|
Susceptibility agar dilution per agent
|
$21.45 |
$21.45 |
$21.45 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$21.45 |
$21.45 |
$21.45 |
$35.75
|
|
Susceptibility mic per plate
|
$39.00 |
$39.00 |
$39.00 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$29.90 |
$29.90 |
$29.90 |
$59.28
|
|
Svc venogram s&i
|
$6,967.35 |
$6,967.35 |
$6,967.35 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$370.50 |
$370.50 |
$370.50 |
$316.55
|
|
Swallowing Therapy Session
|
$431.60 |
$431.60 |
$431.60 |
$240.31
|
|
Synvisc or synvisc-one
|
$534.14 |
$534.14 |
$534.14 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$19.50 |
$19.50 |
$19.50 |
$41.60
|
|
System pacing micra av
|
$25,837.50 |
$25,837.50 |
$25,837.50 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$7,995.00 |
$7,995.00 |
$7,995.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$76.05 |
$76.05 |
$76.05 |
$100.32
|
|
T3 (triiodothyronine) total
|
$63.70 |
$63.70 |
$63.70 |
$93.52
|
|
T4 (thyroxine) free
|
$40.30 |
$40.30 |
$40.30 |
$88.44
|
|
T4 (thyroxine) total
|
$30.55 |
$30.55 |
$30.55 |
$69.58
|
|
Tacrol astagraf ex rel oral
|
$9.01 |
$9.01 |
$9.01 |
$62.32
|
|
Tacrol envarsus ex rel oral
|
$44.58 |
$44.58 |
$44.58 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$28.99 |
$28.99 |
$28.99 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$596.76 |
$596.76 |
$596.76 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$61.75 |
$61.75 |
$61.75 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,355.10 |
$4,355.10 |
$4,355.10 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$395.20 |
$395.20 |
$395.20 |
$289.90
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$21,795.67 |
$21,795.67 |
$21,795.67 |
$1,223.36
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$36,045.46 |
$36,045.46 |
$36,045.46 |
$21,745.13
|
|
Tap block bilat cont infusion 64489
|
$914.55 |
$914.55 |
$914.55 |
$1,541.40
|
|
Target gsa panel hmtlmph neop
|
$3,406.65 |
$3,406.65 |
$3,406.65 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$2,973.10 |
$2,973.10 |
$2,973.10 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,234.70 |
$2,234.70 |
$2,234.70 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$46,800.00 |
$46,800.00 |
$46,800.00 |
$24,217.20
|
|
Tavr perq femoral
|
$9,826.05 |
$9,826.05 |
$9,826.05 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,169.67 |
$1,169.67 |
$1,169.67 |
$937.50
|
|
Tbs dxa cal w/i&r fx risk
|
$200.85 |
$200.85 |
$200.85 |
$127.12
|
|
Tbs i&r fx rsk qhp
|
$66.30 |
$66.30 |
$66.30 |
$61.04
|
|
Tbs techl calculation only
|
$395.20 |
$395.20 |
$395.20 |
$153.60
|
|
Tbs techl prep&transmis data
|
$395.20 |
$395.20 |
$395.20 |
$119.66
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$278.20 |
$278.20 |
$278.20 |
$180.80
|
|
Tc-99m apcitide diag
|
$1,181.70 |
$1,181.70 |
$1,181.70 |
$1,181.70
|
|
Tc-99m bicisate
|
$2,447.90 |
$2,447.90 |
$2,447.90 |
$2,070.00
|
|
Tc-99m depreotide
|
$885.95 |
$885.95 |
$885.95 |
$1,486.80
|
|
Tc-99m disofenin
|
$131.30 |
$131.30 |
$131.30 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,669.20 |
$1,669.20 |
$1,669.20 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$2,033.20 |
$2,033.20 |
$2,033.20 |
$2,135.70
|
|
Tc-99m fanolesomab diag
|
$993.85 |
$993.85 |
$993.85 |
$2,115.12
|
|
Tc-99m labeled rbc
|
$227.50 |
$227.50 |
$227.50 |
$306.00
|
|
Tc-99m maa
|
$709.80 |
$709.80 |
$709.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$40.30 |
$40.30 |
$40.30 |
$157.65
|
|
Tc-99m medronate
|
$36.40 |
$36.40 |
$36.40 |
$111.01
|
|
Tc-99m mertiatide
|
$369.20 |
$369.20 |
$369.20 |
$756.00
|
|
Tc-99m oxidronate
|
$53.30 |
$53.30 |
$53.30 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$276.90 |
$276.90 |
$276.90 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$156.00 |
$156.00 |
$156.00 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$22.10 |
$22.10 |
