|
Susceptibility agar dilution per agent
|
$94.50 |
$94.50 |
$94.50 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$11.70 |
$11.70 |
$11.70 |
$35.89
|
|
Susceptibility mic per plate
|
$94.50 |
$94.50 |
$94.50 |
$106.00
|
|
Svc venogram s&i
|
$142.00 |
$142.00 |
$142.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$384.65 |
$384.65 |
$384.65 |
$316.80
|
|
Swallowing Therapy Session
|
$458.90 |
$458.90 |
$458.90 |
$232.56
|
|
Synch audio-only est high 40
|
$189.40 |
$189.40 |
$189.40 |
$196.80
|
|
Synch audio-only est low 20
|
$86.90 |
$86.90 |
$86.90 |
$93.60
|
|
Synch audio-only est mod 30
|
$128.10 |
$128.10 |
$128.10 |
$136.64
|
|
Synch audio-only est sf 10
|
$47.60 |
$47.60 |
$47.60 |
$53.20
|
|
Synch audio-only new high 60
|
$232.80 |
$232.80 |
$232.80 |
$207.64
|
|
Synch audio-only new low 30
|
$112.50 |
$112.50 |
$112.50 |
$120.80
|
|
Synch audio-only new mod 45
|
$176.70 |
$176.70 |
$176.70 |
$176.70
|
|
Synch audio-only new sf 15
|
$64.90 |
$64.90 |
$64.90 |
$71.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$31.10 |
$31.10 |
$31.10 |
$42.24
|
|
T3 (triiodothyronine) free
|
$199.80 |
$199.80 |
$199.80 |
$100.32
|
|
T3 (triiodothyronine) total
|
$140.35 |
$140.35 |
$140.35 |
$93.52
|
|
T4 (thyroxine) free
|
$156.35 |
$156.35 |
$156.35 |
$89.60
|
|
T4 (thyroxine) total
|
$148.45 |
$148.45 |
$148.45 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$305.10 |
$305.10 |
$305.10 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$6,078.88 |
$6,078.88 |
$6,078.88 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$469.65 |
$469.65 |
$469.65 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,075.05 |
$2,075.05 |
$2,075.05 |
$2,246.30
|
|
Target gsa panel organ neop
|
$1,073.00 |
$1,073.00 |
$1,073.00 |
$1,701.91
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,770.33 |
$2,770.33 |
$2,770.33 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$64.25 |
$64.25 |
$64.25 |
$179.95
|
|
Tc-99m disofenin
|
$205.20 |
$205.20 |
$205.20 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$2,303.90 |
$2,303.90 |
$2,303.90 |
$2,503.15
|
|
Tc-99m labeled rbc
|
$188.95 |
$188.95 |
$188.95 |
$306.00
|
|
Tc-99m maa
|
$67.45 |
$67.45 |
$67.45 |
$312.06
|
|
Tc-99m mebrofenin
|
$94.50 |
$94.50 |
$94.50 |
$157.65
|
|
Tc-99m medronate
|
$35.10 |
$35.10 |
$35.10 |
$111.01
|
|
Tc-99m mertiatide
|
$894.85 |
$894.85 |
$894.85 |
$756.00
|
|
Tc-99m oxidronate
|
$138.70 |
$138.70 |
$138.70 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$67.45 |
$67.45 |
$67.45 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$137.65 |
$137.65 |
$137.65 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$32.40 |
$32.40 |
$32.40 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$188.95 |
$188.95 |
$188.95 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$171.30 |
$171.30 |
$171.30 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$720.75 |
$720.75 |
$720.75 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$178.15 |
$178.15 |
$178.15 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$533.10 |
$533.10 |
$533.10 |
$193.28
|
|
T cells absolute cd4/cd8 including ratio
|
$282.45 |
$282.45 |
$282.45 |
$184.00
|
|
T cells total count
|
$277.80 |
$277.80 |
$277.80 |
$130.20
|
|
Team conf w/pat by hc prof
|
$562.80 |
$562.80 |
$562.80 |
$107.10
|
|
Telehealth original site facility fee
|
$234.90 |
$234.90 |
$234.90 |
$51.00
|
|
Temozolomide 100 mg intravenous solution
|
$4,368.45 |
$4,368.45 |
$4,368.45 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$24,391.51 |
$24,391.51 |
$24,391.51 |
$3,723.60
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$70.84 |
$70.84 |
$70.84 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$993.35 |
