|
Tc-99m pentetate dtpa
|
$190.52 |
$190.52 |
$190.52 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$144.06 |
$144.06 |
$144.06 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$125.54 |
$125.54 |
$125.54 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$165.23 |
$165.23 |
$165.23 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$596.53 |
$596.53 |
$596.53 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$48.51 |
$48.51 |
$48.51 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$245.20 |
$245.20 |
$245.20 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$69.39 |
$69.39 |
$69.39 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$292.24 |
$292.24 |
$292.24 |
$930.54
|
|
Tcd emboli detect w/inj
|
$84.97 |
$84.97 |
$84.97 |
$404.68
|
|
Tcd emboli detect without inj
|
$84.97 |
$84.97 |
$84.97 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$6.62 |
$6.62 |
$12.85 |
$186.00
|
|
T cells absolute cd 4 count
|
$11.41 |
$11.41 |
$22.16 |
$120.25
|
|
T cells total count
|
$6.62 |
$6.62 |
$12.85 |
$124.11
|
|
Team conf w/pat by hc prof
|
$67.62 |
$67.62 |
$67.62 |
$102.48
|
|
Telavancin injection
|
$784.40 |
$784.40 |
$784.40 |
$1,216.45
|
|
Telehealth original site facility fee
|
$33.23 |
$33.23 |
$33.23 |
$60.80
|
|
Telethx isodose plan cplx
|
$1,224.51 |
$1,224.51 |
$1,224.51 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,208.05 |
$1,208.05 |
$1,208.05 |
$848.72
|
|
Temozolomide
|
$687.67 |
$687.67 |
$687.67 |
$374.66
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,826.04 |
$1,826.04 |
$1,826.04 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$8,460.15 |
$8,460.15 |
$8,460.15 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$20.88 |
$20.88 |
$20.88 |
$46.10
|
|
Test for chlorohydrocarbons
|
$29.40 |
$29.40 |
$57.10 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$2,739.79 |
$2,739.79 |
$2,739.79 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$30.29 |
$30.29 |
$30.29 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$1,083.39 |
$1,083.39 |
$1,083.39 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$433.07 |
$433.07 |
$433.07 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$133.05 |
$133.05 |
$326.05 |
$108.00
|
|
Therapeutic procd strg endur
|
$41.16 |
$41.16 |
$41.16 |
$85.80
|
|
Ther nma rdctj intus/obstrcj
|
$1,633.17 |
$1,633.17 |
$1,633.17 |
$534.32
|
|
Ther/proph/diag inj ia
|
$114.37 |
$114.37 |
$114.37 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$19.11 |
$19.11 |
$37.12 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,401.40 |
$2,401.40 |
$2,401.40 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$6,445.95 |
$6,445.95 |
$6,445.95 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,895.77 |
$6,895.77 |
$6,895.77 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$13,929.43 |
$13,929.43 |
$13,929.43 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$21,100.97 |
$21,100.97 |
$21,100.97 |
$24,605.30
|
|
Thrombin time
|
$3.85 |
$3.85 |
$7.48 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$102.32 |
$102.32 |
$230.69 |
$56.93
|
|
Thyroglobulin antibody
|
$5.14 |
$5.14 |
$140.24 |
$84.00
|
|
Thyroid imaging
|
$2,557.80 |
$2,557.80 |
$2,557.80 |
$670.80
|
|
Thyroid met imaging
|
$293.12 |
$293.12 |
$293.12 |
$549.70
|
|
Thyroid met imaging/studies
|
$585.95 |
$585.95 |
$585.95 |
$607.23
|
|
Thyroid mets imag whole body
|
$4,185.98 |
$4,185.98 |
$4,185.98 |
$1,524.99
|
|
Thyroid met uptake
|
$125.54 |
$125.54 |
$125.54 |
$380.00
|
|
Thyroid (TSH) Test
|
$362.80 |
$362.80 |
$521.90 |
$120.00
|
|
Thyroid Ultrasound
|
$1,406.21 |
$1,406.21 |
$1,406.21 |
$589.96
|
|
Thyroid uptake measurement
|
$1,146.90 |
$1,146.90 |
$1,146.90 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,035.37 |
$2,035.37 |
$2,035.37 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$4.20 |
$4.20 |
$8.16 |
$63.60
|
|
