|
Strapping of hand or finger
|
$36.75 |
$36.75 |
$36.75 |
$174.82
|
|
Strapping of knee
|
$36.75 |
$36.75 |
$36.75 |
$205.20
|
|
Strapping of toes 29550
|
$36.75 |
$36.75 |
$36.75 |
$164.70
|
|
Strep b dna amp probe
|
$32.75 |
$32.75 |
$32.75 |
$120.90
|
|
Streptomycin injection
|
$72.74 |
$72.74 |
$72.74 |
$138.30
|
|
Stress test pulmonary
|
$56.00 |
$56.00 |
$56.00 |
$322.85
|
|
St treatment speech individual
|
$271.25 |
$271.25 |
$271.25 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$271.25 |
$271.25 |
$271.25 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$52.31 |
$52.31 |
$52.31 |
$52.31
|
|
Sulfonylurea screen qn-sendout
|
$77.25 |
$77.25 |
$77.25 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$43.37 |
$43.37 |
$43.37 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$9.50 |
$9.50 |
$9.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$15.75 |
$15.75 |
$15.75 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$34.75 |
$34.75 |
$34.75 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$41.25 |
$41.25 |
$41.25 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$130.75 |
$130.75 |
$130.75 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$274.50 |
$274.50 |
$274.50 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$2.50 |
$2.50 |
$2.50 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$5.50 |
$5.50 |
$5.50 |
$35.70
|
|
Susceptibility mic per plate
|
$96.75 |
$96.75 |
$96.75 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$5.25 |
$5.25 |
$5.25 |
$59.28
|
|
Svc venogram s&i
|
$1,061.75 |
$1,061.75 |
$1,061.75 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$40.50 |
$40.50 |
$40.50 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$32.50 |
$32.50 |
$32.50 |
$41.60
|
|
T3 (triiodothyronine) free
|
$161.25 |
$161.25 |
$161.25 |
$99.20
|
|
T3 (triiodothyronine) total
|
$134.25 |
$134.25 |
$134.25 |
$93.52
|
|
T4 (thyroxine) free
|
$39.25 |
$39.25 |
$39.25 |
$85.20
|
|
T4 (thyroxine) total
|
$30.75 |
$30.75 |
$30.75 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.26 |
$3.26 |
$3.26 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$195.25 |
$195.25 |
$195.25 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,026.38 |
$1,026.38 |
$1,026.38 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$462.00 |
$462.00 |
$462.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,847.25 |
$1,847.25 |
$1,847.25 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$196.50 |
$196.50 |
$196.50 |
$177.65
|
|
Tc-99m disofenin
|
$112.11 |
$112.11 |
$112.11 |
$124.32
|
|
Tc-99m exametazime diag
|
$804.75 |
$804.75 |
$804.75 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$76.75 |
$76.75 |
$76.75 |
$302.40
|
|
Tc-99m maa
|
$60.75 |
$60.75 |
$60.75 |
$292.80
|
|
Tc-99m mebrofenin
|
$39.38 |
$39.38 |
$39.38 |
$157.65
|
|
Tc-99m medronate
|
$31.65 |
$31.65 |
$31.65 |
$111.01
|
|
Tc-99m mertiatide
|
$264.00 |
$264.00 |
$264.00 |
$756.00
|
|
Tc-99m oxidronate
|
$15.00 |
$15.00 |
$15.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$10.50 |
$10.50 |
$10.50 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$0.27 |
$0.27 |
$0.27 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$119.92 |
$119.92 |
$119.92 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$54.02 |
$54.02 |
$54.02 |
$274.45
|
|
Tc-99m sulfur colloid
|
$46.75 |
$46.75 |
$46.75 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$39.25 |
$39.25 |
$39.25 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$391.50 |
$391.50 |
$391.50 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$147.25 |
$147.25 |
$147.25 |
$176.40
|
|
T cells absolute cd 4 count
