|
Tc-99m disofenin
|
$97.02 |
$97.02 |
$97.02 |
$124.32
|
|
Tc-99m exametazime diag
|
$2,603.86 |
$2,603.86 |
$2,603.86 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$257.25 |
$257.25 |
$257.25 |
$302.40
|
|
Tc-99m maa
|
$309.19 |
$309.19 |
$309.19 |
$292.80
|
|
Tc-99m mebrofenin
|
$58.31 |
$58.31 |
$58.31 |
$157.65
|
|
Tc-99m medronate
|
$83.79 |
$83.79 |
$83.79 |
$111.01
|
|
Tc-99m mertiatide
|
$553.21 |
$553.21 |
$553.21 |
$756.00
|
|
Tc-99m oxidronate
|
$70.56 |
$70.56 |
$70.56 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$247.45 |
$247.45 |
$247.45 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$281.75 |
$281.75 |
$281.75 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$1.47 |
$1.47 |
$1.47 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$546.35 |
$546.35 |
$546.35 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$137.69 |
$137.69 |
$137.69 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$289.59 |
$289.59 |
$289.59 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$69.58 |
$69.58 |
$69.58 |
$190.80
|
|
T cells absolute cd4/cd8 including ratio
|
$136.22 |
$136.22 |
$136.22 |
$176.40
|
|
T cells absolute cd 4 count
|
$79.87 |
$79.87 |
$79.87 |
$111.20
|
|
T cells total count
|
$136.22 |
$136.22 |
$136.22 |
$126.90
|
|
Team conf w/pat by hc prof
|
$175.91 |
$175.91 |
$175.91 |
$107.10
|
|
Telavancin injection
|
$874.26 |
$874.26 |
$874.26 |
$1,191.80
|
|
Telehealth original site facility fee
|
$27.93 |
$27.93 |
$27.93 |
$51.00
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$4,482.26 |
$4,482.26 |
$4,482.26 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$19,616.81 |
$19,616.81 |
$19,616.81 |
$15,245.38
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$522.34 |
$522.34 |
$522.34 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$48.76 |
$48.76 |
$48.76 |
$39.33
|
|
Test for porphobilinogen
|
$56.35 |
$56.35 |
$56.35 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$703.64 |
$703.64 |
$703.64 |
$842.56
|
|
Testosterone undecanoate 1mg
|
$5,077.59 |
$5,077.59 |
$5,077.59 |
$3,528.08
|
|
Test stress cardiovascular tracing only
|
$806.54 |
$806.54 |
$806.54 |
$949.70
|
|
Test urine for porphyrins
|
$48.02 |
$48.02 |
$48.02 |
$49.98
|
|
Test urine urobilinogen
|
$19.60 |
$19.60 |
$19.60 |
$9.75
|
|
Tetanus immune globulin inj
|
$1,101.23 |
$1,101.23 |
$1,101.23 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$10,194.24 |
$10,194.24 |
$10,194.24 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$88.69 |
$88.69 |
$88.69 |
$108.00
|
|
Therapeutic procd strg endur
|
$54.88 |
$54.88 |
$54.88 |
$85.68
|
|
Therapy activity per session >= 45 minutes
|
$176.89 |
$176.89 |
$176.89 |
$191.50
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$19.11 |
$19.11 |
$19.11 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$17.64 |
$17.64 |
$17.64 |
$50.00
|
|
Ther/proph/diag inj ia
|
$247.45 |
$247.45 |
$247.45 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$48.76 |
$48.76 |
$48.76 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$716.38 |
$716.38 |
$716.38 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit
|
$7,133.42 |
$7,133.42 |
$7,133.42 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$10,922.10 |
$10,922.10 |
$10,922.10 |
$14,277.20
|
|
Thrombin time
|
$66.15 |
$66.15 |
$66.15 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$67.62 |
$67.62 |
$67.62 |
$61.52
|
|
Thyroglobulin antibody
|
$90.16 |
$90.16 |
$90.16 |
$82.00
|
|
Thyroidectomy inc substrnl split/trans approch 60270
|
$1,818.39 |
$1,818.39 |
$1,818.39 |
$2,616.00
|
|
Thyroid imaging
|
$336.14 |
$336.14 |
$336.14 |
$695.02
|
|
Thyroid met imaging
|
$427.77 |
$427.77 |
$427.77 |
$838.25
|
|
Thyroid mets imag whole body
|
$1,100.05 |
$1,100.05 |
