|
T3 (triiodothyronine) total
|
$59.02 |
$74.75 |
$107.90 |
|
|
T4 (thyroxine) free
|
$48.10 |
$61.33 |
$101.40 |
|
|
T4 (thyroxine) total
|
$41.26 |
$53.30 |
$96.00 |
|
|
Tacrol envarsus ex rel oral
|
$2.74 |
$2.74 |
$2.74 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.36 |
$1.36 |
$107.75 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$176.77 |
$176.77 |
$1,280.56 |
|
|
Tacrolimus therapeutic drug level
|
$96.00 |
$96.66 |
$185.90 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,171.70 |
$4,171.70 |
$5,237.62 |
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$303.74 |
$303.74 |
$303.74 |
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$43,800.48 |
$43,800.48 |
$43,800.48 |
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$35.75 |
$35.75 |
$36.45 |
|
|
Target gsa panel hmtlmph neop
|
$925.19 |
$1,608.75 |
$2,707.00 |
|
|
Target gsa panel organ/hmtlmph neop
|
$1,259.70 |
$1,259.70 |
$5,548.40 |
|
|
Target gsa panel organ neop
|
$1,426.07 |
$2,072.85 |
$5,852.60 |
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$45,197.75 |
$45,197.75 |
$56,474.60 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$332.56 |
$665.88 |
$1,302.25 |
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$85.93 |
$131.95 |
$225.00 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$77.52 |
$166.40 |
$256.00 |
|
|
Tc-99m apcitide diag
|
$1,252.55 |
$1,252.55 |
$1,252.55 |
|
|
Tc-99m bicisate
|
$2,525.34 |
$2,525.34 |
$3,641.95 |
|
|
Tc-99m exame autol wbc diag per dose
|
$2,040.35 |
$2,040.35 |
$2,815.80 |
|
|
Tc-99m exametazime diag
|
$2,290.60 |
$2,832.07 |
$2,832.07 |
|
|
Tc-99m labeled rbc
|
$257.40 |
$265.66 |
$343.85 |
|
|
Tc-99m maa
|
$87.75 |
$135.85 |
$281.20 |
|
|
Tc-99m mebrofenin
|
$111.28 |
$188.50 |
$444.60 |
|
|
Tc-99m medronate
|
$43.11 |
$153.40 |
$392.60 |
|
|
Tc-99m mertiatide
|
$582.84 |
$582.84 |
$1,360.45 |
|
|
Tc-99m oxidronate
|
$83.99 |
$83.99 |
$135.20 |
|
|
Tc-99m pentetate dtpa
|
$117.00 |
$161.23 |
$161.85 |
|
|
Tc-99m pentetate dtpa aerosol
|
$132.60 |
$132.60 |
$132.60 |
|
|
Tc-99m pertechnetate per mci
|
$12.35 |
$37.05 |
$49.12 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$130.80 |
$169.65 |
$251.55 |
|
|
Tc-99m sestamibi p study dose
|
$341.90 |
$395.85 |
$807.30 |
|
|
Tc-99m succimer (dmsa)
|
$373.42 |
$373.42 |
$373.42 |
|
|
Tc-99m sulfur colloid
|
$168.35 |
$252.85 |
$720.20 |
|
|
Tc-99m tetrofosmin p study dose
|
$138.29 |
$384.80 |
$1,343.55 |
|
|
Tc-99m tilmanocept diag
|
$572.65 |
$801.70 |
$1,007.50 |
|
|
T cells absolute cd4/cd8 including ratio
|
$170.00 |
$185.28 |
$355.00 |
|
|
T cells absolute cd 4 count
|
$110.72 |
$167.70 |
$279.00 |
|
|
T cells total count
|
$68.92 |
$96.00 |
$181.00 |
|
|
Telavancin injection
|
$464.05 |
$464.05 |
$2,944.48 |
|
|
Telehealth original site facility fee
|
$24.05 |
$24.05 |
$230.75 |
|
|
Telethx isodose plan cplx
|
$277.22 |
$277.22 |
$39,087.10 |
|
|
Telethx isodose plan simple
|
$200.36 |
$200.36 |
$1,166.10 |
|
|
Temozolomide
|
$145.27 |
$427.46 |
$773.04 |
|
|
Temozolomide 100 mg intravenous solution
|
$29.19 |
$29.19 |
$3,700.11 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$116.48 |
$116.48 |
$5,271.27 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,570.16 |
$22,775.57 |
$35,039.34 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.71 |
$17.50 |
$86.18 |
|
|
Test for porphobilinogen
|
$42.25 |
$42.25 |
$42.25 |
|
|
Test for urine cystines
|
$18.50 |
