|
Surgical pathology level 5 gross & microscopic examination
|
$1,014.16 |
$1,131.00 |
$4,312.50 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,636.21 |
$2,404.00 |
$6,189.75 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$71.92 |
$71.92 |
$71.92 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$125.84 |
$155.09 |
$237.00 |
$34.48
|
|
Susceptibility mic per plate
|
$222.63 |
$222.63 |
$942.58 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$102.93 |
$137.23 |
$3,874.50 |
$48.30
|
|
Svc venogram s&i
|
$6,378.63 |
$6,378.63 |
$6,378.63 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$3,033.00 |
$3,033.00 |
$3,609.75 |
$105.21
|
|
Synvisc or synvisc-one
|
$2,202.04 |
$2,202.04 |
$2,202.04 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$21.71 |
$21.71 |
$562.00 |
$44.85
|
|
System pacing micra av
|
$14,018.23 |
$14,018.23 |
$14,018.23 |
$24,469.57
|
|
T3 (triiodothyronine) free
|
$20.50 |
$438.48 |
$1,688.00 |
$89.82
|
|
T3 (triiodothyronine) total
|
$7.50 |
$13.00 |
$1,345.00 |
$94.90
|
|
T4 (thyroxine) free
|
$158.93 |
$205.80 |
$1,308.50 |
$81.60
|
|
T4 (thyroxine) total
|
$110.01 |
$184.93 |
$1,308.50 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$36.00 |
$36.00 |
$36.00 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,154.41 |
$1,502.00 |
$2,886.75 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$390.76 |
$843.28 |
$1,443.00 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$7,270.00 |
$7,270.00 |
$7,270.00 |
$3,817.00
|
|
Target gsa panel hmtlmph neop
|
$1,981.27 |
$1,981.27 |
$16,065.75 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$4,379.40 |
$4,379.40 |
$21,357.25 |
$3,385.00
|
|
Target gsa panel organ neop
|
$2,574.15 |
$2,574.15 |
$2,574.15 |
$1,913.00
|
|
Tas congenital car anomal
|
$20,161.85 |
$20,161.85 |
$20,161.85 |
$6,003.27
|
|
Tavr perq femoral
|
$51,668.30 |
$51,668.30 |
$51,668.30 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,753.12 |
$1,753.12 |
$1,753.12 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$212.75 |
$212.75 |
$743.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$237.00 |
$566.74 |
$993.02 |
$166.46
|
|
Tc-99m bicisate
|
$8,636.00 |
$8,636.00 |
$8,636.00 |
$1,969.45
|
|
Tc-99m disofenin
|
$988.00 |
$988.00 |
$988.00 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$20,031.26 |
$20,031.26 |
$20,031.26 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$17,836.36 |
$17,836.36 |
$23,033.75 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$1,557.50 |
$1,557.50 |
$1,557.50 |
$323.01
|
|
Tc-99m maa
|
$233.45 |
$584.75 |
$621.00 |
$312.06
|
|
Tc-99m mebrofenin
|
$233.45 |
$584.75 |
$1,140.40 |
$169.53
|
|
Tc-99m medronate
|
$259.25 |
$1,086.75 |
$1,160.00 |
$122.46
|
|
Tc-99m mertiatide
|
$778.13 |
$1,951.75 |
$3,700.42 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$134.26 |
$560.25 |
$586.32 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$246.96 |
$246.96 |
$586.32 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$49.00 |
$49.00 |
$412.35 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$784.00 |
$784.00 |
$1,445.25 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$2,573.00 |
$2,573.00 |
$3,882.75 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$412.35 |
$412.35 |
$2,924.00 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$1,086.75 |
$1,086.75 |
$1,205.00 |
$245.70
|
|
Tcd emboli detect w/inj
|
$2,331.41 |
$2,331.41 |
$2,331.41 |
$404.68
|
|
T cells absolute cd4/cd8 including ratio
|
$265.50 |
$509.81 |
$1,061.00 |
$186.00
|
|
T cells absolute cd 4 count
|
$291.84 |
$511.00 |
$912.75 |
$120.25
|
|
T cells total count
|
$265.50 |
$329.29 |
$1,013.00 |
$124.11
|
|
Tcranial magn stim tx deli
|
$1,058.43 |
$1,058.43 |
$1,058.43 |
$368.50
|
|
Tcranial magn stim tx plan
|
$1,936.32 |
$1,936.32 |
$1,936.32 |
$386.88
|
|
Tcran magn stim redetemine
|
$1,058.43 |
$1,058.43 |
$1,058.43 |
$417.06
|
|
Teaec w/wo patch graft iliofemoral
|
$18,214.07 |
$18,214.07 |
$18,214.07 |
$5,030.40
|
|
Tee w or without fol w/cont, mon
