|
Target gsa panel organ/hmtlmph neop
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$3,678.78
|
|
Target gsa panel organ neop
|
$4,714.40 |
$4,714.40 |
$4,714.40 |
$1,643.25
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$349.60 |
$349.60 |
$349.60 |
$175.00
|
|
T cells absolute cd4/cd8 including ratio
|
$376.80 |
$376.80 |
$376.80 |
$175.00
|
|
T cells absolute cd 4 count
|
$272.80 |
$272.80 |
$272.80 |
$110.00
|
|
T cells total count
|
$259.20 |
$259.20 |
$259.20 |
$123.00
|
|
Telehealth original site facility fee
|
$60.00 |
$60.00 |
$60.00 |
$49.80
|
|
Tert gene targeted seq alys
|
$3,325.60 |
$3,325.60 |
$3,325.60 |
$335.00
|
|
Test stress cardiovascular tracing only
|
$1,341.60 |
$1,341.60 |
$1,341.60 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$9,375.20 |
$9,375.20 |
$9,375.20 |
$3,505.00
|
|
Theophylline therapeutic drug level
|
$260.00 |
$260.00 |
$260.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$53.60 |
$53.60 |
$53.60 |
$83.16
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$83.20 |
$83.20 |
$83.20 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$72.00 |
$72.00 |
$72.00 |
$50.00
|
|
Ther/proph/diag inj ia
|
$249.60 |
$249.60 |
$249.60 |
$237.75
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,747.20 |
$2,747.20 |
$2,747.20 |
$1,687.50
|
|
Thrombin time
|
$141.60 |
$141.60 |
$141.60 |
$53.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$246.40 |
$246.40 |
$246.40 |
$60.39
|
|
Thyroglobulin antibody
|
$160.80 |
$160.80 |
$160.80 |
$81.90
|
|
Thyroid imaging
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$673.01
|
|
Thyroid (TSH) Test
|
$192.00 |
$192.00 |
$192.00 |
$112.00
|
|
Thyroid Ultrasound
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$108.00 |
$108.00 |
$108.00 |
$64.92
|
|
Tissue culture placenta
|
$1,722.40 |
$1,722.40 |
$1,722.40 |
$462.80
|
|
Tissue culture skin/biopsy
|
$1,976.80 |
$1,976.80 |
$1,976.80 |
$518.40
|
|
Tissue culture tumor
|
$4,800.00 |
$4,800.00 |
$4,800.00 |
$513.00
|
|
Tissue exam koh skin/hair/nails
|
$156.80 |
$156.80 |
$156.80 |
$47.40
|
|
Tixagev and cilgav inj
|
$131.20 |
$131.20 |
$131.20 |
$216.70
|
|
Tobramycin peak therapeutic drug level
|
$340.00 |
$340.00 |
$340.00 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$202.40 |
$202.40 |
$202.40 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$117.60 |
$117.60 |
$117.60 |
$70.89
|
|
Total tau
|
$444.00 |
$444.00 |
$444.00 |
$297.70
|
|
Toxoplasma antibody igg
|
$263.20 |
$263.20 |
$263.20 |
$89.57
|
|
Toxoplasma antibody igm
|
$263.20 |
$263.20 |
$263.20 |
$87.00
|
|
Tp53 gene full gene sequence
|
$932.80 |
$932.80 |
$932.80 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$1,397.60 |
$1,397.60 |
$1,397.60 |
$823.00
|
|
Tpmt gene com vrnts
|
$1,671.20 |
$1,671.20 |
$1,671.20 |
$373.00
|
|
Trabeculoplasty laser surg
|
$3,662.40 |
$3,662.40 |
$3,662.40 |
$1,224.00
|
|
Tracheostoma revision; simple, without flap rotation
|
$5,836.00 |
$5,836.00 |
$5,836.00 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$126.40 |
$126.40 |
$126.40 |
$101.58
|
|
Transcath biopsy
|
$4,604.00 |
$4,604.00 |
$4,604.00 |
$4,285.93
|
|
Transcath occlusion cns
|
$15,388.00 |
$15,388.00 |
$15,388.00 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$9,509.60 |
$9,509.60 |
$9,509.60 |
$10,416.60
|
|
Transferrin
|
$178.40 |
$178.40 |
$178.40 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$2,048.80 |
$2,048.80 |
$2,048.80 |
$937.30
|
|
Treat clavicle dislocation 23545
|
$9,136.80 |
$9,136.80 |
$9,136.80 |
$705.60
|
|
Treat elbow fracture
|
$1,297.60 |
$1,297.60 |
$1,297.60 |
$1,919.00
|
|
Treat finger fracture each
|
$7,821.60 |
$7,821.60 |
$7,821.60 |
$1,593.00
|
|
Treat foot dislocation
|
$4,178.40 |
$4,178.40 |
$4,178.40 |
$419.73
|
|
Treat foot dislocation
|
$7,013.60 |
$7,013.60 |
$7,013.60 |
$466.14
|
|
Treat foot dislocation
