|
Surg tx anal fistula 2nd stage 46285
|
$9,232.77 |
$9,232.77 |
$9,232.77 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$10.23 |
$25.00 |
$268.10 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$12.54 |
$27.50 |
$128.80 |
$35.75
|
|
Susceptibility mic per plate
|
$41.58 |
$60.00 |
$744.10 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$75.00 |
$75.00 |
$206.50 |
$59.28
|
|
Svc venogram s&i
|
$812.13 |
$1,485.00 |
$2,644.60 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$89.10 |
$200.00 |
$709.10 |
$316.55
|
|
Swallowing Therapy Session
|
$61.71 |
$197.50 |
$517.30 |
$240.31
|
|
Sweat collection by iontophoresis
|
$177.50 |
$177.50 |
$177.50 |
$123.78
|
|
Sympathectomy digital artery
|
$172,115.12 |
$172,115.12 |
$172,115.12 |
$2,310.83
|
|
Sympathectomy supfc palmar
|
$91,592.65 |
$91,592.65 |
$91,592.65 |
$3,839.54
|
|
Synvisc or synvisc-one
|
$441.52 |
$441.52 |
$441.52 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$24.42 |
$37.50 |
$47.60 |
$41.60
|
|
System cardiomems hosp electronics
|
$33,799.75 |
$38,108.50 |
$163,337.27 |
$38,234.70
|
|
System pacing micra av
|
$18,624.38 |
$25,671.00 |
$84,313.69 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,855.80 |
$6,583.45 |
$102,609.31 |
$12,003.00
|
|
System sealant biosentry tract
|
$1,159.47 |
$1,159.47 |
$2,638.52 |
$889.35
|
|
T3 (triiodothyronine) free
|
$32.67 |
$82.50 |
$274.40 |
$100.32
|
|
T3 (triiodothyronine) total
|
$32.67 |
$62.50 |
$231.00 |
$93.52
|
|
T4 (thyroxine) free
|
$34.98 |
$65.00 |
$121.10 |
$88.44
|
|
T4 (thyroxine) total
|
$39.60 |
$85.00 |
$180.60 |
$69.58
|
|
Tacrol envarsus ex rel oral
|
$502.07 |
$502.07 |
$502.07 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$288.75 |
$288.75 |
$1,538.07 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,207.15 |
$1,207.15 |
$1,207.15 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$102.63 |
$122.50 |
$305.90 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$33.53 |
$33.53 |
$33.53 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$101.64 |
$237.50 |
$744.10 |
$289.90
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$147.84 |
$147.84 |
$147.84 |
$1,223.36
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$125.57 |
$125.57 |
$72,338.87 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$2,246.30 |
$2,320.00 |
$2,320.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,025.11 |
$3,385.00 |
$7,585.20 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,923.60 |
$2,270.00 |
$2,270.00 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$2,700.00 |
$2,700.00 |
$93,921.97 |
$24,217.20
|
|
Tas congenital car anomal
|
$11,511.50 |
$11,511.50 |
$11,511.50 |
$6,003.27
|
|
Tavr perq femoral
|
$16,935.80 |
$16,935.80 |
$16,935.80 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$848.95 |
$848.95 |
$983.67 |
$937.50
|
|
Tbp gene detc abnor alleles
|
$316.40 |
$316.40 |
$316.40 |
$225.42
|
|
Tbs techl calculation only
|
$107.91 |
$107.91 |
$196.00 |
$153.60
|
|
Tbs techl prep&transmis data
|
$107.91 |
$107.91 |
$107.91 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$53.79 |
$229.60 |
$290.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$57.75 |
$215.60 |
$247.50 |
$180.80
|
|
Tc-99m apcitide diag
|
$375.21 |
$375.21 |
$375.21 |
$1,181.70
|
|
Tc-99m arcitumomab
|
$1,410.75 |
$1,410.75 |
$1,410.75 |
$2,085.68
|
|
Tc-99m bicisate
|
$5,133.10 |
$5,133.10 |
$5,133.10 |
$2,070.00
|
|
Tc-99m depreotide
|
$1,142.79 |
$1,142.79 |
$1,142.79 |
$1,486.80
|
|
Tc-99m diag per dose
|
$109.89 |
$109.89 |
$109.89 |
$470.40
|
|
Tc-99m disofenin
|
$140.91 |
$140.91 |
$140.91 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,394.58 |
$1,394.58 |
$4,007.50 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$1,203.51 |
$1,203.51 |
$4,383.40 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$140.58 |
$140.58 |
