|
T3 (triiodothyronine) total
|
$276.60 |
$276.60 |
$276.60 |
$88.00
|
|
T4 (thyroxine) free
|
$252.60 |
$252.60 |
$252.60 |
$65.00
|
|
T4 (thyroxine) total
|
$177.60 |
$177.60 |
$177.60 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$393.00 |
$393.00 |
$393.00 |
$137.15
|
|
Target gsa panel organ/hmtlmph neop
|
$2,815.80 |
$2,815.80 |
$2,815.80 |
$3,567.96
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$649.43 |
$649.43 |
$649.43 |
$760.95
|
|
Tbs techl calculation only
|
$153.60 |
$153.60 |
$153.60 |
$119.66
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$340.20 |
$340.20 |
$340.20 |
$178.40
|
|
Tc-99m depreotide
|
$1,181.40 |
$1,181.40 |
$1,181.40 |
$1,937.35
|
|
Tc-99m disofenin
|
$72.00 |
$72.00 |
$72.00 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$2,393.40 |
$2,393.40 |
$2,393.40 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$2,236.65
|
|
Tc-99m labeled rbc
|
$302.40 |
$302.40 |
$302.40 |
$312.70
|
|
Tc-99m maa
|
$258.60 |
$258.60 |
$258.60 |
$306.60
|
|
Tc-99m mebrofenin
|
$58.80 |
$58.80 |
$58.80 |
$169.53
|
|
Tc-99m medronate
|
$69.00 |
$69.00 |
$69.00 |
$120.35
|
|
Tc-99m mertiatide
|
$465.60 |
$465.60 |
$465.60 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.00 |
$10.00
|
|
Tc-99m oxidronate
|
$63.60 |
$63.60 |
$63.60 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$222.60 |
$222.60 |
$222.60 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$17.40 |
$17.40 |
$17.40 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$55.80 |
$55.80 |
$55.80 |
$221.60
|
|
Tc-99m sulfur colloid
|
$239.40 |
$239.40 |
$239.40 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$375.60 |
$375.60 |
$375.60 |
$189.60
|
|
T cells absolute cd 4 count
|
$345.60 |
$345.60 |
$345.60 |
$120.25
|
|
T cells total count
|
$303.60 |
$303.60 |
$303.60 |
$126.90
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$240.21 |
$240.21 |
$240.21 |
$16,233.59
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,228.40 |
$2,228.40 |
$2,228.40 |
$1,985.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$39.33 |
$39.33 |
$39.33 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,380.60 |
$1,380.60 |
$1,380.60 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,073.02 |
$1,073.02 |
$1,073.02 |
$1,073.02
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$6,935.61 |
$6,935.61 |
$6,935.61 |
$6,935.61
|
|
Theophylline therapeutic drug level
|
$231.60 |
$231.60 |
$231.60 |
$101.40
|
|
Therapeutic procd strg endur
|
$145.80 |
$145.80 |
$145.80 |
$72.39
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$41.86 |
$41.86 |
$41.86 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,682.00 |
$2,682.00 |
$2,682.00 |
$1,658.70
|
|
Throat x-ray & fluoroscopy
|
$326.40 |
$326.40 |
$326.40 |
$188.00
|
|
Thrombin time
|
$153.00 |
$153.00 |
$153.00 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$173.40 |
$173.40 |
$173.40 |
$56.93
|
|
Thyroglobulin antibody
|
$235.20 |
$235.20 |
$235.20 |
$86.40
|
|
Thyroid imaging
|
$900.00 |
$900.00 |
$900.00 |
$577.80
|
|
Thyroid (TSH) Test
|
$295.80 |
$295.80 |
$295.80 |
$101.40
|
|
Thyroid Ultrasound
|
$520.20 |
$520.20 |
$520.20 |
$553.80
|
|
Thyroid uptake measurement
|
$583.80 |
$583.80 |
$583.80 |
$580.20
|
|
Thyrotropin releasing hormone
|
$484.80 |
$484.80 |
$484.80 |
$127.20
|
|
Thyroxine binding globulin (tbg)
|
$173.40 |
$173.40 |
$173.40 |
$75.00
|
|
Tissue culture placenta
|
$537.00 |
$537.00 |
$537.00 |
$470.00
|
|
Tissue culture skin/biopsy
|
$828.00 |
$828.00 |
$828.00 |
$626.77
|
|
Tissue culture tumor
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$605.60
|
|
Tissue exam koh skin/hair/nails
|
$135.60 |
$135.60 |
$135.60 |
$45.23
|
|
Tissue transglutaminase iga
|
$25.80 |
$25.80 |
