|
T4 (thyroxine) free
|
$117.00 |
$117.00 |
$117.00 |
$85.20
|
|
T4 (thyroxine) total
|
$117.00 |
$117.00 |
$117.00 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$400.20 |
$400.20 |
$400.20 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$5,314.20 |
$5,314.20 |
$5,314.20 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,592.80 |
$3,592.80 |
$3,592.80 |
$3,746.70
|
|
Target gsa panel organ neop
|
$3,247.80 |
$3,247.80 |
$3,247.80 |
$1,655.52
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$343.20 |
$343.20 |
$343.20 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$304.20 |
$304.20 |
$304.20 |
$176.40
|
|
T cells total count
|
$304.20 |
$304.20 |
$304.20 |
$126.90
|
|
Telehealth original site facility fee
|
$56.40 |
$56.40 |
$56.40 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$1,526.85
|
|
Telethx isodose plan simple
|
$889.80 |
$889.80 |
$889.80 |
$873.62
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$4,211.40 |
$4,211.40 |
$4,211.40 |
$2,139.67
|
|
Tert gene targeted seq alys
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$335.00
|
|
Test stress cardiovascular tracing only
|
$959.40 |
$959.40 |
$959.40 |
$949.70
|
|
Tgsap so/hl 51/< rna alys
|
$7,031.40 |
$7,031.40 |
$7,031.40 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$168.00 |
$168.00 |
$168.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$114.60 |
$114.60 |
$114.60 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.60 |
$66.60 |
$66.60 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$66.60 |
$66.60 |
$66.60 |
$50.00
|
|
Ther/proph/diag inj ia
|
$227.40 |
$227.40 |
$227.40 |
$240.35
|
|
Ther radiology tx plng cplx
|
$442.20 |
$442.20 |
$442.20 |
$332.00
|
|
Ther radiology tx plng intrm
|
$220.80 |
$220.80 |
$220.80 |
$224.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$4,365.00 |
$4,365.00 |
$4,365.00 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$1,611.00 |
$1,611.00 |
$1,611.00 |
$2,138.76
|
|
Thrombectmy crnry perq mechanical
|
$2,405.40 |
$2,405.40 |
$2,405.40 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,847.20 |
$6,847.20 |
$6,847.20 |
$8,084.00
|
|
Thrombin time
|
$96.00 |
$96.00 |
$96.00 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$205.20 |
$205.20 |
$205.20 |
$61.52
|
|
Thyroglobulin antibody
|
$154.80 |
$154.80 |
$154.80 |
$82.00
|
|
Thyroid imaging
|
$783.00 |
$783.00 |
$783.00 |
$695.02
|
|
Thyroid mets imag whole body
|
$870.60 |
$870.60 |
$870.60 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$144.00 |
$144.00 |
$144.00 |
$111.00
|
|
Thyroid Ultrasound
|
$562.20 |
$562.20 |
$562.20 |
$588.50
|
|
Thyroid uptake measurement
|
$578.40 |
$578.40 |
$578.40 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$69.00 |
$69.00 |
$69.00 |
$64.35
|
|
Tilt table study
|
$1,746.60 |
$1,746.60 |
$1,746.60 |
$1,507.01
|
|
Tissue culture placenta
|
$1,385.40 |
$1,385.40 |
$1,385.40 |
$457.00
|
|
Tissue culture skin/biopsy
|
$1,512.60 |
$1,512.60 |
$1,512.60 |
$484.00
|
|
Tissue culture tumor
|
$3,670.80 |
$3,670.80 |
$3,670.80 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$79.20 |
$79.20 |
$79.20 |
$47.20
|
|
Tixagev and cilgav inj
|
$99.00 |
$99.00 |
$99.00 |
$224.55
|
|
Tobramycin peak therapeutic drug level
|
$150.60 |
$150.60 |
$150.60 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$157.80 |
$157.80 |
$157.80 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$90.00 |
$90.00 |
$90.00 |
$72.68
|
|
Total tau
|
$333.00 |
$333.00 |
$333.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$117.00 |
$117.00 |
$117.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$94.80 |
$94.80 |
$94.80 |
$87.00
|
|
Tp53 gene full gene sequence
|
$720.00 |
$720.00 |
$720.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$790.68
|
|
Tpmt gene com vrnts
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$1,867.80 |
$1,867.80 |
$1,867.80 |
$7,144.80
