|
Surgical pathology level 6 gross & microscopic examination
|
$1,653.00 |
$2,182.33 |
$2,230.35 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$207.00 |
$207.00 |
$783.60 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$22.57 |
$83.00 |
$994.05 |
$34.48
|
|
Susceptibility mic per plate
|
$1,669.00 |
$1,669.00 |
$1,669.00 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$31.55 |
$418.35 |
$421.00 |
$48.30
|
|
Svc venogram s&i
|
$5,261.07 |
$5,261.07 |
$8,847.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$1,026.50 |
$1,026.50 |
$1,147.00 |
$105.21
|
|
Synvisc or synvisc-one
|
$2,303.78 |
$2,303.78 |
$2,303.78 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$273.00 |
$273.00 |
$273.00 |
$44.85
|
|
T3 (triiodothyronine) free
|
$804.00 |
$804.00 |
$804.00 |
$89.82
|
|
T3 (triiodothyronine) total
|
$429.42 |
$429.42 |
$494.00 |
$94.90
|
|
T4 (thyroxine) free
|
$534.00 |
$534.00 |
$534.00 |
$81.60
|
|
T4 (thyroxine) total
|
$368.00 |
$368.00 |
$832.38 |
$73.64
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$124.00 |
$124.00 |
$133.00 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$99.48 |
$99.48 |
$915.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$3,955.00 |
$3,955.00 |
$3,955.00 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$15,673.00 |
$15,673.00 |
$15,673.00 |
$3,385.00
|
|
Target gsa panel organ neop
|
$14,452.00 |
$14,452.00 |
$14,452.00 |
$1,913.00
|
|
Tas congenital car anomal
|
$25,114.00 |
$25,114.00 |
$25,114.00 |
$6,003.27
|
|
Tavr perq femoral
|
$29,488.00 |
$29,488.00 |
$29,488.00 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$4,281.29 |
$4,281.29 |
$4,281.29 |
$959.55
|
|
Tbs techl calculation only
|
$281.00 |
$281.00 |
$281.00 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$58.06 |
$58.25 |
$540.00 |
$166.46
|
|
Tc-99m apcitide diag
|
$10,254.30 |
$10,254.30 |
$10,254.30 |
$1,765.30
|
|
Tc-99m bicisate
|
$2,568.41 |
$2,568.41 |
$2,747.55 |
$1,969.45
|
|
Tc-99m disofenin
|
$1,149.45 |
$1,149.45 |
$1,149.45 |
$151.32
|
|
Tc-99m exametazime diag
|
$4,767.08 |
$4,767.08 |
$5,100.80 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$323.01
|
|
Tc-99m maa
|
$972.78 |
$972.78 |
$1,040.55 |
$312.06
|
|
Tc-99m mebrofenin
|
$1,074.25 |
$1,074.25 |
$1,149.45 |
$169.53
|
|
Tc-99m medronate
|
$724.33 |
$724.33 |
$774.40 |
$122.46
|
|
Tc-99m mertiatide
|
$2,147.34 |
$2,147.34 |
$2,298.30 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$1,197.89 |
$1,197.89 |
$1,282.35 |
$245.85
|
|
Tc-99m pertechnetate per mci
|
$25.66 |
$25.66 |
$27.10 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$734.20 |
$734.20 |
$734.20 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$3,842.12 |
$3,842.12 |
$4,111.05 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$2,678.30 |
$2,678.30 |
$2,678.30 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$1,074.25 |
$1,074.25 |
$1,149.45 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$868.97 |
$868.97 |
$4,068.35 |
$198.05
|
|
Tcd emboli detect w/inj
|
$319.55 |
$319.55 |
$827.00 |
$404.68
|
|
Tcd emboli detect without inj
|
$319.55 |
$319.55 |
$319.55 |
$397.15
|
|
T-cell depletion of harvest
|
$5,153.00 |
$5,153.00 |
$5,153.00 |
$1,673.75
|
|
T cells absolute cd4/cd8 including ratio
|
$865.00 |
$865.00 |
$865.00 |
$186.00
|
|
T cells absolute cd 4 count
|
$29.15 |
$167.49 |
$169.00 |
$120.25
|
|
T cells total count
|
$22.30 |
$98.00 |
$179.29 |
$124.11
|
|
Teaec w/wo patch graft iliofemoral
|
$93,671.00 |
$93,671.00 |
$93,671.00 |
$5,030.40
|
|
Telehealth original site facility fee
|
$128.00 |
$128.00 |
$128.00 |
$60.80
|
|
Telethx isodose plan cplx
|
$5,310.26 |
$5,310.26 |
$7,112.00 |
$1,617.00
|
|
Telethx isodose plan simple
|
$3,773.00 |
$3,773.00 |
$3,773.00 |
$848.72
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$6,355.00 |
$6,355.00 |
$16,603.35 |
$16,531.64
|
|
Tenodesis biceps tdn at elbw
