|
Tc-99m pyroph diag per dose up to 25 mci
|
$138.50 |
$138.50 |
$335.80 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$221.60 |
$221.60 |
$373.60 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$802.24 |
$802.24 |
$2,988.10 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$334.40 |
$334.40 |
$3,100.40 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$198.05 |
$198.05 |
$594.45 |
$192.08
|
|
Tc-99m tilmanocept diag
|
$1,472.78 |
$1,472.78 |
$2,740.00 |
$958.31
|
|
Tca peel dermal 15789
|
$1,324.80 |
$1,324.80 |
$1,324.80 |
$1,324.80
|
|
Tcd emboli detect w/inj
|
$764.80 |
$764.80 |
$764.80 |
$475.80
|
|
Tcd emboli detect without inj
|
$666.40 |
$666.40 |
$666.40 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$99.45 |
$99.45 |
$110.00 |
$185.28
|
|
T cells absolute cd 4 count
|
$110.00 |
$110.00 |
$110.00 |
$111.20
|
|
T cells total count
|
$73.45 |
$73.45 |
$110.00 |
$132.63
|
|
Tcranial magn stim tx deli
|
$312.00 |
$312.00 |
$457.00 |
$389.22
|
|
Tcranial magn stim tx plan
|
$513.60 |
$513.60 |
$711.00 |
$437.22
|
|
Tcran magn stim redetemine
|
$322.40 |
$322.40 |
$635.20 |
$457.60
|
|
Tdh sdrl/ventr pnxr
|
$1,087.20 |
$1,087.20 |
$1,087.20 |
$1,087.20
|
|
Teaec w/wo patch graft iliofemoral
|
$5,030.40 |
$5,030.40 |
$5,030.40 |
$6,120.00
|
|
Team conf without pat by hc pro
|
$67.20 |
$67.20 |
$67.20 |
$110.62
|
|
Team conf without pat by phys
|
$102.40 |
$102.40 |
$102.40 |
$139.05
|
|
Team conf w/pat by hc prof
|
$78.40 |
$78.40 |
$78.40 |
$105.70
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$107,550.00 |
$107,550.00 |
$107,550.00 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$2,333.50 |
$2,333.50 |
$2,333.50 |
$2,101.65
|
|
Tee w or without fol w/cont, mon
|
$1,431.95 |
$1,431.95 |
$1,976.69 |
$1,692.44
|
|
Telehealth original site facility fee
|
$25.35 |
$25.35 |
$61.60 |
$51.00
|
|
Telethx isodose plan cplx
|
$513.50 |
$513.50 |
$4,403.75 |
$1,526.85
|
|
Telethx isodose plan simple
|
$2,402.04 |
$2,402.04 |
$2,402.04 |
$889.80
|
|
Temozolomide
|
$2.56 |
$2.56 |
$235.25 |
$540.06
|
|
Temozolomide 100 mg intravenous solution
|
$5,015.55 |
$5,015.55 |
$5,015.55 |
$1,867.28
|
|
Temperature gradient studies
|
$19.20 |
$19.20 |
$19.20 |
$242.25
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$77.60 |
$77.60 |
$10,501.70 |
$3,723.60
|
|
Tendon lengthening
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
$3,986.00
|
|
Tendon lngth upr a/e ea tdn
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
$3,591.33
|
|
Tendon shortening
|
$1,460.80 |
$1,460.80 |
$1,460.80 |
$3,786.00
|
|
Tendon transfer with graft
|
$2,200.80 |
$2,200.80 |
$2,200.80 |
$3,839.54
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$268.32 |
$268.32 |
$23,582.35 |
$14,951.87
|
|
Tenodesis biceps tdn at elbw
|
$3,020.80 |
$3,020.80 |
$3,020.80 |
$6,653.00
|
|
Tenolysis extensor tendon hand/finger each
|
$1,436.00 |
$1,436.00 |
$1,436.00 |
$2,811.20
|
|
Tenolysis triceps
|
$3,012.80 |
$3,012.80 |
$3,012.80 |
$4,350.00
|
|
Tenoplasty elbow to sho 1
|
$1,919.20 |
$1,919.20 |
$1,919.20 |
$7,807.24
|
|
Tenosynovectomy radic 26145
|
$1,266.40 |
$1,266.40 |
$1,266.40 |
$2,211.05
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$2,243.20 |
$2,243.20 |
$2,243.20 |
$3,545.97
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$962.40 |
$962.40 |
$19,275.90 |
$2,211.05
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$6.90 |
$6.90 |
$78.96 |
$39.33
|
|
Teriparatide injection
|
$65.60 |
$65.60 |
$65.60 |
$7,498.09
|
|
Test for chlorohydrocarbons
|
$32.15 |
$32.15 |
$68.90 |
$61.60
|
|
Test for porphobilinogen
|
$33.57 |
$33.57 |
$33.57 |
$29.25
|
|
Test for urine cystines
|
$23.20 |
$23.20 |
$23.20 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$459.20 |
$459.20 |
$459.20 |
$842.56
|
|
Testosterone pellet 75 mg
|
$102.40 |
$102.40 |
$102.40 |
$102.40
|
|
Testosterone response panel
|
$129.60 |
$129.60 |
