|
T cells total count
|
$156.00 |
$156.00 |
$156.00 |
|
|
Teaec w/wo patch graft iliofemoral
|
$3,793.60 |
$3,793.60 |
$3,793.60 |
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$19,240.00 |
$19,240.00 |
$19,240.00 |
|
|
Tee w or without fol w/cont,cong
|
$1,977.60 |
$1,977.60 |
$1,977.60 |
|
|
Telavancin injection
|
$1,102.88 |
$1,102.88 |
$1,102.88 |
|
|
Telehealth original site facility fee
|
$47.20 |
$66.40 |
$80.80 |
|
|
Telethx isodose plan cplx
|
$451.20 |
$451.20 |
$2,169.60 |
|
|
Telethx isodose plan simple
|
$248.80 |
$248.80 |
$1,082.40 |
|
|
Temozolomide
|
$149.00 |
$149.00 |
$369.71 |
|
|
Temozolomide 100 mg intravenous solution
|
$1,153.02 |
$1,153.02 |
$1,153.02 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,804.60 |
$1,804.60 |
$3,001.51 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$6,011.74 |
$6,011.74 |
$10,346.96 |
|
|
Tenolysis extensor tendon hand/finger each
|
$3,068.80 |
$3,068.80 |
$3,068.80 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$16.80 |
$25.21 |
$28.92 |
|
|
Testicular imaging w/vasc flow
|
$900.00 |
$900.00 |
$900.00 |
|
|
Testosterone undecanoate 1mg
|
$2,885.18 |
$2,885.18 |
$2,885.18 |
|
|
Test pathogen(s) for platelets reference
|
$64.80 |
$64.80 |
$64.80 |
|
|
Test stress cardiovascular tracing only
|
$525.60 |
$525.60 |
$1,322.40 |
|
|
Tetanus immune globulin inj
|
$736.80 |
$736.80 |
$1,552.28 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$7,939.04 |
$7,939.04 |
$7,939.04 |
|
|
Thawing cryopresrved embryo
|
$720.00 |
$720.00 |
$720.00 |
|
|
Thawing cryopresrved sperm
|
$56.00 |
$56.00 |
$56.80 |
|
|
Thaw preserved stem cells
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
|
|
Theophylline therapeutic drug level
|
$76.80 |
$76.80 |
$76.80 |
|
|
Therapeutic procd strg endur
|
$90.40 |
$117.60 |
$124.80 |
|
|
Therapy activity per session >= 45 minutes
|
$221.60 |
$536.00 |
$536.00 |
|
|
Therapy Activity Training (each 15 minutes)
|
$109.60 |
$117.60 |
$121.60 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$105.60 |
$109.60 |
$119.20 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$68.00 |
$92.80 |
$92.80 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$63.20 |
$74.40 |
$74.40 |
|
|
Ther nma rdctj intus/obstrcj
|
$612.80 |
$612.80 |
$726.40 |
|
|
Ther/proph/diag inj ia
|
$284.80 |
$284.80 |
$284.80 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$28.78 |
$30.44 |
$31.06 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$172.00 |
$240.00 |
$379.20 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,467.20 |
$1,467.20 |
$1,820.80 |
|
|
Thoracotomy w/expl
|
$1,148.80 |
$1,148.80 |
$1,380.00 |
|
|
Thoracotomy with cardiac massage
|
$700.80 |
$700.80 |
$1,841.60 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,470.40 |
$1,470.40 |
$1,572.00 |
|
|
Thrombectmy crnry perq mechanical
|
$5,600.80 |
$5,600.80 |
$7,453.60 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$11,667.20 |
$11,667.20 |
$11,819.20 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$19,988.00 |
$19,988.00 |
$20,927.20 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$25,200.00 |
$25,200.00 |
$28,365.60 |
|
|
Thrombin time
|
$40.00 |
$40.00 |
$40.00 |
|
|
Thromboendarterectomy common femoral
|
$5,188.80 |
$5,188.80 |
$8,058.40 |
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$2,155.20 |
$2,155.20 |
$2,155.20 |
|
|
Thromboendarterectomy sfa
|
$6,388.00 |
$6,388.00 |
$7,325.60 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$58.40 |
$58.40 |
$58.40 |
|
|
Thyroglobulin antibody
|
$111.20 |
$111.20 |
$111.20 |
|
|
Thyroid imaging
|
$856.00 |
