|
Surgical pathology level 6 gross & microscopic examination
|
$208.22 |
$208.22 |
$208.22 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$20.72 |
$20.72 |
$20.72 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$13.97 |
$13.97 |
$13.97 |
$31.85
|
|
Susceptibility mic per plate
|
$163.98 |
$163.98 |
$163.98 |
$89.70
|
|
Svc venogram s&i
|
$867.10 |
$867.10 |
$867.10 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$50.14 |
$50.14 |
$50.14 |
$100.20
|
|
Synvisc or synvisc-one
|
$1,242.63 |
$1,242.63 |
$1,242.63 |
$1,053.54
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$45.70 |
$45.70 |
$45.70 |
$45.70
|
|
T3 (triiodothyronine) free
|
$89.82 |
$89.82 |
$89.82 |
$91.20
|
|
T3 (triiodothyronine) total
|
$59.02 |
$59.02 |
$59.02 |
$88.00
|
|
T4 (thyroxine) free
|
$61.33 |
$61.33 |
$61.33 |
$65.00
|
|
T4 (thyroxine) total
|
$41.26 |
$41.26 |
$41.26 |
$62.40
|
|
Tacrol envarsus ex rel oral
|
$2.74 |
$2.74 |
$2.74 |
$3.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.36 |
$1.36 |
$1.36 |
$4.87
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$176.77 |
$176.77 |
$176.77 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$96.66 |
$96.66 |
$96.66 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$925.19 |
$925.19 |
$925.19 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,259.70 |
$1,259.70 |
$1,259.70 |
$3,567.96
|
|
Target gsa panel organ neop
|
$1,426.07 |
$1,426.07 |
$1,426.07 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$332.56 |
$332.56 |
$332.56 |
$760.95
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$85.93 |
$85.93 |
$85.93 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$77.52 |
$77.52 |
$77.52 |
$178.40
|
|
Tc-99m bicisate
|
$2,525.34 |
$2,525.34 |
$2,525.34 |
$2,398.20
|
|
Tc-99m exametazime diag
|
$2,832.07 |
$2,832.07 |
$2,832.07 |
$2,236.65
|
|
Tc-99m labeled rbc
|
$265.66 |
$265.66 |
$265.66 |
$312.70
|
|
Tc-99m maa
|
$281.20 |
$281.20 |
$281.20 |
$306.60
|
|
Tc-99m mebrofenin
|
$111.28 |
$111.28 |
$111.28 |
$169.53
|
|
Tc-99m medronate
|
$43.11 |
$43.11 |
$43.11 |
$120.35
|
|
Tc-99m mertiatide
|
$582.84 |
$582.84 |
$582.84 |
$757.25
|
|
Tc-99m oxidronate
|
$83.99 |
$83.99 |
$83.99 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$161.23 |
$161.23 |
$161.23 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$49.12 |
$49.12 |
$49.12 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$130.80 |
$130.80 |
$130.80 |
$137.01
|
|
Tc-99m succimer (dmsa)
|
$373.42 |
$373.42 |
$373.42 |
$1,749.60
|
|
Tc-99m sulfur colloid
|
$199.25 |
$199.25 |
$199.25 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$138.29 |
$138.29 |
$138.29 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$801.70 |
$801.70 |
$801.70 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$185.28 |
$185.28 |
$185.28 |
$189.60
|
|
T cells absolute cd 4 count
|
$110.72 |
$110.72 |
$110.72 |
$120.25
|
|
T cells total count
|
$68.92 |
$68.92 |
$68.92 |
$126.90
|
|
Telavancin injection
|
$464.05 |
$464.05 |
$464.05 |
$2,428.05
|
|
Telethx isodose plan cplx
|
$277.22 |
$277.22 |
$277.22 |
$1,526.85
|
|
Telethx isodose plan simple
|
$200.36 |
$200.36 |
$200.36 |
$848.72
|
|
Temozolomide
|
$427.46 |
$427.46 |
$427.46 |
$632.98
|
|
Temozolomide 100 mg intravenous solution
|
$29.19 |
$29.19 |
$29.19 |
$601.80
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$116.48 |
$116.48 |
$116.48 |
$116.48
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,570.16 |
$7,570.16 |
$7,570.16 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.71 |
$9.71 |
$9.71 |
$39.33
|
|
Test for urine cystines
|
$18.50 |
$18.50 |
$18.50 |
$23.20
|
|
Testicular imaging w/vasc flow
|
$342.62 |
$342.62 |
$342.62 |
$586.96
|
|
Test stress cardiovascular tracing only
|
$365.84 |
$365.84 |