$581.00 |
$306.00
|
|
Tc-99m maa
|
$185.41 |
$471.57 |
$1,454.60 |
$312.06
|
|
Tc-99m mebrofenin
|
$146.19 |
$146.19 |
$275.10 |
$157.65
|
|
Tc-99m medronate
|
$64.35 |
$64.35 |
$220.50 |
$111.01
|
|
Tc-99m mertiatide
|
$313.83 |
$313.83 |
$2,244.20 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$9.10 |
$6.50
|
|
Tc-99m oxidronate
|
$135.63 |
$135.63 |
$256.20 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$82.50 |
$82.50 |
$1,134.70 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$168.63 |
$168.63 |
$168.63 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$1.65 |
$1.65 |
$4.20 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$333.90 |
$333.90 |
$333.90 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$274.56 |
$296.81 |
$581.00 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$1,318.10 |
$1,318.10 |
$1,318.10 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$554.07 |
$554.07 |
$1,098.30 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$200.31 |
$339.50 |
$710.00 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$255.75 |
$255.75 |
$985.60 |
$985.60
|
|
Tcd emboli detect w/inj
|
$895.00 |
$895.00 |
$1,429.40 |
$475.80
|
|
Tcd emboli detect without inj
|
$835.10 |
$835.10 |
$835.10 |
$475.28
|
|
T-cell depletion of harvest
|
$20,451.20 |
$20,451.20 |
$20,451.20 |
$2,475.20
|
|
T cells absolute cd4/cd8 including ratio
|
$77.88 |
$214.20 |
$237.50 |
$185.28
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$95.00 |
$111.20
|
|
T cells total count
|
$52.14 |
$187.50 |
$459.90 |
$130.35
|
|
Teaec w/wo patch graft iliofemoral
|
$8,627.50 |
$8,627.50 |
$8,627.50 |
$6,120.00
|
|
Team conf without pat by hc pro
|
$130.00 |
$130.00 |
$130.00 |
$110.62
|
|
Team conf without pat by phys
|
$145.00 |
$145.00 |
$145.00 |
$139.10
|
|
Team conf w/pat by hc prof
|
$130.00 |
$130.00 |
$130.00 |
$104.59
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$424.38 |
$424.38 |
$131,428.16 |
$40,114.80
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$80.50 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,362.24 |
$2,220.00 |
$5,363.40 |
$1,526.85
|
|
Telethx isodose plan simple
|
$228.36 |
$1,310.00 |
$18,704.00 |
$877.09
|
|
Temozolomide
|
$2,527.00 |
$2,527.00 |
$2,527.00 |
$540.06
|
|
Temozolomide 100 mg intravenous solution
|
$5,143.07 |
$5,143.07 |
$5,143.07 |
$1,867.28
|
|
Temperature gradient studies
|
$614.60 |
$614.60 |
$614.60 |
$242.25
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$10,826.55 |
$10,826.55 |
$10,826.55 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$311.35 |
$312.05 |
$48,139.35 |
$14,951.87
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,175.00 |
$2,175.00 |
$3,664.50 |
$2,175.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$62.81 |
$62.81 |
$86.10 |
$39.33
|
|
Tert gene targeted seq alys
|
$327.50 |
$327.50 |
$504.00 |
$335.00
|
|
Test for chlorohydrocarbons
|
$8.91 |
$95.00 |
$136.50 |
$61.60
|
|
Test for urine cystines
|
$25.20 |
$25.20 |
$25.20 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$563.31 |
$1,180.00 |
$1,180.00 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$60.00 |
$60.00 |
$1,036.70 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$470.00 |
$800.00 |
$1,025.64 |
$953.40
|
|
Tetanus immune globulin inj
|
$878.38 |
$878.38 |
$4,977.17 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$50.16 |
$50.16 |
$6,205.45 |
$8,737.05
|
|
Tgsap so/hl 51/< rna alys
|
$3,505.00 |
$3,505.00 |
$6,744.50 |
$4,563.00
|
|
Thaw preserved stem cells
|
$6,462.57 |
$6,462.57 |
$6,462.57 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$39.93 |
$90.00 |
$243.60 |
$108.00
|
|
Therapeutic procd strg endur
|
$39.93 |
$60.00 |
$60.00 |
$85.68
|
|
Therapy activation ipnss
|
$195.00 |
$195.00 |
$195.00 |
$226.24
|
|
Therapy Activity Training (each 15 minutes)
|
$81.18 |
$85.00 |
$168.70 |
$101.85
|