|
$17,999.00 |
$17,999.00 |
$17,999.00 |
$5,886.74
|
|
Tenolysis extensor tendon hand/finger each
|
$10,690.00 |
$10,690.00 |
$10,690.00 |
$3,594.44
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$26.93 |
$62.00 |
$66.50 |
$46.10
|
|
Test for chlorohydrocarbons
|
$49.10 |
$49.10 |
$513.00 |
$71.04
|
|
Test for urine cystines
|
$324.15 |
$324.15 |
$324.15 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$2,444.00 |
$2,444.00 |
$9,203.10 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$450.00 |
$450.00 |
$450.00 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$2,825.00 |
$2,825.00 |
$10,885.58 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$59.00 |
$59.00 |
$63.75 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$48,505.85 |
$48,505.85 |
$48,505.85 |
$9,460.16
|
|
Tgsap so neo 5-50 rna alys
|
$6,713.00 |
$6,713.00 |
$6,713.00 |
$816.27
|
|
Thaw preserved stem cells
|
$2,751.00 |
$2,751.00 |
$2,751.00 |
$900.90
|
|
Theophylline therapeutic drug level
|
$387.00 |
$387.00 |
$1,063.55 |
$108.00
|
|
Therapeutic procd strg endur
|
$282.00 |
$282.00 |
$282.00 |
$85.80
|
|
Therapy activity per session >= 45 minutes
|
$671.00 |
$671.00 |
$671.00 |
$158.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$106.00 |
$106.00 |
$106.00 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$124.00 |
$124.00 |
$124.00 |
$50.40
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$621.00 |
$621.00 |
$621.00 |
$283.20
|
|
Ther nma rdctj intus/obstrcj
|
$1,331.00 |
$1,331.00 |
$1,331.00 |
$534.32
|
|
Ther/proph/diag inj ia
|
$255.00 |
$255.00 |
$255.00 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$30.00 |
$30.00 |
$237.56 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,955.00 |
$2,955.00 |
$2,955.00 |
$1,804.00
|
|
Thorax spine fusion
|
$22,608.00 |
$22,608.00 |
$22,608.00 |
$4,941.95
|
|
Thrombectmy crnry perq mechanical
|
$3,836.00 |
$3,836.00 |
$3,836.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$15,347.00 |
$15,347.00 |
$15,347.00 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$42,688.00 |
$42,688.00 |
$42,688.00 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$50,645.00 |
$50,645.00 |
$50,645.00 |
$24,605.30
|
|
Thrombin time
|
$32.90 |
$32.90 |
$437.00 |
$48.75
|
|
Thromboendarterectomy common femoral
|
$93,671.00 |
$93,671.00 |
$93,671.00 |
$7,431.06
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$619.00 |
$619.00 |
$619.00 |
$56.93
|
|
Thromboxane urine
|
$519.00 |
$519.00 |
$519.00 |
$52.22
|
|
Thyroglobulin antibody
|
$529.00 |
$529.00 |
$529.00 |
$84.00
|
|
Thyroid imaging
|
$4,570.00 |
$4,570.00 |
$7,557.00 |
$670.80
|
|
Thyroid mets imag whole body
|
$5,291.00 |
$5,291.00 |
$13,770.95 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$624.00 |
$624.00 |
$624.00 |
$120.00
|
|
Thyroid Ultrasound
|
$1,126.00 |
$1,126.00 |
$4,720.63 |
$589.96
|
|
Thyroid uptake measurement
|
$3,071.00 |
$3,071.00 |
$4,043.35 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$11.13 |
$11.15 |
$101.00 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$83,829.00 |
$83,829.00 |
$83,829.00 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$76,080.00 |
$76,080.00 |
$76,080.00 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$39,944.00 |
$39,944.00 |
$39,944.00 |
$10,406.14
|
|
Tigecycline injection
|
$452.00 |
$452.00 |
$487.25 |
$277.31
|
|
Tilt table study
|
$4,800.00 |
$4,800.00 |
$10,767.64 |
$1,495.00
|
|
Tissue culture placenta
|
$291.25 |
$292.20 |
$457.00 |
$520.91
|
|
Tissue culture skin/biopsy
|
$682.54 |
$684.75 |
$947.00 |
$558.87
|
|
Tissue culture tumor
|
$184.00 |
$715.47 |
$717.80 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$105.00 |
$105.00 |
$265.71 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$626.00 |
$626.00 |
$626.00 |
$2,516.07
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$86.00 |
$86.00 |
$86.00 |
$1,679.65
|
