|
Tc-99m succimer (dmsa)
|
$145.74 |
$145.74 |
$145.74 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$291.90 |
$291.90 |
$291.90 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$70.14 |
$70.14 |
$70.14 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$327.60 |
$327.60 |
$327.60 |
$955.60
|
|
Tcd emboli detect w/inj
|
$524.16 |
$524.16 |
$524.16 |
$475.80
|
|
Tcd emboli detect without inj
|
$524.16 |
$524.16 |
$524.16 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$133.56 |
$133.56 |
$133.56 |
$176.40
|
|
T cells total count
|
$133.56 |
$133.56 |
$133.56 |
$126.90
|
|
Telavancin injection
|
$749.37 |
$749.37 |
$749.37 |
$1,191.80
|
|
Telethx isodose plan cplx
|
$1,922.34 |
$1,922.34 |
$1,922.34 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,191.96 |
$1,191.96 |
$1,191.96 |
$873.62
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,841.93 |
$3,841.93 |
$3,841.93 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$16,814.41 |
$16,814.41 |
$16,814.41 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$41.79 |
$41.79 |
$41.79 |
$39.33
|
|
Test for porphobilinogen
|
$55.02 |
$55.02 |
$55.02 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$732.06 |
$732.06 |
$732.06 |
$842.56
|
|
Testosterone undecanoate 1mg
|
$4,352.22 |
$4,352.22 |
$4,352.22 |
$3,528.08
|
|
Test stress cardiovascular tracing only
|
$875.70 |
$875.70 |
$875.70 |
$949.70
|
|
Test urine for porphyrins
|
$49.98 |
$49.98 |
$49.98 |
$49.98
|
|
Test urine urobilinogen
|
$23.94 |
$23.94 |
$23.94 |
$9.75
|
|
Tetanus immune globulin inj
|
$943.91 |
$943.91 |
$943.91 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$8,737.92 |
$8,737.92 |
$8,737.92 |
$8,737.05
|
|
Thaw preserved stem cells
|
$1,236.48 |
$1,236.48 |
$1,236.48 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$70.56 |
$70.56 |
$70.56 |
$108.00
|
|
Therapeutic procd strg endur
|
$83.16 |
$83.16 |
$83.16 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$34.86 |
$34.86 |
$34.86 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$42.00 |
$42.00 |
$42.00 |
$50.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$41.79 |
$41.79 |
$41.79 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$714.84 |
$714.84 |
$714.84 |
$1,687.50
|
|
Thoracoscopy diagnostic 32601
|
$2,728.74 |
$2,728.74 |
$2,728.74 |
$6,442.80
|
|
Thoracotomy w/expl
|
$4,530.96 |
$4,530.96 |
$4,530.96 |
$2,045.17
|
|
Thorcscpy w/biop pleura
|
$2,728.74 |
$2,728.74 |
$2,728.74 |
$6,904.15
|
|
Thrcspy w/diag bp lng nod uni
|
$3,978.66 |
$3,978.66 |
$3,978.66 |
$6,120.30
|
|
Thrombectmy crnry perq mechanical
|
$3,166.38 |
$3,166.38 |
$3,166.38 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,278.64 |
$9,278.64 |
$9,278.64 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$14,111.16 |
$14,111.16 |
$14,111.16 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$3,576.30 |
$3,576.30 |
$3,576.30 |
$21,413.60
|
|
Thrombin time
|
$54.18 |
$54.18 |
$54.18 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$73.92 |
$73.92 |
$73.92 |
$61.52
|
|
Thyroglobulin antibody
|
$38.64 |
$38.64 |
$38.64 |
$82.00
|
|
Thyroid imaging
|
$228.48 |
$228.48 |
$228.48 |
$695.02
|
|
Thyroid met imaging
|
$393.12 |
$393.12 |
$393.12 |
$838.25
|
|
Thyroid mets imag whole body
|
$982.80 |
$982.80 |
$982.80 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$112.98 |
$112.98 |
$112.98 |
$111.00
|
|
Thyroid Ultrasound
|
$367.92 |
$367.92 |
$367.92 |
$588.50
|
|
Thyroid uptake measurement
|
$343.14 |
$343.14 |
$343.14 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,152.21 |
$4,152.21 |
$4,152.21 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$36.12 |
$36.12 |
$36.12 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$13,497.12 |
$13,497.12 |
$13,497.12 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$11,456.34 |
$11,456.34 |
$11,456.34 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$14,419.02 |
