|
Strapping of ankle and/or ft 29540
|
$352.80 |
$352.80 |
$352.80 |
$223.45
|
|
Stress test pulmonary
|
$455.20 |
$455.20 |
$455.20 |
$322.85
|
|
St treatment speech individual
|
$270.40 |
$270.40 |
$270.40 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$296.80 |
$296.80 |
$296.80 |
$240.31
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$83.20 |
$83.20 |
$83.20 |
$82.43
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$21.00 |
$21.00 |
$21.00 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$102.40 |
$102.40 |
$102.40 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$102.40 |
$102.40 |
$102.40 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$204.80 |
$204.80 |
$204.80 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$218.40 |
$218.40 |
$218.40 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$718.00
|
|
Susceptibility enzyme detection per enzyme
|
$20.00 |
$20.00 |
$20.00 |
$35.70
|
|
Susceptibility mic per plate
|
$35.20 |
$35.20 |
$35.20 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$18.40 |
$18.40 |
$18.40 |
$41.60
|
|
T3 (triiodothyronine) free
|
$70.40 |
$70.40 |
$70.40 |
$99.20
|
|
T3 (triiodothyronine) total
|
$59.20 |
$59.20 |
$59.20 |
$93.52
|
|
T4 (thyroxine) free
|
$35.00 |
$35.00 |
$35.00 |
$85.20
|
|
T4 (thyroxine) total
|
$28.00 |
$28.00 |
$28.00 |
$69.00
|
|
Tacrol envarsus ex rel oral
|
$12.80 |
$12.80 |
$12.80 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.40 |
$4.40 |
$4.40 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$50.00 |
$50.00 |
$50.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$2,246.30
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$815.20 |
$815.20 |
$815.20 |
$937.50
|
|
Tbs techl calculation only
|
$398.40 |
$398.40 |
$398.40 |
$153.60
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$257.60 |
$257.60 |
$257.60 |
$177.65
|
|
Tc-99m exame autol wbc diag per dose
|
$6,904.80 |
$6,904.80 |
$6,904.80 |
$2,435.36
|
|
Tc-99m labeled rbc
|
$549.60 |
$549.60 |
$549.60 |
$302.40
|
|
Tc-99m maa
|
$447.20 |
$447.20 |
$447.20 |
$292.80
|
|
Tc-99m mebrofenin
|
$254.40 |
$254.40 |
$254.40 |
$157.65
|
|
Tc-99m medronate
|
$114.40 |
$114.40 |
$114.40 |
$111.01
|
|
Tc-99m mertiatide
|
$1,036.80 |
$1,036.80 |
$1,036.80 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$17.60 |
$17.60 |
$17.60 |
$6.60
|
|
Tc-99m oxidronate
|
$115.20 |
$115.20 |
$115.20 |
$105.60
|
|
Tc-99m pertechnetate per mci
|
$68.80 |
$68.80 |
$68.80 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$294.40 |
$294.40 |
$294.40 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$238.40 |
$238.40 |
$238.40 |
$274.45
|
|
Tc-99m sulfur colloid
|
$476.00 |
$476.00 |
$476.00 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$3,249.60 |
$3,249.60 |
$3,249.60 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$195.20 |
$195.20 |
$195.20 |
$176.40
|
|
T cells absolute cd 4 count
|
$111.20 |
$111.20 |
$111.20 |
$111.20
|
|
T cells total count
|
$157.60 |
$157.60 |
$157.60 |
$126.90
|
|
Telehealth original site facility fee
|
$40.00 |
$40.00 |
$40.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$4,604.80 |
$4,604.80 |
$4,604.80 |
$1,526.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$17,579.80 |
$17,579.80 |
$17,579.80 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$19.40 |
$19.40 |
$19.40 |
$39.33
|
|
Test pathogen(s) for platelets reference
|
$238.40 |
$238.40 |
$238.40 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$705.60 |
$705.60 |
$705.60 |
$949.70
|
|
Tetanus immune globulin inj
|
$3,654.20 |
$3,654.20 |
$3,654.20 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$59.20 |
$59.20 |
$59.20 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$37.60 |
