|
Stent bili rx wallflx 10x80 uncvr
|
$3,806.58 |
$3,806.58 |
$3,806.58 |
$20,962.50
|
|
St evaluate speech sound production
|
$54.60 |
$54.60 |
$54.60 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$54.60 |
$54.60 |
$54.60 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$90.30 |
$90.30 |
$90.30 |
$399.60
|
|
St evaluation swallow function
|
$54.60 |
$54.60 |
$54.60 |
$314.40
|
|
Stress tte complete
|
$403.50 |
$403.50 |
$403.50 |
$1,870.50
|
|
Str markers spec anal addl
|
$189.90 |
$189.90 |
$189.90 |
$479.17
|
|
Str markers specimen anal
|
$270.60 |
$270.60 |
$270.60 |
$751.50
|
|
St treatment speech individual
|
$50.10 |
$50.10 |
$50.10 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$57.90 |
$57.90 |
$57.90 |
$240.31
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$3.96 |
$3.96 |
$3.96 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$16.44 |
$16.44 |
$16.44 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$11.10 |
$11.10 |
$11.10 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$24.60 |
$24.60 |
$24.60 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$29.40 |
$29.40 |
$29.40 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$32.70 |
$32.70 |
$32.70 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$192.60 |
$192.60 |
$192.60 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$270.00 |
$270.00 |
$270.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$14.40 |
$14.40 |
$14.40 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$14.40 |
$14.40 |
$14.40 |
$35.70
|
|
Susceptibility mic per plate
|
$279.00 |
$279.00 |
$279.00 |
$106.00
|
|
Svc venogram s&i
|
$723.60 |
$723.60 |
$723.60 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$1,400.30 |
$1,400.30 |
$1,400.30 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$12.30 |
$12.30 |
$12.30 |
$41.60
|
|
System pacing micra av
|
$13,125.00 |
$13,125.00 |
$13,125.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,678.00 |
$6,678.00 |
$6,678.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$51.30 |
$51.30 |
$51.30 |
$99.20
|
|
T3 (triiodothyronine) total
|
$42.90 |
$42.90 |
$42.90 |
$93.52
|
|
T4 (thyroxine) free
|
$27.30 |
$27.30 |
$27.30 |
$85.20
|
|
T4 (thyroxine) total
|
$20.70 |
$20.70 |
$20.70 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$17.70 |
$17.70 |
$17.70 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$28.80 |
$28.80 |
$28.80 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,427.14 |
$1,427.14 |
$1,427.14 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$11,811.82 |
$11,811.82 |
$11,811.82 |
$21,745.13
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$15,336.00 |
$15,336.00 |
$15,336.00 |
$24,217.20
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$371.68 |
$371.68 |
$371.68 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$29.10 |
$29.10 |
$29.10 |
$177.65
|
|
Tc-99m exame autol wbc diag per dose
|
$1,471.19 |
$1,471.19 |
$1,471.19 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,164.58 |
$1,164.58 |
$1,164.58 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$100.23 |
$100.23 |
$100.23 |
$302.40
|
|
Tc-99m maa
|
$89.62 |
$89.62 |
$89.62 |
$292.80
|
|
Tc-99m mebrofenin
|
$37.82 |
$37.82 |
$37.82 |
$157.65
|
|
Tc-99m medronate
|
$41.05 |
$41.05 |
$41.05 |
$111.01
|
|
Tc-99m mertiatide
|
$183.42 |
$183.42 |
$183.42 |
$756.00
|
|
Tc-99m oxidronate
|
$50.32 |
$50.32 |
$50.32 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$141.16 |
$141.16 |
$141.16 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$86.48 |
$86.48 |
$86.48 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$31.64 |
$31.64 |
$31.64 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$53.51 |
$53.51 |
$53.51 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$30.91 |
$30.91 |
$30.91 |
