|
Strep b dna amp probe
|
$37.92 |
$37.92 |
$37.92 |
$120.90
|
|
Streptomycin injection
|
$69.83 |
$69.83 |
$69.83 |
$138.30
|
|
Stress test pulmonary
|
$53.76 |
$53.76 |
$53.76 |
$322.85
|
|
St treatment speech individual
|
$208.32 |
$208.32 |
$208.32 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$175.92 |
$175.92 |
$175.92 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$50.22 |
$50.22 |
$50.22 |
$52.31
|
|
Sulfonylurea screen qn-sendout
|
$74.16 |
$74.16 |
$74.16 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$41.64 |
$41.64 |
$41.64 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$9.12 |
$9.12 |
$9.12 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$15.12 |
$15.12 |
$15.12 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$33.36 |
$33.36 |
$33.36 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$33.36 |
$33.36 |
$33.36 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$119.76 |
$119.76 |
$119.76 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$252.48 |
$252.48 |
$252.48 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$37.68 |
$37.68 |
$37.68 |
$45.45
|
|
Susceptibility mic per plate
|
$53.28 |
$53.28 |
$53.28 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$5.04 |
$5.04 |
$5.04 |
$59.28
|
|
Sweat collection by iontophoresis
|
$38.88 |
$38.88 |
$38.88 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$45.84 |
$45.84 |
$45.84 |
$41.60
|
|
T3 (triiodothyronine) free
|
$124.08 |
$124.08 |
$124.08 |
$99.20
|
|
T3 (triiodothyronine) total
|
$79.20 |
$79.20 |
$79.20 |
$93.52
|
|
T4 (thyroxine) free
|
$58.32 |
$58.32 |
$58.32 |
$85.20
|
|
T4 (thyroxine) total
|
$55.44 |
$55.44 |
$55.44 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.13 |
$3.13 |
$3.13 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$216.00 |
$216.00 |
$216.00 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$985.32 |
$985.32 |
$985.32 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$443.52 |
$443.52 |
$443.52 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,773.36 |
$1,773.36 |
$1,773.36 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$172.56 |
$172.56 |
$172.56 |
$177.65
|
|
Tc-99m disofenin
|
$107.62 |
$107.62 |
$107.62 |
$124.32
|
|
Tc-99m mebrofenin
|
$37.80 |
$37.80 |
$37.80 |
$157.65
|
|
Tc-99m medronate
|
$30.38 |
$30.38 |
$30.38 |
$111.01
|
|
Tc-99m mertiatide
|
$253.44 |
$253.44 |
$253.44 |
$756.00
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$115.12 |
$115.12 |
$115.12 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$51.86 |
$51.86 |
$51.86 |
$274.45
|
|
Tc-99m tilmanocept diag
|
$375.84 |
$375.84 |
$375.84 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$116.88 |
$116.88 |
$116.88 |
$176.40
|
|
T cells absolute cd 4 count
|
$53.28 |
$53.28 |
$53.28 |
$111.20
|
|
T cells total count
|
$88.08 |
$88.08 |
$88.08 |
$126.90
|
|
Telehealth original site facility fee
|
$16.56 |
$16.56 |
$16.56 |
$51.00
|
|
Temozolomide
|
$140.20 |
$140.20 |
$140.20 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$954.62 |
$954.62 |
$954.62 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,039.68 |
$1,039.68 |
$1,039.68 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.00 |
$9.00 |
$9.00 |
$39.33
|
|
Test for urine cystines
|
$9.12 |
$9.12 |
$9.12 |
$26.00
|
|
Test stress cardiovascular tracing only
|
$241.44 |
$241.44 |
$241.44 |
$949.70
|
|
Tgsap hl neo 5-50 rna alys
|
$591.60 |
$591.60 |
$591.60 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$2,273.52 |
$2,273.52 |
$2,273.52 |
$4,347.00
|
|
Tgsap so neo 5-50 rna alys
|
$465.84 |
$465.84 |
$465.84 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$67.92 |