$37.60 |
$37.60 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$37.60 |
$37.60 |
$37.60 |
$50.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$120.00 |
$120.00 |
$120.00 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,186.40 |
$1,186.40 |
$1,186.40 |
$1,687.50
|
|
Thrombin time
|
$40.80 |
$40.80 |
$40.80 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$30.40 |
$30.40 |
$30.40 |
$61.52
|
|
Thyroglobulin antibody
|
$66.40 |
$66.40 |
$66.40 |
$82.00
|
|
Thyroid mets imag whole body
|
$2,225.60 |
$2,225.60 |
$2,225.60 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$40.00 |
$40.00 |
$40.00 |
$111.00
|
|
Thyroid Ultrasound
|
$583.20 |
$583.20 |
$583.20 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$61.60 |
$61.60 |
$61.60 |
$64.35
|
|
Tissue culture skin/biopsy
|
$591.20 |
$591.20 |
$591.20 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$17.60 |
$17.60 |
$17.60 |
$47.20
|
|
Tissue transglutaminase iga
|
$48.00 |
$48.00 |
$48.00 |
$44.16
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$516.60 |
$516.60 |
$516.60 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$67.20 |
$67.20 |
$67.20 |
$120.60
|
|
Tomosynthesis breast screen bilateral
|
$88.80 |
$88.80 |
$88.80 |
$72.68
|
|
Toxoplasma antibody igg
|
$60.00 |
$60.00 |
$60.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$60.00 |
$60.00 |
$60.00 |
$87.00
|
|
Tpmt gene com vrnts
|
$376.00 |
$376.00 |
$376.00 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,532.00 |
$1,532.00 |
$1,532.00 |
$1,420.44
|
|
Transferrin
|
$50.00 |
$50.00 |
$50.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,714.40 |
$1,714.40 |
$1,714.40 |
$983.00
|
|
Treat finger fracture each
|
$2,567.20 |
$2,567.20 |
$2,567.20 |
$1,536.00
|
|
Treat fracture of radius
|
$864.00 |
$864.00 |
$864.00 |
$1,790.00
|
|
Treat humerus fracture
|
$557.60 |
$557.60 |
$557.60 |
$1,771.43
|
|
Treat knee fracture 27530
|
$701.60 |
$701.60 |
$701.60 |
$550.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$692.80 |
$692.80 |
$692.80 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$692.80 |
$692.80 |
$692.80 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$239.20 |
$239.20 |
$239.20 |
$203.35
|
|
Treatment of ankle fracture 27786
|
$621.60 |
$621.60 |
$621.60 |
$520.80
|
|
Treatment of heel fracture 28400
|
$739.20 |
$739.20 |
$739.20 |
$473.00
|
|
Treatment of thigh fracture
|
$784.00 |
$784.00 |
$784.00 |
$548.90
|
|
Treatment of toe fracture 28510
|
$612.00 |
$612.00 |
$612.00 |
$369.70
|
|
Treat thigh fracture
|
$1,828.00 |
$1,828.00 |
$1,828.00 |
$661.00
|
|
Treat thigh fracture
|
$451.20 |
$451.20 |
$451.20 |
$618.80
|
|
Treat ulnar fracture
|
$335.20 |
$335.20 |
$335.20 |
$1,662.00
|
|
Treponema pallidum antibody
|
$55.20 |
$55.20 |
$55.20 |
$70.40
|
|
Treprostinil injection
|
$25,833.40 |
$25,833.40 |
$25,833.40 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$838.40 |
$838.40 |
$838.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$134.00 |
$134.00 |
$134.00 |
$43.21
|
|
Triglycerides
|
$24.00 |
$24.00 |
$24.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$538.20 |
$538.20 |
$538.20 |
$117.49
|
|
Trmt of fracture (femoral shaft) 27500
|
$804.00 |
$804.00 |
$804.00 |
$754.80
|
|
Troponin quantitative
|
$61.60 |
$61.60 |
$61.60 |
$127.20
|
|
Tx closed tib shaft fx without manip
|
$688.80 |
$688.80 |
$688.80 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$656.00 |
$656.00 |
$656.00 |
$416.16
|
|
Ultrasound abdomen aorta screening study aaa
|
$501.60 |
$501.60 |
$501.60 |
$394.20
|
|
Ultrasound breast complete
|
$540.80 |
$540.80 |
$540.80 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$492.00 |
$492.00 |
$492.00 |
$449.35
|
