|
Target gsa panel organ neop
|
$2,816.80 |
$2,816.80 |
$2,816.80 |
$1,655.52
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$24,217.20 |
$24,217.20 |
$24,217.20 |
$24,217.20
|
|
Tas congenital car anomal
|
$44,408.00 |
$44,408.00 |
$44,408.00 |
$6,003.27
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$2,122.40 |
$2,122.40 |
$2,122.40 |
$953.29
|
|
Tavr perq femoral
|
$5,745.60 |
$5,745.60 |
$5,745.60 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$701.48 |
$701.48 |
$701.48 |
$937.50
|
|
Tbp gene detc abnor alleles
|
$313.60 |
$313.60 |
$313.60 |
$225.42
|
|
Tbs dxa cal w/i&r fx risk
|
$127.12 |
$127.12 |
$127.12 |
$127.12
|
|
Tbs i&r fx rsk qhp
|
$61.04 |
$61.04 |
$61.04 |
$61.04
|
|
Tbs techl calculation only
|
$268.80 |
$268.80 |
$268.80 |
$153.60
|
|
Tbs techl prep&transmis data
|
$268.80 |
$268.80 |
$268.80 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$243.04 |
$243.04 |
$243.04 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$302.40 |
$302.40 |
$302.40 |
$177.65
|
|
Tc-99m apcitide diag
|
$928.48 |
$928.48 |
$928.48 |
$1,181.70
|
|
Tc-99m arcitumomab
|
$2,229.36 |
$2,229.36 |
$2,229.36 |
$2,155.56
|
|
Tc-99m bicisate
|
$5,061.84 |
$5,061.84 |
$5,061.84 |
$1,969.45
|
|
Tc-99m depreotide
|
$1,486.80 |
$1,486.80 |
$1,486.80 |
$1,486.80
|
|
Tc-99m diag per dose
|
$470.40 |
$470.40 |
$470.40 |
$470.40
|
|
Tc-99m disofenin
|
$124.32 |
$124.32 |
$124.32 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$3,385.20 |
$3,385.20 |
$3,385.20 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$3,147.18 |
$3,147.18 |
$3,147.18 |
$2,033.20
|
|
Tc-99m fanolesomab diag
|
$2,115.12 |
$2,115.12 |
$2,115.12 |
$2,115.12
|
|
Tc-99m gluceptate
|
$31.35 |
$31.35 |
$31.35 |
$31.35
|
|
Tc-99m graphite crucible
|
$2,182.32 |
$2,182.32 |
$2,182.32 |
$453.47
|
|
Tc-99m labeled rbc
|
$1,383.21 |
$1,383.21 |
$1,383.21 |
$302.40
|
|
Tc-99m maa
|
$1,335.60 |
$1,335.60 |
$1,335.60 |
$292.80
|
|
Tc-99m mebrofenin
|
$680.40 |
$680.40 |
$680.40 |
$157.65
|
|
Tc-99m medronate
|
$593.04 |
$593.04 |
$593.04 |
$111.01
|
|
Tc-99m mertiatide
|
$1,414.56 |
$1,414.56 |
$1,414.56 |
$756.00
|
|
Tc-99m oxidronate
|
$654.10 |
$654.10 |
$654.10 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$225.52 |
$225.52 |
$225.52 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$38.08 |
$38.08 |
$38.08 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$10,751.03 |
$10,751.03 |
$10,751.03 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$549.25 |
$549.25 |
$549.25 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$1,088.18 |
$1,088.18 |
$1,088.18 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$1,303.12 |
$1,303.12 |
$1,303.12 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$3,738.00 |
$3,738.00 |
$3,738.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$4,282.25 |
$4,282.25 |
$4,282.25 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$1,644.47 |
$1,644.47 |
$1,644.47 |
$955.60
|
|
Tca peel dermal 15789
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$1,324.80
|
|
Tcd emboli detect w/inj
|
$509.60 |
$509.60 |
$509.60 |
$475.80
|
|
Tcd emboli detect without inj
|
$509.60 |
$509.60 |
$509.60 |
$475.28
|
|
T-cell depletion of harvest
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$1,673.75
|
|
T cells absolute cd4/cd8 including ratio
|
$143.92 |
$143.92 |
$143.92 |
$176.40
|
|
T cells absolute cd 4 count
|
$85.12 |
$85.12 |
$85.12 |
$111.20
|
|
T cells total count
|
$108.64 |
$108.64 |
$108.64 |
$126.90
|
|
Tcranial magn stim tx deli
|
$828.80 |
$828.80 |
$828.80 |
$389.22
|
|
Tcranial magn stim tx plan
|
$963.20 |
$963.20 |
$963.20 |
$437.22
|
|
Tcran magn stim redetemine
|
$845.60 |
$845.60 |
$845.60 |
$457.60
|
|
Team conf without pat by hc pro
|
$115.92 |
$115.92 |
$115.92 |
$112.86
|
|
Team conf without pat by phys
|
$143.92 |
$143.92 |
$143.92 |
$140.25
|
|
