|
Susceptibility mic per plate
|
$117.65 |
$117.65 |
$117.65 |
$89.70
|
|
Sweat collection by iontophoresis
|
$133.25 |
$133.25 |
$133.25 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$53.30 |
$53.30 |
$53.30 |
$45.70
|
|
T3 (triiodothyronine) free
|
$128.05 |
$128.05 |
$128.05 |
$91.20
|
|
T3 (triiodothyronine) total
|
$114.40 |
$114.40 |
$114.40 |
$88.00
|
|
T4 (thyroxine) free
|
$104.00 |
$104.00 |
$104.00 |
$65.00
|
|
T4 (thyroxine) total
|
$104.00 |
$104.00 |
$104.00 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$162.50 |
$162.50 |
$162.50 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$1,604.20 |
$1,604.20 |
$1,604.20 |
$1,928.40
|
|
Target gsa panel organ neop
|
$1,911.00 |
$1,911.00 |
$1,911.00 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$208.00 |
$208.00 |
$208.00 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$190.45 |
$190.45 |
$190.45 |
$178.40
|
|
Tc-99m disofenin
|
$202.15 |
$202.15 |
$202.15 |
$151.32
|
|
Tc-99m labeled rbc
|
$341.90 |
$341.90 |
$341.90 |
$312.70
|
|
Tc-99m maa
|
$174.20 |
$174.20 |
$174.20 |
$306.60
|
|
Tc-99m mebrofenin
|
$190.45 |
$190.45 |
$190.45 |
$169.53
|
|
Tc-99m medronate
|
$160.55 |
$160.55 |
$160.55 |
$120.35
|
|
Tc-99m mertiatide
|
$782.60 |
$782.60 |
$782.60 |
$757.25
|
|
Tc-99m oxidronate
|
$151.45 |
$151.45 |
$151.45 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$156.00 |
$156.00 |
$156.00 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$27.95 |
$27.95 |
$27.95 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$344.50 |
$344.50 |
$344.50 |
$221.60
|
|
Tc-99m sulfur colloid
|
$245.70 |
$245.70 |
$245.70 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$344.50 |
$344.50 |
$344.50 |
$198.05
|
|
T cells absolute cd4/cd8 including ratio
|
$204.75 |
$204.75 |
$204.75 |
$189.60
|
|
T cells absolute cd 4 count
|
$130.00 |
$130.00 |
$130.00 |
$120.25
|
|
T cells total count
|
$141.05 |
$141.05 |
$141.05 |
$126.90
|
|
Telehealth original site facility fee
|
$35.10 |
$35.10 |
$35.10 |
$55.65
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$16,233.59 |
$16,233.59 |
$16,233.59 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$7.15 |
$7.15 |
$7.15 |
$39.33
|
|
Test for porphobilinogen
|
$59.15 |
$59.15 |
$59.15 |
$33.57
|
|
Test pathogen(s) for platelets reference
|
$50.70 |
$50.70 |
$50.70 |
$52.00
|
|
Test stress cardiovascular tracing only
|
$603.85 |
$603.85 |
$603.85 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,981.73 |
$1,981.73 |
$1,981.73 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$142.35 |
$142.35 |
$142.35 |
$101.40
|
|
Therapeutic procd strg endur
|
$79.95 |
$79.95 |
$79.95 |
$72.39
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$36.40 |
$36.40 |
$36.40 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$27.30 |
$27.30 |
$27.30 |
$47.50
|
|
Thrombin time
|
$63.70 |
$63.70 |
$63.70 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$87.75 |
$87.75 |
$87.75 |
$56.93
|
|
Thyroglobulin antibody
|
$124.80 |
$124.80 |
$124.80 |
$86.40
|
|
Thyroid (TSH) Test
|
$120.90 |
$120.90 |
$120.90 |
$101.40
|
|
Thyroid Ultrasound
|
$564.85 |
$564.85 |
$564.85 |
$553.80
|
|
Thyroxine binding globulin (tbg)
|
$81.25 |
$81.25 |
$81.25 |
$75.00
|
|
Tigecycline injection
|
$302.25 |
$302.25 |
$302.25 |
$7.44
|
|
Tirofiban 12.5 mg/50 ml
|
$278.07 |
$278.07 |
$278.07 |
$696.08
|
|
Tissue culture placenta
|
$424.45 |
$424.45 |
$424.45 |
$470.00
|
|
Tissue culture skin/biopsy
|
$419.90 |
$419.90 |
$419.90 |
$626.77
|
|
Tissue exam koh skin/hair/nails
|
$46.15 |
$46.15 |
$46.15 |
$45.23
|
|
Tissue transglutaminase iga
|
$87.75 |
$87.75 |
$87.75 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$136.50 |
$136.50 |
$136.50 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.15 |