Tibial length sock fx or equ
|
$46.46 |
$46.46 |
$46.46 |
$73.17
|
|
Tib/per revasc stent & ather 37231
|
$14,274.88 |
$14,274.88 |
$14,274.88 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$7,185.95 |
$7,185.95 |
$7,185.95 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$6,117.85 |
$6,117.85 |
$6,117.85 |
$10,406.14
|
|
Tigecycline injection
|
$179.05 |
$179.05 |
$179.05 |
$277.31
|
|
Tilt table study
|
$621.23 |
$621.23 |
$621.23 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$593.88 |
$593.88 |
$593.88 |
$384.17
|
|
Tissue culture placenta
|
$66.63 |
$66.63 |
$129.39 |
$520.91
|
|
Tissue culture skin/biopsy
|
$58.22 |
$58.22 |
$113.06 |
$558.87
|
|
Tissue culture tumor
|
$51.45 |
$51.45 |
$51.45 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$13.21 |
$13.21 |
$32.34 |
$47.40
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$6,050.52 |
$6,050.52 |
$6,050.52 |
$1,525.91
|
|
Tissue transglutaminase iga
|
$3.53 |
$3.53 |
$6.86 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$64.98 |
$64.98 |
$64.98 |
$77.22
|
|
Tlso 2 shl symphys-stern cst
|
$1,461.18 |
$1,461.18 |
$1,461.18 |
$1,535.15
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$209.04 |
$209.04 |
$209.04 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$176.44 |
$176.44 |
$271.95 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,394.05 |
$2,394.05 |
$2,394.05 |
$4,711.84
|
|
Tocilizumab for covid-19
|
$2,643.95 |
$2,643.95 |
$2,643.95 |
$563.00
|
|
Tomosynthesis breast diagnostic left
|
$28.82 |
$28.82 |
$28.82 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$39.99 |
$39.99 |
$39.99 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1,248.03 |
$1,248.03 |
$1,248.03 |
$404.20
|
|
Toxoplasma antibody igg
|
$23.15 |
$23.15 |
$44.96 |
$84.35
|
|
Toxoplasma antibody igm
|
$10.82 |
$10.82 |
$21.02 |
$83.20
|
|
Tprnl plmt biodegrdabl matrl
|
$5,356.68 |
$5,356.68 |
$5,356.68 |
$6,105.61
|
|
Trabectedin 1 mg intravenous solution
|
$3,413.64 |
$3,413.64 |
$3,413.64 |
$7,403.70
|
|
Tracheobrnchsc thru est trachs incisn
|
$75.27 |
$75.27 |
$75.27 |
$1,459.48
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$52.63 |
$52.63 |
$52.63 |
$104.50
|
|
Transabdom amnioinfus w/us
|
$290.48 |
$290.48 |
$290.48 |
$791.05
|
|
Transcath biopsy
|
$2,775.95 |
$2,775.95 |
$2,775.95 |
$4,298.05
|
|
Transcath closure of asd
|
$10,714.54 |
$10,714.54 |
$10,714.54 |
$18,772.00
|
|
Transcath closure of vsd
|
$10,714.54 |
$10,714.54 |
$10,714.54 |
$18,837.00
|
|
Transcatheter bx s&i
|
$862.01 |
$862.01 |
$862.01 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$4,417.94 |
$4,417.94 |
$4,417.94 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$4,460.28 |
$4,460.28 |
$4,460.28 |
$17,106.18
|
|
Transcath occlusion cns
|
$1,629.35 |
$1,629.35 |
$1,629.35 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$11,063.22 |
$11,063.22 |
$11,063.22 |
$12,427.79
|
|
Trans cath replace aortic valve 33366
|
$12,469.13 |
$12,469.13 |
$12,469.13 |
$17,848.35
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,638.65 |
$2,638.65 |
$2,638.65 |
$4,627.00
|
|
Transferrin
|
$85.56 |
$85.56 |
$182.15 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,031.36 |
$1,031.36 |
$1,031.36 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$1,635.53 |
$1,635.53 |
$1,635.53 |
$3,900.04
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$1,388.86 |
$1,388.86 |
$1,388.86 |
$4,500.03
|
|
Tray bonemarrw oncontrol 102mm
|
$583.30 |
$583.30 |
$583.30 |
$977.62
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$409.84 |
$409.84 |
$602.41 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$57.33 |
$57.33 |
$130.76 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$157.88 |
$157.88 |
$199.85 |
$210.00
|
|
Treatment radiation delivery level 2
|
$373.68 |
$373.68 |
$373.68 |
$735.00
|
|
Treponema pallidum antibody
|
$15.29 |
$15.29 |
$38.83 |
$72.80
|
