|
Tc-99m mertiatide
|
$4,717.50 |
$4,717.50 |
$4,717.50 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$975.00 |
$975.00 |
$975.00 |
$222.60
|
|
Tc-99m sestamibi p study dose
|
$6,044.97 |
$6,044.97 |
$6,044.97 |
$287.20
|
|
Tc-99m sulfur colloid
|
$3,734.48 |
$3,734.48 |
$3,734.48 |
$245.70
|
|
T cells total count
|
$108.00 |
$108.00 |
$108.00 |
$130.20
|
|
Tee w or without fol w/cont,cong
|
$1,563.75 |
$1,563.75 |
$1,563.75 |
$2,101.65
|
|
Tee w or without fol w/cont, mon
|
$865.50 |
$865.50 |
$865.50 |
$1,692.44
|
|
Telavancin injection
|
$2,428.05 |
$2,428.05 |
$2,428.05 |
$1,191.80
|
|
Telehealth original site facility fee
|
$125.25 |
$125.25 |
$125.25 |
$51.00
|
|
Temozolomide
|
$1,918.68 |
$1,918.68 |
$1,918.68 |
$540.06
|
|
Temozolomide 100 mg intravenous solution
|
$3,438.61 |
$3,438.61 |
$3,438.61 |
$1,867.28
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$29,758.74 |
$29,758.74 |
$29,758.74 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$68.57 |
$68.57 |
$68.57 |
$39.33
|
|
Tert gene targeted seq alys
|
$347.25 |
$347.25 |
$347.25 |
$335.00
|
|
Test for chlorohydrocarbons
|
$207.75 |
$207.75 |
$207.75 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$1,047.00 |
$1,047.00 |
$1,047.00 |
$842.56
|
|
Testosterone response panel
|
$168.75 |
$168.75 |
$168.75 |
$129.60
|
|
Test stress cardiovascular tracing only
|
$820.50 |
$820.50 |
$820.50 |
$953.40
|
|
Tetanus immune globulin inj
|
$1,939.05 |
$1,939.05 |
$1,939.05 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$108.75 |
$108.75 |
$108.75 |
$108.00
|
|
Therapy activation ipnss
|
$90.00 |
$90.00 |
$90.00 |
$226.24
|
|
Therapy Activity Training (each 15 minutes)
|
$93.75 |
$93.75 |
$93.75 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$96.75 |
$96.75 |
$96.75 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$58.50 |
$58.50 |
$58.50 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$58.50 |
$58.50 |
$58.50 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$208.50 |
$208.50 |
$208.50 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$23.67 |
$23.67 |
$23.67 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$414.00 |
$414.00 |
$414.00 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,942.50 |
$1,942.50 |
$1,942.50 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,654.25 |
$2,654.25 |
$2,654.25 |
$1,703.45
|
|
Thrombin time
|
$99.00 |
$99.00 |
$99.00 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$102.75 |
$102.75 |
$102.75 |
$62.01
|
|
Thyroglobulin antibody
|
$95.25 |
$95.25 |
$95.25 |
$82.50
|
|
Thyroid mets imag whole body
|
$2,013.75 |
$2,013.75 |
$2,013.75 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$164.25 |
$164.25 |
$164.25 |
$112.70
|
|
Thyroid Ultrasound
|
$764.25 |
$764.25 |
$764.25 |
$588.50
|
|
Thyroid uptake measurement
|
$737.25 |
$737.25 |
$737.25 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$7,476.81 |
$7,476.81 |
$7,476.81 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$66.75 |
$66.75 |
$66.75 |
$64.51
|
|
Tigecycline injection
|
$534.77 |
$534.77 |
$534.77 |
$235.29
|
|
Tisagenlecleucel car-pos t
|
$2,194,589.53 |
$2,194,589.53 |
$2,194,589.53 |
$1,780,600.03
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$27,364.47 |
$27,364.47 |
$27,364.47 |
$13,339.20
|
|
Tissue culture placenta
|
$6,844.50 |
$6,844.50 |
$6,844.50 |
$453.00
|
|
Tissue culture skin/biopsy
|
$1,358.25 |
$1,358.25 |
$1,358.25 |
$488.74
|
|
Tissue culture tumor
|
$873.75 |
$873.75 |
$873.75 |
$486.50
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$2,516.07 |
$2,516.07 |
$2,516.07 |
$537.50
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$1,679.65 |
$1,679.65 |
$1,679.65 |
$830.41
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$6,114.24 |
$6,114.24 |
$6,114.24 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$41.25 |
$41.25 |
$41.25 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$286.24 |