$22.10 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$76.70 |
$76.70 |
$76.70 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$42.90 |
$42.90 |
$42.90 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$187.20 |
$187.20 |
$187.20 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$130.00 |
$130.00 |
$130.00 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$40.30 |
$40.30 |
$40.30 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$773.50 |
$773.50 |
$773.50 |
$985.60
|
|
Tcd emboli detect w/inj
|
$397.15 |
$397.15 |
$397.15 |
$475.80
|
|
Tcd emboli detect without inj
|
$397.15 |
$397.15 |
$397.15 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$210.60 |
$210.60 |
$210.60 |
$185.28
|
|
T cells absolute cd 4 count
|
$120.25 |
$120.25 |
$120.25 |
$111.20
|
|
T cells total count
|
$169.00 |
$169.00 |
$169.00 |
$130.35
|
|
Teaec w/wo patch graft iliofemoral
|
$4,327.70 |
$4,327.70 |
$4,327.70 |
$6,120.00
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$130,977.60 |
$130,977.60 |
$130,977.60 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$2,952.95 |
$2,952.95 |
$2,952.95 |
$2,101.65
|
|
Telehealth original site facility fee
|
$27.95 |
$27.95 |
$27.95 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,641.90 |
$1,641.90 |
$1,641.90 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,641.90 |
$1,641.90 |
$1,641.90 |
$877.09
|
|
Temozolomide
|
$673.36 |
$673.36 |
$673.36 |
$540.06
|
|
Temozolomide 100 mg intravenous solution
|
$3,129.70 |
$3,129.70 |
$3,129.70 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$4,914.80 |
$4,914.80 |
$4,914.80 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$19,998.07 |
$19,998.07 |
$19,998.07 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$46.10 |
$46.10 |
$46.10 |
$39.33
|
|
Test for porphobilinogen
|
$26.00 |
$26.00 |
$26.00 |
$29.25
|
|
Testosterone undecanoate 1mg
|
$1,694.94 |
$1,694.94 |
$1,694.94 |
$3,528.08
|
|
Test pathogen(s) for platelets reference
|
$266.50 |
$266.50 |
$266.50 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$1,164.15 |
$1,164.15 |
$1,164.15 |
$953.40
|
|
Test urine for porphyrins
|
$59.80 |
$59.80 |
$59.80 |
$49.98
|
|
Tetanus immune globulin inj
|
$1,534.24 |
$1,534.24 |
$1,534.24 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$5,727.70 |
$5,727.70 |
$5,727.70 |
$8,737.05
|
|
Thaw preserved stem cells
|
$1,136.85 |
$1,136.85 |
$1,136.85 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$63.70 |
$63.70 |
$63.70 |
$108.00
|
|
Therapeutic procd strg endur
|
$63.70 |
$63.70 |
$63.70 |
$85.68
|
|
Therapy activation ipnss
|
$411.45 |
$411.45 |
$411.45 |
$226.24
|
|
Therapy Activity Training (each 15 minutes)
|
$178.10 |
$178.10 |
$178.10 |
$101.85
|
|
Therapy Exercise Session (each 15 minutes)
|
$167.70 |
$167.70 |
$167.70 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$137.80 |
$137.80 |
$137.80 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$117.00 |
$117.00 |
$117.00 |
$50.40
|
|
Ther/proph/diag inj ia
|
$945.10 |
$945.10 |
$945.10 |
$247.33
|
|
Ther radiology tx plng cplx
|
$737.75 |
$737.75 |
$737.75 |
$332.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$11.64 |
$11.64 |
$11.64 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$395.20 |
$395.20 |
$395.20 |
$314.50
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,848.60 |
$1,848.60 |
$1,848.60 |
$1,733.65
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,802.45 |
$1,802.45 |
$1,802.45 |
$1,684.80
|
|
Thrombectmy crnry perq mechanical
|
$2,483.65 |
$2,483.65 |
$2,483.65 |
$3,836.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$21,309.60 |
$21,309.60 |
$21,309.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$42,385.20 |
$42,385.20 |
$42,385.20 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$34,570.25 |
$34,570.25 |
$34,570.25 |
$21,413.60
|
|
Thrombin time
|
$26.00 |
$26.00 |
$26.00 |
$54.18
|
