|
Surgical pathology level 5 gross & microscopic examination
|
$142.60 |
$239.40 |
$858.88 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$166.50 |
$318.78 |
$1,011.98 |
|
|
Surg tx anal fistula 2nd stage 46285
|
$1,315.55 |
$1,331.40 |
$1,347.25 |
|
|
Susceptibility agar dilution per agent
|
$10.62 |
$35.70 |
$175.18 |
|
|
Susceptibility enzyme detection per enzyme
|
$38.47 |
$71.40 |
$105.00 |
|
|
Susceptibility mic per plate
|
$45.54 |
$88.50 |
$176.80 |
|
|
Suscept studies macrobroth dilution ea
|
$39.85 |
$39.85 |
$39.85 |
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$2,356.37 |
$2,384.76 |
$2,413.15 |
|
|
Svc venogram s&i
|
$877.68 |
$981.12 |
$1,571.76 |
|
|
Swallowing Evaluation (Bedside)
|
$133.98 |
$159.62 |
$508.30 |
|
|
Swallowing Therapy Session
|
$154.98 |
$180.84 |
$1,300.50 |
|
|
Synvisc or synvisc-one
|
$31.56 |
$864.30 |
$1,749.18 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.62 |
$34.02 |
$57.80 |
|
|
System cardiomems hosp electronics
|
$19,126.80 |
$19,547.22 |
$35,343.00 |
|
|
System pacing micra av
|
$17,293.50 |
$20,115.26 |
$34,998.75 |
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,070.30 |
$9,607.50 |
$62,855.30 |
|
|
System sealant biosentry tract
|
$439.78 |
$507.38 |
$890.03 |
|
|
T3 (triiodothyronine) free
|
$43.52 |
$226.10 |
$272.50 |
|
|
T3 (triiodothyronine) total
|
$22.57 |
$86.52 |
$141.10 |
|
|
T4 (thyroxine) free
|
$40.46 |
$63.84 |
$141.95 |
|
|
T4 (thyroxine) total
|
$24.84 |
$32.50 |
$120.70 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.49 |
$176.74 |
$357.68 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$107.30 |
$142.29 |
$991.32 |
|
|
Tacrolimus therapeutic drug level
|
$39.23 |
$84.79 |
$368.90 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$585.87 |
$2,674.63 |
$5,412.93 |
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$102.06 |
$179.00 |
$272.58 |
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$4,763.22 |
$21,745.13 |
$44,007.99 |
|
|
Target gsa panel hmtlmph neop
|
$1,765.12 |
$1,765.12 |
$1,765.12 |
|
|
Target gsa panel organ/hmtlmph neop
|
$6,455.38 |
$6,455.38 |
$6,455.38 |
|
|
Tavr perq femoral
|
$7,939.14 |
$8,256.36 |
$9,233.50 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$234.07 |
$850.84 |
$1,721.93 |
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$230.40 |
$230.40 |
$230.40 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$142.85 |
$201.60 |
$408.00 |
|
|
Tc-99m bicisate
|
$1,202.50 |
$2,905.14 |
$4,994.60 |
|
|
Tc-99m depreotide
|
$721.56 |
$721.56 |
$1,394.00 |
|
|
Tc-99m diag per dose
|
$53.07 |
$220.08 |
$3,977.19 |
|
|
Tc-99m disofenin
|
$73.50 |
$133.98 |
$168.30 |
|
|
Tc-99m exame autol wbc diag per dose
|
$1,463.26 |
$1,463.26 |
$1,590.50 |
|
|
Tc-99m exametazime diag
|
$1,090.50 |
$2,625.84 |
$4,516.90 |
|
|
Tc-99m fanolesomab diag
|
$1,590.96 |
$1,590.96 |
$1,590.96 |
|
|
Tc-99m labeled rbc
|
$164.02 |
$259.56 |
$446.25 |
|
|
Tc-99m maa
|
$32.00 |
$312.06 |
$536.35 |
|
|
Tc-99m mebrofenin
|
$55.46 |
$59.00 |
$168.02 |
|
|
Tc-99m medronate
|
$40.50 |
$84.42 |
$219.67 |
|
|
Tc-99m mertiatide
|
$177.51 |
$558.18 |
$959.65 |
|
|
Tc-99m non-heu per study dose
|
$4.20 |
$4.20 |
$5.00 |
|
|
Tc-99m oxidronate
|
$60.48 |
$66.24 |
$122.40 |
|
|
Tc-99m pentetate dtpa
|
$38.00 |
$249.90 |
$429.25 |
|
|
Tc-99m pentetate dtpa aerosol
|
$284.34 |
$284.34 |
$488.75 |
|
|
Tc-99m pertechnetate per mci
|
$1.26 |
$2.52 |
$119.14 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$43.50 |
