|
Target gsa panel organ/hmtlmph neop
|
$7,632.00 |
$7,632.00 |
$7,632.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$3,549.60 |
$3,549.60 |
$3,549.60 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$2,828.40 |
$2,828.40 |
$2,828.40 |
$24,217.20
|
|
Tavr perq femoral
|
$24,406.80 |
$24,406.80 |
$24,406.80 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$3.60 |
$3.60 |
$3.60 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$436.80 |
$436.80 |
$436.80 |
$180.80
|
|
Tc-99m exametazime diag
|
$3,633.00 |
$3,633.00 |
$3,633.00 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$330.60 |
$330.60 |
$330.60 |
$306.00
|
|
Tc-99m maa
|
$181.80 |
$181.80 |
$181.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$250.80 |
$250.80 |
$250.80 |
$157.65
|
|
Tc-99m medronate
|
$129.60 |
$129.60 |
$129.60 |
$111.01
|
|
Tc-99m mertiatide
|
$1,470.60 |
$1,470.60 |
$1,470.60 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$15.00 |
$15.00 |
$15.00 |
$6.50
|
|
Tc-99m oxidronate
|
$108.00 |
$108.00 |
$108.00 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$138.00 |
$138.00 |
$138.00 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$81.60 |
$81.60 |
$81.60 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$161.40 |
$161.40 |
$161.40 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$498.60 |
$498.60 |
$498.60 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$1,420.20 |
$1,420.20 |
$1,420.20 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$359.40 |
$359.40 |
$359.40 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$74.40 |
$74.40 |
$74.40 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$268.20 |
$268.20 |
$268.20 |
$185.28
|
|
T cells absolute cd 4 count
|
$234.60 |
$234.60 |
$234.60 |
$111.20
|
|
T cells total count
|
$202.20 |
$202.20 |
$202.20 |
$130.35
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$437.40 |
$437.40 |
$437.40 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$2,101.65
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3.40 |
$3.40 |
$3.40 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$14,038.20 |
$14,038.20 |
$14,038.20 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$563.20 |
$563.20 |
$563.20 |
$39.33
|
|
Teriparatide injection
|
$53.80 |
$53.80 |
$53.80 |
$7,403.20
|
|
Testicular imaging w/vasc flow
|
$815.40 |
$815.40 |
$815.40 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,861.80 |
$1,861.80 |
$1,861.80 |
$953.40
|
|
Tetanus immune globulin inj
|
$1,582.40 |
$1,582.40 |
$1,582.40 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$50.00 |
$50.00 |
$50.00 |
$8,737.05
|
|
Tgsap so/hl 51/< rna alys
|
$2,157.60 |
$2,157.60 |
$2,157.60 |
$4,563.00
|
|
Theophylline therapeutic drug level
|
$182.40 |
$182.40 |
$182.40 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$80.40 |
$80.40 |
$80.40 |
$101.85
|
|
Therapy Exercise Session (each 15 minutes)
|
$102.00 |
$102.00 |
$102.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$27.00 |
$27.00 |
$27.00 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$20.40 |
$20.40 |
$20.40 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$702.60 |
$702.60 |
$702.60 |
$538.88
|
|
Ther/proph/diag inj ia
|
$250.20 |
$250.20 |
$250.20 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$42.20 |
$42.20 |
$42.20 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$288.00 |
$288.00 |
$288.00 |
$314.50
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,974.60 |
$1,974.60 |
$1,974.60 |
$1,733.65
|
|
Thoracotomy with cardiac massage
|
$6,357.60 |
$6,357.60 |
$6,357.60 |
$2,138.76
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,297.80 |
$1,297.80 |
$1,297.80 |
$1,684.80
|
|
Thrombectmy crnry perq mechanical
|
$3,809.40 |
$3,809.40 |
$3,809.40 |
$3,836.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,865.60 |
$2,865.60 |
$2,865.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$5,134.20 |
