|
Strep b dna amp probe
|
$145.60 |
$145.60 |
$145.60 |
$124.15
|
|
Stress test pulmonary
|
$273.65 |
$273.65 |
$273.65 |
$324.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$77.20 |
$77.20 |
$77.20 |
$54.80
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$17.70 |
$17.70 |
$17.70 |
$129.89
|
|
Support clav 29.6-40.5in med
|
$94.19 |
$94.19 |
$94.19 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$72.15 |
$72.15 |
$72.15 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$116.35 |
$116.35 |
$116.35 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$122.20 |
$122.20 |
$122.20 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$12,467.75 |
$12,467.75 |
$12,467.75 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$321.10 |
$321.10 |
$321.10 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$531.05 |
$531.05 |
$531.05 |
$720.75
|
|
Susceptibility enzyme detection per enzyme
|
$14.30 |
$14.30 |
$14.30 |
$35.89
|
|
Susceptibility mic per plate
|
$89.70 |
$89.70 |
$89.70 |
$106.00
|
|
Swallowing Evaluation (Bedside)
|
$293.15 |
$293.15 |
$293.15 |
$316.80
|
|
Swallowing Therapy Session
|
$221.00 |
$221.00 |
$221.00 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$21.45 |
$21.45 |
$21.45 |
$42.24
|
|
System cardiomems hosp electronics
|
$24,023.02 |
$24,023.02 |
$24,023.02 |
$38,234.70
|
|
System pacing micra av
|
$16,760.25 |
$16,760.25 |
$16,760.25 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$27,099.09 |
$27,099.09 |
$27,099.09 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$8,955.20 |
$8,955.20 |
$8,955.20 |
$11,183.00
|
|
System sealant biosentry tract
|
$652.35 |
$652.35 |
$652.35 |
$889.35
|
|
T3 (triiodothyronine) free
|
$122.20 |
$122.20 |
$122.20 |
$100.32
|
|
T3 (triiodothyronine) total
|
$96.85 |
$96.85 |
$96.85 |
$93.52
|
|
T4 (thyroxine) free
|
$78.65 |
$78.65 |
$78.65 |
$89.60
|
|
T4 (thyroxine) total
|
$52.65 |
$52.65 |
$52.65 |
$70.20
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,208.10 |
$1,208.10 |
$1,208.10 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$158.60 |
$158.60 |
$158.60 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,272.00 |
$4,272.00 |
$4,272.00 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$221.65 |
$221.65 |
$221.65 |
$289.20
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$88,021.00 |
$88,021.00 |
$88,021.00 |
$1,223.36
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$35,941.50 |
$35,941.50 |
$35,941.50 |
$21,745.13
|
|
Tape plstc 1inx5yd hosp tb pk
|
$3.04 |
$3.04 |
$3.04 |
$2.06
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$46,350.00 |
$46,350.00 |
$46,350.00 |
$24,217.20
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$463.10 |
$463.10 |
$463.10 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$221.65 |
$221.65 |
$221.65 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$164.45 |
$164.45 |
$164.45 |
$179.95
|
|
Tc-99m apcitide diag
|
$1,765.30 |
$1,765.30 |
$1,765.30 |
$1,181.70
|
|
Tc-99m arcitumomab
|
$4,224.15 |
$4,224.15 |
$4,224.15 |
$2,085.68
|
|
Tc-99m bicisate
|
$7,128.20 |
$7,128.20 |
$7,128.20 |
$2,070.00
|
|
Tc-99m depreotide
|
$1,937.35 |
$1,937.35 |
$1,937.35 |
$1,486.80
|
|
Tc-99m diag per dose
|
$575.50 |
$575.50 |
$575.50 |
$470.40
|
|
Tc-99m disofenin
|
$339.80 |
$339.80 |
$339.80 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$8,194.15 |
$8,194.15 |
$8,194.15 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$7,382.05 |
$7,382.05 |
$7,382.05 |
$2,135.70
|
|
Tc-99m fanolesomab diag
|
$17,688.75 |
$17,688.75 |
$17,688.75 |
$2,115.12
|
|
Tc-99m gluceptate
|
$1,105.40 |
$1,105.40 |
$1,105.40 |
$31.35
|
|
Tc-99m labeled rbc
|
$857.40 |
$857.40 |
$857.40 |
$306.00
|
|
Tc-99m maa
|
$760.95 |
$760.95 |
$760.95 |
$312.06
|
|
Tc-99m mebrofenin
|
$308.25 |
$308.25 |
$308.25 |
$157.65
|
|
Tc-99m medronate
|
$210.35 |
$210.35 |
$210.35 |
$111.01
|
|
Tc-99m mertiatide
|
$1,340.90 |
$1,340.90 |
$1,340.90 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$1.00 |
