|
Tc-99m pertechnetate per mci
|
$87.75 |
$87.75 |
$87.75 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$167.85 |
$167.85 |
$167.85 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$226.35 |
$226.35 |
$226.35 |
$221.60
|
|
Tc-99m sulfur colloid
|
$87.75 |
$87.75 |
$87.75 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$508.95 |
$508.95 |
$508.95 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$10.13 |
$10.13 |
$10.13 |
$186.00
|
|
T cells absolute cd 4 count
|
$13.50 |
$13.50 |
$13.50 |
$120.25
|
|
T cells total count
|
$10.13 |
$10.13 |
$10.13 |
$124.11
|
|
Temozolomide
|
$1,450.35 |
$1,450.35 |
$1,450.35 |
$374.66
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,960.66 |
$9,960.66 |
$9,960.66 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$77.73 |
$77.73 |
$77.73 |
$46.10
|
|
Testicular imaging w/vasc flow
|
$1,032.75 |
$1,032.75 |
$1,032.75 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$60.75 |
$60.75 |
$60.75 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$980.55 |
$980.55 |
$980.55 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,631.27 |
$1,631.27 |
$1,631.27 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$4,904.55 |
$4,904.55 |
$4,904.55 |
$9,460.16
|
|
Theophylline therapeutic drug level
|
$407.70 |
$407.70 |
$407.70 |
$108.00
|
|
Therapeutic procd strg endur
|
$76.05 |
$76.05 |
$76.05 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$99.45 |
$99.45 |
$99.45 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$83.70 |
$83.70 |
$83.70 |
$50.40
|
|
Ther/proph/diag inj ia
|
$372.15 |
$372.15 |
$372.15 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$44.79 |
$44.79 |
$44.79 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$1,129.05 |
$1,129.05 |
$1,129.05 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,559.80 |
$9,559.80 |
$9,559.80 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$21,456.00 |
$21,456.00 |
$21,456.00 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$32,502.60 |
$32,502.60 |
$32,502.60 |
$24,605.30
|
|
Thrombin time
|
$8.48 |
$8.48 |
$8.48 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$6.36 |
$6.36 |
$6.36 |
$56.93
|
|
Thyroglobulin antibody
|
$2.93 |
$2.93 |
$2.93 |
$84.00
|
|
Thyroid imaging
|
$546.30 |
$546.30 |
$546.30 |
$670.80
|
|
Thyroid mets imag whole body
|
$2,866.50 |
$2,866.50 |
$2,866.50 |
$1,524.99
|
|
Thyroid met uptake
|
$745.20 |
$745.20 |
$745.20 |
$380.00
|
|
Thyroid (TSH) Test
|
$382.05 |
$382.05 |
$382.05 |
$120.00
|
|
Thyroid Ultrasound
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$589.96
|
|
Thyroid uptake measurement
|
$546.30 |
$546.30 |
$546.30 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$6.43 |
$6.43 |
$6.43 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$20,165.85 |
$20,165.85 |
$20,165.85 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$5,478.75 |
$5,478.75 |
$5,478.75 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$11,656.80 |
$11,656.80 |
$11,656.80 |
$10,406.14
|
|
Tigecycline injection
|
$387.47 |
$387.47 |
$387.47 |
$277.31
|
|
Tilt table study
|
$2,103.30 |
$2,103.30 |
$2,103.30 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$2,236.95 |
$2,236.95 |
$2,236.95 |
$384.17
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$7,944.75 |
$7,944.75 |
$7,944.75 |
$14,271.00
|
|
Tissue amnio epifix inj 100mg
|
$6,996.60 |
$6,996.60 |
$6,996.60 |
$3,846.61
|
|
Tissue culture skin/biopsy
|
$89.10 |
$89.10 |
$89.10 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$160.65 |
$160.65 |
$160.65 |
$47.40
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$2,238.75 |
$2,238.75 |
$2,238.75 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$5.40 |
$5.40 |
$5.40 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$113.85 |
$113.85 |
