|
Sulfonylurea screen qn-sendout
|
$262.50 |
$262.50 |
$262.50 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$283.85 |
$283.85 |
$283.85 |
$114.88
|
|
Surg dx exam anorectal
|
$18,925.92 |
$18,925.92 |
$18,925.92 |
$3,245.23
|
|
Surgical pathology level 1 gross examination only
|
$29,867.51 |
$29,867.51 |
$29,867.51 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$31,214.48 |
$31,214.48 |
$31,214.48 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$29,541.61 |
$29,541.61 |
$29,541.61 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$8,605.29 |
$8,605.29 |
$8,605.29 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$26,330.04 |
$26,330.04 |
$26,330.04 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$87,273.82 |
$87,273.82 |
$87,273.82 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$114.10 |
$114.10 |
$114.10 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$86.80 |
$86.80 |
$86.80 |
$35.70
|
|
Susceptibility mic per plate
|
$744.10 |
$744.10 |
$744.10 |
$106.00
|
|
Svc venogram s&i
|
$2,644.60 |
$2,644.60 |
$2,644.60 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.30 |
$76.30 |
$76.30 |
$41.60
|
|
System cardiomems hosp electronics
|
$95,189.64 |
$95,189.64 |
$95,189.64 |
$39,037.95
|
|
System pacing micra av
|
$59,798.62 |
$59,798.62 |
$59,798.62 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$19,363.04 |
$19,363.04 |
$19,363.04 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$168.70 |
$168.70 |
$168.70 |
$99.20
|
|
T3 (triiodothyronine) total
|
$113.40 |
$113.40 |
$113.40 |
$93.52
|
|
T4 (thyroxine) free
|
$121.10 |
$121.10 |
$121.10 |
$85.20
|
|
T4 (thyroxine) total
|
$75.60 |
$75.60 |
$75.60 |
$69.00
|
|
Tacrol envarsus ex rel oral
|
$220.15 |
$220.15 |
$220.15 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$94.50 |
$94.50 |
$94.50 |
$9.84
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,235.32 |
$1,235.32 |
$1,235.32 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$173.60 |
$173.60 |
$173.60 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$7,592.37 |
$7,592.37 |
$7,592.37 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$33,777.27 |
$33,777.27 |
$33,777.27 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$2,246.30 |
$2,246.30 |
$2,246.30 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$7,585.20 |
$7,585.20 |
$7,585.20 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,963.50 |
$1,963.50 |
$1,963.50 |
$1,655.52
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$43,855.00 |
$43,855.00 |
$43,855.00 |
$24,217.20
|
|
Tas congenital car anomal
|
$11,511.50 |
$11,511.50 |
$11,511.50 |
$6,003.27
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,719.85 |
$2,719.85 |
$2,719.85 |
$937.50
|
|
Tbp gene detc abnor alleles
|
$316.40 |
$316.40 |
$316.40 |
$225.42
|
|
Tbs techl calculation only
|
$196.00 |
$196.00 |
$196.00 |
$153.60
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$227.50 |
$227.50 |
$227.50 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$232.40 |
$232.40 |
$232.40 |
$177.65
|
|
Tc-99m bicisate
|
$5,133.10 |
$5,133.10 |
$5,133.10 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$4,007.50 |
$4,007.50 |
$4,007.50 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$4,383.40 |
$4,383.40 |
$4,383.40 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$581.00 |
$581.00 |
$581.00 |
$302.40
|
|
Tc-99m maa
|
$1,454.60 |
$1,454.60 |
$1,454.60 |
$292.80
|
|
Tc-99m mebrofenin
|
$275.10 |
$275.10 |
$275.10 |
$157.65
|
|
Tc-99m medronate
|
$220.50 |
$220.50 |
$220.50 |
$111.01
|
|
Tc-99m mertiatide
|
$2,244.20 |
$2,244.20 |
$2,244.20 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$9.10 |
$9.10 |
$9.10 |
$6.60
|
|
Tc-99m oxidronate
|
$256.20 |
$256.20 |
$256.20 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$1,134.70 |
$1,134.70 |
$1,134.70 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$4.20 |
$4.20 |
$4.20 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$333.90 |