$14,419.02 |
$14,419.02 |
$9,769.65
|
|
Tigecycline injection
|
$201.68 |
$201.68 |
$201.68 |
$234.00
|
|
Tilt table study
|
$1,946.28 |
$1,946.28 |
$1,946.28 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$458.85 |
$458.85 |
$458.85 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$13,339.20 |
$13,339.20 |
$13,339.20 |
$13,339.20
|
|
Tissue amnio epifix inj 100mg
|
$2,825.08 |
$2,825.08 |
$2,825.08 |
$4,834.73
|
|
Tissue culture placenta
|
$484.26 |
$484.26 |
$484.26 |
$457.00
|
|
Tissue culture skin/biopsy
|
$465.36 |
$465.36 |
$465.36 |
$484.00
|
|
Tissue culture tumor
|
$470.40 |
$470.40 |
$470.40 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$44.94 |
$44.94 |
$44.94 |
$47.20
|
|
Tissue transglutaminase iga
|
$50.82 |
$50.82 |
$50.82 |
$44.16
|
|
Tixagev and cilgav inj
|
$113.82 |
$113.82 |
$113.82 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$33.60 |
$33.60 |
$33.60 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$887.33 |
$887.33 |
$887.33 |
$152.36
|
|
Tobramycin non-comp unit
|
$28.50 |
$28.50 |
$28.50 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$113.82 |
$113.82 |
$113.82 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,382.05 |
$5,382.05 |
$5,382.05 |
$5,258.52
|
|
Tomosynthesis breast screen bilateral
|
$42.00 |
$42.00 |
$42.00 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$268.89 |
$268.89 |
$268.89 |
$325.00
|
|
Toxoplasma antibody igg
|
$110.46 |
$110.46 |
$110.46 |
$89.40
|
|
Toxoplasma antibody igm
|
$105.00 |
$105.00 |
$105.00 |
$87.00
|
|
Tpmt gene com vrnts
|
$609.42 |
$609.42 |
$609.42 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$6,504.29 |
$6,504.29 |
$6,504.29 |
$6,827.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$216.72 |
$216.72 |
$216.72 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$53.76 |
$53.76 |
$53.76 |
$101.25
|
|
Transabdom amnioinfus w/us
|
$465.36 |
$465.36 |
$465.36 |
$678.70
|
|
Transcath biopsy
|
$3,937.08 |
$3,937.08 |
$3,937.08 |
$4,285.93
|
|
Transcath closure of asd
|
$11,393.76 |
$11,393.76 |
$11,393.76 |
$16,741.40
|
|
Transcath closure of vsd
|
$13,999.02 |
$13,999.02 |
$13,999.02 |
$17,115.04
|
|
Transcatheter bx s&i
|
$1,185.66 |
$1,185.66 |
$1,185.66 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$7,993.44 |
$7,993.44 |
$7,993.44 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$15,082.20 |
$15,082.20 |
$15,082.20 |
$12,418.00
|
|
Transcath occlusion cns
|
$2,776.20 |
$2,776.20 |
$2,776.20 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$8,106.84 |
$8,106.84 |
$8,106.84 |
$10,031.28
|
|
Trans cath replace aortic valve 33366
|
$8,371.02 |
$8,371.02 |
$8,371.02 |
$14,363.70
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,387.70 |
$2,387.70 |
$2,387.70 |
$4,775.16
|
|
Transcutaneous carboxyhb
|
$147.84 |
$147.84 |
$147.84 |
$33.57
|
|
Transcutaneous hgb 88738
|
$201.18 |
$201.18 |
$201.18 |
$13.80
|
|
Transcutaneous methb
|
$132.72 |
$132.72 |
$132.72 |
$19.20
|
|
Transferrin
|
$81.48 |
$81.48 |
$81.48 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,040.76 |
$1,040.76 |
$1,040.76 |
$983.00
|
|
Transparent film <= 16 sq in
|
$0.65 |
$0.65 |
$0.65 |
$4.50
|
|
Transplt allo hct/donor
|
$2,572.08 |
$2,572.08 |
$2,572.08 |
$29,206.10
|
|
Transplt autol hct/donor
|
$2,572.08 |
$2,572.08 |
$2,572.08 |
$3,786.00
|
|
Trastuzumab 150 mg intravenous solution
|
$8,785.19 |
$8,785.19 |
$8,785.19 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$7,327.83 |
$7,327.83 |
$7,327.83 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$4,529.03 |
$4,529.03 |
$4,529.03 |
$5,835.15
|
|
Trauma partial team response w/critical care services level 4
|
$4,153.80 |
$4,153.80 |
$4,153.80 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$504.00 |
$504.00 |
$504.00 |
$940.80
|
|
Treat ankle dislocation
|
$1,289.40 |
$1,289.40 |
$1,289.40 |
$2,358.40
|
