|
Surgical pathology level 2 gross & microscopic examination
|
$461.37 |
$461.37 |
$461.37 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$599.53 |
$599.53 |
$599.53 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$612.19 |
$612.19 |
$612.19 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$2,283.57 |
$2,283.57 |
$2,283.57 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$4,803.71 |
$4,803.71 |
$4,803.71 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$71.92 |
$71.92 |
$71.92 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$125.84 |
$125.84 |
$125.84 |
$34.48
|
|
Susceptibility mic per plate
|
$222.63 |
$222.63 |
$222.63 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$102.93 |
$102.93 |
$102.93 |
$48.30
|
|
Svc venogram s&i
|
$6,378.63 |
$6,378.63 |
$6,378.63 |
$1,908.00
|
|
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 |
$21.71 |
$44.85
|
|
System pacing micra av
|
$14,018.23 |
$14,018.23 |
$14,018.23 |
$24,469.57
|
|
T3 (triiodothyronine) free
|
$1,028.05 |
$1,028.05 |
$1,028.05 |
$89.82
|
|
T3 (triiodothyronine) total
|
$227.06 |
$227.06 |
$227.06 |
$94.90
|
|
T4 (thyroxine) free
|
$158.93 |
$158.93 |
$158.93 |
$81.60
|
|
T4 (thyroxine) total
|
$110.01 |
$110.01 |
$110.01 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$843.28 |
$843.28 |
$843.28 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,981.27 |
$1,981.27 |
$1,981.27 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$4,379.40 |
$4,379.40 |
$4,379.40 |
$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 gamma interferon
|
$993.02 |
$993.02 |
$993.02 |
$166.46
|
|
Tcd emboli detect w/inj
|
$2,331.41 |
$2,331.41 |
$2,331.41 |
$404.68
|
|
T cells absolute cd4/cd8 including ratio
|
$568.62 |
$568.62 |
$568.62 |
$186.00
|
|
T cells absolute cd 4 count
|
$291.84 |
$291.84 |
$291.84 |
$120.25
|
|
T cells total count
|
$329.29 |
$329.29 |
$329.29 |
$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
|
|
Telethx isodose plan cplx
|
$11,127.57 |
$11,127.57 |
$11,127.57 |
$1,617.00
|
|
Telethx isodose plan simple
|
$9,986.14 |
$9,986.14 |
$9,986.14 |
$848.72
|
|
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 |
$58.44 |
$58.44 |
$46.10
|
|
Tert gene targeted seq alys
|
$131.68 |
$131.68 |
$131.68 |
$304.59
|
|
Test pathogen(s) for platelets reference
|
$163.08 |
$163.08 |
$163.08 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$5,090.34 |
$5,090.34 |
$5,090.34 |
$1,001.55
|
|
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
|
$249.45 |
$249.45 |
$249.45 |
$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 |
$55.98 |
$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
|
$1,569.61 |
$1,569.61 |
$1,569.61 |
$534.32
|
|
Ther/proph/diag inj ia
|
$69.50 |
$69.50 |
$69.50 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$465.37 |
$465.37 |
$465.37 |
$35.72
|
|
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 |
$245.25 |
$245.25 |
$48.75
|
|
Thromboendarterectomy common femoral
|
$18,214.07 |
$18,214.07 |
$18,214.07 |
$7,431.06
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$404.30 |
$404.30 |
$404.30 |
$56.93
|
|
Thromboxane urine
|
$162.26 |
$162.26 |
$162.26 |
$52.22
|
|
Thyroglobulin antibody
|
$254.25 |
$254.25 |
$254.25 |
$84.00
|
|
Thyroid imaging
|
$2,001.65 |
$2,001.65 |
$2,001.65 |
$670.80
|
|
Thyroid mets imag whole body
|
$5,662.10 |
$5,662.10 |
$5,662.10 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$269.06 |
$269.06 |
$269.06 |
$120.00
|
|
Thyroid Ultrasound
|
$1,602.55 |
$1,602.55 |
$1,602.55 |
$589.96
|
|
Thyroid uptake measurement
|
$1,075.86 |
$1,075.86 |
$1,075.86 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$188.35 |
$188.35 |
$188.35 |
$63.60
|
|
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
|
|
Tilt table study
|
$3,997.05 |
$3,997.05 |
$3,997.05 |
$1,495.00
|
|
Tissue culture placenta
|
$1,358.33 |
$1,358.33 |
$1,358.33 |
$520.91
|
|
Tissue culture skin/biopsy
|
$1,180.87 |
$1,180.87 |
$1,180.87 |
$558.87
|
|
Tissue culture tumor
|
$2,318.36 |
$2,318.36 |
$2,318.36 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$117.37 |
$117.37 |
$117.37 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$275.55 |
$275.55 |
$275.55 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$172.10 |
$172.10 |
$172.10 |
$48.57
|
|
Tlh w/t/o 250 g or less
|
$26,485.84 |
$26,485.84 |
$26,485.84 |
$10,799.26
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$221.70 |
$221.70 |
$221.70 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$331.33 |
$331.33 |
$331.33 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,545.32 |
$3,545.32 |
$3,545.32 |
$4,711.84
|
|
Tomosynthesis breast screen bilateral
|
$46.33 |
$46.33 |
$46.33 |
$73.45
|
|
Tongue biopsy; posterior one-third 41105
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$3,589.62
|
|
Tonsillectomy (age 12+)
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$3,837.72
|
|
Tonsillectomy (child under 12)
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$4,881.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$310.78 |
$310.78 |
$310.78 |
$404.20
|
|
Toxoplasma antibody igg
|
$233.45 |
$233.45 |
$233.45 |
$84.35
|
|
Toxoplasma antibody igm
|
$251.69 |
$251.69 |
$251.69 |
$83.20
|
|
Tpmt gene com vrnts
|
$278.43 |
$278.43 |
$278.43 |
$381.55
|
|
Tprnl plmt biodegrdabl matrl
|
$11,682.65 |
$11,682.65 |
$11,682.65 |
$6,105.61
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$58.97 |
$58.97 |
$58.97 |
$104.50
|
|
Transabdom amnioinfus w/us
|
$1,938.27 |
$1,938.27 |
$1,938.27 |
$791.05
|
|
Transcath biopsy
|
$6,986.63 |
$6,986.63 |
$6,986.63 |
$4,298.05
|
|
Transcath closure of asd
|
$27,539.20 |
$27,539.20 |
$27,539.20 |
$18,772.00
|
|
Transcath closure of vsd
|
$27,539.20 |
$27,539.20 |
$27,539.20 |
$18,837.00
|
|
Transcatheter bx s&i
|
$7,330.09 |
$7,330.09 |
$7,330.09 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$10,746.21 |
$10,746.21 |
$10,746.21 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$46,722.62 |
$46,722.62 |
$46,722.62 |
$17,106.18
|
|
Transcath occlusion cns
|
$14,549.12 |
$14,549.12 |
$14,549.12 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$19,727.96 |
$19,727.96 |
$19,727.96 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$11,776.79 |
$11,776.79 |
$11,776.79 |
$4,627.00
|
