|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$313.78 |
$313.78 |
$313.78 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$165.88 |
$165.88 |
$165.88 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$141.52 |
$141.52 |
$141.52 |
$392.09
|
|
Splint finger frog med
|
$11.60 |
$11.60 |
$11.60 |
$38.08
|
|
Split blood or products
|
$12.18 |
$12.18 |
$12.18 |
$127.48
|
|
St analysis behavior qualitative voice/resonance
|
$52.78 |
$52.78 |
$52.78 |
$297.60
|
|
Static or dynami afo pre ots
|
$98.79 |
$98.79 |
$98.79 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$39.15 |
$39.15 |
$39.15 |
$286.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$362.85 |
$362.85 |
$362.85 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,812.50 |
$1,812.50 |
$1,812.50 |
$20,962.50
|
|
St evaluate speech sound production
|
$52.78 |
$52.78 |
$52.78 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$52.78 |
$52.78 |
$52.78 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$87.29 |
$87.29 |
$87.29 |
$399.60
|
|
St evaluation swallow function
|
$52.78 |
$52.78 |
$52.78 |
$314.40
|
|
Stress test pulmonary
|
$63.51 |
$63.51 |
$63.51 |
$322.85
|
|
Stress tte complete
|
$390.05 |
$390.05 |
$390.05 |
$1,870.50
|
|
St treatment speech individual
|
$48.43 |
$48.43 |
$48.43 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$55.97 |
$55.97 |
$55.97 |
$240.31
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$3.83 |
$3.83 |
$3.83 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$10.73 |
$10.73 |
$10.73 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$23.78 |
$23.78 |
$23.78 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$28.42 |
$28.42 |
$28.42 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$31.61 |
$31.61 |
$31.61 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$186.18 |
$186.18 |
$186.18 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$261.00 |
$261.00 |
$261.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$13.92 |
$13.92 |
$13.92 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$13.92 |
$13.92 |
$13.92 |
$35.70
|
|
Susceptibility mic per plate
|
$269.70 |
$269.70 |
$269.70 |
$106.00
|
|
Svc venogram s&i
|
$699.48 |
$699.48 |
$699.48 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$1,353.62 |
$1,353.62 |
$1,353.62 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.89 |
$11.89 |
$11.89 |
$41.60
|
|
System pacing micra av
|
$12,687.50 |
$12,687.50 |
$12,687.50 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,235.00 |
$6,235.00 |
$6,235.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$51.33 |
$51.33 |
$51.33 |
$99.20
|
|
T3 (triiodothyronine) total
|
$41.47 |
$41.47 |
$41.47 |
$93.52
|
|
T4 (thyroxine) free
|
$26.39 |
$26.39 |
$26.39 |
$85.20
|
|
T4 (thyroxine) total
|
$20.01 |
$20.01 |
$20.01 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$17.11 |
$17.11 |
$17.11 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$27.84 |
$27.84 |
$27.84 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,379.57 |
$1,379.57 |
$1,379.57 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$11,418.09 |
$11,418.09 |
$11,418.09 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$1,325.88 |
$1,325.88 |
$1,325.88 |
$2,246.30
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$14,824.80 |
$14,824.80 |
$14,824.80 |
$24,217.20
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$359.29 |
$359.29 |
$359.29 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$28.13 |
$28.13 |
$28.13 |
$177.65
|
|
Tc-99m exame autol wbc diag per dose
|
$1,422.15 |
$1,422.15 |
$1,422.15 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,125.76 |
$1,125.76 |
$1,125.76 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$96.89 |
$96.89 |
$96.89 |
$302.40
|
|
Tc-99m maa
|
$86.63 |
$86.63 |
