|
Target gsa panel organ neop
|
$441.00 |
$441.00 |
$441.00 |
$1,655.52
|
|
Tavr perq femoral
|
$5,353.11 |
$5,353.11 |
$5,353.11 |
$15,454.40
|
|
Tbs techl calculation only
|
$53.13 |
$53.13 |
$53.13 |
$153.60
|
|
Tbs techl prep&transmis data
|
$53.13 |
$53.13 |
$53.13 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$39.69 |
$39.69 |
$39.69 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$160.02 |
$160.02 |
$160.02 |
$177.65
|
|
Tc-99m disofenin
|
$94.17 |
$94.17 |
$94.17 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$393.75 |
$393.75 |
$393.75 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$675.99 |
$675.99 |
$675.99 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$64.47 |
$64.47 |
$64.47 |
$302.40
|
|
Tc-99m maa
|
$51.03 |
$51.03 |
$51.03 |
$292.80
|
|
Tc-99m mebrofenin
|
$33.07 |
$33.07 |
$33.07 |
$157.65
|
|
Tc-99m medronate
|
$26.58 |
$26.58 |
$26.58 |
$111.01
|
|
Tc-99m mertiatide
|
$221.76 |
$221.76 |
$221.76 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$2.10 |
$2.10 |
$2.10 |
$6.60
|
|
Tc-99m oxidronate
|
$12.60 |
$12.60 |
$12.60 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$6.72 |
$6.72 |
$6.72 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$15.12 |
$15.12 |
$15.12 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$0.23 |
$0.23 |
$0.23 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$100.73 |
$100.73 |
$100.73 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$45.38 |
$45.38 |
$45.38 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$107.52 |
$107.52 |
$107.52 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$78.33 |
$78.33 |
$78.33 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$32.97 |
$32.97 |
$32.97 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$328.86 |
$328.86 |
$328.86 |
$955.60
|
|
Tcd emboli detect w/inj
|
$253.47 |
$253.47 |
$253.47 |
$475.80
|
|
Tcd emboli detect without inj
|
$253.47 |
$253.47 |
$253.47 |
$475.28
|
|
Tcd vasoreactivity study
|
$265.86 |
$265.86 |
$265.86 |
$566.88
|
|
T cells absolute cd4/cd8 including ratio
|
$271.32 |
$271.32 |
$271.32 |
$176.40
|
|
T cells absolute cd 4 count
|
$39.27 |
$39.27 |
$39.27 |
$111.20
|
|
T cells total count
|
$217.77 |
$217.77 |
$217.77 |
$126.90
|
|
Telehealth original site facility fee
|
$14.49 |
$14.49 |
$14.49 |
$51.00
|
|
Telethx isodose plan cplx
|
$530.46 |
$530.46 |
$530.46 |
$1,526.85
|
|
Telethx isodose plan simple
|
$426.51 |
$426.51 |
$426.51 |
$873.62
|
|
Temozolomide
|
$122.67 |
$122.67 |
$122.67 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$835.29 |
$835.29 |
$835.29 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$955.92 |
$955.92 |
$955.92 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$7.87 |
$7.87 |
$7.87 |
$39.33
|
|
Test for urine cystines
|
$46.20 |
$46.20 |
$46.20 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$294.63 |
$294.63 |
$294.63 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$23.31 |
$23.31 |
$23.31 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$308.07 |
$308.07 |
$308.07 |
$949.70
|
|
Tgsap hl neo 5-50 rna alys
|
$517.65 |
$517.65 |
$517.65 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$1,989.33 |
$1,989.33 |
$1,989.33 |
$4,347.00
|
|
Tgsap so neo 5-50 rna alys
|
$407.61 |
$407.61 |
$407.61 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$81.27 |
$81.27 |
$81.27 |
$108.00
|
|
Therapy activation ipnss
|
$54.60 |
$54.60 |
$54.60 |
$226.24
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$21.00 |
$21.00 |
$21.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$18.90 |
$18.90 |
$18.90 |
$50.00
|
|
Ther/proph/diag inj ia
|
$77.28 |
$77.28 |
$77.28 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$14.50 |
$14.50 |
