|
Tc-99m labeled rbc
|
$88.76 |
$302.40 |
$1,333.86 |
|
|
Tc-99m maa
|
$68.80 |
$258.60 |
$1,286.58 |
|
|
Tc-99m mebrofenin
|
$58.80 |
$94.80 |
$393.50 |
|
|
Tc-99m medronate
|
$69.00 |
$109.80 |
$403.79 |
|
|
Tc-99m mertiatide
|
$465.60 |
$877.24 |
$3,291.31 |
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.60 |
|
|
Tc-99m oxidronate
|
$60.00 |
$121.16 |
$378.95 |
|
|
Tc-99m pentetate dtpa
|
$222.60 |
$406.80 |
$1,849.72 |
|
|
Tc-99m pentetate dtpa aerosol
|
$190.80 |
$190.80 |
$740.30 |
|
|
Tc-99m pertechnetate per mci
|
$8.41 |
$26.40 |
$88.80 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$94.20 |
$274.68 |
$649.34 |
|
|
Tc-99m sestamibi p study dose
|
$55.80 |
$150.50 |
$384.46 |
|
|
Tc-99m succimer (dmsa)
|
$1,732.16 |
$1,732.16 |
$2,315.40 |
|
|
Tc-99m sulfur colloid
|
$150.60 |
$335.12 |
$977.99 |
|
|
Tc-99m tetrofosmin p study dose
|
$68.40 |
$150.50 |
$354.88 |
|
|
Tc-99m tilmanocept diag
|
$986.40 |
$1,602.65 |
$5,721.60 |
|
|
Tcd emboli detect w/inj
|
$876.19 |
$876.19 |
$876.19 |
|
|
Tcd emboli detect without inj
|
$580.00 |
$591.00 |
$743.06 |
|
|
T cells absolute cd4/cd8 including ratio
|
$110.00 |
$231.00 |
$771.46 |
|
|
T cells absolute cd 4 count
|
$200.40 |
$334.80 |
$370.80 |
|
|
T cells total count
|
$75.25 |
$181.20 |
$771.46 |
|
|
Team conf without pat by hc pro
|
$142.80 |
$147.00 |
$147.00 |
|
|
Team conf without pat by phys
|
$109.20 |
$109.20 |
$109.20 |
|
|
Team conf w/pat by hc prof
|
$57.60 |
$57.60 |
$123.60 |
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$303.82 |
$303.82 |
$303.82 |
|
|
Telavancin injection
|
$1,710.70 |
$1,710.70 |
$4,717.71 |
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$82.16 |
|
|
Telethx isodose plan cplx
|
$877.80 |
$1,786.80 |
$4,853.46 |
|
|
Telethx isodose plan simple
|
$485.40 |
$687.00 |
$3,236.09 |
|
|
Temozolomide
|
$10.74 |
$10.74 |
$849.67 |
|
|
Temperature gradient studies
|
$295.20 |
$295.20 |
$295.20 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$151.94 |
$2,197.78 |
$20,244.22 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$240.21 |
$240.21 |
$57,946.25 |
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,306.80 |
$2,110.80 |
$5,365.80 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$29.20 |
$39.33 |
$382.01 |
|
|
Teriparatide injection
|
$1,364.31 |
$3,072.72 |
$8,625.43 |
|
|
Tert gene targeted seq alys
|
$1,922.87 |
$1,922.87 |
$1,922.87 |
|
|
Test for chlorohydrocarbons
|
$93.23 |
$93.23 |
$291.00 |
|
|
Test for urine cystines
|
$45.47 |
$45.47 |
$45.47 |
|
|
Testicular imaging w/vasc flow
|
$831.00 |
$831.60 |
$3,268.36 |
|
|
Test pathogen(s) for platelets reference
|
$52.00 |
$53.00 |
$194.97 |
|
|
Test stress cardiovascular tracing only
|
$485.12 |
$999.00 |
$3,059.42 |
|
|
Tetanus immune globulin inj
|
$1,073.02 |
$1,073.02 |
$5,638.95 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$242.64 |
$10,424.22 |
$10,424.22 |
|
|
Tgsap so/hl 51/< rna alys
|
$9,855.00 |
$9,855.00 |
$9,855.00 |
|
|
Theophylline therapeutic drug level
|
$106.62 |
$178.50 |
$252.00 |
|
|
Therapeutic procd strg endur
|
$83.50 |
$148.20 |
$169.00 |
|
|
Therapy activation ipnss
|
$462.38 |
$462.38 |
$462.38 |
|
|
Therapy activity per session >= 45 minutes
|
$190.40 |
$190.40 |
$190.40 |
|
|
Therapy Activity Training (each 15 minutes)
|
$63.60 |
$81.00 |
$184.78 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$48.00 |
$90.50 |