$129.60 |
$129.60
|
|
Testosterone undecanoate 1mg
|
$2.40 |
$2.40 |
$2.40 |
$3,528.08
|
|
Test pathogen(s) for platelets reference
|
$70.00 |
$70.00 |
$104.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$845.26 |
$845.26 |
$889.20 |
$949.70
|
|
Test urine for lactose
|
$23.20 |
$23.20 |
$23.20 |
$23.20
|
|
Test urine for porphyrins
|
$27.20 |
$27.20 |
$27.20 |
$49.98
|
|
Test urine urobilinogen
|
$9.60 |
$9.60 |
$9.60 |
$9.75
|
|
Tetanus ig im
|
$624.00 |
$624.00 |
$624.00 |
$250.88
|
|
Tetanus immune globulin inj
|
$937.31 |
$937.31 |
$2,622.15 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$32.04 |
$32.04 |
$22,937.05 |
$8,737.05
|
|
Tgsap hl neo 5-50 rna alys
|
$729.16 |
$729.16 |
$729.16 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$2,802.82 |
$2,802.82 |
$2,802.82 |
$4,563.00
|
|
Tgsap so neo 5-50 rna alys
|
$792.10 |
$792.10 |
$792.10 |
$1,009.32
|
|
Thaw cryoprsvrd reprod tiss
|
$419.20 |
$419.20 |
$419.20 |
$234.27
|
|
Thawing cryopresrved embryo
|
$419.20 |
$419.20 |
$419.20 |
$326.15
|
|
Thawing cryopresrved oocyte
|
$419.20 |
$419.20 |
$419.20 |
$402.80
|
|
Thawing cryopresrved sperm
|
$419.20 |
$419.20 |
$419.20 |
$117.61
|
|
Theophylline therapeutic drug level
|
$66.43 |
$66.43 |
$173.55 |
$108.00
|
|
Therapeutic procd strg endur
|
$44.85 |
$44.85 |
$132.48 |
$85.68
|
|
Therapy activation ipnss
|
$228.80 |
$228.80 |
$228.80 |
$226.24
|
|
Therapy activity per session >= 45 minutes
|
$132.60 |
$132.60 |
$132.60 |
$191.50
|
|
Therapy Activity Training (each 15 minutes)
|
$141.26 |
$141.26 |
$2,053.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$149.89 |
$149.89 |
$1,905.00 |
$98.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$83.20 |
$83.20 |
$132.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$72.00 |
$72.00 |
$803.00 |
$50.00
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$283.20 |
$283.20 |
$283.20 |
$314.50
|
|
Ther fx nasal inf turbinate
|
$291.20 |
$291.20 |
$39,131.01 |
$3,837.72
|
|
Ther nma rdctj intus/obstrcj
|
$534.32 |
$534.32 |
$557.05 |
$534.32
|
|
Ther/proph/diag inj ia
|
$40.00 |
$40.00 |
$181.35 |
$247.33
|
|
Ther radiology tx plng cplx
|
$332.00 |
$332.00 |
$544.00 |
$332.00
|
|
Ther radiology tx plng intrm
|
$224.00 |
$224.00 |
$224.00 |
$224.00
|
|
Ther radiology tx plng smpl
|
$148.80 |
$148.80 |
$148.80 |
$148.80
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$5.80 |
$5.80 |
$77.96 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$421.87 |
$421.87 |
$65,462.18 |
$311.15
|
|
Thiotepa 15 mg solution for injection
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$1,090.00
|
|
Thorabd diaphr hern repair
|
$3,542.40 |
$3,542.40 |
$3,542.40 |
$3,542.40
|
|
Thorabd diaphr hern repair
|
$3,777.60 |
$3,777.60 |
$3,777.60 |
$6,837.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,238.80 |
$2,238.80 |
$5,846.00 |
$1,748.50
|
|
Thoracic aortic graft 33875
|
$6,691.20 |
$6,691.20 |
$6,691.20 |
$5,329.20
|
|
Thoracic duct procedure
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$1,406.40
|
|
Thoracic duct procedure
|
$1,958.40 |
$1,958.40 |
$1,958.40 |
$1,958.40
|
|
Thoracic duct procedure
|
$1,656.80 |
$1,656.80 |
$1,656.80 |
$1,656.80
|
|
Thoracic lymphadenect/thoracotomy 38746
|
$524.80 |
$524.80 |
$703.00 |
$499.80
|
|
Thoracoabdominal graft 33877
|
$8,824.00 |
$8,824.00 |
$11,598.00 |
$8,824.00
|
|
Thoracoscop w/esoph musc exc
|
$2,999.20 |
$2,999.20 |
$2,999.20 |
$2,999.20
|
|
Thoracoscopy bilobectomy 32670
|
$3,910.40 |
$3,910.40 |
$5,407.50 |
$3,910.40
|
|
Thoracoscopy diagnostic 32601
|
$654.00 |
$654.00 |
$752.80 |
$6,442.80
|
|
Thoracoscopy for lvrs
|
$3,711.20 |
$3,711.20 |
$3,711.20 |
$5,411.20
|
|
Thoracoscopy lymph node exc
|
$525.60 |
$525.60 |
$653.00 |
$1,071.20
|
|
Thoracoscopy pneumonectomy
|
$4,325.60 |
$4,325.60 |
$4,325.60 |
$6,238.40
|
|
Thoracoscopy remove cortex
|
$5,332.80 |
$5,332.80 |
$5,332.80 |
$5,332.80
|
