|
Test for porphobilinogen
|
$6.40 |
$6.40 |
$6.40 |
$33.57
|
|
Test for urine cystines
|
$10.51 |
$10.51 |
$10.51 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$238.08 |
$238.08 |
$238.08 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$16.24 |
$16.24 |
$16.24 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$414.72 |
$414.72 |
$414.72 |
$1,001.55
|
|
Test urine for lactose
|
$12.38 |
$12.38 |
$12.38 |
$12.38
|
|
Test urine for porphyrins
|
$14.70 |
$14.70 |
$14.70 |
$27.30
|
|
Test urine urobilinogen
|
$4.92 |
$4.92 |
$4.92 |
$6.17
|
|
Tgsap hl neo 5-50 rna alys
|
$835.48 |
$835.48 |
$835.48 |
$1,048.15
|
|
Tgsap so/hl 51/< rna alys
|
$3,211.56 |
$3,211.56 |
$3,211.56 |
$4,563.00
|
|
Tgsap so neo 5-50 rna alys
|
$657.70 |
$657.70 |
$657.70 |
$816.27
|
|
Thaw preserved stem cells
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$900.90
|
|
Theophylline therapeutic drug level
|
$15.55 |
$15.55 |
$15.55 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$43.53 |
$43.53 |
$43.53 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$39.36 |
$39.36 |
$39.36 |
$50.40
|
|
Ther fx nasal inf turbinate
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,589.62
|
|
Ther/proph/diag inj ia
|
$119.77 |
$119.77 |
$119.77 |
$247.33
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,804.00
|
|
Thoracoscopy diagnostic 32601
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,736.84
|
|
Thoracoscopy w/bx med space
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,508.80
|
|
Thoracoscopy wbx sac
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,110.00
|
|
Thorcscpy w/biop pleura
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,376.26
|
|
Thrcspy w/diag bp lng inf uni
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,339.00
|
|
Thrcspy w/diag bp lng nod uni
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,339.00
|
|
Thrombectmy crnry perq mechanical
|
$1,625.57 |
$1,625.57 |
$1,625.57 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$24,605.30
|
|
Thrombin time
|
$6.35 |
$6.35 |
$6.35 |
$48.75
|
|
Thrombin time titer
|
$7.54 |
$7.54 |
$7.54 |
$9.10
|
|
Thromboendarterectomy including patch graft if preformed;
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,983.35
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$7.12 |
$7.12 |
$7.12 |
$56.93
|
|
Thromboxane urine
|
$38.62 |
$38.62 |
$38.62 |
$52.22
|
|
Thumb fusion with graft
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,839.00
|
|
Thumb fusion with graft
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$7,089.25
|
|
Thumb tendon transfer
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,594.44
|
|
Thymectomy prtl/tot transcervical appr 60520
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,682.81
|
|
Thyroglobulin antibody
|
$17.50 |
$17.50 |
$17.50 |
$84.00
|
|
Thyroid mets imag whole body
|
$630.52 |
$630.52 |
$630.52 |
$1,524.99
|
|
Thyroid met uptake
|
$156.43 |
$156.43 |
$156.43 |
$380.00
|
|
Thyroid (TSH) Test
|
$18.48 |
$18.48 |
$18.48 |
$120.00
|
|
Thyroid Ultrasound
|
$231.42 |
$231.42 |
$231.42 |
$589.96
|
|
Thyroid uptake measurement
|
$185.80 |
$185.80 |
$185.80 |
$653.60
|
|
Thyrotropin releasing hormone
|
$55.45 |
$55.45 |
$55.45 |
$55.45
|
|
Thyroxine binding globulin (tbg)
|
$16.26 |
$16.26 |
$16.26 |
$63.60
|
|
Tibial arthroscopy/surgery
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,855.00
|
|
Tibial arthroscopy/surgery
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$7,223.44
|
|
Tib/per revasc stent & ather 37231
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,406.14
|
|
Tilt table study
|
$773.62 |
$773.62 |
$773.62 |
$1,495.00
|
|
Tissue culture placenta
|
$165.33 |
$165.33 |
$165.33 |
$520.91
|
|
Tissue culture skin/biopsy
|
$154.80 |
$154.80 |
$154.80 |
$558.87
|
|
Tissue culture tumor
|
$162.27 |
$162.27 |
$162.27 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$4.70 |
$4.70 |
$4.70 |
$47.40
|
|
Tissue transglutaminase iga
|
$12.68 |
$12.68 |
$12.68 |
$48.57
|
|
Tlh uterus 250 g or less
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$8,134.69
|
|
Tlh uterus over 250 g
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,311.00
|
|
Tlh w/t/o 250 g or less
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,799.26
|
|
Tlh w/t/o uterus over 250 g
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,700.71
|
|
Tnot opn elbw to sho ea tdn
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,591.33
|
|
Tobramycin peak therapeutic drug level
|
$17.74 |
$17.74 |
$17.74 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$106.23 |
$106.23 |
$106.23 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$57.90 |
$57.90 |
$57.90 |
$73.45
|
|
Tongue base vol reduction
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Tongue biopsy; posterior one-third 41105
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,589.62
|
|
Tongue suspension
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,419.00
|
|
Tongue to lip surgery
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,592.74
|
|
Tonsillectomy (age 12+)
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Tonsillectomy (child under 12)
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,881.00
|
|
Total Hip Replacement
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,675.20
|
|
Total Knee Replacement
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,668.80
|
|
Tot disc arthrp 1ntrspc crv
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,646.17
|
|
Toxoplasma antibody igg
|
$15.83 |
$15.83 |
$15.83 |
$84.35
|
|
Toxoplasma antibody igm
|
$15.85 |
$15.85 |
$15.85 |
$83.20
|
|
Tp53 gene full gene sequence
|
$706.04 |
$706.04 |
$706.04 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$362.46 |
$362.46 |
$362.46 |
$919.10
|
|
Tpmt gene com vrnts
|
$192.29 |
$192.29 |
$192.29 |
$381.55
|
|
Tprnl balo cntnc dev adjmt
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$287.81
|
|
Tprnl balo cntnc dev bi
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$14,393.26
|
|
Tprnl balo cntnc dev rmvl ea
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Tprnl balo cntnc dev uni
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$10,244.18
|
|
Tprnl plmt biodegrdabl matrl
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,105.61
|
|
Trabeculoplasty laser surg
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,224.00
|
|
Trachelectomy (cervicectomy) 57530
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,933.66
|
|
Tracheobrnchsc thru est trachs incisn
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,459.48
|
|
Tracheostoma revision; simple, without flap rotation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$69.98 |
$69.98 |
$69.98 |
$104.50
|
|
Transabdom amnioinfus w/us
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$791.05
|
|
Transcath biopsy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,298.05
|
|
Transcath closure of asd
|
$7,918.10 |
$7,918.10 |
$7,918.10 |
$18,772.00
|
|
Transcath closure of vsd
|
$7,116.15 |
$7,116.15 |
$7,116.15 |
$18,837.00
|
|
Transcatheter bx s&i
|
$885.89 |
$885.89 |
$885.89 |
$1,875.96
|
|
Transcath occlusion non-cns
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,627.00
|
|
Transcrv abltj utrn fibrd rf
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$8,708.57
|
|
Transcutaneous hgb 88738
|
$5.52 |
$5.52 |
$5.52 |
$11.40
|
|
Transfer of abdominal muscle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
|
Transfer of embryo
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$419.01
|
|
Transfer of iliopsoas muscle
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,886.74
|