$274.45
|
|
Tc-99m sulfur colloid
|
$104.30 |
$104.30 |
$104.30 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$33.81 |
$33.81 |
$33.81 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$486.97 |
$486.97 |
$486.97 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$40.50 |
$40.50 |
$40.50 |
$176.40
|
|
T cells total count
|
$32.70 |
$32.70 |
$32.70 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$20,938.75 |
$20,938.75 |
$20,938.75 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$360.30 |
$360.30 |
$360.30 |
$2,101.65
|
|
Telavancin injection
|
$523.09 |
$523.09 |
$523.09 |
$1,191.80
|
|
Telehealth original site facility fee
|
$14.40 |
$14.40 |
$14.40 |
$51.00
|
|
Telethx isodose plan cplx
|
$432.90 |
$432.90 |
$432.90 |
$1,526.85
|
|
Telethx isodose plan simple
|
$234.00 |
$234.00 |
$234.00 |
$873.62
|
|
Temozolomide
|
$164.02 |
$164.02 |
$164.02 |
$588.46
|
|
Temozolomide 100 mg intravenous solution
|
$1,025.58 |
$1,025.58 |
$1,025.58 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,045.12 |
$2,045.12 |
$2,045.12 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$8,483.12 |
$8,483.12 |
$8,483.12 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$34.33 |
$34.33 |
$34.33 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$183.90 |
$183.90 |
$183.90 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$31.50 |
$31.50 |
$31.50 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$146.10 |
$146.10 |
$146.10 |
$949.70
|
|
Tetanus immune globulin inj
|
$568.86 |
$568.86 |
$568.86 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$42.90 |
$42.90 |
$42.90 |
$108.00
|
|
Ther/proph/diag inj ia
|
$97.80 |
$97.80 |
$97.80 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$10.72 |
$10.72 |
$10.72 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$885.60 |
$885.60 |
$885.60 |
$1,687.50
|
|
Thrombectmy crnry perq mechanical
|
$135.30 |
$135.30 |
$135.30 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,938.90 |
$1,938.90 |
$1,938.90 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$3,919.20 |
$3,919.20 |
$3,919.20 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$5,940.30 |
$5,940.30 |
$5,940.30 |
$21,413.60
|
|
Thrombin time
|
$59.10 |
$59.10 |
$59.10 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$36.60 |
$36.60 |
$36.60 |
$61.52
|
|
Thyroglobulin antibody
|
$18.60 |
$18.60 |
$18.60 |
$82.00
|
|
Thyroid imaging
|
$183.90 |
$183.90 |
$183.90 |
$695.02
|
|
Thyroid mets imag whole body
|
$290.70 |
$290.70 |
$290.70 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$50.70 |
$50.70 |
$50.70 |
$111.00
|
|
Thyroid Ultrasound
|
$138.00 |
$138.00 |
$138.00 |
$588.50
|
|
Thyroid uptake measurement
|
$183.90 |
$183.90 |
$183.90 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$20.40 |
$20.40 |
$20.40 |
$64.35
|
|
Tigecycline injection
|
$159.50 |
$159.50 |
$159.50 |
$234.00
|
|
Tilt table study
|
$395.40 |
$395.40 |
$395.40 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$502.47 |
$502.47 |
$502.47 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$7,282.55 |
$7,282.55 |
$7,282.55 |
$13,339.20
|
|
Tissue culture placenta
|
$120.60 |
$120.60 |
$120.60 |
$457.00
|
|
Tissue culture skin/biopsy
|
$115.80 |
$115.80 |
$115.80 |
$484.00
|
|
Tissue transglutaminase iga
|
$9.60 |
$9.60 |
$9.60 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$20.84 |
$20.84 |
$20.84 |
$78.40
|
|
Tlso 2 shl symphys-stern cst
|
$1,453.38 |
$1,453.38 |
$1,453.38 |
$1,808.59
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$85.50 |
$85.50 |
$85.50 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$48.60 |
$48.60 |
$48.60 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,715.31 |
$2,715.31 |
$2,715.31 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$10.50 |
$10.50 |
$10.50 |
$73.00
|