|
Surgical pathology level 3 gross & microscopic examination
|
$391.95 |
$391.95 |
$391.95 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$531.05 |
$531.05 |
$531.05 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$575.25 |
$575.25 |
$575.25 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$734.50 |
$734.50 |
$734.50 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$94.25 |
$94.25 |
$94.25 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$50.70 |
$50.70 |
$50.70 |
$34.48
|
|
Susceptibility mic per plate
|
$326.95 |
$326.95 |
$326.95 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$406.25 |
$406.25 |
$406.25 |
$48.30
|
|
Svc venogram s&i
|
$1,448.85 |
$1,448.85 |
$1,448.85 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$37.86 |
$37.86 |
$1,415.99 |
$1,257.54
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$66.95 |
$66.95 |
$66.95 |
$44.85
|
|
System cardiomems hosp electronics
|
$42,927.01 |
$42,927.01 |
$42,927.01 |
$40,625.98
|
|
System pacing micra av
|
$20,783.35 |
$20,783.35 |
$20,783.35 |
$23,128.97
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,114.73 |
$6,114.73 |
$6,114.73 |
$11,441.25
|
|
System sealant biosentry tract
|
$698.82 |
$698.82 |
$698.82 |
$888.00
|
|
T3 (triiodothyronine) free
|
$38.35 |
$38.35 |
$38.35 |
$89.82
|
|
T3 (triiodothyronine) total
|
$34.45 |
$34.45 |
$34.45 |
$94.90
|
|
T4 (thyroxine) free
|
$57.20 |
$57.20 |
$57.20 |
$81.60
|
|
T4 (thyroxine) total
|
$146.25 |
$146.25 |
$146.25 |
$73.64
|
|
Tacrol envarsus ex rel oral
|
$3.04 |
$3.04 |
$48.75 |
$7.38
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.29 |
$6.24 |
$11.80 |
$10.76
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$286.86 |
$286.86 |
$829.72 |
$668.52
|
|
Tacrolimus therapeutic drug level
|
$59.80 |
$59.80 |
$59.80 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$37.39 |
$3,817.00 |
$3,817.00 |
$3,817.00
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$19,079.16 |
$19,079.16 |
$19,079.16 |
$3,580.84
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$185.62 |
$31,203.38 |
$31,203.38 |
$27,488.34
|
|
Target gsa panel hmtlmph neop
|
$4,650.75 |
$4,650.75 |
$4,650.75 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$6,844.50 |
$6,844.50 |
$6,844.50 |
$3,385.00
|
|
Target gsa panel organ neop
|
$3,953.95 |
$3,953.95 |
$3,953.95 |
$1,913.00
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$40,817.63 |
$40,817.63 |
$40,817.63 |
$27,030.00
|
|
Tavr perq femoral
|
$27,888.25 |
$27,888.25 |
$27,888.25 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$937.50 |
$937.50 |
$937.50 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$126.10 |
$126.10 |
$126.10 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$137.80 |
$137.80 |
$137.80 |
$166.46
|
|
Tc-99m bicisate
|
$1,599.84 |
$1,599.84 |
$1,599.84 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$3,915.05 |
$3,915.05 |
$3,915.05 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$1,882.18 |
$1,882.18 |
$1,882.18 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$236.55 |
$236.55 |
$236.55 |
$323.01
|
|
Tc-99m maa
|
$312.06 |
$312.06 |
$312.06 |
$312.06
|
|
Tc-99m mebrofenin
|
$59.48 |
$59.48 |
$59.48 |
$169.53
|
|
Tc-99m medronate
|
$68.20 |
$68.20 |
$68.20 |
$122.46
|
|
Tc-99m mertiatide
|
$523.61 |
$523.61 |
$523.61 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$0.67 |
$0.67 |
$0.67 |
$8.00
|
|
Tc-99m oxidronate
|
$85.38 |
$85.38 |
$85.38 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$316.58 |
$316.58 |
$316.58 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$320.22 |
$320.22 |
$320.22 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$1.04 |
$1.04 |
$1.04 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$75.92 |
$75.92 |
$75.92 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$64.31 |
$64.31 |
$64.35 |
$221.60
|
|
Tc-99m sulfur colloid
|
$246.40 |
$246.40 |