$14.50 |
$25.54
|
|
Thiotepa injection
|
$1,369.61 |
$1,369.61 |
$1,369.61 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$641.76 |
$641.76 |
$641.76 |
$1,687.50
|
|
Thoracotomy w/expl
|
$610.26 |
$610.26 |
$610.26 |
$2,045.17
|
|
Throat x-ray & fluoroscopy
|
$118.86 |
$118.86 |
$118.86 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$2,174.97 |
$2,174.97 |
$2,174.97 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,234.19 |
$2,234.19 |
$2,234.19 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$4,516.47 |
$4,516.47 |
$4,516.47 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$6,709.50 |
$6,709.50 |
$6,709.50 |
$21,413.60
|
|
Thrombin time
|
$60.90 |
$60.90 |
$60.90 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$33.39 |
$33.39 |
$33.39 |
$61.52
|
|
Thyroglobulin antibody
|
$69.93 |
$69.93 |
$69.93 |
$82.00
|
|
Thyroid imaging
|
$309.12 |
$309.12 |
$309.12 |
$695.02
|
|
Thyroid mets imag whole body
|
$396.48 |
$396.48 |
$396.48 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$46.62 |
$46.62 |
$46.62 |
$111.00
|
|
Thyroid Ultrasound
|
$164.22 |
$164.22 |
$164.22 |
$588.50
|
|
Thyroid uptake measurement
|
$266.91 |
$266.91 |
$266.91 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$85.05 |
$85.05 |
$85.05 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$16,064.58 |
$16,064.58 |
$16,064.58 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$14,090.79 |
$14,090.79 |
$14,090.79 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$8,812.44 |
$8,812.44 |
$8,812.44 |
$9,769.65
|
|
Tigecycline injection
|
$153.06 |
$153.06 |
$153.06 |
$234.00
|
|
Tilt table study
|
$408.03 |
$408.03 |
$408.03 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$132.30 |
$132.30 |
$132.30 |
$458.85
|
|
Tissue culture placenta
|
$115.29 |
$115.29 |
$115.29 |
$457.00
|
|
Tissue culture skin/biopsy
|
$523.32 |
$523.32 |
$523.32 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$19.32 |
$19.32 |
$19.32 |
$47.20
|
|
Tissue transglutaminase iga
|
$7.98 |
$7.98 |
$7.98 |
$44.16
|
|
Tixagev and cilgav inj
|
$106.89 |
$106.89 |
$106.89 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$72.41 |
$72.41 |
$72.41 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$112.19 |
$112.19 |
$112.19 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$117.18 |
$117.18 |
$117.18 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$22.05 |
$22.05 |
$22.05 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$22.05 |
$22.05 |
$22.05 |
$72.68
|
|
Tone decay hearing test
|
$32.13 |
$32.13 |
$32.13 |
$90.37
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$271.95 |
$271.95 |
$271.95 |
$325.00
|
|
Toxoplasma antibody igg
|
$99.54 |
$99.54 |
$99.54 |
$89.40
|
|
Toxoplasma antibody igm
|
$63.42 |
$63.42 |
$63.42 |
$87.00
|
|
Tp53 gene full gene sequence
|
$454.86 |
$454.86 |
$454.86 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$224.70 |
$224.70 |
$224.70 |
$790.68
|
|
Tpmt gene com vrnts
|
$75.60 |
$75.60 |
$75.60 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$266.91 |
$266.91 |
$266.91 |
$1,420.44
|
|
Transcath biopsy
|
$1,719.48 |
$1,719.48 |
$1,719.48 |
$4,285.93
|
|
Transcath closure of asd
|
$6,008.52 |
$6,008.52 |
$6,008.52 |
$16,741.40
|
|
Transcatheter bx s&i
|
$532.14 |
$532.14 |
$532.14 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$4,095.63 |
$4,095.63 |
$4,095.63 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$8,190.84 |
$8,190.84 |
$8,190.84 |
$12,418.00
|
|
Transcath occlusion cns
|
$5,213.88 |
$5,213.88 |
$5,213.88 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$4,964.82 |
$4,964.82 |
$4,964.82 |
$10,031.28
|
|
Transcath rmvl perm ldss pmkr rv
|
$1,226.82 |
$1,226.82 |
$1,226.82 |
$4,775.16
|
