|
Strapping of ankle and/or ft 29540
|
$674.46 |
$674.46 |
$674.46 |
$205.38
|
|
Strapping of elbow or wrist 29260
|
$329.36 |
$329.36 |
$329.36 |
$157.46
|
|
Strapping of hand or finger
|
$170.62 |
$170.62 |
$170.62 |
$177.45
|
|
Strapping of hip
|
$546.80 |
$546.80 |
$546.80 |
$165.90
|
|
Strapping of knee
|
$546.80 |
$546.80 |
$546.80 |
$205.20
|
|
Strapping of toes 29550
|
$261.84 |
$261.84 |
$261.84 |
$164.70
|
|
Strep b assay w/optic
|
$1,313.77 |
$1,313.77 |
$1,313.77 |
$80.16
|
|
Streptomycin injection
|
$204.48 |
$204.48 |
$204.48 |
$143.00
|
|
Stress tte complete
|
$10,012.66 |
$10,012.66 |
$10,012.66 |
$1,784.25
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$38.64 |
$38.64 |
$38.64 |
$50.22
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$52.15 |
$52.15 |
$52.15 |
$82.46
|
|
Sulfonylurea screen qn-sendout
|
$988.51 |
$988.51 |
$988.51 |
$152.64
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,646.86 |
$1,646.86 |
$1,646.86 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$833.72 |
$833.72 |
$833.72 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$1,244.17 |
$1,244.17 |
$1,244.17 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,725.65 |
$1,725.65 |
$1,725.65 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$2,352.00 |
$2,352.00 |
$2,352.00 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$3,481.13 |
$3,481.13 |
$3,481.13 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$3,908.64 |
$3,908.64 |
$3,908.64 |
$730.20
|
|
Susceptibility enzyme detection per enzyme
|
$159.07 |
$159.07 |
$159.07 |
$35.10
|
|
Susceptibility mic per plate
|
$766.95 |
$766.95 |
$766.95 |
$104.00
|
|
Suscept studies macrobroth dilution ea
|
$940.24 |
$940.24 |
$940.24 |
$59.28
|
|
Svc venogram s&i
|
$2,063.90 |
$2,063.90 |
$2,063.90 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$210.20 |
$210.20 |
$210.20 |
$40.11
|
|
T3 (triiodothyronine) free
|
$867.80 |
$867.80 |
$867.80 |
$99.20
|
|
T3 (triiodothyronine) total
|
$1,298.14 |
$1,298.14 |
$1,298.14 |
$93.52
|
|
T4 (thyroxine) free
|
$1,035.40 |
$1,035.40 |
$1,035.40 |
$85.20
|
|
T4 (thyroxine) total
|
$646.23 |
$646.23 |
$646.23 |
$67.80
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$2,452.03 |
$2,452.03 |
$2,452.03 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$1,771.10 |
$1,771.10 |
$1,771.10 |
$120.60
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$65.88 |
$65.88 |
$65.88 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$2,362.15 |
$2,362.15 |
$2,362.15 |
$2,160.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$362.17 |
$362.17 |
$362.17 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$593.69 |
$593.69 |
$593.69 |
$175.00
|
|
Tc-99m exame autol wbc diag per dose
|
$8,493.26 |
$8,493.26 |
$8,493.26 |
$2,431.95
|
|
Tc-99m exametazime diag
|
$11,592.47 |
$11,592.47 |
$11,592.47 |
$2,033.20
|
|
Tc-99m fanolesomab diag
|
$7,422.56 |
$7,422.56 |
$7,422.56 |
$2,115.12
|
|
Tc-99m labeled rbc
|
$1,593.52 |
$1,593.52 |
$1,593.52 |
$302.40
|
|
Tc-99m maa
|
$577.86 |
$577.86 |
$577.86 |
$283.41
|
|
Tc-99m mebrofenin
|
$863.00 |
$863.00 |
$863.00 |
$160.58
|
|
Tc-99m medronate
|
$367.67 |
$367.67 |
$367.67 |
$109.50
|
|
Tc-99m mertiatide
|
$940.84 |
$940.84 |
$940.84 |
$756.00
|
|
Tc-99m oxidronate
|
$729.26 |
$729.26 |
$729.26 |
$105.30
|
|
Tc-99m pentetate dtpa
|
$695.20 |
$695.20 |
$695.20 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$750.71 |
$750.71 |
$750.71 |
$181.37
|
|
Tc-99m pertechnetate per mci
|
$334.56 |
$334.56 |
$334.56 |
$27.20
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$537.48 |
$537.48 |
$537.48 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$2,166.34 |
$2,166.34 |
$2,166.34 |
$293.73
|
|
Tc-99m sulfur colloid
|
$910.95 |
$910.95 |
$910.95 |
$239.40
|
|
Tc-99m tetrofosmin p study dose
|
$289.02 |
$289.02 |
$289.02 |
$188.50
|
|
Tc-99m tilmanocept diag
|
$1,433.51 |
$1,433.51 |
