|
Support clav 29.6-40.5in med
|
$9.36 |
$9.36 |
$10.17 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$20.24 |
$20.24 |
$24.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$48.76 |
$48.76 |
$51.00 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$27.14 |
$27.14 |
$52.50 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$43.24 |
$43.24 |
$221.50 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$142.60 |
$142.60 |
$166.50 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$166.50 |
$166.50 |
$201.48 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$35.42 |
$35.42 |
$38.50 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$39.10 |
$39.10 |
$105.00 |
$35.70
|
|
Susceptibility mic per plate
|
$45.54 |
$45.54 |
$88.50 |
$106.00
|
|
Svc venogram s&i
|
$877.68 |
$877.68 |
$1,152.00 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$31.56 |
$31.56 |
$34.30 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$25.50 |
$25.50 |
$25.50 |
$41.60
|
|
System cardiomems hosp electronics
|
$19,126.80 |
$19,126.80 |
$20,790.00 |
$39,037.95
|
|
System pacing micra av
|
$18,940.50 |
$18,940.50 |
$20,587.50 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,838.90 |
$8,838.90 |
$9,607.50 |
$12,003.00
|
|
System sealant biosentry tract
|
$507.38 |
$507.38 |
$523.55 |
$889.35
|
|
T3 (triiodothyronine) free
|
$99.82 |
$99.82 |
$272.50 |
$99.20
|
|
T3 (triiodothyronine) total
|
$65.32 |
$65.32 |
$99.50 |
$93.52
|
|
T4 (thyroxine) free
|
$42.32 |
$42.32 |
$73.50 |
$85.20
|
|
T4 (thyroxine) total
|
$24.84 |
$24.84 |
$32.50 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.49 |
$0.49 |
$0.53 |
$9.84
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$107.30 |
$107.30 |
$116.63 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$89.70 |
$89.70 |
$92.50 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$585.87 |
$585.87 |
$636.82 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$4,763.22 |
$4,763.22 |
$5,177.41 |
$21,745.13
|
|
Tavr perq femoral
|
$7,939.14 |
$7,939.14 |
$9,233.50 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$234.07 |
$234.07 |
$254.42 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$153.64 |
$153.64 |
$218.00 |
$177.65
|
|
Tc-99m bicisate
|
$1,202.50 |
$1,202.50 |
$1,202.50 |
$1,969.45
|
|
Tc-99m disofenin
|
$73.50 |
$73.50 |
$73.50 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,463.26 |
$1,463.26 |
$1,590.50 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,090.50 |
$1,090.50 |
$1,407.14 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$199.64 |
$199.64 |
$229.50 |
$302.40
|
|
Tc-99m maa
|
$32.00 |
$32.00 |
$42.78 |
$292.80
|
|
Tc-99m mebrofenin
|
$59.00 |
$59.00 |
$62.56 |
$157.65
|
|
Tc-99m medronate
|
$40.50 |
$40.50 |
$46.46 |
$111.01
|
|
Tc-99m mertiatide
|
$222.18 |
$222.18 |
$377.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$5.00 |
$6.60
|
|
Tc-99m oxidronate
|
$66.24 |
$66.24 |
$72.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$38.00 |
$38.00 |
$38.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$338.50 |
$338.50 |
$338.50 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$40.50 |
$40.50 |
$119.14 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$43.50 |
$43.50 |
$43.50 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$220.34 |
$220.34 |
$230.50 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$220.50 |
$220.50 |
$220.50 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$130.00 |
$130.00 |
$130.00 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$620.50 |
$620.50 |
$620.50 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$132.94 |
$132.94 |
$144.50 |
$176.40
|
|
T cells absolute cd 4 count
|
$39.50 |
$39.50 |
$39.50 |
$111.20
|
|
T cells total count
|
$111.00 |
$111.00 |
$111.00 |
$126.90
|
|