$303.49 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$18.90 |
$33.60 |
$49.20 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$33.00 |
$33.60 |
$49.20 |
|
|
Ther nma rdctj intus/obstrcj
|
$258.00 |
$258.00 |
$1,425.02 |
|
|
Ther/proph/diag inj ia
|
$316.80 |
$321.00 |
$410.00 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$24.71 |
$41.86 |
$42.98 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$281.40 |
$390.00 |
$1,767.26 |
|
|
Thiotepa injection
|
$810.10 |
$810.10 |
$810.10 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$496.00 |
$2,560.80 |
$3,140.50 |
|
|
Thoracotomy with cardiac massage
|
$3,107.40 |
$3,107.40 |
$3,107.40 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$448.00 |
$1,761.60 |
$5,214.14 |
|
|
Throat x-ray & fluoroscopy
|
$326.40 |
$326.40 |
$349.80 |
|
|
Thrombectmy crnry perq mechanical
|
$2,230.80 |
$2,898.60 |
$20,270.20 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$10,047.60 |
$26,410.20 |
$29,242.20 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$19,439.00 |
$38,373.60 |
$40,851.60 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$30,825.00 |
$55,199.40 |
$58,512.00 |
|
|
Thrombin time
|
$26.62 |
$95.40 |
$165.60 |
|
|
Thrombin time titer
|
$166.55 |
$166.55 |
$166.55 |
|
|
Thromboplastin inhibition
|
$228.00 |
$280.80 |
$308.84 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$58.80 |
$127.80 |
$241.80 |
|
|
Thromboxane urine
|
$578.21 |
$578.21 |
$578.21 |
|
|
Thyroglobulin antibody
|
$82.00 |
$177.00 |
$306.00 |
|
|
Thyroid imaging
|
$624.00 |
$894.00 |
$2,595.89 |
|
|
Thyroid met imaging
|
$1,068.29 |
$1,068.29 |
$1,153.20 |
|
|
Thyroid mets imag whole body
|
$1,457.40 |
$1,589.00 |
$3,243.62 |
|
|
Thyroid met uptake
|
$148.43 |
$709.20 |
$709.20 |
|
|
Thyroid (TSH) Test
|
$43.25 |
$204.00 |
$301.20 |
|
|
Thyroid Ultrasound
|
$331.88 |
$431.00 |
$942.66 |
|
|
Thyroid uptake measurement
|
$566.40 |
$580.20 |
$796.17 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,167.70 |
$5,213.25 |
$21,224.78 |
|
|
Thyrotropin releasing hormone
|
$330.00 |
$454.20 |
$484.80 |
|
|
Thyroxine binding globulin (tbg)
|
$22.00 |
$150.00 |
$202.80 |
|
|
Tib/per revasc stent & ather 37231
|
$32,149.20 |
$38,692.80 |
$38,692.80 |
|
|
Tib/per revasc stnt & ather
|
$12,145.80 |
$42,734.40 |
$42,734.40 |
|
|
Tib/per revasc w/ather add-on 37233
|
$16,037.40 |
$22,282.20 |
$23,296.80 |
|
|
Tigecycline injection
|
$8.38 |
$8.38 |
$1,428.19 |
|
|
Tilt table study
|
$488.00 |
$1,207.20 |
$7,614.83 |
|
|
Tirofiban 12.5 mg/50 ml
|
$578.62 |
$578.62 |
$2,081.19 |
|
|
Tis cgen car anomal 1st shnt
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
|
|
Tis cgen car anomal ea addl
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$264.18 |
$17,166.00 |
$17,166.00 |
|
|
Tissue amnio epifix inj 100mg
|
$6,767.40 |
$6,767.40 |
$6,767.40 |
|
|
Tissue culture placenta
|
$230.40 |
$537.00 |
$1,618.71 |
|
|
Tissue culture skin/biopsy
|
$676.80 |
$1,004.40 |
$1,648.92 |
|
|
Tissue culture tumor
|
$767.96 |
$1,300.80 |
$1,562.40 |
|
|
Tissue exam koh skin/hair/nails
|
$43.20 |
$81.60 |
$289.05 |
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$54,232.98 |
$54,232.98 |
$54,232.98 |
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$6,727.80 |
$21,297.60 |
$23,767.20 |
|
|
Tissue transglutaminase iga
|
$15.50 |
$25.80 |
$743.90 |
|
|
Tl-201 thallium diag per mci
|
$24.60 |
$26.40 |
$567.22 |
|