$18.50 |
$18.50 |
|
|
Testicular imaging w/vasc flow
|
$342.62 |
$342.62 |
$984.75 |
|
|
Test pathogen(s) for platelets reference
|
$55.90 |
$55.90 |
$71.50 |
|
|
Test stress cardiovascular tracing only
|
$365.84 |
$365.84 |
$1,435.85 |
|
|
Tetanus immune globulin inj
|
$404.61 |
$404.61 |
$3,196.34 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$13,424.68 |
$14,944.83 |
$16,793.56 |
|
|
Theophylline therapeutic drug level
|
$60.77 |
$76.05 |
$159.00 |
|
|
Therapeutic procd strg endur
|
$35.71 |
$67.60 |
$143.65 |
|
|
Therapy activity per session >= 45 minutes
|
$210.44 |
$210.44 |
$210.44 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$41.60 |
$48.29 |
$117.65 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$26.64 |
$33.15 |
$94.90 |
|
|
Ther fx nasal inf turbinate
|
$23,727.33 |
$23,727.33 |
$23,727.33 |
|
|
Ther nma rdctj intus/obstrcj
|
$254.19 |
$254.19 |
$1,355.25 |
|
|
Ther/proph/diag inj ia
|
$66.95 |
$221.54 |
$221.54 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$7.31 |
$11.68 |
$45.00 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$410.80 |
$967.18 |
$3,719.30 |
|
|
Thoracotomy with cardiac massage
|
$921.49 |
$921.49 |
$921.49 |
|
|
Throat x-ray & fluoroscopy
|
$271.05 |
$271.05 |
$271.05 |
|
|
Thrombectmy crnry perq mechanical
|
$2,061.92 |
$3,043.30 |
$4,954.30 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,284.08 |
$6,284.08 |
$13,237.26 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$14,037.62 |
$14,037.62 |
$14,759.55 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$21,277.04 |
$21,277.04 |
$26,212.25 |
|
|
Thrombin time
|
$32.00 |
$48.10 |
$133.90 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$34.60 |
$44.85 |
$118.30 |
|
|
Thyroglobulin antibody
|
$29.25 |
$56.89 |
$91.00 |
|
|
Thyroid imaging
|
$176.21 |
$176.21 |
$698.75 |
|
|
Thyroid mets imag whole body
|
$589.32 |
$1,173.25 |
$10,337.37 |
|
|
Thyroid met uptake
|
$229.45 |
$229.45 |
$229.45 |
|
|
Thyroid (TSH) Test
|
$59.80 |
$83.07 |
$128.05 |
|
|
Thyroid Ultrasound
|
$198.25 |
$408.02 |
$578.00 |
|
|
Thyroid uptake measurement
|
$134.03 |
$134.03 |
$892.45 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,335.83 |
$2,335.83 |
$7,570.32 |
|
|
Thyroxine binding globulin (tbg)
|
$61.42 |
$75.40 |
$163.15 |
|
|
Tibial arthroscopy/surgery
|
$17,233.86 |
$17,233.86 |
$17,233.86 |
|
|
Tib/per revasc stent & ather 37231
|
$39,520.44 |
$39,520.44 |
$39,520.44 |
|
|
Tib/per revasc stnt & ather
|
$20,058.26 |
$20,058.26 |
$20,058.26 |
|
|
Tib/per revasc w/ather add-on 37233
|
$21,667.94 |
$21,667.94 |
$21,667.94 |
|
|
Tigecycline injection
|
$178.71 |
$178.71 |
$437.45 |
|
|
Tilt table study
|
$487.29 |
$487.29 |
$3,207.75 |
|
|
Tirofiban 12.5 mg/50 ml
|
$696.08 |
$696.08 |
$1,045.51 |
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$27,070.87 |
$27,070.87 |
$27,070.87 |
|
|
Tissue culture placenta
|
$353.60 |
$440.05 |
$712.00 |
|
|
Tissue culture skin/biopsy
|
$273.65 |
$560.27 |
$748.15 |
|
|
Tissue culture tumor
|
$320.05 |
$320.05 |
$320.05 |
|
|
Tissue exam koh skin/hair/nails
|
$21.09 |
$55.90 |
$145.60 |
|
|
Tissue transglutaminase iga
|
$40.95 |
$93.60 |
$144.00 |
|
|
Tl-201 thallium diag per mci
|
$43.38 |
$65.00 |
$363.35 |
|
|
Tlh uterus 250 g or less
|
$13,377.07 |
$13,377.07 |
$15,462.32 |
|
|
Tlh w/t/o 250 g or less
|
$15,540.92 |
$15,540.92 |
$17,583.00 |
|
|
Tlh w/t/o uterus over 250 g
|
$16,872.63 |
$16,872.63 |
$21,804.07 |
|
