|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$220.50 |
$220.50 |
$220.50 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$8.64 |
$8.64 |
$8.64 |
$94.19
|
|
Supprelin la implant
|
$130,070.77 |
$130,070.77 |
$130,070.77 |
$80,935.72
|
|
Surgical pathology level 1 gross examination only
|
$159.84 |
$159.84 |
$159.84 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$262.80 |
$262.80 |
$262.80 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$338.40 |
$338.40 |
$338.40 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$340.56 |
$340.56 |
$340.56 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$695.52 |
$695.52 |
$695.52 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$894.96 |
$894.96 |
$894.96 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$100.08 |
$100.08 |
$100.08 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$36.72 |
$36.72 |
$36.72 |
$35.70
|
|
Susceptibility mic per plate
|
$732.96 |
$732.96 |
$732.96 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$74.88 |
$74.88 |
$74.88 |
$59.28
|
|
Svc venogram s&i
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$192.24 |
$192.24 |
$192.24 |
$41.60
|
|
System cardiomems hosp electronics
|
$41,842.08 |
$41,842.08 |
$41,842.08 |
$39,037.95
|
|
System pacing micra av
|
$29,520.00 |
$29,520.00 |
$29,520.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$12,852.00 |
$12,852.00 |
$12,852.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$72.00 |
$72.00 |
$72.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$198.72 |
$198.72 |
$198.72 |
$93.52
|
|
T4 (thyroxine) free
|
$159.12 |
$159.12 |
$159.12 |
$85.20
|
|
T4 (thyroxine) total
|
$68.40 |
$68.40 |
$68.40 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.84 |
$12.84 |
$12.84 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$64.80 |
$64.80 |
$64.80 |
$122.40
|
|
Tap block bilat cont infusion 64489
|
$195.12 |
$195.12 |
$195.12 |
$1,407.60
|
|
Tap block uni by cont infusion 64487
|
$195.12 |
$195.12 |
$195.12 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$3,023.28 |
$3,023.28 |
$3,023.28 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$5,340.96 |
$5,340.96 |
$5,340.96 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,700.72 |
$2,700.72 |
$2,700.72 |
$1,655.52
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$3,888.00 |
$3,888.00 |
$3,888.00 |
$24,217.20
|
|
Tavr perq femoral
|
$39,347.28 |
$39,347.28 |
$39,347.28 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,648.87 |
$1,648.87 |
$1,648.87 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$238.32 |
$238.32 |
$238.32 |
$177.65
|
|
Tc-99m non-heu per study dose
|
$18.72 |
$18.72 |
$18.72 |
$6.60
|
|
T cells absolute cd4/cd8 including ratio
|
$250.56 |
$250.56 |
$250.56 |
$176.40
|
|
T cells absolute cd 4 count
|
$186.48 |
$186.48 |
$186.48 |
$111.20
|
|
T cells total count
|
$191.52 |
$191.52 |
$191.52 |
$126.90
|
|
Telavancin injection
|
$22.07 |
$22.07 |
$22.07 |
$1,191.80
|
|
Telehealth original site facility fee
|
$73.44 |
$73.44 |
$73.44 |
$51.00
|
|
Telethx isodose plan cplx
|
$2,193.12 |
$2,193.12 |
$2,193.12 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,689.84 |
$1,689.84 |
$1,689.84 |
$873.62
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$430.13 |
$430.13 |
$430.13 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$85.10 |
$85.10 |
$85.10 |
$39.33
|
|
Tert gene targeted seq alys
|
$1,023.12 |
$1,023.12 |
$1,023.12 |
$335.00
|
|
Test for porphobilinogen
|
$82.08 |
$82.08 |
$82.08 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$1,711.44 |
$1,711.44 |
$1,711.44 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,388.88 |
$1,388.88 |
$1,388.88 |
$949.70
|
|
Tetanus immune globulin inj
|
$1,682.64 |
$1,682.64 |
$1,682.64 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$57.71 |
$57.71 |
$57.71 |
$8,737.05