$7.15 |
$7.15 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$119.60 |
$119.60 |
$119.60 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,790.85 |
$5,790.85 |
$5,790.85 |
$2,743.02
|
|
Tomosynthesis breast diagnostic left
|
$68.90 |
$68.90 |
$68.90 |
$53.92
|
|
Tomosynthesis breast screen bilateral
|
$68.90 |
$68.90 |
$68.90 |
$77.46
|
|
Toxoplasma antibody igg
|
$76.05 |
$76.05 |
$76.05 |
$83.20
|
|
Toxoplasma antibody igm
|
$76.05 |
$76.05 |
$76.05 |
$85.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$90.35 |
$90.35 |
$90.35 |
$90.35
|
|
Transferrin
|
$139.75 |
$139.75 |
$139.75 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$1,926.27 |
$1,926.27 |
$1,926.27 |
$988.24
|
|
Treat clavicle dislocation 23545
|
$828.75 |
$828.75 |
$828.75 |
$759.61
|
|
Treat elbow dislocation
|
$1,203.15 |
$1,203.15 |
$1,203.15 |
$2,326.40
|
|
Treat finger fracture each
|
$741.65 |
$741.65 |
$741.65 |
$1,808.00
|
|
Treat foot dislocation
|
$258.70 |
$258.70 |
$258.70 |
$422.45
|
|
Treat fracture of radius
|
$841.75 |
$841.75 |
$841.75 |
$1,884.74
|
|
Treat hip dislocation
|
$1,647.75 |
$1,647.75 |
$1,647.75 |
$2,644.00
|
|
Treat hip dislocation
|
$895.70 |
$895.70 |
$895.70 |
$3,493.90
|
|
Treat hip socket fracture
|
$2,228.20 |
$2,228.20 |
$2,228.20 |
$1,903.18
|
|
Treat kneecap dislocation
|
$1,108.25 |
$1,108.25 |
$1,108.25 |
$1,931.40
|
|
Treat knuckle dislocation
|
$793.65 |
$793.65 |
$793.65 |
$1,796.80
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$140.40 |
$140.40 |
$140.40 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$134.55 |
$134.55 |
$134.55 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$140.40 |
$140.40 |
$140.40 |
$197.60
|
|
Treatment missed abortion completed surgically 1st trimester
|
$5,186.58 |
$5,186.58 |
$5,186.58 |
$3,820.53
|
|
Treatment of ankle fracture 27786
|
$638.30 |
$638.30 |
$638.30 |
$575.25
|
|
Treatment of toe fracture 28510
|
$272.35 |
$272.35 |
$272.35 |
$362.00
|
|
Treat ulnar fracture
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$1,771.43
|
|
Treponema pallidum antibody
|
$68.90 |
$68.90 |
$68.90 |
$74.40
|
|
Trg gene rearrangement anal
|
$385.45 |
$385.45 |
$385.45 |
$474.50
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$24.45 |
$24.45 |
$24.45 |
$28.90
|
|
#tricyclicantidprssnt
|
$129.35 |
$129.35 |
$129.35 |
$38.73
|
|
Triglycerides
|
$90.35 |
$90.35 |
$90.35 |
$48.75
|
|
Trimethobenzamide hcl inj
|
$19.93 |
$19.93 |
$19.93 |
$105.89
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$1,621.75 |
$1,621.75 |
$1,621.75 |
$2,328.30
|
|
Troponin quantitative
|
$143.00 |
$143.00 |
$143.00 |
$112.80
|
|
Tx closed hip disl traumatic without anes
|
$1,079.65 |
$1,079.65 |
$1,079.65 |
$650.45
|
|
Ua w/micro/comp poc
|
$43.55 |
$43.55 |
$43.55 |
$25.72
|
|
Ugt1a1 gene analy common variants
|
$607.10 |
$607.10 |
$607.10 |
$438.75
|
|
Ultrasound breast complete
|
$633.10 |
$633.10 |
$633.10 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$499.85 |
$499.85 |
$499.85 |
$427.00
|
|
Ultrasound chest
|
$452.40 |
$452.40 |
$452.40 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$320.45 |
$320.45 |
$320.45 |
$340.03
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$433.55 |
$433.55 |
$433.55 |
$428.68
|
|
Ultrasound guided needle placement supervision & interpretation
|
$670.15 |
$670.15 |
$670.15 |
$629.64
|
|
Ultrasound guide intraoperative
|
$727.35 |
$727.35 |
$727.35 |
$628.80
|
|
Ultrasound joint/nonvascular extremity limited left
|
$616.85 |
$616.85 |
$616.85 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$538.20 |
$538.20 |
$538.20 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$366.60 |
$366.60 |
$366.60 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$760.50 |
$760.50 |
$760.50 |
$680.71
|