$246.40 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$68.25 |
$68.25 |
$68.25 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$814.78 |
$814.78 |
$814.78 |
$930.54
|
|
T-cell depletion of harvest
|
$1,673.75 |
$1,673.75 |
$1,673.75 |
$1,673.75
|
|
T cells absolute cd4/cd8 including ratio
|
$303.55 |
$303.55 |
$303.55 |
$186.00
|
|
T cells absolute cd 4 count
|
$329.55 |
$329.55 |
$329.55 |
$120.25
|
|
T cells total count
|
$464.10 |
$464.10 |
$464.10 |
$124.11
|
|
Tcranial magn stim tx deli
|
$409.50 |
$409.50 |
$409.50 |
$368.50
|
|
Tcranial magn stim tx plan
|
$577.85 |
$577.85 |
$577.85 |
$386.88
|
|
Tcran magn stim redetemine
|
$577.85 |
$577.85 |
$577.85 |
$417.06
|
|
Telavancin injection
|
$0.42 |
$0.42 |
$0.42 |
$1,226.70
|
|
Telehealth original site facility fee
|
$98.15 |
$98.15 |
$98.15 |
$61.60
|
|
Telethx isodose plan cplx
|
$8,553.35 |
$8,553.35 |
$8,553.35 |
$1,617.00
|
|
Telethx isodose plan simple
|
$6,947.20 |
$6,947.20 |
$6,947.20 |
$848.72
|
|
Temozolomide
|
$397.48 |
$397.48 |
$397.48 |
$397.48
|
|
Temozolomide 100 mg intravenous solution
|
$2,567.04 |
$2,567.04 |
$2,567.04 |
$3,423.11
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$4,202.61 |
$4,202.61 |
$4,408.36 |
$3,838.30
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$20,845.40 |
$20,874.78 |
$20,874.78 |
$16,603.35
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$4,798.30 |
$4,798.30 |
$4,798.30 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$23.60 |
$23.60 |
$23.60 |
$44.87
|
|
Tert gene targeted seq alys
|
$1,459.90 |
$1,459.90 |
$1,459.90 |
$304.59
|
|
Test for chlorohydrocarbons
|
$251.55 |
$251.55 |
$251.55 |
$71.04
|
|
Test for porphobilinogen
|
$78.65 |
$78.65 |
$78.65 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$588.25 |
$588.25 |
$588.25 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$180.05 |
$180.05 |
$180.05 |
$75.95
|
|
Test stress cardiovascular tracing only
|
$759.20 |
$759.20 |
$759.20 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,836.49 |
$1,836.49 |
$1,836.49 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$65.40 |
$65.40 |
$14,189.56 |
$11,963.15
|
|
Tgsap so/hl 51/< rna alys
|
$6,119.75 |
$6,119.75 |
$6,119.75 |
$4,563.00
|
|
Thaw preserved stem cells
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$900.90
|
|
Theophylline therapeutic drug level
|
$70.20 |
$70.20 |
$70.20 |
$108.00
|
|
Therapeutic procd strg endur
|
$79.30 |
$79.30 |
$79.30 |
$85.80
|
|
Therapy activity per session >= 45 minutes
|
$440.70 |
$440.70 |
$440.70 |
$158.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$42.25 |
$42.25 |
$42.25 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$29.25 |
$29.25 |
$29.25 |
$50.40
|
|
Ther/proph/diag inj ia
|
$226.85 |
$226.85 |
$226.85 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$23.98 |
$23.98 |
$23.98 |
$35.82
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$7,315.10 |
$7,315.10 |
$7,315.10 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$2,616.90 |
$2,616.90 |
$2,616.90 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$10,026.25 |
$10,026.25 |
$10,026.25 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$15,987.40 |
$15,987.40 |
$15,987.40 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$28,418.00 |
$28,418.00 |
$28,418.00 |
$24,605.30
|
|
Thrombin time
|
$196.95 |
$196.95 |
$196.95 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$757.90 |
$757.90 |
$757.90 |
$56.93
|
|
Thyroglobulin antibody
|
$81.90 |
$81.90 |
$81.90 |
$84.00
|
|
Thyroid imaging
|
$846.95 |
$846.95 |
$846.95 |
$670.80
|
|
Thyroid mets imag whole body
|
$1,891.50 |
$1,891.50 |
$1,891.50 |
$1,524.99
|
|
Thyroid met uptake
|
$474.50 |
$474.50 |
$474.50 |
$380.00
|
|
Thyroid (TSH) Test
|
$46.15 |
$46.15 |
$46.15 |
$120.00
|
|
Thyroid Ultrasound
|
$478.40 |
$478.40 |
$478.40 |
$589.96
|
|
Thyroid uptake measurement
|
$727.35 |
$727.35 |
$727.35 |
$653.60
|