|
$7,013.60 |
$7,013.60 |
$7,013.60 |
$445.00
|
|
Treat fracture of radius
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$1,790.00
|
|
Treat hip dislocation
|
$2,199.20 |
$2,199.20 |
$2,199.20 |
$2,132.50
|
|
Treat humerus fracture
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$1,772.97
|
|
Treat knee dislocation
|
$1,297.60 |
$1,297.60 |
$1,297.60 |
$2,126.80
|
|
Treat knee fracture 27530
|
$13,269.60 |
$13,269.60 |
$13,269.60 |
$535.60
|
|
Treat knee fracture(s)
|
$15,773.60 |
$15,773.60 |
$15,773.60 |
$642.55
|
|
Treat lower leg dislocation
|
$8,728.80 |
$8,728.80 |
$8,728.80 |
$530.75
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$216.00 |
$216.00 |
$216.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$203.20 |
$203.20 |
$203.20 |
$141.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$116.00 |
$116.00 |
$116.00 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$1,035.20 |
$1,035.20 |
$1,035.20 |
$515.20
|
|
Treatment of fibula fracture 27780
|
$872.80 |
$872.80 |
$872.80 |
$478.40
|
|
Treatment of heel fracture 28400
|
$929.60 |
$929.60 |
$929.60 |
$473.00
|
|
Treatment of thigh fracture
|
$23,257.60 |
$23,257.60 |
$23,257.60 |
$477.75
|
|
Treatment of thigh fracture
|
$11,798.40 |
$11,798.40 |
$11,798.40 |
$591.20
|
|
Treatment of thigh fracture
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,790.00
|
|
Treatment of toe fracture 28510
|
$2,248.80 |
$2,248.80 |
$2,248.80 |
$342.65
|
|
Treat sternum fracture
|
$2,799.20 |
$2,799.20 |
$2,799.20 |
$432.64
|
|
Treat thigh fracture
|
$9,488.80 |
$9,488.80 |
$9,488.80 |
$1,884.74
|
|
Treat thigh fracture
|
$14,132.00 |
$14,132.00 |
$14,132.00 |
$618.80
|
|
Treat thigh fx growth plate
|
$11,897.60 |
$11,897.60 |
$11,897.60 |
$466.14
|
|
Treat ulnar fracture
|
$5,969.60 |
$5,969.60 |
$5,969.60 |
$1,672.00
|
|
Treat vaginal bleeding
|
$1,433.60 |
$1,433.60 |
$1,433.60 |
$379.60
|
|
Treat wrist dislocation
|
$375.20 |
$375.20 |
$375.20 |
$656.25
|
|
Treponema pallidum antibody
|
$185.60 |
$185.60 |
$185.60 |
$70.85
|
|
Triglycerides
|
$120.00 |
$120.00 |
$120.00 |
$57.85
|
|
Trim nondyst nails
|
$92.80 |
$92.80 |
$92.80 |
$115.70
|
|
Trmt of fracture (femoral shaft) 27500
|
$21,961.60 |
$21,961.60 |
$21,961.60 |
$754.80
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,604.80 |
$4,604.80 |
$4,604.80 |
$5,006.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$4,250.25
|
|
Trnscath tx thromblytc vein ini day
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$3,866.70
|
|
Troponin quantitative
|
$285.60 |
$285.60 |
$285.60 |
$128.80
|
|
Tx atrial fib pulm vein isol
|
$20,412.80 |
$20,412.80 |
$20,412.80 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$797.60 |
$797.60 |
$797.60 |
$547.20
|
|
Tx closed tib shaft fx without manip
|
$8,405.60 |
$8,405.60 |
$8,405.60 |
$535.60
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$394.20
|
|
Ultrasound breast complete
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$533.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$455.26
|
|
Ultrasound chest
|
$750.40 |
$750.40 |
$750.40 |
$451.52
|
|
Ultrasound exam k transpl w/doppler
|
$877.60 |
$877.60 |
$877.60 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$786.40 |
$786.40 |
$786.40 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$795.20 |
$795.20 |
$795.20 |
$379.36
|
|
Ultrasound guided needle placement supervision & interpretation
|
$504.00 |
$504.00 |
$504.00 |
$720.00
|
|
Ultrasound joint complete left
|
$1,784.80 |
$1,784.80 |
$1,784.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,784.80 |
$1,784.80 |
$1,784.80 |
$418.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,093.60 |
$2,093.60 |
$2,093.60 |
$397.15
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$693.00
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,012.00 |
$1,012.00 |
$1,012.00 |
$420.80
|
