|
Surgical exposure prostate 55860
|
$3,891.34 |
$3,891.34 |
$3,891.34 |
$5,626.86
|
|
Surgical pathology level 1 gross examination only
|
$113.42 |
$113.42 |
$152.65 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$152.65 |
$152.65 |
$182.09 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$217.32 |
$217.32 |
$319.68 |
$181.31
|
|
Surgical pathology level 4 gross & microscopic examination
|
$319.68 |
$319.68 |
$474.00 |
$243.10
|
|
Surgical pathology level 5 gross & microscopic examination
|
$491.47 |
$491.47 |
$502.44 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$502.44 |
$502.44 |
$677.44 |
$720.75
|
|
Surg tx anal fistula 2nd stage 46285
|
$3,978.37 |
$3,978.37 |
$3,978.37 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$18.00 |
$18.00 |
$90.41 |
$45.00
|
|
Susceptibility enzyme detection per enzyme
|
$88.04 |
$88.04 |
$90.41 |
$35.70
|
|
Susceptibility mic per plate
|
$128.89 |
$128.89 |
$164.46 |
$104.65
|
|
Suscept studies macrobroth dilution ea
|
$68.89 |
$68.89 |
$68.89 |
$59.28
|
|
Suspension of testis
|
$3,538.08 |
$3,538.08 |
$3,538.08 |
$4,055.01
|
|
Svc venogram s&i
|
$1,864.99 |
$1,864.99 |
$2,254.95 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$279.84 |
$279.84 |
$400.18 |
$314.40
|
|
Swallowing Therapy Session
|
$228.43 |
$228.43 |
$276.32 |
$240.50
|
|
Sweat collection by iontophoresis
|
$194.29 |
$194.29 |
$194.29 |
$121.55
|
|
Sympathectomy digital artery
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$2,310.83
|
|
Sympathectomy lumbar
|
$2,298.21 |
$2,298.21 |
$2,298.21 |
$1,147.85
|
|
Sympathectomy supfc palmar
|
$3,127.67 |
$3,127.67 |
$3,127.67 |
$3,839.54
|
|
Synthetic sentence id test
|
$147.25 |
$147.25 |
$147.25 |
$99.32
|
|
Synvisc or synvisc-one
|
$1,232.66 |
$1,232.66 |
$1,232.66 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$58.48 |
$58.48 |
$58.48 |
$42.24
|
|
System cardiomems hosp electronics
|
$45,886.50 |
$45,886.50 |
$45,886.50 |
$38,234.70
|
|
System pacing micra av
|
$32,426.46 |
$32,426.46 |
$32,426.46 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$17,621.40 |
$17,621.40 |
$17,621.40 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$14,020.88 |
$14,020.88 |
$14,020.88 |
$11,183.00
|
|
System sealant biosentry tract
|
$1,023.33 |
$1,023.33 |
$1,023.33 |
$890.03
|
|
T3 (triiodothyronine) free
|
$152.02 |
$152.02 |
$322.53 |
$100.00
|
|
T3 (triiodothyronine) total
|
$125.51 |
$125.51 |
$269.77 |
$93.52
|
|
T4 (thyroxine) free
|
$144.14 |
$144.14 |
$171.69 |
$87.30
|
|
T4 (thyroxine) total
|
$102.22 |
$102.22 |
$130.84 |
$68.40
|
|
Tacrol envarsus ex rel oral
|
$32.80 |
$32.80 |
$32.80 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$29.82 |
$29.82 |
$43.10 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$668.52 |
$668.52 |
$668.52 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$204.72 |
$204.72 |
$261.26 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$2,456.76 |
$2,456.76 |
$2,456.76 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$313.72 |
$313.72 |
$327.92 |
$288.60
|
|
Tap block bilat cont infusion 64489
