 |
$23,626.24 |
$23,626.24 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$6,420.18 |
$6,420.18 |
$6,420.18 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$13,674.92 |
$13,674.92 |
$13,674.92 |
$10,406.14
|
|
Tilt table study
|
$1,113.28 |
$1,113.28 |
$1,113.28 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$2,435.89 |
$2,435.89 |
$2,435.89 |
$384.17
|
|
Tissue amnio epifix inj 100mg
|
$5,507.21 |
$5,507.21 |
$5,507.21 |
$3,846.61
|
|
Tissue culture placenta
|
$64.47 |
$64.47 |
$64.47 |
$520.91
|
|
Tissue culture skin/biopsy
|
$82.04 |
$82.04 |
$82.04 |
$558.87
|
|
Tissue culture tumor
|
$63.39 |
$63.39 |
$63.39 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$21.17 |
$21.17 |
$21.17 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$22,595.28 |
$22,595.28 |
$22,595.28 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$57.19 |
$57.19 |
$57.19 |
$48.57
|
|
Tlso 2mod symphis-xipho pre
|
$517.05 |
$517.05 |
$517.05 |
$1,512.56
|
|
Tlso 2 shl symphys-stern cst
|
$397.10 |
$397.10 |
$397.10 |
$1,535.15
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$823.20 |
$823.20 |
$823.20 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$212.47 |
$212.47 |
$212.47 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$8,767.87 |
$8,767.87 |
$8,767.87 |
$4,711.84
|
|
Tocilizumab for covid-19
|
$8,767.87 |
$8,767.87 |
$8,767.87 |
$21.60
|
|
Tomosynthesis breast diagnostic left
|
$69.39 |
$69.39 |
$69.39 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$30.19 |
$30.19 |
$30.19 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1,404.54 |
$1,404.54 |
$1,404.54 |
$404.20
|
|
Toxoplasma antibody igg
|
$84.68 |
$84.68 |
$84.68 |
$84.35
|
|
Toxoplasma antibody igm
|
$67.30 |
$67.30 |
$67.30 |
$83.20
|
|
Tp53 gene full gene sequence
|
$57.06 |
$57.06 |
$57.06 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$385.63 |
$385.63 |
$385.63 |
$919.10
|
|
Tpmt gene com vrnts
|
$39.20 |
$39.20 |
$39.20 |
$381.55
|
|
Transcath biopsy
|
$4,354.34 |
$4,354.34 |
$4,354.34 |
$4,298.05
|
|
Transcath closure of asd
|
$11,078.71 |
$11,078.71 |
$11,078.71 |
$18,772.00
|
|
Transcath closure of vsd
|
$11,642.80 |
$11,642.80 |
$11,642.80 |
$18,837.00
|
|
Transcatheter bx s&i
|
$1,023.52 |
$1,023.52 |
$1,023.52 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$22,704.64 |
$22,704.64 |
$22,704.64 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$45,252.88 |
$45,252.88 |
$45,252.88 |
$17,106.18
|
|
Transcath occlusion cns
|
$1,829.86 |
$1,829.86 |
$1,829.86 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$10,031.28 |
$10,031.28 |
$10,031.28 |
$12,427.79
|
|
Trans cath replace aortic valve 33366
|
$43,098.05 |
$43,098.05 |
$43,098.05 |
$17,848.35
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,091.70 |
$4,091.70 |
$4,091.70 |
$4,627.00
|
|
Transcutaneous hgb 88738
|
$9.80 |
$9.80 |
$9.80 |
$11.40
|
|
Transferrin
|
$23.92 |
$23.92 |
$23.92 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,548.80 |
$1,548.80 |
$1,548.80 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$6,708.69 |
$6,708.69 |
$6,708.69 |
$3,900.04
|
|
Trauma partial team response w/critical care services level 4
|
$5,441.36 |
$5,441.36 |
$5,441.36 |
$5,104.55
|
|
Tray bonemarrw oncontrol 102mm
|
$874.95 |
$874.95 |
$874.95 |
$977.62
|
|
Treat hip dislocation
|
$1,967.84 |
$1,967.84 |
$1,967.84 |
$2,561.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$183.85 |
$183.85 |
$183.85 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$150.53 |
$150.53 |
$150.53 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$272.44 |
$272.44 |
$272.44 |
$210.00
|
|
Treponema pallidum antibody
|
$43.52 |
$43.52 |
$43.52 |
$72.80
|
|
Treprostinil injection
|
$2,636.20 |
$2,636.20 |
$2,636.20 |
$841.84
|
|
Trg gene rearrangement anal
|
$258.72 |
$258.72 |
$258.72 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$40.38 |
$40.38 |
$40.38 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$4,440.58 |
$4,440.58 |
$4,440.58 |
$1,309.80
|
|
Trichinella antibody
|
$29.33 |
$29.33 |
$29.33 |
$70.65
|
|
Triglycerides
|
$141.52 |
$141.52 |
$141.52 |
$54.60
|
|
Trnscath plc stent crv crtd w/prtct
|
$24,354.96 |
$24,354.96 |
$24,354.96 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$8,244.55 |
$8,244.55 |
$8,244.55 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,244.55 |
$8,244.55 |
$8,244.55 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$17,559.25 |
$17,559.25 |
$17,559.25 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,143.44 |
$4,143.44 |
$4,143.44 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,345.32 |
$5,345.32 |
$5,345.32 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,345.32 |
$5,345.32 |
$5,345.32 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,345.32 |
$5,345.32 |
$5,345.32 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$5,345.32 |
$5,345.32 |
$5,345.32 |
$4,329.36
|
|
Troponin quantitative
|
$283.42 |
$283.42 |
$283.42 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$1,446.48 |
$1,446.48 |
$1,446.48 |
$1,582.75
|
|
Tte w or without fol w/cont, com
|
$1,453.15 |
$1,453.15 |
$1,453.15 |
$1,220.31
|
|
Tx atrial fib pulm vein isol
|
$27,347.49 |
$27,347.49 |
$27,347.49 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$1,409.64 |
$1,409.64 |
$1,409.64 |
$7,717.80
|
|
Ugt1a1 gene analy common variants
|
$87.48 |
$87.48 |
$87.48 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$228.15 |
$228.15 |
$228.15 |
$403.26
|
|
Ultrasound chest
|
$388.08 |
$388.08 |
$388.08 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$211.29 |
$211.29 |
$211.29 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$285.77 |
$285.77 |
$285.77 |
$284.25
|
|
Ultrasound encephalogram
|
$473.54 |
$473.54 |
$473.54 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$451.59 |
$451.59 |
$451.59 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$645.24 |
$645.24 |
$645.24 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$317.52 |
$317.52 |
$317.52 |
$340.22
|
