|
Stent bili dbl pgtl 10fx5cm
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,512.00
|
|
Stent bili rx wallflx 10x80 uncvr
|
$15,394.96 |
$15,394.96 |
$15,394.96 |
$23,887.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$19,896.24 |
$19,896.24 |
$19,896.24 |
$19,385.83
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$12,877.76 |
$12,877.76 |
$12,877.76 |
$10,086.20
|
|
Stent placemt retro carotid
|
$12,185.04 |
$12,185.04 |
$12,185.04 |
$5,623.15
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$21,960.96 |
$21,960.96 |
$21,960.96 |
$24,161.40
|
|
St evaluate speech sound production
|
$130.48 |
$130.48 |
$130.48 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$233.52 |
$233.52 |
$233.52 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$278.32 |
$278.32 |
$278.32 |
$336.00
|
|
St evaluation swallow function
|
$137.76 |
$137.76 |
$137.76 |
$323.72
|
|
Stress tte complete
|
$1,277.92 |
$1,277.92 |
$1,277.92 |
$1,989.60
|
|
St treatment speech individual
|
$83.44 |
$83.44 |
$83.44 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$113.68 |
$113.68 |
$113.68 |
$221.00
|
|
Sugars single quant
|
$13.44 |
$13.44 |
$13.44 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$48.72 |
$48.72 |
$48.72 |
$52.49
|
|
Supprelin la implant
|
$23,946.72 |
$23,946.72 |
$23,946.72 |
$45,560.39
|
|
Surgical pathology level 1 gross examination only
|
$16.80 |
$16.80 |
$16.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$34.72 |
$34.72 |
$34.72 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$42.00 |
$42.00 |
$42.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$74.48 |
$74.48 |
$74.48 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$105.84 |
$105.84 |
$105.84 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$153.44 |
$153.44 |
$153.44 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$10.08 |
$10.08 |
$10.08 |
$38.58
|
|
Susceptibility mic per plate
|
$19.04 |
$19.04 |
$19.04 |
$89.70
|
|
Svc venogram s&i
|
$1,127.28 |
$1,127.28 |
$1,127.28 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$51.52 |
$51.52 |
$51.52 |
$100.20
|
|
Synvisc or synvisc-one
|
$1,053.54 |
$1,053.54 |
$1,053.54 |
$1,053.54
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$21.84 |
$21.84 |
$21.84 |
$45.70
|
|
System cardiomems hosp electronics
|
$25,200.00 |
$25,200.00 |
$25,200.00 |
$53,437.50
|
|
System pacing micra av
|
$15,288.00 |
$15,288.00 |
$15,288.00 |
$22,146.00
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,851.44 |
$5,851.44 |
$5,851.44 |
$11,441.25
|
|
T3 (triiodothyronine) free
|
$29.68 |
$29.68 |
$29.68 |
$91.20
|
|
T3 (triiodothyronine) total
|
$56.00 |
$56.00 |
$56.00 |
$88.00
|
|
T4 (thyroxine) free
|
$38.08 |
$38.08 |
$38.08 |
$65.00
|
|
T4 (thyroxine) total
|
$42.00 |
$42.00 |
$42.00 |
$62.40
|
|
Tacrol astagraf ex rel oral
|
$0.50 |
$0.50 |
$0.50 |
$16.80
|
|
Tacrol envarsus ex rel oral
|
$1.21 |
$1.21 |
$1.21 |
$3.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.10 |
$4.10 |
$4.10 |
$4.87
|
|
Tacrolimus therapeutic drug level
|
$63.28 |
$63.28 |
$63.28 |
$137.15
|
|
Tavr perq femoral
|
$5,152.56 |
$5,152.56 |
$5,152.56 |
$15,614.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.34 |
$1.34 |
$1.34 |
$760.95
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$72.80 |
$72.80 |
$72.80 |
$178.40
|
|
Tc-99m bicisate
|
$665.28 |
$665.28 |
$665.28 |
$2,398.20
|
|
Tc-99m exame autol wbc diag per dose
|
$1,337.84 |
$1,337.84 |
$1,337.84 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$850.08 |
$850.08 |
$850.08 |
$2,236.65
|
|
Tc-99m labeled rbc
|
$202.16 |
$202.16 |
$202.16 |
$312.70
|
|
Tc-99m maa
|
$46.48 |
$46.48 |
$46.48 |
$306.60
|
|
Tc-99m mebrofenin
|
$82.88 |
$82.88 |
$82.88 |
$169.53
|
|
Tc-99m medronate
|
$54.32 |
$54.32 |
$54.32 |
$120.35
|
|
Tc-99m mertiatide
|
$220.64 |
$220.64 |
$220.64 |
