|
Susceptibility mic per plate
|
$60.00 |
$60.00 |
$60.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$75.00 |
$75.00 |
$75.00 |
$59.28
|
|
Svc venogram s&i
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$200.00 |
$200.00 |
$200.00 |
$316.80
|
|
Swallowing Therapy Session
|
$200.00 |
$200.00 |
$200.00 |
$232.56
|
|
Sweat collection by iontophoresis
|
$177.50 |
$177.50 |
$177.50 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$37.50 |
$37.50 |
$37.50 |
$42.24
|
|
System cardiomems hosp electronics
|
$38,156.25 |
$38,156.25 |
$38,156.25 |
$38,234.70
|
|
System pacing micra av
|
$26,251.50 |
$26,251.50 |
$26,251.50 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,244.40 |
$6,244.40 |
$6,244.40 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$82.50 |
$82.50 |
$82.50 |
$100.32
|
|
T3 (triiodothyronine) total
|
$62.50 |
$62.50 |
$62.50 |
$93.52
|
|
T4 (thyroxine) free
|
$65.00 |
$65.00 |
$65.00 |
$89.60
|
|
T4 (thyroxine) total
|
$85.00 |
$85.00 |
$85.00 |
$70.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$25.76 |
$25.76 |
$25.76 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$122.50 |
$122.50 |
$122.50 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$237.50 |
$237.50 |
$237.50 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,320.00 |
$2,320.00 |
$2,320.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,385.00 |
$3,385.00 |
$3,385.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,270.00 |
$2,270.00 |
$2,270.00 |
$1,701.91
|
|
Tas congenital car anomal
|
$1,610.00 |
$1,610.00 |
$1,610.00 |
$6,003.27
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$290.00 |
$290.00 |
$290.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$247.50 |
$247.50 |
$247.50 |
$179.95
|
|
Tc-99m maa
|
$222.50 |
$222.50 |
$222.50 |
$312.06
|
|
Tc-99m mebrofenin
|
$122.50 |
$122.50 |
$122.50 |
$157.65
|
|
Tc-99m mertiatide
|
$352.50 |
$352.50 |
$352.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$5.00 |
$8.00
|
|
Tc-99m pentetate dtpa aerosol
|
$168.00 |
$168.00 |
$168.00 |
$191.50
|
|
Tc-99m sestamibi p study dose
|
$345.00 |
$345.00 |
$345.00 |
$287.20
|
|
Tc-99m tetrofosmin p study dose
|
$200.00 |
$200.00 |
$200.00 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$450.00 |
$450.00 |
$450.00 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$237.50 |
$237.50 |
$237.50 |
$184.00
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$95.00 |
$111.20
|
|
T cells total count
|
$187.50 |
$187.50 |
$187.50 |
$130.20
|
|
Teaec w/wo patch graft iliofemoral
|
$6,120.00 |
$6,120.00 |
$6,120.00 |
$7,365.12
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$37.50 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,930.00 |
$1,930.00 |
$1,930.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,135.00 |
$1,135.00 |
$1,135.00 |
$880.61
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$372.05 |
$372.05 |
$372.05 |
$14,951.87
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$2,175.00
|
|
Tert gene targeted seq alys
|
$327.50 |
$327.50 |
$327.50 |
$335.00
|
|
Test for chlorohydrocarbons
|
$95.00 |
$95.00 |
$95.00 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$1,180.00 |
$1,180.00 |
$1,180.00 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$60.00 |
$60.00 |
$60.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$970.00 |
$970.00 |
$970.00 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$3,505.00 |
$3,505.00 |
$3,505.00 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$60.00 |
$60.00 |
$60.00 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$85.00 |
$85.00 |
$85.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$85.00 |
$85.00 |
$85.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$55.00 |