$365.84 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$404.61 |
$404.61 |
$404.61 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$60.77 |
$60.77 |
$60.77 |
$101.40
|
|
Therapeutic procd strg endur
|
$35.71 |
$35.71 |
$35.71 |
$72.39
|
|
Therapy activity per session >= 45 minutes
|
$210.44 |
$210.44 |
$210.44 |
$210.44
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$48.29 |
$48.29 |
$48.29 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$26.64 |
$26.64 |
$26.64 |
$47.50
|
|
Ther nma rdctj intus/obstrcj
|
$254.19 |
$254.19 |
$254.19 |
$524.80
|
|
Ther/proph/diag inj ia
|
$221.54 |
$221.54 |
$221.54 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$11.68 |
$11.68 |
$11.68 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$967.18 |
$967.18 |
$967.18 |
$1,658.70
|
|
Thoracotomy with cardiac massage
|
$921.49 |
$921.49 |
$921.49 |
$2,313.88
|
|
Thrombectmy crnry perq mechanical
|
$2,061.92 |
$2,061.92 |
$2,061.92 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,284.08 |
$6,284.08 |
$6,284.08 |
$8,395.40
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$14,037.62 |
$14,037.62 |
$14,037.62 |
$15,640.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$21,277.04 |
$21,277.04 |
$21,277.04 |
$25,597.40
|
|
Thrombin time
|
$42.83 |
$42.83 |
$42.83 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$34.60 |
$34.60 |
$34.60 |
$56.93
|
|
Thyroglobulin antibody
|
$56.89 |
$56.89 |
$56.89 |
$86.40
|
|
Thyroid imaging
|
$176.21 |
$176.21 |
$176.21 |
$577.80
|
|
Thyroid mets imag whole body
|
$589.32 |
$589.32 |
$589.32 |
$1,320.00
|
|
Thyroid (TSH) Test
|
$83.07 |
$83.07 |
$83.07 |
$101.40
|
|
Thyroid Ultrasound
|
$408.02 |
$408.02 |
$408.02 |
$553.80
|
|
Thyroid uptake measurement
|
$134.03 |
$134.03 |
$134.03 |
$580.20
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,335.83 |
$2,335.83 |
$2,335.83 |
$3,167.70
|
|
Thyroxine binding globulin (tbg)
|
$61.42 |
$61.42 |
$61.42 |
$75.00
|
|
Tib/per revasc stent & ather 37231
|
$39,520.44 |
$39,520.44 |
$39,520.44 |
$23,525.00
|
|
Tib/per revasc stnt & ather
|
$20,058.26 |
$20,058.26 |
$20,058.26 |
$13,321.00
|
|
Tib/per revasc w/ather add-on 37233
|
$21,667.94 |
$21,667.94 |
$21,667.94 |
$12,855.00
|
|
Tigecycline injection
|
$178.71 |
$178.71 |
$178.71 |
$7.44
|
|
Tilt table study
|
$487.29 |
$487.29 |
$487.29 |
$1,488.24
|
|
Tirofiban 12.5 mg/50 ml
|
$696.08 |
$696.08 |
$696.08 |
$696.08
|
|
Tissue culture skin/biopsy
|
$560.27 |
$560.27 |
$560.27 |
$626.77
|
|
Tissue culture tumor
|
$320.05 |
$320.05 |
$320.05 |
$605.60
|
|
Tissue exam koh skin/hair/nails
|
$21.09 |
$21.09 |
$21.09 |
$45.23
|
|
Tl-201 thallium diag per mci
|
$43.38 |
$43.38 |
$43.38 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$141.75 |
$141.75 |
$141.75 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$65.95 |
$65.95 |
$65.95 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$25.62 |
$25.62 |
$25.62 |
$2,743.02
|
|
Tomosynthesis breast diagnostic left
|
$34.97 |
$34.97 |
$34.97 |
$53.92
|
|
Tomosynthesis breast screen bilateral
|
$34.97 |
$34.97 |
$34.97 |
$77.46
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$28.64 |
$28.64 |
$28.64 |
$200.93
|
|
Toxoplasma antibody igg
|
$49.77 |
$49.77 |
$49.77 |
$83.20
|
|
Toxoplasma antibody igm
|
$48.93 |
$48.93 |
$48.93 |
$85.80
|
|
Tp53 gene full gene sequence
|
$535.76 |
$535.76 |
$535.76 |
$660.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$429.02 |
$429.02 |
$429.02 |
$1,522.95
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$40.89 |
$40.89 |
$40.89 |
$90.35
|
|
Transcath biopsy
|
$1,720.69 |
$1,720.69 |
$1,720.69 |
$4,285.93
|
|
Transcath closure of asd
|
$6,954.34 |
$6,954.34 |
$6,954.34 |
$19,715.47
|
|
Transcath closure of vsd
|
$6,954.34 |
$6,954.34 |
$6,954.34 |
$18,837.00
|