$113.85 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$1,151.75 |
$1,151.75 |
$1,151.75 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$431.10 |
$431.10 |
$431.10 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,026.15 |
$4,026.15 |
$4,026.15 |
$4,711.84
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1,289.70 |
$1,289.70 |
$1,289.70 |
$404.20
|
|
Toxoplasma antibody igg
|
$4.50 |
$4.50 |
$4.50 |
$84.35
|
|
Toxoplasma antibody igm
|
$4.50 |
$4.50 |
$4.50 |
$83.20
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$131.85 |
$131.85 |
$131.85 |
$104.50
|
|
Transabdom amnioinfus w/us
|
$1,232.10 |
$1,232.10 |
$1,232.10 |
$791.05
|
|
Transcath biopsy
|
$5,005.35 |
$5,005.35 |
$5,005.35 |
$4,298.05
|
|
Transcath closure of asd
|
$17,004.15 |
$17,004.15 |
$17,004.15 |
$18,772.00
|
|
Transcatheter bx s&i
|
$2,741.85 |
$2,741.85 |
$2,741.85 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$11,407.50 |
$11,407.50 |
$11,407.50 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$22,815.00 |
$22,815.00 |
$22,815.00 |
$17,106.18
|
|
Transcath occlusion cns
|
$24,973.65 |
$24,973.65 |
$24,973.65 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$18,981.45 |
$18,981.45 |
$18,981.45 |
$12,427.79
|
|
Trans cath replace aortic valve 33366
|
$1,251.45 |
$1,251.45 |
$1,251.45 |
$17,848.35
|
|
Transferrin
|
$67.95 |
$67.95 |
$67.95 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$8,407.80 |
$8,407.80 |
$8,407.80 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$3,900.04
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$3,600.00 |
$3,600.00 |
$3,600.00 |
$4,500.03
|
|
Tray bonemarrw oncontrol 102mm
|
$1,111.95 |
$1,111.95 |
$1,111.95 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$227.70 |
$227.70 |
$227.70 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$140.85 |
$140.85 |
$140.85 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$267.75 |
$267.75 |
$267.75 |
$210.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$52,650.00 |
$52,650.00 |
$52,650.00 |
$101,032.80
|
|
Treponema pallidum antibody
|
$54.45 |
$54.45 |
$54.45 |
$72.80
|
|
Trg gene rearrangement anal
|
$135.00 |
$135.00 |
$135.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$187.38 |
$187.38 |
$187.38 |
$55.80
|
|
Triglycerides
|
$316.80 |
$316.80 |
$316.80 |
$54.60
|
|
Trnscath plc stent crv crtd without prtct
|
$9,145.80 |
$9,145.80 |
$9,145.80 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$11,432.70 |
$11,432.70 |
$11,432.70 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$9,385.20 |
$9,385.20 |
$9,385.20 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$12,486.60 |
$12,486.60 |
$12,486.60 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$21,654.90 |
$21,654.90 |
$21,654.90 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,594.50 |
$4,594.50 |
$4,594.50 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$4,239.45 |
$4,239.45 |
$4,239.45 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,239.45 |
$4,239.45 |
$4,239.45 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$1,611.90 |
$1,611.90 |
$1,611.90 |
$4,329.36
|
|
Troponin quantitative
|
$460.80 |
$460.80 |
$460.80 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$1,876.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$999.90 |
$999.90 |
$999.90 |
$403.26
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$447.75 |
$447.75 |
$447.75 |
$340.14
|
|
Ultrasound encephalogram
|
$1,029.15 |
$1,029.15 |
$1,029.15 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$578.70 |
$578.70 |
$578.70 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,062.00 |
$1,062.00 |
$1,062.00 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$557.10 |
$557.10 |
$557.10 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,574.10 |
$1,574.10 |
$1,574.10 |
$701.35
|