|
|
Tracheostoma revision; simple, without flap rotation
|
$4,550.40 |
$4,550.40 |
$4,550.40 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$177.60 |
$177.60 |
$177.60 |
$101.25
|
|
Transcath biopsy
|
$3,537.60 |
$3,537.60 |
$3,537.60 |
$4,285.93
|
|
Transcath closure of asd
|
$30,769.20 |
$30,769.20 |
$30,769.20 |
$16,741.40
|
|
Transcatheter bx s&i
|
$5,206.20 |
$5,206.20 |
$5,206.20 |
$1,915.00
|
|
Transcath occlusion cns
|
$11,823.00 |
$11,823.00 |
$11,823.00 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$9,283.20 |
$9,283.20 |
$9,283.20 |
$10,031.28
|
|
Transferrin
|
$125.40 |
$125.40 |
$125.40 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$2,442.00 |
$2,442.00 |
$2,442.00 |
$983.00
|
|
Transperi needle place pros
|
$1,644.00 |
$1,644.00 |
$1,644.00 |
$6,015.75
|
|
Trauma partial team response w/critical care services level 4
|
$5,048.40 |
$5,048.40 |
$5,048.40 |
$4,523.04
|
|
Treat elbow fracture
|
$981.00 |
$981.00 |
$981.00 |
$1,919.13
|
|
Treat finger fracture each
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,536.00
|
|
Treat fracture of radius
|
$1,400.40 |
$1,400.40 |
$1,400.40 |
$1,790.00
|
|
Treat fracture of ulna
|
$948.60 |
$948.60 |
$948.60 |
$726.05
|
|
Treat hip dislocation
|
$2,266.20 |
$2,266.20 |
$2,266.20 |
$2,192.80
|
|
Treat humerus fracture
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,771.43
|
|
Treat humerus fracture
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,771.43
|
|
Treat knee dislocation
|
$981.00 |
$981.00 |
$981.00 |
$2,220.89
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$109.20 |
$109.20 |
$109.20 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$82.80 |
$82.80 |
$82.80 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$102.00 |
$102.00 |
$102.00 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$252.60 |
$252.60 |
$252.60 |
$520.80
|
|
Treatment of fibula fracture 27780
|
$318.00 |
$318.00 |
$318.00 |
$491.50
|
|
Treatment of thigh fracture
|
$433.80 |
$433.80 |
$433.80 |
$548.90
|
|
Treatment of thigh fracture
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,772.97
|
|
Treatment of toe fracture 28510
|
$149.40 |
$149.40 |
$149.40 |
$369.70
|
|
Treatment radiation delivery level 2
|
$3,191.40 |
$3,191.40 |
$3,191.40 |
$767.65
|
|
Treat sternum fracture
|
$151.20 |
$151.20 |
$151.20 |
$423.00
|
|
Treat thigh fracture
|
$2,013.00 |
$2,013.00 |
$2,013.00 |
$1,893.86
|
|
Treat ulnar fracture
|
$1,224.60 |
$1,224.60 |
$1,224.60 |
$1,662.00
|
|
Treat vaginal bleeding
|
$589.20 |
$589.20 |
$589.20 |
$379.60
|
|
Treat wrist dislocation
|
$342.60 |
$342.60 |
$342.60 |
$656.25
|
|
Treponema pallidum antibody
|
$166.20 |
$166.20 |
$166.20 |
$70.40
|
|
Trg gene rearrangement anal
|
$880.80 |
$880.80 |
$880.80 |
$455.70
|
|
Triglycerides
|
$175.80 |
$175.80 |
$175.80 |
$58.05
|
|
Trnscath plc stent crv crtd without prtct
|
$4,752.00 |
$4,752.00 |
$4,752.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$5,711.40 |
$5,711.40 |
$5,711.40 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$4,759.80 |
$4,759.80 |
$4,759.80 |
$6,069.00
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$5,759.40 |
$5,759.40 |
$5,759.40 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$5,759.40 |
$5,759.40 |
$5,759.40 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$13,490.40 |
$13,490.40 |
$13,490.40 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$8,098.80 |
$8,098.80 |
$8,098.80 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,803.40 |
$3,803.40 |
$3,803.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$7,496.40 |
$7,496.40 |
$7,496.40 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,496.40 |
$7,496.40 |
$7,496.40 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$4,003.20 |
$4,003.20 |
$4,003.20 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm
|
$2,445.60 |
$2,445.60 |
$2,445.60 |
$4,713.66
|