Telethx isodose plan cplx
|
$1,702.00 |
$1,702.00 |
$1,702.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,021.50 |
$1,021.50 |
$1,021.50 |
$873.62
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$841.57 |
$841.57 |
$914.75 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$3,683.16 |
$3,683.16 |
$4,003.43 |
$15,245.38
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,199.00 |
$1,199.00 |
$1,199.00 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$1.06 |
$1.06 |
$1.15 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$704.00 |
$704.00 |
$704.00 |
$842.56
|
|
Testosterone undecanoate 1mg
|
$317.79 |
$317.79 |
$345.42 |
$3,528.08
|
|
Test stress cardiovascular tracing only
|
$653.66 |
$653.66 |
$901.00 |
$949.70
|
|
Test urine for porphyrins
|
$50.50 |
$50.50 |
$50.50 |
$49.98
|
|
Tetanus immune globulin inj
|
$206.77 |
$206.77 |
$224.74 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$1,002.11 |
$1,002.11 |
$1,089.25 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$65.00 |
$65.00 |
$85.10 |
$108.00
|
|
Therapeutic procd strg endur
|
$66.00 |
$66.00 |
$66.00 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$41.50 |
$41.50 |
$41.50 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$45.50 |
$45.50 |
$45.50 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$940.50 |
$940.50 |
$940.50 |
$529.08
|
|
Ther/proph/diag inj ia
|
$301.76 |
$301.76 |
$301.76 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$1.80 |
$1.80 |
$1.96 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$539.50 |
$539.50 |
$1,205.66 |
$1,687.50
|
|
Thoracotomy w/expl
|
$5,008.94 |
$5,008.94 |
$5,008.94 |
$2,045.17
|
|
Thrombectmy crnry perq mechanical
|
$3,271.52 |
$3,271.52 |
$3,271.52 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,781.58 |
$1,781.58 |
$3,966.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$3,299.12 |
$3,299.12 |
$7,592.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$8,385.50 |
$8,385.50 |
$17,652.50 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$1,738.80 |
$1,738.80 |
$1,890.00 |
$5,520.00
|
|
Thrombin time
|
$58.50 |
$58.50 |
$83.72 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$1,363.90 |
$1,363.90 |
$1,363.90 |
$3,980.60
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$3,249.44 |
$3,249.44 |
$3,249.44 |
$4,585.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$69.50 |
$69.50 |
$104.42 |
$61.52
|
|
Thyroglobulin antibody
|
$28.06 |
$28.06 |
$46.50 |
$82.00
|
|
Thyroid imaging
|
$392.00 |
$392.00 |
$392.00 |
$695.02
|
|
Thyroid met imaging
|
$448.50 |
$448.50 |
$448.50 |
$838.25
|
|
Thyroid met imaging/studies
|
$1,139.00 |
$1,139.00 |
$1,139.00 |
$763.73
|
|
Thyroid mets imag whole body
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$44.16 |
$44.16 |
$129.50 |
$111.00
|
|
Thyroid Ultrasound
|
$408.94 |
$408.94 |
$432.00 |
$588.50
|
|
Thyroid uptake measurement
|
$148.12 |
$148.12 |
$251.50 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$909.54 |
$909.54 |
$988.62 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$111.50 |
$111.50 |
$111.50 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$8,834.50 |
$8,834.50 |
$15,527.30 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$1,996.00 |
$1,996.00 |
$4,972.14 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$6,118.50 |
$6,118.50 |
$7,942.82 |
$9,769.65
|
|
Tigecycline injection
|
$44.18 |
$44.18 |
$48.02 |
$234.00
|
|
Tilt table study
|
$832.60 |
$832.60 |
$1,457.00 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$1.65 |
$1.65 |
$1.79 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$2,921.92 |
$2,921.92 |
$3,176.00 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$3,094.14 |
$3,094.14 |
$3,363.19 |
$4,834.73
|
|
Tissue culture placenta
|
$715.00 |
$715.00 |
$715.00 |
$457.00
|
