|
Tc-99m medronate
|
$51.20 |
$51.20 |
$51.20 |
$111.15
|
|
Tc-99m mertiatide
|
$188.32 |
$188.32 |
$188.32 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$57.92 |
$57.92 |
$57.92 |
$225.52
|
|
Tc-99m pentetate dtpa aerosol
|
$52.96 |
$52.96 |
$52.96 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$52.96 |
$52.96 |
$52.96 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$83.84 |
$83.84 |
$83.84 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$168.80 |
$168.80 |
$168.80 |
$292.50
|
|
Tc-99m sulfur colloid
|
$38.24 |
$38.24 |
$38.24 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$142.24 |
$142.24 |
$142.24 |
$188.50
|
|
Tc-99m tilmanocept diag
|
$300.64 |
$300.64 |
$300.64 |
$958.31
|
|
T cells absolute cd4/cd8 including ratio
|
$6.65 |
$6.65 |
$6.65 |
$175.00
|
|
T cells absolute cd 4 count
|
$3.81 |
$3.81 |
$3.81 |
$110.72
|
|
T cells total count
|
$5.40 |
$5.40 |
$5.40 |
$123.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$6,531.60 |
$6,531.60 |
$6,531.60 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$8.00 |
$8.00 |
$8.00 |
$37.76
|
|
Test for chlorohydrocarbons
|
$18.72 |
$18.72 |
$18.72 |
$61.60
|
|
Testicular imaging w/vasc flow
|
$291.36 |
$291.36 |
$291.36 |
$890.63
|
|
Test stress cardiovascular tracing only
|
$577.12 |
$577.12 |
$577.12 |
$951.60
|
|
Theophylline therapeutic drug level
|
$51.20 |
$51.20 |
$51.20 |
$108.00
|
|
Therapeutic procd strg endur
|
$16.96 |
$16.96 |
$16.96 |
$83.50
|
|
Ther nma rdctj intus/obstrcj
|
$198.56 |
$198.56 |
$198.56 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$14.38 |
$14.38 |
$14.38 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$921.60 |
$921.60 |
$921.60 |
$1,687.50
|
|
Throat x-ray & fluoroscopy
|
$121.28 |
$121.28 |
$121.28 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$1,934.40 |
$1,934.40 |
$1,934.40 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,637.92 |
$1,637.92 |
$1,637.92 |
$7,648.35
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$2,881.92 |
$2,881.92 |
$2,881.92 |
$14,227.80
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$7,675.20 |
$7,675.20 |
$7,675.20 |
$21,249.26
|
|
Thrombin time
|
$1.54 |
$1.54 |
$1.54 |
$53.76
|
|
Thromboplastin inhibition
|
$20.80 |
$20.80 |
$20.80 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$75.20 |
$75.20 |
$75.20 |
$61.50
|
|
Thyroglobulin antibody
|
$44.96 |
$44.96 |
$44.96 |
$81.90
|
|
Thyroid imaging
|
$285.92 |
$285.92 |
$285.92 |
$695.02
|
|
Thyroid mets imag whole body
|
$567.36 |
$567.36 |
$567.36 |
$1,544.00
|
|
Thyroid (TSH) Test
|
$68.32 |
$68.32 |
$68.32 |
$112.67
|
|
Thyroid Ultrasound
|
$325.12 |
$325.12 |
$325.12 |
$588.50
|
|
Thyroid uptake measurement
|
$192.96 |
$192.96 |
$192.96 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$2.10 |
$2.10 |
$2.10 |
$64.51
|
|
Tilt table study
|
$615.68 |
$615.68 |
$615.68 |
$1,551.60
|
|
Tissue culture placenta
|
$28.08 |
$28.08 |
$28.08 |
$457.00
|
|
Tissue culture skin/biopsy
|
$104.19 |
$104.19 |
$104.19 |
$498.40
|
|
Tissue exam koh skin/hair/nails
|
$25.28 |
$25.28 |
$25.28 |
$47.52
|
|
Tissue transglutaminase iga
|
$1.92 |
$1.92 |
$1.92 |
$44.60
|
|
Tl-201 thallium diag per mci
|
$133.28 |
$133.28 |
$133.28 |
$78.40
|
|
Tobramycin peak therapeutic drug level
|
$68.00 |
$68.00 |
$68.00 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$52.48 |
$52.48 |
$52.48 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$54.24 |
$54.24 |
$54.24 |
$68.80
|
|
Total tau
|
$48.00 |
$48.00 |
$48.00 |
$312.00
|
|
Toxoplasma antibody igg
|
$33.60 |
$33.60 |
$33.60 |
$89.40
|
|
Toxoplasma antibody igm
|
$2.05 |
$2.05 |
$2.05 |
$87.00
|
|
Tp53 gene full gene sequence
|
$102.40 |
$102.40 |
$102.40 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$52.80 |
