|
Stress test pulmonary
|
$79.31 |
$79.31 |
$79.31 |
$322.85
|
|
St treatment speech individual
|
$62.86 |
$62.86 |
$62.86 |
$252.54
|
|
St treatment swallow dysfunction/oral
|
$62.86 |
$62.86 |
$62.86 |
$244.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$35.35 |
$35.35 |
$35.35 |
$52.39
|
|
Sulfonylurea screen qn-sendout
|
$11.74 |
$11.74 |
$11.74 |
$152.64
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$138.04 |
$138.04 |
$138.04 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$0.97 |
$0.97 |
$0.97 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$2.11 |
$2.11 |
$2.11 |
$144.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$2.51 |
$2.51 |
$2.51 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$2.83 |
$2.83 |
$2.83 |
$252.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$16.52 |
$16.52 |
$16.52 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$22.98 |
$22.98 |
$22.98 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$16.59 |
$16.59 |
$16.59 |
$43.50
|
|
Susceptibility enzyme detection per enzyme
|
$31.36 |
$31.36 |
$31.36 |
$35.70
|
|
Susceptibility mic per plate
|
$35.98 |
$35.98 |
$35.98 |
$106.00
|
|
Svc venogram s&i
|
$743.47 |
$743.47 |
$743.47 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$59.64 |
$59.64 |
$59.64 |
$41.40
|
|
T3 (triiodothyronine) free
|
$13.79 |
$13.79 |
$13.79 |
$99.82
|
|
T3 (triiodothyronine) total
|
$35.28 |
$35.28 |
$35.28 |
$93.52
|
|
T4 (thyroxine) free
|
$35.14 |
$35.14 |
$35.14 |
$85.20
|
|
T4 (thyroxine) total
|
$59.36 |
$59.36 |
$59.36 |
$68.40
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.81 |
$12.81 |
$12.81 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$358.89 |
$358.89 |
$358.89 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$1.19 |
$1.19 |
$1.19 |
$121.39
|
|
Target gsa panel organ/hmtlmph neop
|
$204.37 |
$204.37 |
$204.37 |
$3,746.70
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$0.77 |
$0.77 |
$0.77 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$14.70 |
$14.70 |
$14.70 |
$191.75
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$6.09 |
$6.09 |
$6.09 |
$175.00
|
|
Tc-99m disofenin
|
$57.26 |
$57.26 |
$57.26 |
$124.32
|
|
Tc-99m exametazime diag
|
$270.76 |
$270.76 |
$270.76 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$54.25 |
$54.25 |
$54.25 |
$302.40
|
|
Tc-99m maa
|
$14.28 |
$14.28 |
$14.28 |
$281.40
|
|
Tc-99m mebrofenin
|
$33.32 |
$33.32 |
$33.32 |
$159.25
|
|
Tc-99m medronate
|
$14.28 |
$14.28 |
$14.28 |
$109.80
|
|
Tc-99m mertiatide
|
$206.99 |
$206.99 |
$206.99 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$15.33 |
$15.33 |
$15.33 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$33.32 |
$33.32 |
$33.32 |
$181.37
|
|
Tc-99m pertechnetate per mci
|
$13.44 |
$13.44 |
$13.44 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$43.96 |
$43.96 |
$43.96 |
$292.95
|
|
Tc-99m sulfur colloid
|
$108.50 |
$108.50 |
$108.50 |
$239.40
|
|
Tc-99m tilmanocept diag
|
$198.10 |
$198.10 |
$198.10 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$1.16 |
$1.16 |
$1.16 |
$175.20
|
|
T cells absolute cd 4 count
|
$1.16 |
$1.16 |
$1.16 |
$110.72
|
|
Telehealth original site facility fee
|
$8.12 |
$8.12 |
$8.12 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$46.34 |
$46.34 |
$46.34 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$35.98 |
$35.98 |
$35.98 |
$39.18
|
|
Test stress cardiovascular tracing only
|
$239.19 |
$239.19 |
$239.19 |
$953.40
|
|
Tetanus immune globulin inj
|
$76.72 |
$76.72 |
$76.72 |
$1,210.21
|
|
Theophylline therapeutic drug level
|
$57.05 |
$57.05 |
$57.05 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$32.48 |
$32.48 |
$32.48 |
$25.54
|
|
Thrombin time
|