$67.92 |
$67.92 |
$108.00
|
|
Therapeutic procd strg endur
|
$19.44 |
$19.44 |
$19.44 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$24.00 |
$24.00 |
$24.00 |
$57.31
|
|
Ther/proph/diag inj ia
|
$88.32 |
$88.32 |
$88.32 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$16.57 |
$16.57 |
$16.57 |
$25.54
|
|
Thiotepa injection
|
$1,565.27 |
$1,565.27 |
$1,565.27 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$558.24 |
$558.24 |
$558.24 |
$1,687.50
|
|
Thoracotomy w/expl
|
$697.44 |
$697.44 |
$697.44 |
$2,045.17
|
|
Thrombin time
|
$49.68 |
$49.68 |
$49.68 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$49.68 |
$49.68 |
$49.68 |
$61.52
|
|
Thyroglobulin antibody
|
$96.48 |
$96.48 |
$96.48 |
$82.00
|
|
Thyroid imaging
|
$318.24 |
$318.24 |
$318.24 |
$695.02
|
|
Thyroid (TSH) Test
|
$97.44 |
$97.44 |
$97.44 |
$111.00
|
|
Thyroid Ultrasound
|
$205.44 |
$205.44 |
$205.44 |
$588.50
|
|
Thyroid uptake measurement
|
$238.56 |
$238.56 |
$238.56 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$62.88 |
$62.88 |
$62.88 |
$64.35
|
|
Tigecycline injection
|
$174.92 |
$174.92 |
$174.92 |
$234.00
|
|
Tirofiban 12.5 mg/50 ml
|
$151.20 |
$151.20 |
$151.20 |
$458.85
|
|
Tissue culture skin/biopsy
|
$154.32 |
$154.32 |
$154.32 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$22.56 |
$22.56 |
$22.56 |
$47.20
|
|
Tissue transglutaminase iga
|
$9.12 |
$9.12 |
$9.12 |
$44.16
|
|
Tixagev and cilgav inj
|
$122.16 |
$122.16 |
$122.16 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$82.75 |
$82.75 |
$82.75 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$128.22 |
$128.22 |
$128.22 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$67.92 |
$67.92 |
$67.92 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$25.20 |
$25.20 |
$25.20 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$25.20 |
$25.20 |
$25.20 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$310.80 |
$310.80 |
$310.80 |
$325.00
|
|
Toxoplasma antibody igg
|
$56.16 |
$56.16 |
$56.16 |
$89.40
|
|
Toxoplasma antibody igm
|
$62.88 |
$62.88 |
$62.88 |
$87.00
|
|
Tp53 gene full gene sequence
|
$519.84 |
$519.84 |
$519.84 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$256.80 |
$256.80 |
$256.80 |
$790.68
|
|
Tpmt gene com vrnts
|
$102.24 |
$102.24 |
$102.24 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$305.04 |
$305.04 |
$305.04 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$33.60 |
$33.60 |
$33.60 |
$101.25
|
|
Transferrin
|
$56.64 |
$56.64 |
$56.64 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$538.80 |
$538.80 |
$538.80 |
$983.00
|
|
Trauma partial team response w/critical care services level 4
|
$923.52 |
$923.52 |
$923.52 |
$4,523.04
|
|
Trb@ gene rearrange dirprobe
|
$40.08 |
$40.08 |
$40.08 |
$73.46
|
|
Treat ankle dislocation
|
$1,045.68 |
$1,045.68 |
$1,045.68 |
$2,358.40
|
|
Treat clavicle dislocation 23545
|
$750.24 |
$750.24 |
$750.24 |
$705.60
|
|
Treat elbow dislocation
|
$1,044.72 |
$1,044.72 |
$1,044.72 |
$2,223.20
|
|
Treat elbow fracture
|
$1,021.44 |
$1,021.44 |
$1,021.44 |
$1,919.13
|
|
Treat finger fracture each
|
$439.68 |
$439.68 |
$439.68 |
$1,536.00
|
|
Treat foot dislocation
|
$60.00 |
$60.00 |
$60.00 |
$396.30
|
|
Treat foot dislocation
|
$186.72 |
$186.72 |
$186.72 |
$527.28
|
|
Treat foot dislocation
|
$95.52 |
$95.52 |
$95.52 |
$445.80
|
|
Treat fracture of radius
|
$439.68 |
$439.68 |
$439.68 |
$1,790.00
|
|
Treat fracture of radius
|
$1,034.16 |
$1,034.16 |
$1,034.16 |
$1,849.00
|
|
Treat fracture of ulna
|
$151.68 |
$151.68 |
$151.68 |
$726.05
|
|
Treat hip dislocation
|
$1,117.20 |
$1,117.20 |
$1,117.20 |
$2,192.80
|