$25.80 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$24.60 |
$24.60 |
$24.60 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$39.35 |
$39.35 |
$39.35 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$313.20 |
$313.20 |
$313.20 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,669.70 |
$1,669.70 |
$1,669.70 |
$2,743.02
|
|
Tomosynthesis breast screen bilateral
|
$53.40 |
$53.40 |
$53.40 |
$77.46
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$200.93 |
$200.93 |
$200.93 |
$200.93
|
|
Toxoplasma antibody igg
|
$194.40 |
$194.40 |
$194.40 |
$83.20
|
|
Toxoplasma antibody igm
|
$219.00 |
$219.00 |
$219.00 |
$85.80
|
|
Trabectedin 1 mg intravenous solution
|
$6,133.80 |
$6,133.80 |
$6,133.80 |
$2,653.88
|
|
Transferrin
|
$244.20 |
$244.20 |
$244.20 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$1,477.20 |
$1,477.20 |
$1,477.20 |
$988.24
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$15.70 |
$15.70 |
$15.70 |
$43.28
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$226.20 |
$226.20 |
$226.20 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$58.80 |
$58.80 |
$58.80 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$141.60 |
$141.60 |
$141.60 |
$197.60
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$200.64 |
$200.64 |
$200.64 |
$200.64
|
|
Treponema pallidum antibody
|
$89.40 |
$89.40 |
$89.40 |
$74.40
|
|
Trg gene rearrangement anal
|
$485.40 |
$485.40 |
$485.40 |
$474.50
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$205.13 |
$205.13 |
$205.13 |
$28.90
|
|
Triamcinolone a inj prs-free
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$696.00
|
|
Trichomonas assay w/optic
|
$189.60 |
$189.60 |
$189.60 |
$68.90
|
|
Triglycerides
|
$126.00 |
$126.00 |
$126.00 |
$48.75
|
|
Trimethobenzamide hcl inj
|
$120.73 |
$120.73 |
$120.73 |
$105.89
|
|
Troponin quantitative
|
$265.80 |
$265.80 |
$265.80 |
$112.80
|
|
Tympanometry & reflex thresh
|
$88.80 |
$88.80 |
$88.80 |
$170.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$479.40 |
$479.40 |
$479.40 |
$394.20
|
|
Ultrasound bone density measure
|
$111.60 |
$111.60 |
$111.60 |
$116.22
|
|
Ultrasound breast complete
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$798.00 |
$798.00 |
$798.00 |
$427.00
|
|
Ultrasound chest
|
$410.40 |
$410.40 |
$410.40 |
$430.10
|
|
Ultrasound dx ophth b-scan
|
$298.20 |
$298.20 |
$298.20 |
$335.68
|
|
Ultrasound exam k transpl w/doppler
|
$575.40 |
$575.40 |
$575.40 |
$494.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$604.20 |
$604.20 |
$604.20 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$432.60 |
$432.60 |
$432.60 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$589.80 |
$589.80 |
$589.80 |
$629.64
|
|
Ultrasound guide intraoperative
|
$603.00 |
$603.00 |
$603.00 |
$628.80
|
|
Ultrasound hips infant dynamic
|
$188.40 |
$188.40 |
$188.40 |
$395.20
|
|
Ultrasound infant hips ltd without stress
|
$113.40 |
$113.40 |
$113.40 |
$311.25
|
|
Ultrasound joint complete left
|
$475.80 |
$475.80 |
$475.80 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$383.40 |
$383.40 |
$383.40 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$435.00 |
$435.00 |
$435.00 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$241.80 |
$241.80 |
$241.80 |
$304.80
|
|
Ultrasound pregnant uterus follow up per fetus
|
$476.40 |
$476.40 |
$476.40 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$481.20 |
$481.20 |
$481.20 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$425.40 |
$425.40 |
$425.40 |
$477.10
|
|
Ultrasound retroperitoneal limited
|
$475.20 |
$475.20 |
$475.20 |
$469.58
|
|
Ultrasound scrotum and contents
|
$552.60 |
$552.60 |
$552.60 |
$558.03
|
|
Ultrasound transvaginal non obstetric
|
$481.20 |
$481.20 |
$481.20 |
$523.20
|