$333.90 |
$333.90 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$581.00 |
$581.00 |
$581.00 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$1,318.10 |
$1,318.10 |
$1,318.10 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$1,098.30 |
$1,098.30 |
$1,098.30 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$339.50 |
$339.50 |
$339.50 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$985.60 |
$985.60 |
$985.60 |
$955.60
|
|
Tcd emboli detect w/inj
|
$1,429.40 |
$1,429.40 |
$1,429.40 |
$475.80
|
|
Tcd emboli detect without inj
|
$835.10 |
$835.10 |
$835.10 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$214.20 |
$214.20 |
$214.20 |
$176.40
|
|
T cells total count
|
$156.80 |
$156.80 |
$156.80 |
$126.90
|
|
Teaec w/wo patch graft iliofemoral
|
$8,627.50 |
$8,627.50 |
$8,627.50 |
$5,163.60
|
|
Telehealth original site facility fee
|
$60.90 |
$60.90 |
$60.90 |
$51.00
|
|
Telethx isodose plan cplx
|
$21,744.80 |
$21,744.80 |
$21,744.80 |
$1,526.85
|
|
Telethx isodose plan simple
|
$12,985.00 |
$12,985.00 |
$12,985.00 |
$873.62
|
|
Temperature gradient studies
|
$614.60 |
$614.60 |
$614.60 |
$242.25
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$13,645.27 |
$13,645.27 |
$13,645.27 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$22,485.05 |
$22,485.05 |
$22,485.05 |
$15,245.38
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$3,664.50 |
$3,664.50 |
$3,664.50 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$86.10 |
$86.10 |
$86.10 |
$39.33
|
|
Tert gene targeted seq alys
|
$428.40 |
$428.40 |
$428.40 |
$335.00
|
|
Test for chlorohydrocarbons
|
$136.50 |
$136.50 |
$136.50 |
$65.00
|
|
Test for urine cystines
|
$25.20 |
$25.20 |
$25.20 |
$26.00
|
|
Test pathogen(s) for platelets reference
|
$1,036.70 |
$1,036.70 |
$1,036.70 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$648.20 |
$648.20 |
$648.20 |
$949.70
|
|
Tetanus immune globulin inj
|
$3,531.67 |
$3,531.67 |
$3,531.67 |
$1,285.36
|
|
Tgsap so/hl 51/< rna alys
|
$6,744.50 |
$6,744.50 |
$6,744.50 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$110.60 |
$110.60 |
$110.60 |
$108.00
|
|
Therapeutic procd strg endur
|
$37.10 |
$37.10 |
$37.10 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$40.60 |
$40.60 |
$40.60 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$42.70 |
$42.70 |
$42.70 |
$50.00
|
|
Ther fx nasal inf turbinate
|
$20,210.41 |
$20,210.41 |
$20,210.41 |
$3,786.00
|
|
Ther nma rdctj intus/obstrcj
|
$519.40 |
$519.40 |
$519.40 |
$529.08
|
|
Ther/proph/diag inj ia
|
$356.30 |
$356.30 |
$356.30 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$100.80 |
$100.80 |
$100.80 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,419.01 |
$2,419.01 |
$2,419.01 |
$1,687.50
|
|
Thoracoscopy diagnostic 32601
|
$11,188.10 |
$11,188.10 |
$11,188.10 |
$6,442.80
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$27,052.20 |
$27,052.20 |
$27,052.20 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$21,413.60
|
|
Thrombin time
|
$64.40 |
$64.40 |
$64.40 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$16,705.50 |
$16,705.50 |
$16,705.50 |
$3,980.60
|
|
Thromboendarterectomy sfa
|
$4,185.30 |
$4,185.30 |
$4,185.30 |
$4,185.30
|
|
Thromboplastin inhibition
|
$87.50 |
$87.50 |
$87.50 |
$53.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$84.70 |
$84.70 |
$84.70 |
$61.52
|
|
Thyroglobulin antibody
|
$274.40 |
$274.40 |
$274.40 |
$82.00
|
|
Thyroid mets imag whole body
|
$879.90 |
$879.90 |
$879.90 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$162.40 |
$162.40 |
$162.40 |
$111.00
|
|
Thyroid Ultrasound
|
$1,343.30 |
$1,343.30 |
$1,343.30 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$6,276.72 |
$6,276.72 |
$6,276.72 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$79.80 |
$79.80 |
$79.80 |
$64.35
|
|
Tib/per revasc w/ather add-on 37233
|
$84,670.31 |
$84,670.31 |
$84,670.31 |
$9,769.65
|
|
Tigecycline injection
|
$134.05 |
$134.05 |
$134.05 |
$234.00
|