$1,433.51 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$1,719.98 |
$1,719.98 |
$1,719.98 |
$175.00
|
|
T cells total count
|
$1,719.98 |
$1,719.98 |
$1,719.98 |
$123.00
|
|
Telethx isodose plan cplx
|
$1,008.18 |
$1,008.18 |
$1,008.18 |
$1,488.40
|
|
Temozolomide
|
$172.92 |
$172.92 |
$172.92 |
$540.06
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$223.96 |
$223.96 |
$223.96 |
$39.18
|
|
Test for porphobilinogen
|
$399.10 |
$399.10 |
$399.10 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$3,488.59 |
$3,488.59 |
$3,488.59 |
$842.56
|
|
Test urine for porphyrins
|
$471.54 |
$471.54 |
$471.54 |
$50.50
|
|
Tetanus immune globulin inj
|
$6,211.41 |
$6,211.41 |
$6,211.41 |
$1,228.80
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$192.59 |
$192.59 |
$192.59 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$1,062.37 |
$1,062.37 |
$1,062.37 |
$108.00
|
|
Therapeutic procd strg endur
|
$490.28 |
$490.28 |
$490.28 |
$83.16
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$163.46 |
$163.46 |
$163.46 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$163.46 |
$163.46 |
$163.46 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$3,504.05 |
$3,504.05 |
$3,504.05 |
$538.88
|
|
Ther/proph/diag inj ia
|
$359.11 |
$359.11 |
$359.11 |
$237.75
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,719.90 |
$2,719.90 |
$2,719.90 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit
|
$31,167.36 |
$31,167.36 |
$31,167.36 |
$7,594.40
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$19,306.31 |
$19,306.31 |
$19,306.31 |
$14,227.80
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$29,747.00 |
$29,747.00 |
$29,747.00 |
$21,249.26
|
|
Thrombin time
|
$784.00 |
$784.00 |
$784.00 |
$53.60
|
|
Thromboendarterectomy common femoral
|
$12,231.61 |
$12,231.61 |
$12,231.61 |
$3,666.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$60.39
|
|
Thyroglobulin antibody
|
$1,275.42 |
$1,275.42 |
$1,275.42 |
$81.90
|
|
Thyroid imaging
|
$2,765.63 |
$2,765.63 |
$2,765.63 |
$673.01
|
|
Thyroid met imaging/studies
|
$6,693.29 |
$6,693.29 |
$6,693.29 |
$763.73
|
|
Thyroid mets imag whole body
|
$7,549.99 |
$7,549.99 |
$7,549.99 |
$1,544.00
|
|
Thyroid (TSH) Test
|
$1,201.56 |
$1,201.56 |
$1,201.56 |
$112.00
|
|
Thyroid Ultrasound
|
$2,304.44 |
$2,304.44 |
$2,304.44 |
$589.96
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$9,391.15 |
$9,391.15 |
$9,391.15 |
$4,044.25
|
|
Thyrotropin releasing hormone
|
$1,719.98 |
$1,719.98 |
$1,719.98 |
$127.20
|
|
Thyroxine binding globulin (tbg)
|
$835.12 |
$835.12 |
$835.12 |
$64.92
|
|
Tigecycline injection
|
$1,841.75 |
$1,841.75 |
$1,841.75 |
$234.00
|
|
Tilt table study
|
$17,492.17 |
$17,492.17 |
$17,492.17 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$6,458.45 |
$6,458.45 |
$6,458.45 |
$452.93
|
|
Tissue culture skin/biopsy
|
$3,082.04 |
$3,082.04 |
$3,082.04 |
$518.40
|
|
Tissue exam koh skin/hair/nails
|
$677.48 |
$677.48 |
$677.48 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$17,410.00 |
$17,410.00 |
$17,410.00 |
$2,205.00
|
|
Tl-201 thallium diag per mci
|
$2,317.74 |
$2,317.74 |
$2,317.74 |
$80.10
|
|
Tlso 3mod sacro-scap pre
|
$9,366.00 |
$9,366.00 |
$9,366.00 |
$1,986.72
|
|
Tlso rig fram pelvic pre cst
|
$7,218.00 |
$7,218.00 |
$7,218.00 |
$1,125.03
|
|
Tlso rigid lined custom fab
|
$5,729.00 |
$5,729.00 |
$5,729.00 |
$2,831.21
|
|
Tobramycin comp unit
|
$101.85 |
$101.85 |
$101.85 |
$662.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$12.36 |
$12.36 |
$12.36 |
$152.80
|
|
Tobramycin peak therapeutic drug level
|
$711.57 |
$711.57 |
$711.57 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$281.63 |
$281.63 |
$281.63 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$281.63 |
$281.63 |
$281.63 |
$70.89
|
|
Toxoplasma antibody igg
|
$923.18 |
$923.18 |
$923.18 |
$89.57
|
|
Toxoplasma antibody igm
|
$420.40 |
$420.40 |
$420.40 |
$87.00
|