$1,100.05 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$86.24 |
$86.24 |
$86.24 |
$111.00
|
|
Thyroid Ultrasound
|
$349.37 |
$349.37 |
$349.37 |
$588.50
|
|
Thyroid uptake measurement
|
$458.64 |
$458.64 |
$458.64 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,844.24 |
$4,844.24 |
$4,844.24 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$33.32 |
$33.32 |
$33.32 |
$64.35
|
|
Tigecycline injection
|
$235.29 |
$235.29 |
$235.29 |
$234.00
|
|
Tilt table study
|
$1,256.85 |
$1,256.85 |
$1,256.85 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$535.33 |
$535.33 |
$535.33 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$15,562.40 |
$15,562.40 |
$15,562.40 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$3,295.93 |
$3,295.93 |
$3,295.93 |
$4,834.73
|
|
Tissue culture placenta
|
$483.14 |
$483.14 |
$483.14 |
$457.00
|
|
Tissue culture skin/biopsy
|
$464.52 |
$464.52 |
$464.52 |
$484.00
|
|
Tissue culture tumor
|
$493.43 |
$493.43 |
$493.43 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$56.35 |
$56.35 |
$56.35 |
$47.20
|
|
Tissue transglutaminase iga
|
$103.88 |
$103.88 |
$103.88 |
$44.16
|
|
Tixagev and cilgav inj
|
$108.78 |
$108.78 |
$108.78 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$33.32 |
$33.32 |
$33.32 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$1,035.22 |
$1,035.22 |
$1,035.22 |
$152.36
|
|
Tobramycin non-comp unit
|
$33.25 |
$33.25 |
$33.25 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$101.92 |
$101.92 |
$101.92 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$6,279.06 |
$6,279.06 |
$6,279.06 |
$5,258.52
|
|
Tomosynthesis breast screen bilateral
|
$66.15 |
$66.15 |
$66.15 |
$72.68
|
|
Tongue biopsy; posterior one-third 41105
|
$1,199.52 |
$1,199.52 |
$1,199.52 |
$3,544.29
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$313.70 |
$313.70 |
$313.70 |
$325.00
|
|
Total Knee Replacement
|
$1,709.12 |
$1,709.12 |
$1,709.12 |
$14,543.50
|
|
Toxoplasma antibody igg
|
$73.99 |
$73.99 |
$73.99 |
$89.40
|
|
Toxoplasma antibody igm
|
$73.99 |
$73.99 |
$73.99 |
$87.00
|
|
Tpmt gene com vrnts
|
$573.30 |
$573.30 |
$573.30 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$7,588.34 |
$7,588.34 |
$7,588.34 |
$6,827.00
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$38.71 |
$38.71 |
$38.71 |
$101.25
|
|
Transferrin
|
$36.75 |
$36.75 |
$36.75 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$713.93 |
$713.93 |
$713.93 |
$983.00
|
|
Transparent film <= 16 sq in
|
$0.75 |
$0.75 |
$0.75 |
$4.50
|
|
Trastuzumab 150 mg intravenous solution
|
$10,249.38 |
$10,249.38 |
$10,249.38 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$8,549.13 |
$8,549.13 |
$8,549.13 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$5,283.87 |
$5,283.87 |
$5,283.87 |
$5,835.15
|
|
Trauma partial team response w/critical care services level 4
|
$1,404.34 |
$1,404.34 |
$1,404.34 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$588.00 |
$588.00 |
$588.00 |
$940.80
|
|
Treat ankle dislocation
|
$685.51 |
$685.51 |
$685.51 |
$2,358.40
|
|
Treat clavicle dislocation 23545
|
$479.71 |
$479.71 |
$479.71 |
$705.60
|
|
Treat elbow dislocation
|
$764.89 |
$764.89 |
$764.89 |
$2,223.20
|
|
Treat eyelid lesion 67850
|
$644.84 |
$644.84 |
$644.84 |
$1,146.13
|
|
Treat finger fracture each
|
$513.03 |
$513.03 |
$513.03 |
$1,536.00
|
|
Treat foot dislocation
|
$270.97 |
$270.97 |
$270.97 |
$396.30
|
|
Treat fracture of radius
|
$689.43 |
$689.43 |
$689.43 |
$1,790.00
|
|
Treat fracture of ulna
|
$677.67 |
$677.67 |
$677.67 |
$726.05
|
|
Treat hip dislocation
|
$1,013.81 |
$1,013.81 |
$1,013.81 |
$2,192.80
|
|
Treat hip dislocation
|
$818.79 |
$818.79 |
$818.79 |
$2,641.60
|
|
Treat humerus fracture
|
$840.84 |
$840.84 |
$840.84 |
$1,771.43
|
|
Treat humerus fracture
|
$737.45 |
$737.45 |
$737.45 |
$1,771.43
|