$286.24 |
$286.24 |
$152.36
|
|
Tobramycin non-comp unit
|
$124.14 |
$124.14 |
$124.14 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$94.50 |
$94.50 |
$94.50 |
$120.60
|
|
Toe X-ray (both feet)
|
$281.25 |
$281.25 |
$281.25 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$74.25 |
$74.25 |
$74.25 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$517.65 |
$517.65 |
$517.65 |
$316.84
|
|
Total tau
|
$504.00 |
$504.00 |
$504.00 |
$312.50
|
|
Tot estradiol response panel
|
$299.25 |
$299.25 |
$299.25 |
$140.80
|
|
Toxoplasma antibody igg
|
$188.25 |
$188.25 |
$188.25 |
$91.65
|
|
Toxoplasma antibody igm
|
$106.50 |
$106.50 |
$106.50 |
$87.75
|
|
Tpmt gene com vrnts
|
$840.00 |
$840.00 |
$840.00 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$13,641.34 |
$13,641.34 |
$13,641.34 |
$6,684.23
|
|
Trabeculoplasty laser surg
|
$1,606.50 |
$1,606.50 |
$1,606.50 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,812.00 |
$1,812.00 |
$1,812.00 |
$1,437.45
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$93.75 |
$93.75 |
$93.75 |
$102.27
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$77.65 |
$77.65 |
$77.65 |
$56.38
|
|
Transcath biopsy
|
$3,482.25 |
$3,482.25 |
$3,482.25 |
$4,285.93
|
|
Transcatheter bx s&i
|
$2,886.75 |
$2,886.75 |
$2,886.75 |
$1,950.85
|
|
Transcath occlusion cns
|
$19,546.50 |
$19,546.50 |
$19,546.50 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$16,788.75 |
$16,788.75 |
$16,788.75 |
$10,270.00
|
|
Transferrin
|
$121.50 |
$121.50 |
$121.50 |
$82.00
|
|
Transorl lwr esophgl myotomy
|
$5,814.75 |
$5,814.75 |
$5,814.75 |
$6,921.60
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$873.75 |
$873.75 |
$873.75 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$754.50 |
$754.50 |
$754.50 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$5,762.28 |
$5,762.28 |
$5,762.28 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$12,199.65 |
$12,199.65 |
$12,199.65 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$1,094.25 |
$1,094.25 |
$1,094.25 |
$940.80
|
|
Treat ankle dislocation
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$2,360.00
|
|
Treat elbow dislocation
|
$1,398.75 |
$1,398.75 |
$1,398.75 |
$2,272.50
|
|
Treat elbow fracture
|
$1,398.75 |
$1,398.75 |
$1,398.75 |
$2,026.50
|
|
Treat finger fracture each
|
$1,398.75 |
$1,398.75 |
$1,398.75 |
$1,592.00
|
|
Treat fracture of radius
|
$1,399.50 |
$1,399.50 |
$1,399.50 |
$1,790.00
|
|
Treat fracture of radius
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$1,849.00
|
|
Treat fracture of ulna
|
$2,006.25 |
$2,006.25 |
$2,006.25 |
$731.04
|
|
Treat hip dislocation
|
$1,398.75 |
$1,398.75 |
$1,398.75 |
$2,211.05
|
|
Treat humerus fracture
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$1,790.00
|
|
Treat humerus fracture
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$1,790.00
|
|
Treat knee dislocation
|
$1,678.50 |
$1,678.50 |
$1,678.50 |
$2,220.89
|
|
Treat knee fracture 27530
|
$318.00 |
$318.00 |
$318.00 |
$550.73
|
|
Treat knee fracture(s)
|
$593.25 |
$593.25 |
$593.25 |
$643.26
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$254.25 |
$254.25 |
$254.25 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$234.75 |
$234.75 |
$234.75 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$262.50 |
$262.50 |
$262.50 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$516.00 |
$516.00 |
$516.00 |
$501.20
|
|
Treatment of foot infection
|
$1,560.75 |
$1,560.75 |
$1,560.75 |
$2,939.13
|
|
Treatment of heel fracture 28400
|
$313.50 |
$313.50 |
$313.50 |
$473.00
|
|
Treatment of thigh fracture
|
$677.25 |
$677.25 |
$677.25 |
$477.75
|
|
Treatment of thigh fracture
|
$1,912.50 |
$1,912.50 |
$1,912.50 |
$1,749.06
|
|
Treatment of thigh fracture
|
$486.00 |
$486.00 |
$486.00 |
$549.00
|
|
Treatment of thigh fracture
|
$1,935.75 |
$1,935.75 |
$1,935.75 |
$1,790.00
|