$72.66 |
$136.40 |
|
|
Tc-99m sestamibi p study dose
|
$172.30 |
$468.30 |
$947.75 |
|
|
Tc-99m succimer (dmsa)
|
$145.74 |
$145.74 |
$238.85 |
|
|
Tc-99m sulfur colloid
|
$61.00 |
$291.90 |
$502.35 |
|
|
Tc-99m tetrofosmin p study dose
|
$70.14 |
$70.14 |
$181.78 |
|
|
Tc-99m tilmanocept diag
|
$327.60 |
$327.60 |
$958.31 |
|
|
Tcd emboli detect w/inj
|
$524.16 |
$524.16 |
$524.16 |
|
|
Tcd emboli detect without inj
|
$524.16 |
$524.16 |
$524.16 |
|
|
T cells absolute cd4/cd8 including ratio
|
$108.29 |
$133.56 |
$236.30 |
|
|
T cells absolute cd 4 count
|
$19.52 |
$39.50 |
$138.55 |
|
|
T cells total count
|
$84.37 |
$133.56 |
$236.30 |
|
|
Team conf without pat by hc pro
|
$59.00 |
$59.00 |
$59.00 |
|
|
Team conf w/pat by hc prof
|
$110.33 |
$301.56 |
$305.15 |
|
|
Telavancin injection
|
$749.37 |
$749.37 |
$1,516.57 |
|
|
Telehealth original site facility fee
|
$21.56 |
$47.88 |
$49.80 |
|
|
Telethx isodose plan cplx
|
$1,702.00 |
$1,922.34 |
$2,983.85 |
|
|
Telethx isodose plan simple
|
$1,021.50 |
$1,191.96 |
$1,546.35 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$841.57 |
$3,841.93 |
$7,775.34 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$3,683.16 |
$16,814.41 |
$34,029.16 |
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$884.78 |
$895.44 |
$1,199.00 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$1.06 |
$41.79 |
$84.58 |
|
|
Test for porphobilinogen
|
$55.02 |
$55.02 |
$97.75 |
|
|
Testicular imaging w/vasc flow
|
$586.96 |
$732.06 |
$1,220.60 |
|
|
Testosterone undecanoate 1mg
|
$317.79 |
$4,352.22 |
$8,808.05 |
|
|
Test stress cardiovascular tracing only
|
$653.66 |
$901.00 |
$1,399.10 |
|
|
Test urine for porphyrins
|
$49.98 |
$49.98 |
$83.30 |
|
|
Test urine urobilinogen
|
$23.94 |
$23.94 |
$34.00 |
|
|
Tetanus immune globulin inj
|
$206.77 |
$943.91 |
$1,910.29 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$1,002.11 |
$8,737.92 |
$17,683.88 |
|
|
Thaw preserved stem cells
|
$1,236.48 |
$1,236.48 |
$1,236.48 |
|
|
Theophylline therapeutic drug level
|
$26.36 |
$70.56 |
$153.85 |
|
|
Therapeutic procd strg endur
|
$66.00 |
$83.16 |
$98.21 |
|
|
Therapy activity per session >= 45 minutes
|
$303.24 |
$303.24 |
$306.85 |
|
|
Therapy Activity Training (each 15 minutes)
|
$54.00 |
$57.12 |
$96.90 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$56.12 |
$58.50 |
$1,493.45 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$32.76 |
$34.86 |
$53.68 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$30.24 |
$42.00 |
$45.50 |
|
|
Ther nma rdctj intus/obstrcj
|
$940.50 |
$940.50 |
$940.50 |
|
|
Ther/proph/diag inj ia
|
$301.76 |
$424.20 |
$429.25 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$1.80 |
$41.79 |
$84.58 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$65.52 |
$115.60 |
$291.33 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$189.51 |
$714.84 |
$1,242.70 |
|
|
Thoracoscopy diagnostic 32601
|
$2,728.74 |
$2,728.74 |
$2,728.74 |
|
|
Thoracotomy w/expl
|
$917.13 |
$4,530.96 |
$5,008.94 |
|
|
Thoracotomy with cardiac massage
|
$1,773.54 |
$1,773.54 |
$1,773.54 |
|
|
Thorcscpy w/biop pleura
|
$2,728.74 |
$2,728.74 |
$2,728.74 |
|
|
Thrcspy w/diag bp lng nod uni
|
$3,978.66 |
$3,978.66 |
$3,978.66 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$306.36 |
$1,359.00 |
$2,519.40 |
|
|
Thrombectmy crnry perq mechanical
|
$3,166.38 |
$3,166.38 |
$4,511.56 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,781.58 |
$9,278.64 |
$12,374.30 |
|