$55.00 |
$55.00 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$47.50 |
$47.50 |
$47.50 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$51.43 |
$51.43 |
$51.43 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$375.00 |
$375.00 |
$375.00 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,215.00 |
$1,215.00 |
$1,215.00 |
$1,724.25
|
|
Thoracotomy with cardiac massage
|
$1,130.00 |
$1,130.00 |
$1,130.00 |
$2,138.76
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$3,260.00 |
$3,260.00 |
$3,260.00 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,950.00 |
$6,950.00 |
$6,950.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$12,785.00 |
$12,785.00 |
$12,785.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$19,340.00 |
$19,340.00 |
$19,340.00 |
$21,413.60
|
|
Thrombin time
|
$40.00 |
$40.00 |
$40.00 |
$54.18
|
|
Thromboendarterectomy common femoral
|
$6,120.00 |
$6,120.00 |
$6,120.00 |
$3,987.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$47.50 |
$47.50 |
$47.50 |
$62.01
|
|
Thyroglobulin antibody
|
$72.50 |
$72.50 |
$72.50 |
$82.50
|
|
Thyroid imaging
|
$795.00 |
$795.00 |
$795.00 |
$695.60
|
|
Thyroid mets imag whole body
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,524.99
|
|
Thyroid met uptake
|
$380.00 |
$380.00 |
$380.00 |
$407.40
|
|
Thyroid (TSH) Test
|
$110.00 |
$110.00 |
$110.00 |
$112.70
|
|
Thyroid Ultrasound
|
$645.00 |
$645.00 |
$645.00 |
$588.50
|
|
Thyroid uptake measurement
|
$720.00 |
$720.00 |
$720.00 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$90.00 |
$90.00 |
$90.00 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$19,260.00 |
$19,260.00 |
$19,260.00 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$8,110.00 |
$8,110.00 |
$8,110.00 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$12,855.00 |
$12,855.00 |
$12,855.00 |
$10,131.15
|
|
Tilt table study
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,561.82
|
|
Tis cgen car anomal 1st shnt
|
$6,930.00 |
$6,930.00 |
$6,930.00 |
$9,216.90
|
|
Tis cgen car anomal ea addl
|
$3,470.00 |
$3,470.00 |
$3,470.00 |
$6,546.38
|
|
Tissue culture placenta
|
$470.00 |
$470.00 |
$470.00 |
$453.00
|
|
Tissue culture skin/biopsy
|
$775.00 |
$775.00 |
$775.00 |
$488.74
|
|
Tissue culture tumor
|
$740.00 |
$740.00 |
$740.00 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$22.50 |
$22.50 |
$22.50 |
$47.40
|
|
Tissue transglutaminase iga
|
$75.00 |
$75.00 |
$75.00 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$92.50 |
$92.50 |
$92.50 |
$120.60
|
|
Toe X-ray (both feet)
|
$265.00 |
$265.00 |
$265.00 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$152.50 |
$152.50 |
$152.50 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$152.50 |
$152.50 |
$152.50 |
$74.10
|
|
Total tau
|
$312.50 |
$312.50 |
$312.50 |
$312.50
|
|
Toxoplasma antibody igg
|
$97.50 |
$97.50 |
$97.50 |
$91.65
|
|
Toxoplasma antibody igm
|
$90.00 |
$90.00 |
$90.00 |
$87.75
|
|
Tp53 gene trgt sequence alys
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$804.00
|
|
Tpmt gene com vrnts
|
$307.50 |
$307.50 |
$307.50 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$105.00 |
$105.00 |
$105.00 |
$102.27
|
|
Transcath biopsy
|
$4,090.00 |
$4,090.00 |
$4,090.00 |
$4,285.93
|
|
Transcath closure of asd
|
$19,260.00 |
$19,260.00 |
$19,260.00 |
$17,041.80
|
|
Transcatheter bx s&i
|
$1,580.00 |
$1,580.00 |
$1,580.00 |
$1,950.85
|
|
Transcath occlusion cns
|
$2,840.00 |
$2,840.00 |
$2,840.00 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$12,495.00 |
$12,495.00 |
$12,495.00 |
$10,270.00
|
|
Transferrin
|
$70.00 |
$70.00 |
$70.00 |
$82.00
|
|
Transplant forearm tendon
|
$3,630.00 |
$3,630.00 |
$3,630.00 |
$3,630.00
|