|
$9,167.50 |
$9,167.50 |
$9,167.50 |
$1,077.92
|
|
Telethx isodose plan cplx
|
$11,127.57 |
$21,098.00 |
$39,759.00 |
$1,617.00
|
|
Telethx isodose plan simple
|
$9,785.00 |
$9,986.14 |
$22,935.75 |
$848.72
|
|
Temozolomide 100 mg intravenous solution
|
$7,636.75 |
$7,636.75 |
$7,636.75 |
$3,129.70
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$419.74 |
$419.74 |
$419.74 |
$16,531.64
|
|
Tenodesis biceps tdn at elbw
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
$5,886.74
|
|
Tenolysis extensor tendon hand/finger each
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,594.44
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,840.91 |
$2,840.91 |
$2,840.91 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$58.44 |
$150.56 |
$271.00 |
$46.10
|
|
Tert gene targeted seq alys
|
$131.68 |
$131.68 |
$131.68 |
$304.59
|
|
Test for porphobilinogen
|
$720.00 |
$720.00 |
$720.00 |
$33.57
|
|
Test for urine cystines
|
$1,174.25 |
$1,174.25 |
$1,174.25 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$5,542.50 |
$5,542.50 |
$8,022.00 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$163.08 |
$163.08 |
$4,570.50 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$4,281.25 |
$4,281.25 |
$5,090.34 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,712.32 |
$2,967.00 |
$3,288.00 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$19,645.50 |
$19,645.50 |
$19,645.50 |
$9,460.16
|
|
Theophylline therapeutic drug level
|
$202.84 |
$249.45 |
$1,407.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$1,071.56 |
$1,071.56 |
$1,071.56 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$55.98 |
$55.98 |
$164.00 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$87.97 |
$87.97 |
$87.97 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$874.00 |
$1,569.61 |
$2,642.00 |
$534.32
|
|
Ther/proph/diag inj ia
|
$69.50 |
$69.50 |
$653.00 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$93.25 |
$327.31 |
$465.37 |
$35.72
|
|
Thiotepa injection
|
$3,018.50 |
$3,018.50 |
$3,018.50 |
$1,618.85
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$4,893.55 |
$4,893.55 |
$4,893.55 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$5,123.03 |
$5,123.03 |
$5,123.03 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$21,635.99 |
$21,635.99 |
$21,635.99 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$34,440.07 |
$34,440.07 |
$34,440.07 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$46,932.15 |
$46,932.15 |
$46,932.15 |
$24,605.30
|
|
Thrombin time
|
$245.25 |
$274.43 |
$1,254.50 |
$48.75
|
|
Thromboendarterectomy common femoral
|
$18,214.07 |
$18,214.07 |
$18,214.07 |
$7,431.06
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$217.76 |
$404.30 |
$1,795.00 |
$56.93
|
|
Thromboxane urine
|
$162.26 |
$162.26 |
$1,261.00 |
$52.22
|
|
Thyroglobulin antibody
|
$254.25 |
$347.46 |
$1,480.50 |
$84.00
|
|
Thyroid imaging
|
$2,001.65 |
$5,111.44 |
$5,957.50 |
$670.80
|
|
Thyroid mets imag whole body
|
$5,662.10 |
$5,840.50 |
$13,258.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$238.61 |
$269.06 |
$1,308.50 |
$120.00
|
|
Thyroid Ultrasound
|
$1,084.19 |
$1,084.19 |
$1,602.55 |
$589.96
|
|
Thyroid uptake measurement
|
$1,075.86 |
$3,005.00 |
$4,166.46 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$15,168.00 |
$15,168.00 |
$16,317.50 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$188.35 |
$906.00 |
$1,139.00 |
$63.60
|
|
Tibial length sock fx or equ
|
$69.55 |
$69.55 |
$1,246.00 |
$88.92
|
|
Tib/per revasc stent & ather 37231
|
$51,099.23 |
$51,099.23 |
$51,099.23 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$24,009.25 |
$24,009.25 |
$24,009.25 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$15,717.67 |
$15,717.67 |
$15,717.67 |
$10,406.14
|
|
Tigecycline injection
|
$618.46 |
$1,027.25 |
$1,124.00 |
$277.31
|
|
Tilt table study
|
$3,997.05 |
$5,462.00 |
$6,639.25 |
$1,495.00
|
|
Tisagenlecleucel car-pos t
|
$8,066,000.00 |
$8,066,000.00 |
$8,066,000.00 |
$1,382,069.38
|
