|
Tc-99m oxidronate
|
$55.68 |
$55.68 |
$55.68 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$782.08 |
$782.08 |
$782.08 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$43.20 |
$43.20 |
$43.20 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$43.84 |
$43.84 |
$43.84 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$116.48 |
$116.48 |
$116.48 |
$274.45
|
|
Tc-99m sulfur colloid
|
$50.56 |
$50.56 |
$50.56 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$89.28 |
$89.28 |
$89.28 |
$190.80
|
|
T cells absolute cd4/cd8 including ratio
|
$176.00 |
$176.00 |
$176.00 |
$176.40
|
|
T cells absolute cd 4 count
|
$16.64 |
$16.64 |
$16.64 |
$111.20
|
|
T cells total count
|
$176.00 |
$176.00 |
$176.00 |
$126.90
|
|
Telehealth original site facility fee
|
$16.00 |
$16.00 |
$16.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$373.12 |
$373.12 |
$373.12 |
$1,526.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$6,850.22 |
$6,850.22 |
$6,850.22 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$12.16 |
$12.16 |
$12.16 |
$39.33
|
|
Test for chlorohydrocarbons
|
$5.44 |
$5.44 |
$5.44 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$503.36 |
$503.36 |
$503.36 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$452.80 |
$452.80 |
$452.80 |
$949.70
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$3,607.01 |
$3,607.01 |
$3,607.01 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$74.24 |
$74.24 |
$74.24 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$11.52 |
$11.52 |
$11.52 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$11.52 |
$11.52 |
$11.52 |
$50.00
|
|
Ther fx nasal inf turbinate
|
$98.88 |
$98.88 |
$98.88 |
$3,786.00
|
|
Ther nma rdctj intus/obstrcj
|
$380.16 |
$380.16 |
$380.16 |
$529.08
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$15.21 |
$15.21 |
$15.21 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$782.40 |
$782.40 |
$782.40 |
$1,687.50
|
|
Thoracic lymphadenect/thoracotomy 38746
|
$74.56 |
$74.56 |
$74.56 |
$499.80
|
|
Thoracoscopy bilobectomy 32670
|
$569.92 |
$569.92 |
$569.92 |
$5,407.50
|
|
Thoracoscopy diagnostic 32601
|
$109.76 |
$109.76 |
$109.76 |
$6,442.80
|
|
Thoracoscopy for lvrs
|
$540.48 |
$540.48 |
$540.48 |
$5,700.80
|
|
Thoracoscopy lymph node exc
|
$74.88 |
$74.88 |
$74.88 |
$1,071.20
|
|
Thoracoscopy remove cortex
|
$394.24 |
$394.24 |
$394.24 |
$5,332.80
|
|
Thoracoscopy resect bullae 32655
|
$345.92 |
$345.92 |
$345.92 |
$4,204.20
|
|
Thoracoscopy surgical 32650
|
$516.80 |
$516.80 |
$516.80 |
$2,815.80
|
|
Thoracoscopy/tot pulm decortication32652
|
$594.56 |
$594.56 |
$594.56 |
$7,573.80
|
|
Thoracoscopy w/lobectomy
|
$1,046.08 |
$1,046.08 |
$1,046.08 |
$3,408.80
|
|
Thoracoscopy w/pleurectomy 32656
|
$292.16 |
$292.16 |
$292.16 |
$3,447.60
|
|
Thoracoscopy w/sac drng 32659
|
$268.16 |
$268.16 |
$268.16 |
$1,780.00
|
|
Thoracoscopy w/wedge resect
|
$662.08 |
$662.08 |
$662.08 |
$4,232.00
|
|
Thoracoscopy w w resect addl 32667
|
$54.40 |
$54.40 |
$54.40 |
$780.00
|
|
Thoracoscopy w w resect diag 32668
|
$54.40 |
$54.40 |
$54.40 |
$304.20
|
|
Thoracotomy w/expl
|
$620.48 |
$620.48 |
$620.48 |
$2,045.17
|
|
Thrcspy w/diag bp lng inf uni
|
$231.04 |
$231.04 |
$231.04 |
$6,792.80
|
|
Thrcspy w/diag bp lng nod uni
|
$134.08 |
$134.08 |
$134.08 |
$6,120.30
|
|
Throat x-ray & fluoroscopy
|
$135.68 |
$135.68 |
$135.68 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$949.76 |
$949.76 |
$949.76 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,944.32 |
$2,944.32 |
$2,944.32 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$5,291.52 |
$5,291.52 |
$5,291.52 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$14,958.40 |
$14,958.40 |
$14,958.40 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$831.36 |
$831.36 |