$1.00 |
$1.00 |
$8.00
|
|
Tc-99m oxidronate
|
$199.60 |
$199.60 |
$199.60 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$627.25 |
$627.25 |
$627.25 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$627.25 |
$627.25 |
$627.25 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$99.30 |
$99.30 |
$99.30 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$335.80 |
$335.80 |
$335.80 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$221.60 |
$221.60 |
$221.60 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$2,988.10 |
$2,988.10 |
$2,988.10 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$855.40 |
$855.40 |
$855.40 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$198.05 |
$198.05 |
$198.05 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$2,740.00 |
$2,740.00 |
$2,740.00 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$99.45 |
$99.45 |
$99.45 |
$184.00
|
|
T cells total count
|
$91.65 |
$91.65 |
$91.65 |
$130.20
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$107,550.00 |
$107,550.00 |
$107,550.00 |
$40,114.80
|
|
Telehealth original site facility fee
|
$52.00 |
$52.00 |
$52.00 |
$51.00
|
|
Temozolomide 100 mg intravenous solution
|
$5,015.55 |
$5,015.55 |
$5,015.55 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$10,501.70 |
$10,501.70 |
$10,501.70 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$23,582.35 |
$23,582.35 |
$23,582.35 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$6.90 |
$6.90 |
$6.90 |
$39.33
|
|
Test pathogen(s) for platelets reference
|
$73.45 |
$73.45 |
$73.45 |
$70.00
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$22,937.05 |
$22,937.05 |
$22,937.05 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$117.00 |
$117.00 |
$117.00 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$128.70 |
$128.70 |
$128.70 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$129.35 |
$129.35 |
$129.35 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$94.90 |
$94.90 |
$94.90 |
$57.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$8.30 |
$8.30 |
$8.30 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$403.65 |
$403.65 |
$403.65 |
$313.60
|
|
Thiotepa 15 mg solution for injection
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$1,090.00
|
|
Thrombin time
|
$33.80 |
$33.80 |
$33.80 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$41.60 |
$41.60 |
$41.60 |
$62.01
|
|
Thyroglobulin antibody
|
$122.20 |
$122.20 |
$122.20 |
$82.50
|
|
Thyroid (TSH) Test
|
$835.00 |
$835.00 |
$835.00 |
$112.70
|
|
Thyroid Ultrasound
|
$553.80 |
$553.80 |
$553.80 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$10,828.50 |
$10,828.50 |
$10,828.50 |
$4,152.21
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$22,202.40 |
$22,202.40 |
$22,202.40 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$2,555.89 |
$2,555.89 |
$2,555.89 |
$4,201.20
|
|
Tissue dermagraft 2x3in 37.5sqcm-cost per sq cm
|
$67.73 |
$67.73 |
$67.73 |
$67.73
|
|
Tissue exam koh skin/hair/nails
|
$28.60 |
$28.60 |
$28.60 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$271.69 |
$271.69 |
$271.69 |
$537.50
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$49.04 |
$49.04 |
$49.04 |
$830.41
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$38.88 |
$38.88 |
$38.88 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$176.80 |
$176.80 |
$176.80 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$80.10 |
$80.10 |
$80.10 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$3.60 |
$3.60 |
$3.60 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$121.55 |
$121.55 |
$121.55 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$12,214.20 |
$12,214.20 |
$12,214.20 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$270.40 |
$270.40 |
$270.40 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$221.65 |
$221.65 |
$221.65 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$78.00 |
$78.00 |
$78.00 |
$74.10
|