|
T4 (thyroxine) total
|
$106.04 |
$106.04 |
$106.04 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$182.41 |
$182.41 |
$182.41 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$6,282.22 |
$6,282.22 |
$6,282.22 |
$959.55
|
|
Tbs techl calculation only
|
$299.00 |
$299.00 |
$299.00 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$307.63 |
$307.63 |
$307.63 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$233.18 |
$233.18 |
$233.18 |
$186.00
|
|
T cells absolute cd 4 count
|
$413.35 |
$413.35 |
$413.35 |
$120.25
|
|
T cells total count
|
$582.36 |
$582.36 |
$582.36 |
$124.11
|
|
Telehealth original site facility fee
|
$113.37 |
$113.37 |
$113.37 |
$44.85
|
|
Telethx isodose plan cplx
|
$1,770.01 |
$1,770.01 |
$1,770.01 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,223.91 |
$1,223.91 |
$1,223.91 |
$848.72
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$44.87 |
$44.87 |
$44.87 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$670.29 |
$670.29 |
$670.29 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$3,212.94 |
$3,212.94 |
$3,212.94 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$71,015.50 |
$71,015.50 |
$71,015.50 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$220.19 |
$220.19 |
$220.19 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$106.58 |
$106.58 |
$106.58 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$91.47 |
$91.47 |
$91.47 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$275.68 |
$275.68 |
$275.68 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,539.66 |
$2,539.66 |
$2,539.66 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$6,630.39 |
$6,630.39 |
$6,630.39 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$12,426.74 |
$12,426.74 |
$12,426.74 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$35,207.30 |
$35,207.30 |
$35,207.30 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$45,979.75 |
$45,979.75 |
$45,979.75 |
$24,605.30
|
|
Thrombin time
|
$68.34 |
$68.34 |
$68.34 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$99.87 |
$99.87 |
$99.87 |
$56.93
|
|
Thyroglobulin antibody
|
$245.57 |
$245.57 |
$245.57 |
$84.00
|
|
Thyroid imaging
|
$3,951.75 |
$3,951.75 |
$3,951.75 |
$670.80
|
|
Thyroid (TSH) Test
|
$402.85 |
$402.85 |
$402.85 |
$120.00
|
|
Thyroid Ultrasound
|
$2,443.11 |
$2,443.11 |
$2,443.11 |
$589.96
|
|
Thyroid uptake measurement
|
$4,194.99 |
$4,194.99 |
$4,194.99 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$228.13 |
$228.13 |
$228.13 |
$63.60
|
|
Tilt table study
|
$3,780.15 |
$3,780.15 |
$3,780.15 |
$1,495.00
|
|
Tissue transglutaminase iga
|
$143.55 |
$143.55 |
$143.55 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$188.82 |
$188.82 |
$188.82 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$636.54 |
$636.54 |
$636.54 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$12,766.24 |
$12,766.24 |
$12,766.24 |
$5,790.85
|
|
Tomosynthesis breast screen bilateral
|
$218.99 |
$218.99 |
$218.99 |
$73.45
|
|
Tonsillectomy (age 12+)
|
$33,427.05 |
$33,427.05 |
$33,427.05 |
$3,837.72
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$232.01 |
$232.01 |
$232.01 |
$303.88
|
|
Toxoplasma antibody igg
|
$95.79 |
$95.79 |
$95.79 |
$84.35
|
|
Toxoplasma antibody igm
|
$143.02 |
$143.02 |
$143.02 |
$83.20
|
|
Tpmt gene com vrnts
|
$2,698.20 |
$2,698.20 |
$2,698.20 |
$381.55
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$213.75 |
$213.75 |
$213.75 |
$93.75
|
|
Transferrin
|
$230.90 |
$230.90 |
$230.90 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$2,082.72 |
$2,082.72 |
$2,082.72 |
$988.24
|
|
Treat finger fracture each
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,815.75
|
|
Treat fracture of radius
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,030.33
|
|
Treat hip dislocation
|
$17,772.67 |
$17,772.67 |
$17,772.67 |
$2,561.90
|
|
Treat knee fracture 27530
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$580.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$452.03 |
$452.03 |