$5,134.20 |
$5,134.20 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$2,865.60 |
$2,865.60 |
$2,865.60 |
$21,413.60
|
|
Thrombin time
|
$89.40 |
$89.40 |
$89.40 |
$54.18
|
|
Thromboplastin inhibition
|
$118.80 |
$118.80 |
$118.80 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$102.60 |
$102.60 |
$102.60 |
$61.52
|
|
Thyroglobulin antibody
|
$193.20 |
$193.20 |
$193.20 |
$82.73
|
|
Thyroid mets imag whole body
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$257.40 |
$257.40 |
$257.40 |
$112.67
|
|
Thyroid Ultrasound
|
$598.20 |
$598.20 |
$598.20 |
$588.50
|
|
Thyroid uptake measurement
|
$666.60 |
$666.60 |
$666.60 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,949.60 |
$4,949.60 |
$4,949.60 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$152.40 |
$152.40 |
$152.40 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$50,165.40 |
$50,165.40 |
$50,165.40 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$42,124.80 |
$42,124.80 |
$42,124.80 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$11,931.00 |
$11,931.00 |
$11,931.00 |
$10,165.00
|
|
Tigecycline injection
|
$23.60 |
$23.60 |
$23.60 |
$235.29
|
|
Tilt table study
|
$4,359.60 |
$4,359.60 |
$4,359.60 |
$1,561.82
|
|
Tissue culture placenta
|
$1,551.00 |
$1,551.00 |
$1,551.00 |
$440.50
|
|
Tissue culture skin/biopsy
|
$1,636.80 |
$1,636.80 |
$1,636.80 |
$484.00
|
|
Tissue culture tumor
|
$2,206.20 |
$2,206.20 |
$2,206.20 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$55.20 |
$55.20 |
$55.20 |
$47.40
|
|
Tissue transglutaminase iga
|
$271.20 |
$271.20 |
$271.20 |
$44.80
|
|
Tixagev and cilgav inj
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$241.92
|
|
Tl-201 thallium diag per mci
|
$133.80 |
$133.80 |
$133.80 |
$80.10
|
|
Tobramycin comp unit
|
$662.40 |
$662.40 |
$662.40 |
$810.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$155.20 |
$155.20 |
$155.20 |
$152.36
|
|
Tobramycin non-comp unit
|
$542.40 |
$542.40 |
$542.40 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$255.60 |
$255.60 |
$255.60 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,636.20 |
$4,636.20 |
$4,636.20 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$221.40 |
$221.40 |
$221.40 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$123.00 |
$123.00 |
$123.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$45.00 |
$45.00 |
$45.00 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$144.60 |
$144.60 |
$144.60 |
$316.84
|
|
Toxoplasma antibody igg
|
$225.00 |
$225.00 |
$225.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$168.60 |
$168.60 |
$168.60 |
$88.00
|
|
Tp53 gene full gene sequence
|
$3,902.40 |
$3,902.40 |
$3,902.40 |
$709.80
|
|
Tpmt gene com vrnts
|
$477.00 |
$477.00 |
$477.00 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$977.60 |
$977.60 |
$977.60 |
$6,684.23
|
|
Tracheobrnchsc thru est trachs incisn
|
$3,385.20 |
$3,385.20 |
$3,385.20 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$121.20 |
$121.20 |
$121.20 |
$103.20
|
|
Transcath closure of asd
|
$15,964.20 |
$15,964.20 |
$15,964.20 |
$17,088.00
|
|
Transcatheter bx s&i
|
$1,911.60 |
$1,911.60 |
$1,911.60 |
$1,950.85
|
|
Transcath occlusion cns
|
$4,158.60 |
$4,158.60 |
$4,158.60 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$9,757.80 |
$9,757.80 |
$9,757.80 |
$10,270.00
|
|
Transferrin
|
$192.00 |
$192.00 |
$192.00 |
$82.00
|
|
Transparent film >16<=48 in
|
$3.00 |
$3.00 |
$3.00 |
$12.95
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$462.00 |
$462.00 |
$462.00 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$906.60 |
$906.60 |
$906.60 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$510.60 |
$510.60 |
$510.60 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$496.80 |
$496.80 |
$496.80 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$214.80 |
$214.80 |
$214.80 |
$5,846.40
|