Team conf w/pat by hc prof
|
$119.84 |
$119.84 |
$119.84 |
$107.10
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$33,877.87 |
$33,877.87 |
$33,877.87 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$3,046.40 |
$3,046.40 |
$3,046.40 |
$2,101.65
|
|
Tee w or without fol w/cont, mon
|
$3,046.40 |
$3,046.40 |
$3,046.40 |
$1,431.95
|
|
Teflon or equal cable lining
|
$56.00 |
$56.00 |
$56.00 |
$56.00
|
|
Telavancin injection
|
$1,197.95 |
$1,197.95 |
$1,197.95 |
$1,191.80
|
|
Telehealth original site facility fee
|
$38.64 |
$38.64 |
$38.64 |
$51.00
|
|
Telethx isodose plan cplx
|
$4,866.40 |
$4,866.40 |
$4,866.40 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,394.40 |
$1,394.40 |
$1,394.40 |
$873.62
|
|
Temozolomide
|
$3,806.02 |
$3,806.02 |
$3,806.02 |
$588.46
|
|
Temozolomide 100 mg intravenous solution
|
$1,777.83 |
$1,777.83 |
$1,777.83 |
$1,867.28
|
|
Temperature gradient studies
|
$526.40 |
$526.40 |
$526.40 |
$242.25
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,418.37 |
$3,418.37 |
$3,418.37 |
$3,723.60
|
|
Tendon lengthening
|
$8,741.60 |
$8,741.60 |
$8,741.60 |
$3,839.54
|
|
Tendon lngth upr a/e ea tdn
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$3,545.97
|
|
Tendon shortening
|
$7,537.60 |
$7,537.60 |
$7,537.60 |
$3,821.05
|
|
Tendon transfer with graft
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,786.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$14,499.77 |
$14,499.77 |
$14,499.77 |
$15,245.38
|
|
Tenodesis biceps tdn at elbw
|
$11,379.20 |
$11,379.20 |
$11,379.20 |
$5,886.74
|
|
Tenolysis extensor tendon hand/finger each
|
$2,811.20 |
$2,811.20 |
$2,811.20 |
$2,811.20
|
|
Tenolysis triceps
|
$7,285.60 |
$7,285.60 |
$7,285.60 |
$3,839.54
|
|
Tenoplasty elbow to sho 1
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$7,907.11
|
|
Tenosynovectomy radic 26145
|
$2,262.40 |
$2,262.40 |
$2,262.40 |
$1,893.86
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$3,545.97
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$4,076.80 |
$4,076.80 |
$4,076.80 |
$2,139.67
|
|
Tension based scoliosis orth
|
$3,528.00 |
$3,528.00 |
$3,528.00 |
$3,528.00
|
|
Tens suppl 2 lead per month
|
$40.32 |
$40.32 |
$40.32 |
$40.32
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$17.54 |
$17.54 |
$17.54 |
$39.33
|
|
Teriparatide injection
|
$7,498.09 |
$7,498.09 |
$7,498.09 |
$7,403.20
|
|
Term dev auto grasp feature
|
$4,513.60 |
$4,513.60 |
$4,513.60 |
$4,513.60
|
|
Term device, multi art digit
|
$3,874.08 |
$3,874.08 |
$3,874.08 |
$3,874.08
|
|
Term dev mech hand vol close
|
$1,817.20 |
$1,817.20 |
$1,817.20 |
$1,817.20
|
|
Term dev mech hand vol open
|
$1,254.40 |
$1,254.40 |
$1,254.40 |
$1,254.40
|
|
Term dev mech hook vol close
|
$1,853.60 |
$1,853.60 |
$1,853.60 |
$1,853.60
|
|
Term dev mech hook vol open
|
$487.20 |
$487.20 |
$487.20 |
$487.20
|
|
Term dev modifier wrist unit
|
$476.00 |
$476.00 |
$476.00 |
$476.00
|
|
Term dev, passive hand mitt
|
$406.00 |
$406.00 |
$406.00 |
$406.00
|
|
Term dev precision pinch dev
|
$246.40 |
$246.40 |
$246.40 |
$246.40
|
|
Term dev, sport/rec/work att
|
$879.20 |
$879.20 |
$879.20 |
$879.20
|
|
Tert gene targeted seq alys
|
$425.60 |
$425.60 |
$425.60 |
$335.00
|
|
Test for chlorohydrocarbons
|
$61.60 |
$61.60 |
$61.60 |
$65.00
|
|
Test for porphobilinogen
|
$16.80 |
$16.80 |
$16.80 |
$33.57
|
|
Test for urine cystines
|
$82.88 |
$82.88 |
$82.88 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$1,243.20 |
$1,243.20 |
$1,243.20 |
$842.56
|
|
Testosterone response panel
|
$509.60 |
$509.60 |
$509.60 |
$129.60
|
|
Testosterone undecanoate 1mg
|
$3,799.47 |
$3,799.47 |
$3,799.47 |
$3,528.08
|
|
Test pathogen(s) for platelets reference
|
$11.20 |
$11.20 |
$11.20 |
$70.00
|
|
Test sock elbw disart/above
|
$347.20 |
$347.20 |
$347.20 |
$347.20
|
|
Test socket above knee
|
$467.60 |
$467.60 |
$467.60 |
$467.60
|