$452.03 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$87.72 |
$87.72 |
$87.72 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$550.17 |
$550.17 |
$550.17 |
$210.00
|
|
Treatment of ankle fracture 27786
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$580.00
|
|
Treatment of fibula fracture 27780
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$558.75
|
|
Treatment of toe fracture 28510
|
$1,907.68 |
$1,907.68 |
$1,907.68 |
$371.40
|
|
Treatment radiation delivery level 2
|
$938.60 |
$938.60 |
$938.60 |
$735.00
|
|
Treat toe dislocation
|
$2,976.33 |
$2,976.33 |
$2,976.33 |
$855.66
|
|
Treat wrist dislocation
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$237,434.85 |
$237,434.85 |
$237,434.85 |
$120,541.18
|
|
Treponema pallidum antibody
|
$204.36 |
$204.36 |
$204.36 |
$72.80
|
|
Trg gene rearrangement anal
|
$3,110.15 |
$3,110.15 |
$3,110.15 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$416.25 |
$416.25 |
$416.25 |
$48.22
|
|
#tricyclicantidprssnt
|
$45.40 |
$45.40 |
$45.40 |
$57.08
|
|
Triglycerides
|
$215.88 |
$215.88 |
$215.88 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$1,129.76 |
$1,129.76 |
$1,129.76 |
$154.09
|
|
Trim nondyst nails
|
$670.29 |
$670.29 |
$670.29 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$777.00
|
|
Trnscath plc stent crv crtd w/prtct
|
$17,295.86 |
$17,295.86 |
$17,295.86 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$15,391.99 |
$15,391.99 |
$15,391.99 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$27,718.38 |
$27,718.38 |
$27,718.38 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$45,718.00 |
$45,718.00 |
$45,718.00 |
$15,408.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$15,318.58 |
$15,318.58 |
$15,318.58 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$12,694.52 |
$12,694.52 |
$12,694.52 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$12,405.83 |
$12,405.83 |
$12,405.83 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$8,723.39 |
$8,723.39 |
$8,723.39 |
$4,329.36
|
|
Troponin quantitative
|
$453.25 |
$453.25 |
$453.25 |
$123.75
|
|
Tx closed tib shaft fx without manip
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$635.46
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$4,499.12
|
|
Tx tarsal bone fx without manip 28450
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$469.20
|
|
Ua w/micro/comp poc
|
$71.35 |
$71.35 |
$71.35 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,066.77 |
$1,066.77 |
$1,066.77 |
$403.26
|
|
Ultrasound breast complete
|
$2,331.74 |
$2,331.74 |
$2,331.74 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,553.45 |
$1,553.45 |
$1,553.45 |
$449.35
|
|
Ultrasound chest
|
$1,893.70 |
$1,893.70 |
$1,893.70 |
$459.55
|
|
Ultrasound elastography parenchyma
|
$1,344.82 |
$1,344.82 |
$1,344.82 |
$284.25
|
|
Ultrasound encephalogram
|
$1,872.60 |
$1,872.60 |
$1,872.60 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$2,294.20 |
$2,294.20 |
$2,294.20 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,421.84 |
$1,421.84 |
$1,421.84 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$1,918.06 |
$1,918.06 |
$1,918.06 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$2,947.22 |
$2,947.22 |
$2,947.22 |
$701.35
|
|
Ultrasound guide intraoperative
|
$2,442.78 |
$2,442.78 |
$2,442.78 |
$632.90
|
|
Ultrasound joint complete left
|
$1,943.72 |
$1,943.72 |
$1,943.72 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,880.00 |
$1,880.00 |
$1,880.00 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,576.70 |
$2,576.70 |
$2,576.70 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,595.74 |
$1,595.74 |
$1,595.74 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$3,198.77 |
$3,198.77 |
$3,198.77 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,414.91 |
$1,414.91 |
$1,414.91 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,180.21 |
$1,180.21 |
$1,180.21 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,728.92 |
$1,728.92 |
$1,728.92 |
$485.48
|