$52.80 |
$52.80 |
$823.00
|
|
Tpmt gene com vrnts
|
$29.60 |
$29.60 |
$29.60 |
$371.80
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$9.51 |
$9.51 |
$9.51 |
$55.69
|
|
Transcath biopsy
|
$1,357.76 |
$1,357.76 |
$1,357.76 |
$4,285.93
|
|
Transcath closure of asd
|
$11,920.64 |
$11,920.64 |
$11,920.64 |
$18,034.50
|
|
Transcath closure of vsd
|
$14,187.52 |
$14,187.52 |
$14,187.52 |
$18,837.00
|
|
Transcatheter bx s&i
|
$674.88 |
$674.88 |
$674.88 |
$1,961.75
|
|
Transcath occlusion cns
|
$8,989.92 |
$8,989.92 |
$8,989.92 |
$7,125.60
|
|
Transcath occlusion non-cns
|
$5,661.28 |
$5,661.28 |
$5,661.28 |
$10,452.00
|
|
Transferrin
|
$37.12 |
$37.12 |
$37.12 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$464.16 |
$464.16 |
$464.16 |
$936.80
|
|
Tray bonemarrw oncontrol 102mm
|
$452.48 |
$452.48 |
$452.48 |
$940.80
|
|
Treat ankle fracture
|
$416.00 |
$416.00 |
$416.00 |
$5,488.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$100.00 |
$100.00 |
$100.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$100.00 |
$100.00 |
$100.00 |
$143.75
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$64.48 |
$64.48 |
$64.48 |
$203.49
|
|
Treponema pallidum antibody
|
$37.28 |
$37.28 |
$37.28 |
$70.20
|
|
Trg gene rearrangement anal
|
$32.24 |
$32.24 |
$32.24 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$16.16 |
$16.16 |
$16.16 |
$43.09
|
|
Trichinella antibody
|
$15.18 |
$15.18 |
$15.18 |
$70.65
|
|
#tricyclicantidprssnt
|
$22.60 |
$22.60 |
$22.60 |
$50.54
|
|
Triglycerides
|
$40.32 |
$40.32 |
$40.32 |
$56.96
|
|
Trnscath plc stent crv crtd without prtct
|
$3,456.64 |
$3,456.64 |
$3,456.64 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$4,952.80 |
$4,952.80 |
$4,952.80 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,824.32 |
$3,824.32 |
$3,824.32 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$6,540.00 |
$6,540.00 |
$6,540.00 |
$14,819.58
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,204.80 |
$2,204.80 |
$2,204.80 |
$4,735.50
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,373.76 |
$1,373.76 |
$1,373.76 |
$5,190.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$799.84 |
$799.84 |
$799.84 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$799.84 |
$799.84 |
$799.84 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$799.84 |
$799.84 |
$799.84 |
$3,866.70
|
|
Troponin quantitative
|
$84.64 |
$84.64 |
$84.64 |
$125.40
|
|
Tx atrial fib pulm vein isol
|
$10,258.40 |
$10,258.40 |
$10,258.40 |
$29,199.75
|
|
Tx l/r atrial fib addl
|
$4,040.00 |
$4,040.00 |
$4,040.00 |
$6,986.85
|
|
Ultrasound abdomen aorta screening study aaa
|
$206.40 |
$206.40 |
$206.40 |
$394.20
|
|
Ultrasound breast complete
|
$328.80 |
$328.80 |
$328.80 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$234.56 |
$234.56 |
$234.56 |
$452.40
|
|
Ultrasound chest
|
$282.08 |
$282.08 |
$282.08 |
$459.55
|
|
Ultrasound dx ophth b-scan
|
$22.08 |
$22.08 |
$22.08 |
$300.00
|
|
Ultrasound encephalogram
|
$165.28 |
$165.28 |
$165.28 |
$491.37
|
|
Ultrasound exam k transpl w/doppler
|
$313.92 |
$313.92 |
$313.92 |
$584.35
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$222.08 |
$222.08 |
$222.08 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$141.44 |
$141.44 |
$141.44 |
$384.45
|
|
Ultrasound guided needle placement supervision & interpretation
|
$396.16 |
$396.16 |
$396.16 |
$720.00
|
|
Ultrasound guide intraoperative
|
$349.60 |
$349.60 |
$349.60 |
$625.15
|
|
Ultrasound infant hips ltd without stress
|
$91.52 |
$91.52 |
$91.52 |
$311.25
|
|
Ultrasound joint complete left
|
$279.04 |
$279.04 |
$279.04 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$22.72 |
$22.72 |
$22.72 |
$420.80
|