$993.35 |
$993.35 |
$953.40
|
|
Tetanus immune globulin inj
|
$3,015.53 |
$3,015.53 |
$3,015.53 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$14,610.18 |
$14,610.18 |
$14,610.18 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$175.50 |
$175.50 |
$175.50 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$167.35 |
$167.35 |
$167.35 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$159.45 |
$159.45 |
$159.45 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$75.60 |
$75.60 |
$75.60 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$62.05 |
$62.05 |
$62.05 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$1,044.65 |
$1,044.65 |
$1,044.65 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$81.21 |
$81.21 |
$81.21 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$332.00 |
$332.00 |
$332.00 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,048.95 |
$3,048.95 |
$3,048.95 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,186.50 |
$2,186.50 |
$2,186.50 |
$1,703.45
|
|
Thrombin time
|
$190.25 |
$190.25 |
$190.25 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$91.75 |
$91.75 |
$91.75 |
$62.01
|
|
Thyroglobulin antibody
|
$143.45 |
$143.45 |
$143.45 |
$82.50
|
|
Thyroid imaging
|
$903.00 |
$903.00 |
$903.00 |
$695.60
|
|
Thyroid (TSH) Test
|
$191.65 |
$191.65 |
$191.65 |
$112.70
|
|
Thyroid Ultrasound
|
$727.50 |
$727.50 |
$727.50 |
$588.50
|
|
Thyroid uptake measurement
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$8,219.15 |
$8,219.15 |
$8,219.15 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$294.75 |
$294.75 |
$294.75 |
$64.51
|
|
Tilt table study
|
$909.75 |
$909.75 |
$909.75 |
$1,561.82
|
|
Tissue culture placenta
|
$248.50 |
$248.50 |
$248.50 |
$453.00
|
|
Tissue culture skin/biopsy
|
$860.95 |
$860.95 |
$860.95 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$67.00 |
$67.00 |
$67.00 |
$47.40
|
|
Tissue transglutaminase iga
|
$59.10 |
$59.10 |
$59.10 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$214.60 |
$214.60 |
$214.60 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,782.92 |
$5,782.92 |
$5,782.92 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$307.70 |
$307.70 |
$307.70 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$121.45 |
$121.45 |
$121.45 |
$74.10
|
|
Tone decay hearing test
|
$99.90 |
$99.90 |
$99.90 |
$90.37
|
|
Total tau
|
$159.10 |
$159.10 |
$159.10 |
$312.50
|
|
Toxoplasma antibody igg
|
$84.35 |
$84.35 |
$84.35 |
$91.65
|
|
Toxoplasma antibody igm
|
$84.35 |
$84.35 |
$84.35 |
$87.75
|
|
Transabdom amnioinfus w/us
|
$824.60 |
$824.60 |
$824.60 |
$678.70
|
|
Transferrin
|
$62.05 |
$62.05 |
$62.05 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$732.85 |
$732.85 |
$732.85 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$476.40 |
$476.40 |
$476.40 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$615,685.74 |
$615,685.74 |
$615,685.74 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$13,267.32 |
$13,267.32 |
$13,267.32 |
$7,540.20
|
|
Treat ankle dislocation
|
$1,105.35 |
$1,105.35 |
$1,105.35 |
$2,360.00
|
|
Treat clavicle dislocation 23545
|
$749.00 |
$749.00 |
$749.00 |
$692.80
|
|
Treat elbow dislocation
|
$1,051.40 |
$1,051.40 |
$1,051.40 |
$2,272.50
|
|
Treat elbow fracture
|
$1,091.00 |
$1,091.00 |
$1,091.00 |
$2,026.50
|
|
Treat finger fracture each
|
$732.05 |
$732.05 |
$732.05 |
$1,592.00
|
|
Treat foot dislocation
|
$431.90 |
$431.90 |
$431.90 |
$405.60
|
|
Treat foot dislocation
|
$617.15 |
$617.15 |
$617.15 |
$4,192.86
|
|
Treat foot dislocation
|
$344.15 |
$344.15 |
$344.15 |
$534.05
|
|
Treat foot dislocation
|
$422.45 |
$422.45 |
$422.45 |
$445.80
|
|
Treat foot dislocation
|
$676.20 |
$676.20 |
$676.20 |
$469.20
|