$856.00 |
$1,142.40 |
|
|
Thyroid mets imag whole body
|
$1,508.80 |
$1,508.80 |
$2,178.40 |
|
|
Thyroid met uptake
|
$452.80 |
$452.80 |
$604.00 |
|
|
Thyroid (TSH) Test
|
$85.60 |
$85.60 |
$85.60 |
|
|
Thyroid Ultrasound
|
$480.00 |
$480.00 |
$646.40 |
|
|
Thyroid uptake measurement
|
$653.60 |
$653.60 |
$1,069.60 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,286.95 |
$2,286.95 |
$2,286.95 |
|
|
Tibial length sock fx or equ
|
$96.63 |
$96.63 |
$96.63 |
|
|
Tigecycline injection
|
$201.93 |
$201.93 |
$412.36 |
|
|
Tilt table study
|
$1,090.40 |
$1,090.40 |
$1,962.40 |
|
|
Tirofiban 12.5 mg/50 ml
|
$686.44 |
$686.44 |
$686.44 |
|
|
Tisagenlecleucel car-pos t
|
$1,705,363.20 |
$1,705,363.20 |
$1,705,363.20 |
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$6,885.00 |
$6,885.00 |
$6,885.00 |
|
|
Tissue exam koh skin/hair/nails
|
$28.80 |
$28.80 |
$28.80 |
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$51.92 |
$51.92 |
$64.48 |
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$45.30 |
$45.30 |
$51.27 |
|
|
Tissue transglutaminase iga
|
$42.40 |
$42.40 |
$42.40 |
|
|
Tl-201 thallium diag per mci
|
$78.40 |
$78.40 |
$180.80 |
|
|
Tlso rigid lined custom fab
|
$4,989.95 |
$4,989.95 |
$4,989.95 |
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$134.53 |
$134.53 |
$190.50 |
|
|
Tobramycin non-comp unit
|
$168.18 |
$168.18 |
$168.18 |
|
|
Tobramycin peak therapeutic drug level
|
$60.80 |
$60.80 |
$60.80 |
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$608.92 |
$2,935.54 |
$4,163.79 |
|
|
Toe X-ray (both feet)
|
$160.80 |
$178.40 |
$313.60 |
|
|
Tomosynthesis breast diagnostic left
|
$60.00 |
$86.40 |
$95.20 |
|
|
Tomosynthesis breast screen bilateral
|
$60.00 |
$84.00 |
$91.20 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$195.53 |
$195.53 |
$772.40 |
|
|
Toxoplasma antibody igg
|
$84.80 |
$84.80 |
$84.80 |
|
|
Toxoplasma antibody igm
|
$74.40 |
$74.40 |
$74.40 |
|
|
Trabectedin 1 mg intravenous solution
|
$3,234.00 |
$3,234.00 |
$3,234.00 |
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,784.00 |
$1,784.00 |
$1,958.40 |
|
|
Trach/laryn tube plug/stop
|
$94.80 |
$94.80 |
$287.78 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$130.40 |
$130.40 |
$130.40 |
|
|
Transabdom amnioinfus w/us
|
$543.20 |
$543.20 |
$543.20 |
|
|
Transcath biopsy
|
$6,076.80 |
$6,076.80 |
$7,949.60 |
|
|
Transcath closure of asd
|
$23,834.40 |
$23,834.40 |
$30,207.20 |
|
|
Transcath closure of vsd
|
$22,131.20 |
$22,131.20 |
$22,131.20 |
|
|
Transcatheter bx s&i
|
$2,182.40 |
$2,182.40 |
$2,445.60 |
|
|
Transcath mv repair addl prosthesis
|
$9,950.40 |
$9,950.40 |
$9,950.40 |
|
|
Transcath mv repair init prosthesis
|
$17,580.00 |
$17,580.00 |
$17,580.00 |
|
|
Transcath occlusion cns
|
$8,308.00 |
$8,308.00 |
$17,950.40 |
|
|
Transcath occlusion non-cns
|
$14,039.20 |
$14,039.20 |
$17,949.60 |
|
|
Trans cath replace aortic valve 33366
|
$13,403.20 |
$13,403.20 |
$25,038.40 |
|
|
Transcath rmvl perm ldss pmkr rv
|
$3,750.40 |
$3,750.40 |
$6,531.20 |
|
|
Transferrin
|
$78.40 |
$78.40 |
$78.40 |
|
|
Transplt allo hct/donor
|
$11,460.80 |
$11,460.80 |
$11,460.80 |
|
|
Transplt allo lymphocytes
|
$3,653.60 |
$3,653.60 |
$3,653.60 |
|
|
Transplt autol hct/donor
|
$5,302.40 |
$5,302.40 |
$5,302.40 |
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$523.20 |
$523.20 |
$592.80 |
|
|
Transvaginal Pregnancy Ultrasound
|
$364.80 |
$364.80 |
$492.80 |
|
|
Trastuzumab 150 mg intravenous solution
|
$2,038.36 |
$2,038.36 |
$2,432.99 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$4,012.63 |
$4,012.63 |
$4,012.63 |
|