$831.36 |
$5,520.00
|
|
Thrombin time
|
$51.84 |
$51.84 |
$51.84 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$594.24 |
$594.24 |
$594.24 |
$3,980.60
|
|
Thromboendarterectomy sfa
|
$810.56 |
$810.56 |
$810.56 |
$4,185.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$66.88 |
$66.88 |
$66.88 |
$61.52
|
|
Thymectomy prtl/tot without rad medstnl dsj 60521
|
$860.48 |
$860.48 |
$860.48 |
$2,736.00
|
|
Thyroglobulin antibody
|
$71.36 |
$71.36 |
$71.36 |
$82.00
|
|
Thyroid imaging
|
$273.28 |
$273.28 |
$273.28 |
$695.02
|
|
Thyroid met imaging
|
$475.84 |
$475.84 |
$475.84 |
$838.25
|
|
Thyroid mets imag whole body
|
$640.96 |
$640.96 |
$640.96 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$81.28 |
$81.28 |
$81.28 |
$111.00
|
|
Thyroid Ultrasound
|
$216.00 |
$216.00 |
$216.00 |
$588.50
|
|
Thyroid uptake measurement
|
$273.28 |
$273.28 |
$273.28 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$36.16 |
$36.16 |
$36.16 |
$64.35
|
|
Tilt table study
|
$72.00 |
$72.00 |
$72.00 |
$1,507.01
|
|
Tissue culture placenta
|
$133.44 |
$133.44 |
$133.44 |
$457.00
|
|
Tissue culture skin/biopsy
|
$224.96 |
$224.96 |
$224.96 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$11.84 |
$11.84 |
$11.84 |
$47.20
|
|
Tissue transglutaminase iga
|
$7.68 |
$7.68 |
$7.68 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$131.84 |
$131.84 |
$131.84 |
$78.40
|
|
Tlh uterus 250 g or less
|
$646.40 |
$646.40 |
$646.40 |
$11,533.76
|
|
Tlh uterus over 250 g
|
$804.80 |
$804.80 |
$804.80 |
$9,363.13
|
|
Tlh w/t/o 250 g or less
|
$728.00 |
$728.00 |
$728.00 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$969.60 |
$969.60 |
$969.60 |
$12,320.22
|
|
Tmvr w/prosthetic ring 33426
|
$843.52 |
$843.52 |
$843.52 |
$5,816.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$6.91 |
$6.91 |
$6.91 |
$152.36
|
|
Tobramycin non-comp unit
|
$105.08 |
$105.08 |
$105.08 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$70.40 |
$70.40 |
$70.40 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,096.32 |
$1,096.32 |
$1,096.32 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$41.28 |
$41.28 |
$41.28 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$32.96 |
$32.96 |
$32.96 |
$72.68
|
|
Tongue biopsy; posterior one-third 41105
|
$91.20 |
$91.20 |
$91.20 |
$3,544.29
|
|
Tonsillectomy (age 12+)
|
$213.12 |
$213.12 |
$213.12 |
$4,424.11
|
|
Total hip arthroplasty
|
$1,324.16 |
$1,324.16 |
$1,324.16 |
$7,347.60
|
|
Total Hip Replacement
|
$1,024.00 |
$1,024.00 |
$1,024.00 |
$9,161.60
|
|
Total hysterectomy
|
$809.28 |
$809.28 |
$809.28 |
$3,001.70
|
|
Total Knee Replacement
|
$1,022.72 |
$1,022.72 |
$1,022.72 |
$14,543.50
|
|
Total tau
|
$211.84 |
$211.84 |
$211.84 |
$312.50
|
|
Tot esophagectomy without thoracotomy 43107
|
$2,232.96 |
$2,232.96 |
$2,232.96 |
$7,284.80
|
|
Toxoplasma antibody igg
|
$50.24 |
$50.24 |
$50.24 |
$89.40
|
|
Toxoplasma antibody igm
|
$28.16 |
$28.16 |
$28.16 |
$87.00
|
|
Tp53 gene full gene sequence
|
$620.80 |
$620.80 |
$620.80 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$256.00 |
$256.00 |
$256.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$143.36 |
$143.36 |
$143.36 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$92.48 |
$92.48 |
$92.48 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$20.48 |
$20.48 |
$20.48 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$12.08 |
$12.08 |
$12.08 |
$56.38
|
|
Transab esoph hiat hern repair 43332
|
$883.20 |
$883.20 |
$883.20 |
$2,835.20
|
|
Transcath biopsy
|
$3,256.32 |
$3,256.32 |
$3,256.32 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,221.12 |
$1,221.12 |
$1,221.12 |
$1,915.00
|
|
Transcath occlusion cns
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$5,291.52 |
$5,291.52 |
$5,291.52 |
$10,031.28
|