$1.46 |
$1.46 |
$1.46 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$86.24 |
$86.24 |
$86.24 |
$61.52
|
|
Thyroglobulin antibody
|
$0.25 |
$0.25 |
$0.25 |
$82.00
|
|
Thyroid met imaging
|
$337.68 |
$337.68 |
$337.68 |
$838.25
|
|
Thyroid mets imag whole body
|
$342.93 |
$342.93 |
$342.93 |
$1,560.50
|
|
Thyroid (TSH) Test
|
$48.02 |
$48.02 |
$48.02 |
$112.70
|
|
Thyroid Ultrasound
|
$149.87 |
$149.87 |
$149.87 |
$598.20
|
|
Thyroid uptake measurement
|
$167.93 |
$167.93 |
$167.93 |
$589.22
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$1,227.87 |
$1,227.87 |
$1,227.87 |
$4,044.25
|
|
Tigecycline injection
|
$0.70 |
$0.70 |
$0.70 |
$234.00
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$14.35 |
$14.35 |
$14.35 |
$1,041.00
|
|
Tissue transglutaminase iga
|
$2.08 |
$2.08 |
$2.08 |
$46.15
|
|
Tl-201 thallium diag per mci
|
$209.37 |
$209.37 |
$209.37 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$49.14 |
$49.14 |
$49.14 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$59.92 |
$59.92 |
$59.92 |
$121.80
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4.83 |
$4.83 |
$4.83 |
$5,258.52
|
|
Tocilizumab for covid-19
|
$4.27 |
$4.27 |
$4.27 |
$21.08
|
|
Toxoplasma antibody igg
|
$6.65 |
$6.65 |
$6.65 |
$90.75
|
|
Toxoplasma antibody igm
|
$0.79 |
$0.79 |
$0.79 |
$87.75
|
|
Transferrin
|
$24.29 |
$24.29 |
$24.29 |
$81.85
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$101.43 |
$101.43 |
$101.43 |
$220.51
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$50.19 |
$50.19 |
$50.19 |
$143.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$46.48 |
$46.48 |
$46.48 |
$203.35
|
|
Treatment radiation delivery level 2
|
$82.74 |
$82.74 |
$82.74 |
$787.80
|
|
Treponema pallidum antibody
|
$9.73 |
$9.73 |
$9.73 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$1.61 |
$1.61 |
$1.61 |
$43.80
|
|
#tricyclicantidprssnt
|
$0.91 |
$0.91 |
$0.91 |
$48.50
|
|
Triglycerides
|
$30.24 |
$30.24 |
$30.24 |
$58.05
|
|
Troponin quantitative
|
$60.13 |
$60.13 |
$60.13 |
$127.60
|
|
Ultrasound abdomen aorta screening study aaa
|
$70.07 |
$70.07 |
$70.07 |
$394.20
|
|
Ultrasound breast complete
|
$70.91 |
$70.91 |
$70.91 |
$534.24
|
|
Ultrasound breast unilateral limited (both sides)
|
$57.68 |
$57.68 |
$57.68 |
$458.25
|
|
Ultrasound chest
|
$107.73 |
$107.73 |
$107.73 |
$460.85
|
|
Ultrasound encephalogram
|
$109.97 |
$109.97 |
$109.97 |
$496.36
|
|
Ultrasound exam k transpl w/doppler
|
$112.49 |
$112.49 |
$112.49 |
$592.12
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$264.53 |
$264.53 |
$264.53 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$27.58 |
$27.58 |
$27.58 |
$396.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$209.79 |
$209.79 |
$209.79 |
$720.15
|
|
Ultrasound guide intraoperative
|
$257.60 |
$257.60 |
$257.60 |
$628.80
|
|
Ultrasound hips infant dynamic
|
$74.55 |
$74.55 |
$74.55 |
$403.88
|
|
Ultrasound joint complete left
|
$180.74 |
$180.74 |
$180.74 |
$557.99
|
|
Ultrasound joint/nonvascular extremity limited left
|
$147.56 |
$147.56 |
$147.56 |
$419.25
|
|
Ultrasound ob >=14wks ea addl gest
|
$81.69 |
$81.69 |
$81.69 |
$393.65
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$86.38 |
$86.38 |
$86.38 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$319.48 |
$319.48 |
$319.48 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$134.61 |
$134.61 |
$134.61 |
$428.25
|
|
Ultrasound pregnant uterus transvaginal
|
$165.69 |
$165.69 |
$165.69 |
$492.80
|
|
Ultrasound prostate/transrectal
|
$168.63 |
$168.63 |
$168.63 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$182.49 |
$182.49 |
$182.49 |
$479.60
|
|
Ultrasound scrotum and contents
|
$231.98 |
$231.98 |
$231.98 |
$612.55
|