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$93.60 |
$93.60 |
$93.60 |
$108.00
|
|
Therapeutic procd strg endur
|
$75.60 |
$75.60 |
$75.60 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$106.56 |
$106.56 |
$106.56 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$61.20 |
$61.20 |
$61.20 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$483.84 |
$483.84 |
$483.84 |
$529.08
|
|
Ther radiology tx plng cplx
|
$851.76 |
$851.76 |
$851.76 |
$332.00
|
|
Ther radiology tx plng smpl
|
$347.04 |
$347.04 |
$347.04 |
$148.80
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$43.20 |
$43.20 |
$43.20 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,592.80 |
$3,592.80 |
$3,592.80 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$2,140.56 |
$2,140.56 |
$2,140.56 |
$2,138.76
|
|
Thorax stereo rad targetw/tx
|
$1,697.76 |
$1,697.76 |
$1,697.76 |
$529.60
|
|
Thrombectmy crnry perq mechanical
|
$16,476.48 |
$16,476.48 |
$16,476.48 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$12,315.60 |
$12,315.60 |
$12,315.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$28,185.12 |
$28,185.12 |
$28,185.12 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$42,554.88 |
$42,554.88 |
$42,554.88 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$31,444.56 |
$31,444.56 |
$31,444.56 |
$5,520.00
|
|
Thrombin time
|
$78.48 |
$78.48 |
$78.48 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$11,663.28 |
$11,663.28 |
$11,663.28 |
$3,980.60
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$992.16 |
$992.16 |
$992.16 |
$4,585.00
|
|
Thromboendarterectomy sfa
|
$18,397.44 |
$18,397.44 |
$18,397.44 |
$4,185.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$54.00 |
$54.00 |
$54.00 |
$61.52
|
|
Thyroglobulin antibody
|
$64.08 |
$64.08 |
$64.08 |
$82.00
|
|
Thyroid mets imag whole body
|
$3,352.32 |
$3,352.32 |
$3,352.32 |
$1,524.99
|
|
Thyroid met uptake
|
$748.08 |
$748.08 |
$748.08 |
$398.40
|
|
Thyroid (TSH) Test
|
$159.12 |
$159.12 |
$159.12 |
$111.00
|
|
Thyroid Ultrasound
|
$878.40 |
$878.40 |
$878.40 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$5,241.35 |
$5,241.35 |
$5,241.35 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$48.24 |
$48.24 |
$48.24 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$41,615.28 |
$41,615.28 |
$41,615.28 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$28,926.72 |
$28,926.72 |
$28,926.72 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$31,739.04 |
$31,739.04 |
$31,739.04 |
$9,769.65
|
|
Tigecycline injection
|
$12.17 |
$12.17 |
$12.17 |
$234.00
|
|
Tilt table study
|
$2,758.32 |
$2,758.32 |
$2,758.32 |
$1,507.01
|
|
Tissue culture placenta
|
$523.44 |
$523.44 |
$523.44 |
$457.00
|
|
Tissue culture skin/biopsy
|
$409.68 |
$409.68 |
$409.68 |
$484.00
|
|
Tissue culture tumor
|
$498.24 |
$498.24 |
$498.24 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$76.32 |
$76.32 |
$76.32 |
$47.20
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$7,560.00 |
$7,560.00 |
$7,560.00 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$95.76 |
$95.76 |
$95.76 |
$44.16
|
|
Tixagev and cilgav inj
|
$325.44 |
$325.44 |
$325.44 |
$224.55
|
|
Tlso 2 shl symphys-stern cst
|
$565.20 |
$565.20 |
$565.20 |
$1,808.59
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$43.20 |
$43.20 |
$43.20 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$141.84 |
$141.84 |
$141.84 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$17.21 |
$17.21 |
$17.21 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$95.76 |
$95.76 |
$95.76 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$105.12 |
$105.12 |
$105.12 |
$72.68
|
|
Total tau
|
$511.20 |
$511.20 |
$511.20 |
$312.50
|
|
Toxoplasma antibody igg
|
$121.68 |
$121.68 |
$121.68 |
$89.40
|
|
Toxoplasma antibody igm
|
$54.72 |
$54.72 |
$54.72 |
$87.00
|
|
Tp53 gene full gene sequence
|
$1,691.28 |
$1,691.28 |
$1,691.28 |
$709.80
|
