|
Target gsa panel hmtlmph neop
|
$1,519.20 |
$1,519.20 |
$1,519.20 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$5,839.20 |
$5,839.20 |
$5,839.20 |
$3,762.00
|
|
Target gsa panel organ neop
|
$1,196.00 |
$1,196.00 |
$1,196.00 |
$1,749.44
|
|
Tas congenital car anomal
|
$1,882.40 |
$1,882.40 |
$1,882.40 |
$6,003.27
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$520.00 |
$520.00 |
$520.00 |
$931.50
|
|
Tavr perq femoral
|
$2,966.40 |
$2,966.40 |
$2,966.40 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.57 |
$1.57 |
$1.57 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$200.00 |
$200.00 |
$200.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$153.60 |
$153.60 |
$153.60 |
$181.80
|
|
Tc-99m exame autol wbc diag per dose
|
$3,378.47 |
$3,378.47 |
$3,378.47 |
$2,486.31
|
|
Tc-99m exametazime diag
|
$5,730.25 |
$5,730.25 |
$5,730.25 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$162.96 |
$162.96 |
$162.96 |
$306.00
|
|
Tc-99m maa
|
$542.56 |
$542.56 |
$542.56 |
$306.60
|
|
Tc-99m mebrofenin
|
$191.74 |
$191.74 |
$191.74 |
$157.50
|
|
Tc-99m medronate
|
$303.52 |
$303.52 |
$303.52 |
$111.01
|
|
Tc-99m mertiatide
|
$966.40 |
$966.40 |
$966.40 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$8.00 |
$8.00 |
$8.00 |
$6.50
|
|
Tc-99m oxidronate
|
$60.00 |
$60.00 |
$60.00 |
$108.04
|
|
Tc-99m pentetate dtpa
|
$797.11 |
$797.11 |
$797.11 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$973.13 |
$973.13 |
$973.13 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$16.96 |
$16.96 |
$16.96 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$140.04 |
$140.04 |
$140.04 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$469.20 |
$469.20 |
$469.20 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$374.16 |
$374.16 |
$374.16 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$582.48 |
$582.48 |
$582.48 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$794.40 |
$794.40 |
$794.40 |
$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
|
$110.00 |
$110.00 |
$110.00 |
$185.28
|
|
T cells absolute cd 4 count
|
$110.00 |
$110.00 |
$110.00 |
$111.20
|
|
T cells total count
|
$110.00 |
$110.00 |
$110.00 |
$132.63
|
|
Tcranial magn stim tx deli
|
$312.00 |
$312.00 |
$312.00 |
$389.22
|
|
Tcranial magn stim tx plan
|
$513.60 |
$513.60 |
$513.60 |
$437.22
|
|
Tcran magn stim redetemine
|
$635.20 |
$635.20 |
$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
|
|
Tee w or without fol w/cont,cong
|
$1,720.64 |
$1,720.64 |
$1,720.64 |
$2,101.65
|
|
Telehealth original site facility fee
|
$61.60 |
$61.60 |
$61.60 |
$51.00
|
|
Telethx isodose plan cplx
|
$4,125.55 |
$4,125.55 |
$4,125.55 |
$1,526.85
|
|
Telethx isodose plan simple
|
$2,903.18 |
$2,903.18 |
$2,903.18 |
$889.80
|
|
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 |
$77.60 |
$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)
|
$240.07 |
$240.07 |
$240.07 |
$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
|
$1,676.73 |
$1,676.73 |
$1,676.73 |
$2,211.05
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$77.88 |
$77.88 |
$77.88 |
$39.33
|
|
Teriparatide injection
|
$65.60 |
$65.60 |
$65.60 |
$7,498.09
|
|
Test for chlorohydrocarbons
|
$32.15 |
$32.15 |
$32.15 |
$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 |
$70.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$648.04 |
$648.04 |
$648.04 |
$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
|
$634.40 |
$634.40 |
$634.40 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$34.26 |
$34.26 |
$34.26 |
$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 |
$66.43 |
$108.00
|
|
Therapeutic procd strg endur
|
$119.74 |
$119.74 |
$119.74 |
$85.68
|
|
Therapy activation ipnss
|
$228.80 |
$228.80 |
$228.80 |
$226.24
|
|
Therapy Activity Training (each 15 minutes)
|
$109.80 |
$109.80 |
$109.80 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$109.80 |
$109.80 |
$109.80 |
$98.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$83.20 |
$83.20 |
$83.20 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$72.00 |
$72.00 |
$72.00 |
$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 |
$291.20 |
$3,837.72
|
|
Ther nma rdctj intus/obstrcj
|
$524.80 |
$524.80 |
$524.80 |
$534.32
|
|
Ther/proph/diag inj ia
|
$309.40 |
$309.40 |
$309.40 |
$247.33
|
|
Ther radiology tx plng cplx
|
$332.00 |
$332.00 |
$332.00 |
$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
|
$75.28 |
$75.28 |
$75.28 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$282.27 |
$282.27 |
$282.27 |
$311.15
|
|
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
|