$757.25
|
|
Tc-99m oxidronate
|
$72.80 |
$72.80 |
$72.80 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$36.96 |
$36.96 |
$36.96 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$36.96 |
$36.96 |
$36.96 |
$231.60
|
|
Tc-99m pertechnetate per mci
|
$3.36 |
$3.36 |
$3.36 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$56.00 |
$56.00 |
$56.00 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$192.08 |
$192.08 |
$192.08 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$149.52 |
$149.52 |
$149.52 |
$1,749.60
|
|
Tc-99m sulfur colloid
|
$67.76 |
$67.76 |
$67.76 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$192.08 |
$192.08 |
$192.08 |
$198.05
|
|
Tcd emboli detect w/inj
|
$173.04 |
$173.04 |
$173.04 |
$475.80
|
|
Tcd emboli detect without inj
|
$173.04 |
$173.04 |
$173.04 |
$430.89
|
|
T cells absolute cd4/cd8 including ratio
|
$108.64 |
$108.64 |
$108.64 |
$189.60
|
|
T cells absolute cd 4 count
|
$38.64 |
$38.64 |
$38.64 |
$120.25
|
|
T cells total count
|
$85.68 |
$85.68 |
$85.68 |
$126.90
|
|
Telethx isodose plan cplx
|
$1,392.72 |
$1,392.72 |
$1,392.72 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,052.24 |
$1,052.24 |
$1,052.24 |
$848.72
|
|
Temozolomide
|
$6.74 |
$6.74 |
$6.74 |
$632.98
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$34.07 |
$34.07 |
$34.07 |
$116.48
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$97.25 |
$97.25 |
$97.25 |
$16,233.59
|
|
Test for porphobilinogen
|
$34.72 |
$34.72 |
$34.72 |
$33.57
|
|
Test stress cardiovascular tracing only
|
$1,020.88 |
$1,020.88 |
$1,020.88 |
$1,016.00
|
|
Test urine for porphyrins
|
$38.08 |
$38.08 |
$38.08 |
$27.30
|
|
Tetanus immune globulin inj
|
$168.18 |
$168.18 |
$168.18 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$63.28 |
$63.28 |
$63.28 |
$101.40
|
|
Ther/proph/diag inj ia
|
$84.00 |
$84.00 |
$84.00 |
$247.33
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,769.04 |
$1,769.04 |
$1,769.04 |
$1,658.70
|
|
Thrombectmy crnry perq mechanical
|
$2,260.16 |
$2,260.16 |
$2,260.16 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$13,670.16 |
$13,670.16 |
$13,670.16 |
$8,395.40
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$15,817.76 |
$15,817.76 |
$15,817.76 |
$15,640.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$44,415.28 |
$44,415.28 |
$44,415.28 |
$25,597.40
|
|
Thrombin time
|
$21.84 |
$21.84 |
$21.84 |
$53.50
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$1,524.32 |
$1,524.32 |
$1,524.32 |
$6,262.40
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$64.40 |
$64.40 |
$64.40 |
$56.93
|
|
Thymectomy prtl/tot transcervical appr 60520
|
$5,826.24 |
$5,826.24 |
$5,826.24 |
$4,682.81
|
|
Thyroglobulin antibody
|
$85.68 |
$85.68 |
$85.68 |
$86.40
|
|
Thyroid imaging
|
$343.84 |
$343.84 |
$343.84 |
$577.80
|
|
Thyroid mets imag whole body
|
$444.64 |
$444.64 |
$444.64 |
$1,320.00
|
|
Thyroid met uptake
|
$190.40 |
$190.40 |
$190.40 |
$380.00
|
|
Thyroid (TSH) Test
|
$81.76 |
$81.76 |
$81.76 |
$101.40
|
|
Thyroid Ultrasound
|
$430.64 |
$430.64 |
$430.64 |
$553.80
|
|
Thyroid uptake measurement
|
$210.00 |
$210.00 |
$210.00 |
$580.20
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$1,146.61 |
$1,146.61 |
$1,146.61 |
$3,167.70
|
|
Thyroxine binding globulin (tbg)
|
$59.36 |
$59.36 |
$59.36 |
$75.00
|
|
Tib/per revasc stent & ather 37231
|
$38,032.40 |
$38,032.40 |
$38,032.40 |
$23,525.00
|
|
Tib/per revasc stnt & ather
|
$22,738.24 |
$22,738.24 |
$22,738.24 |
$13,321.00
|
|
Tib/per revasc w/ather add-on 37233
|
$21,960.96 |
$21,960.96 |
$21,960.96 |
$12,855.00
|
|
Tigecycline injection
|
$1.53 |
$1.53 |
$1.53 |
$7.44
|
|
Tilt table study
|
$1,516.48 |
$1,516.48 |
$1,516.48 |
$1,488.24
|
|
Tirofiban 12.5 mg/50 ml
|
$11.92 |
$11.92 |
$11.92 |
$696.08
|
|
Tissue culture placenta
|
$347.76 |
$347.76 |
$347.76 |
$470.00
|