$86.63 |
$292.80
|
|
Tc-99m mebrofenin
|
$36.56 |
$36.56 |
$36.56 |
$157.65
|
|
Tc-99m medronate
|
$39.68 |
$39.68 |
$39.68 |
$111.01
|
|
Tc-99m mertiatide
|
$177.31 |
$177.31 |
$177.31 |
$756.00
|
|
Tc-99m oxidronate
|
$48.64 |
$48.64 |
$48.64 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$136.45 |
$136.45 |
$136.45 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$83.60 |
$83.60 |
$83.60 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$30.58 |
$30.58 |
$30.58 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$51.72 |
$51.72 |
$51.72 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$29.88 |
$29.88 |
$29.88 |
$274.45
|
|
Tc-99m sulfur colloid
|
$100.82 |
$100.82 |
$100.82 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$32.68 |
$32.68 |
$32.68 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$470.73 |
$470.73 |
$470.73 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$39.15 |
$39.15 |
$39.15 |
$176.40
|
|
T cells total count
|
$31.61 |
$31.61 |
$31.61 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$20,240.79 |
$20,240.79 |
$20,240.79 |
$40,114.80
|
|
Tee w or without fol w/cont,cong
|
$348.29 |
$348.29 |
$348.29 |
$2,101.65
|
|
Telavancin injection
|
$505.65 |
$505.65 |
$505.65 |
$1,191.80
|
|
Telehealth original site facility fee
|
$13.92 |
$13.92 |
$13.92 |
$51.00
|
|
Telethx isodose plan cplx
|
$418.47 |
$418.47 |
$418.47 |
$1,526.85
|
|
Telethx isodose plan simple
|
$226.20 |
$226.20 |
$226.20 |
$873.62
|
|
Temozolomide
|
$158.55 |
$158.55 |
$158.55 |
$588.46
|
|
Temozolomide 100 mg intravenous solution
|
$991.39 |
$991.39 |
$991.39 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,976.95 |
$1,976.95 |
$1,976.95 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$8,200.35 |
$8,200.35 |
$8,200.35 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$33.18 |
$33.18 |
$33.18 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$177.77 |
$177.77 |
$177.77 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$30.45 |
$30.45 |
$30.45 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$141.23 |
$141.23 |
$141.23 |
$949.70
|
|
Tetanus immune globulin inj
|
$549.90 |
$549.90 |
$549.90 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$41.47 |
$41.47 |
$41.47 |
$108.00
|
|
Ther/proph/diag inj ia
|
$94.54 |
$94.54 |
$94.54 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$10.36 |
$10.36 |
$10.36 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$856.08 |
$856.08 |
$856.08 |
$1,687.50
|
|
Thrombectmy crnry perq mechanical
|
$130.79 |
$130.79 |
$130.79 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,874.27 |
$1,874.27 |
$1,874.27 |
$8,084.00
|
|
Thrombin time
|
$57.13 |
$57.13 |
$57.13 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$35.38 |
$35.38 |
$35.38 |
$61.52
|
|
Thyroglobulin antibody
|
$17.98 |
$17.98 |
$17.98 |
$82.00
|
|
Thyroid imaging
|
$177.77 |
$177.77 |
$177.77 |
$695.02
|
|
Thyroid mets imag whole body
|
$281.01 |
$281.01 |
$281.01 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$49.01 |
$49.01 |
$49.01 |
$111.00
|
|
Thyroid Ultrasound
|
$133.40 |
$133.40 |
$133.40 |
$588.50
|
|
Thyroid uptake measurement
|
$177.77 |
$177.77 |
$177.77 |
$591.25
|
|
Tigecycline injection
|
$154.18 |
$154.18 |
$154.18 |
$234.00
|
|
Tirofiban 12.5 mg/50 ml
|
$485.72 |
$485.72 |
$485.72 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$7,039.80 |
$7,039.80 |
$7,039.80 |
$13,339.20
|
|
Tissue culture skin/biopsy
|
$111.94 |
$111.94 |
$111.94 |
$484.00
|
|
Tissue transglutaminase iga
|
$9.28 |
$9.28 |
$9.28 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$20.15 |
$20.15 |
$20.15 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$82.65 |
$82.65 |
$82.65 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$46.98 |
$46.98 |
$46.98 |
$120.60
|