|
Tc-99m sestamibi p study dose
|
$352.00 |
$352.00 |
$352.00 |
$287.20
|
|
Tc-99m sulfur colloid
|
$308.00 |
$308.00 |
$308.00 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$184.00 |
$184.00 |
$184.00 |
$184.00
|
|
T cells total count
|
$160.80 |
$160.80 |
$160.80 |
$130.20
|
|
Telehealth original site facility fee
|
$69.60 |
$69.60 |
$69.60 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$12,366.50 |
$12,366.50 |
$12,366.50 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$60.96 |
$60.96 |
$60.96 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,112.80 |
$1,112.80 |
$1,112.80 |
$953.40
|
|
Tetanus immune globulin inj
|
$874.64 |
$874.64 |
$874.64 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$162.40 |
$162.40 |
$162.40 |
$108.00
|
|
Therapeutic procd strg endur
|
$136.00 |
$136.00 |
$136.00 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$133.60 |
$133.60 |
$133.60 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$128.80 |
$128.80 |
$128.80 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$70.40 |
$70.40 |
$70.40 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$64.00 |
$64.00 |
$64.00 |
$50.40
|
|
Ther/proph/diag inj ia
|
$226.40 |
$226.40 |
$226.40 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$63.50 |
$63.50 |
$63.50 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$468.80 |
$468.80 |
$468.80 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,754.40 |
$1,754.40 |
$1,754.40 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,329.60 |
$2,329.60 |
$2,329.60 |
$1,703.45
|
|
Thrombin time
|
$57.60 |
$57.60 |
$57.60 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$179.20 |
$179.20 |
$179.20 |
$62.01
|
|
Thyroglobulin antibody
|
$181.60 |
$181.60 |
$181.60 |
$82.50
|
|
Thyroid imaging
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
$695.60
|
|
Thyroid (TSH) Test
|
$141.60 |
$141.60 |
$141.60 |
$112.70
|
|
Thyroid Ultrasound
|
$902.40 |
$902.40 |
$902.40 |
$588.50
|
|
Thyroid uptake measurement
|
$1,538.40 |
$1,538.40 |
$1,538.40 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$48.80 |
$48.80 |
$48.80 |
$64.51
|
|
Tissue exam koh skin/hair/nails
|
$140.80 |
$140.80 |
$140.80 |
$47.40
|
|
Tissue transglutaminase iga
|
$11.20 |
$11.20 |
$11.20 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$60.62 |
$60.62 |
$60.62 |
$152.36
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,203.08 |
$4,203.08 |
$4,203.08 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$351.20 |
$351.20 |
$351.20 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$90.40 |
$90.40 |
$90.40 |
$74.10
|
|
Toxoplasma antibody igg
|
$180.80 |
$180.80 |
$180.80 |
$91.65
|
|
Toxoplasma antibody igm
|
$184.00 |
$184.00 |
$184.00 |
$87.75
|
|
Tp53 gene trgt sequence alys
|
$550.40 |
$550.40 |
$550.40 |
$804.00
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$128.80 |
$128.80 |
$128.80 |
$102.27
|
|
Transferrin
|
$144.80 |
$144.80 |
$144.80 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$903.20 |
$903.20 |
$903.20 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$896.80 |
$896.80 |
$896.80 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,565.60 |
$2,565.60 |
$2,565.60 |
$4,523.04
|
|
Treat ankle dislocation
|
$2,006.40 |
$2,006.40 |
$2,006.40 |
$2,360.00
|
|
Treat elbow dislocation
|
$2,699.20 |
$2,699.20 |
$2,699.20 |
$2,272.50
|
|
Treat finger fracture each
|
$1,012.00 |
$1,012.00 |
$1,012.00 |
$1,592.00
|
|
Treat foot dislocation
|
$348.00 |
$348.00 |
$348.00 |
$405.60
|
|
Treat foot dislocation
|
$348.00 |
$348.00 |
$348.00 |
$534.05
|
|
Treat foot dislocation
|
$384.80 |
$384.80 |
$384.80 |
$445.80
|
|
Treat fracture of ulna
|
$1,955.20 |
$1,955.20 |