|
$143.00 |
$143.00 |
$143.00 |
$111.20
|
|
T cells total count
|
$68.75 |
$68.75 |
$68.75 |
$126.90
|
|
Telehealth original site facility fee
|
$17.25 |
$17.25 |
$17.25 |
$51.00
|
|
Telethx isodose plan cplx
|
$512.50 |
$512.50 |
$512.50 |
$1,526.85
|
|
Telethx isodose plan simple
|
$456.00 |
$456.00 |
$456.00 |
$873.62
|
|
Temozolomide
|
$146.04 |
$146.04 |
$146.04 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$994.40 |
$994.40 |
$994.40 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.38 |
$9.38 |
$9.38 |
$39.33
|
|
Test for chlorohydrocarbons
|
$92.25 |
$92.25 |
$92.25 |
$65.00
|
|
Test stress cardiovascular tracing only
|
$229.50 |
$229.50 |
$229.50 |
$949.70
|
|
Tgsap hl neo 5-50 rna alys
|
$616.25 |
$616.25 |
$616.25 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$2,368.25 |
$2,368.25 |
$2,368.25 |
$4,347.00
|
|
Tgsap so neo 5-50 rna alys
|
$485.25 |
$485.25 |
$485.25 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$134.25 |
$134.25 |
$134.25 |
$108.00
|
|
Therapeutic procd strg endur
|
$20.25 |
$20.25 |
$20.25 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$25.00 |
$25.00 |
$25.00 |
$57.31
|
|
Ther/proph/diag inj ia
|
$92.00 |
$92.00 |
$92.00 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.26 |
$17.26 |
$17.26 |
$25.54
|
|
Thiotepa injection
|
$1,630.49 |
$1,630.49 |
$1,630.49 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$764.00 |
$764.00 |
$764.00 |
$1,687.50
|
|
Thoracotomy w/expl
|
$726.50 |
$726.50 |
$726.50 |
$2,045.17
|
|
Thrombectmy crnry perq mechanical
|
$2,330.00 |
$2,330.00 |
$2,330.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,025.75 |
$2,025.75 |
$2,025.75 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$4,094.50 |
$4,094.50 |
$4,094.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$6,206.50 |
$6,206.50 |
$6,206.50 |
$21,413.60
|
|
Thrombin time
|
$19.00 |
$19.00 |
$19.00 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$4,533.00 |
$4,533.00 |
$4,533.00 |
$3,980.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$59.00 |
$59.00 |
$59.00 |
$61.52
|
|
Thyroglobulin antibody
|
$148.50 |
$148.50 |
$148.50 |
$82.00
|
|
Thyroid imaging
|
$386.25 |
$386.25 |
$386.25 |
$695.02
|
|
Thyroid mets imag whole body
|
$307.25 |
$307.25 |
$307.25 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$89.25 |
$89.25 |
$89.25 |
$111.00
|
|
Thyroid Ultrasound
|
$220.25 |
$220.25 |
$220.25 |
$588.50
|
|
Thyroid uptake measurement
|
$317.75 |
$317.75 |
$317.75 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$254.25 |
$254.25 |
$254.25 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$18,214.25 |
$18,214.25 |
$18,214.25 |
$21,249.26
|
|
Tib/per revasc w/ather add-on 37233
|
$10,491.00 |
$10,491.00 |
$10,491.00 |
$9,769.65
|
|
Tigecycline injection
|
$182.21 |
$182.21 |
$182.21 |
$234.00
|
|
Tilt table study
|
$382.50 |
$382.50 |
$382.50 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$157.50 |
$157.50 |
$157.50 |
$458.85
|
|
Tissue culture skin/biopsy
|
$247.75 |
$247.75 |
$247.75 |
$484.00
|
|
Tissue culture tumor
|
$129.50 |
$129.50 |
$129.50 |
$483.36
|
|
Tissue transglutaminase iga
|
$9.50 |
$9.50 |
$9.50 |
$44.16
|
|
Tixagev and cilgav inj
|
$127.25 |
$127.25 |
$127.25 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$86.20 |
$86.20 |
$86.20 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$133.56 |
$133.56 |
$133.56 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$132.75 |
$132.75 |
$132.75 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$26.25 |
$26.25 |
$26.25 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$26.25 |
$26.25 |
$26.25 |
$72.68
|