$1,955.20 |
$731.04
|
|
Treat humerus fracture
|
$1,874.40 |
$1,874.40 |
$1,874.40 |
$1,790.00
|
|
Treat knee fracture 27530
|
$460.80 |
$460.80 |
$460.80 |
$550.73
|
|
Treat lower leg dislocation
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$532.60
|
|
Treatment of ankle fracture 27786
|
$448.00 |
$448.00 |
$448.00 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$386.40 |
$386.40 |
$386.40 |
$501.20
|
|
Treatment of heel fracture 28400
|
$404.80 |
$404.80 |
$404.80 |
$473.00
|
|
Treatment of toe fracture 28510
|
$342.40 |
$342.40 |
$342.40 |
$371.40
|
|
Treat metatarsal fracture
|
$6,875.20 |
$6,875.20 |
$6,875.20 |
$3,839.54
|
|
Treat metatarsal fracture
|
$8,840.80 |
$8,840.80 |
$8,840.80 |
$8,241.00
|
|
Treat midfoot fracture each
|
$2,836.80 |
$2,836.80 |
$2,836.80 |
$1,884.74
|
|
Treat wrist dislocation
|
$521.60 |
$521.60 |
$521.60 |
$656.25
|
|
Treponema pallidum antibody
|
$152.00 |
$152.00 |
$152.00 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$67.01 |
$67.01 |
$67.01 |
$43.09
|
|
Triglycerides
|
$85.60 |
$85.60 |
$85.60 |
$58.50
|
|
Trim nail(s)
|
$77.60 |
$77.60 |
$77.60 |
$79.00
|
|
Trim nondyst nails
|
$113.60 |
$113.60 |
$113.60 |
$113.88
|
|
Troponin quantitative
|
$212.80 |
$212.80 |
$212.80 |
$127.60
|
|
Tx closed hip disl traumatic without anes
|
$612.80 |
$612.80 |
$612.80 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$448.00 |
$448.00 |
$448.00 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$354.40 |
$354.40 |
$354.40 |
$419.04
|
|
Ultrasound breast unilateral limited (both sides)
|
$480.00 |
$480.00 |
$480.00 |
$452.40
|
|
Ultrasound exam k transpl w/doppler
|
$905.60 |
$905.60 |
$905.60 |
$578.40
|
|
Ultrasound Guidance for a Needle Procedure
|
$961.60 |
$961.60 |
$961.60 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$388.08
|
|
Ultrasound hips infant dynamic
|
$645.60 |
$645.60 |
$645.60 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$391.20 |
$391.20 |
$391.20 |
$311.25
|
|
Ultrasound joint complete left
|
$729.60 |
$729.60 |
$729.60 |
$557.99
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$580.80 |
$580.80 |
$580.80 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$812.00 |
$812.00 |
$812.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$641.60 |
$641.60 |
$641.60 |
$463.00
|
|
Unlisted px forearm/wrist
|
$3,908.80 |
$3,908.80 |
$3,908.80 |
$859.50
|
|
Unlisted px hands/fingers
|
$2,334.40 |
$2,334.40 |
$2,334.40 |
$354.20
|
|
Unlisted ultrasound procedure
|
$669.60 |
$669.60 |
$669.60 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$403.20 |
$403.20 |
$403.20 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,322.40 |
$4,322.40 |
$4,322.40 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,496.80 |
$3,496.80 |
$3,496.80 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,370.40 |
$3,370.40 |
$3,370.40 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$463.20 |
$463.20 |
$463.20 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$580.80 |
$580.80 |
$580.80 |
$381.60
|
|
Urea nitrogen
|
$85.60 |
$85.60 |
$85.60 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$48.80 |
$48.80 |
$48.80 |
$52.00
|
|
Uric acid blood
|
$74.40 |
$74.40 |
$74.40 |
$49.44
|
|
Uric acid urine
|
$72.00 |
$72.00 |
$72.00 |
$45.36
|
|
Urinalysis microscopic only
|
$76.00 |
$76.00 |
$76.00 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$50.40 |
$50.40 |
$50.40 |
$25.72
|
|
Urinalysis (with microscopy)
|
$82.40 |
$82.40 |
$82.40 |
$55.20
|
|
Urinalysis (without microscopy)
|
$39.20 |
$39.20 |
$39.20 |
$36.00
|
|
Urine Culture Test
|
$114.40 |
$114.40 |
$114.40 |
$83.00
|
|
Urine pregnancy test
|
$88.80 |
$88.80 |
$88.80 |
$68.78
|