|
$3,767.00 |
$3,767.00 |
$3,767.00 |
$1,541.40
|
|
Tap block uni by cont infusion 64487
|
$1,321.38 |
$1,321.38 |
$1,321.38 |
$868.40
|
|
Target gsa panel hmtlmph neop
|
$1,085.33 |
$1,085.33 |
$8,967.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$7,208.55 |
$7,208.55 |
$7,208.55 |
$3,762.00
|
|
Target gsa panel organ neop
|
$5,238.75 |
$5,238.75 |
$5,238.75 |
$1,749.44
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$27,030.00 |
$27,030.00 |
$27,030.00 |
$24,217.20
|
|
Tas congenital car anomal
|
$8,068.54 |
$8,068.54 |
$8,068.54 |
$6,003.27
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$953.29 |
$953.29 |
$953.29 |
$931.50
|
|
Tavr perq femoral
|
$25,400.50 |
$25,400.50 |
$25,400.50 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.24 |
$1.24 |
$1.24 |
$937.50
|
|
Tbs techl calculation only
|
$99.13 |
$99.13 |
$99.13 |
$153.60
|
|
Tbs techl prep&transmis data
|
$99.13 |
$99.13 |
$99.13 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$506.22 |
$506.22 |
$506.22 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$251.99 |
$251.99 |
$1,020.86 |
$181.80
|
|
Tc-99m exame autol wbc diag per dose
|
$2,435.36 |
$2,435.36 |
$2,435.36 |
$2,486.31
|
|
Tc-99m maa
|
$51.16 |
$51.16 |
$51.16 |
$306.60
|
|
Tc-99m mebrofenin
|
$166.54 |
$166.54 |
$166.54 |
$157.50
|
|
Tc-99m medronate
|
$112.37 |
$112.37 |
$112.37 |
$111.01
|
|
Tc-99m pentetate dtpa
|
$72.66 |
$72.66 |
$72.66 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$50.67 |
$50.67 |
$50.67 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$75.66 |
$75.66 |
$75.66 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$109.62 |
$109.62 |
$404.33 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$2,970.00 |
$2,970.00 |
$2,970.00 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$156.51 |
$156.51 |
$205.55 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$1,380.86 |
$1,380.86 |
$1,380.86 |
$192.08
|
|
Tc-99m tilmanocept diag
|
$1,386.69 |
$1,386.69 |
$1,386.69 |
$958.31
|
|
Tca peel dermal 15789
|
$811.45 |
$811.45 |
$811.45 |
$1,324.80
|
|
Tcd emboli detect w/inj
|
$394.51 |
$394.51 |
$394.51 |
$475.80
|
|
Tcd emboli detect without inj
|
$381.02 |
$381.02 |
$381.02 |
$475.28
|
|
Tcd vasoreactivity study
|
$494.08 |
$494.08 |
$494.08 |
$566.88
|
|
T cells absolute cd4/cd8 including ratio
|
$210.41 |
$210.41 |
$876.85 |
$185.28
|
|
T cells absolute cd 4 count
|
$258.20 |
$258.20 |
$440.93 |
$111.20
|
|
T cells total count
|
$52.69 |
$52.69 |
$363.75 |
$132.63
|
|
Tcranial magn stim tx deli
|
$455.49 |
$455.49 |
$455.49 |
$389.22
|
|
Tcranial magn stim tx plan
|
$437.22 |
$437.22 |
$437.22 |
$437.22
|
|
Tcran magn stim redetemine
|
$417.06 |
$417.06 |
$417.06 |
$457.60
|
|
Team conf without pat by hc pro
|
$132.15 |
$132.15 |
$132.15 |
$110.62
|
|
Team conf w/pat by hc prof
|
$203.18 |
$203.18 |
$203.18 |
$105.70
|
|
Telehealth original site facility fee
|
$64.26 |
$64.26 |
$570.17 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,391.17 |
$1,391.17 |
$1,391.17 |
$1,526.85
|
|
Telethx isodose plan simple
|
$813.43 |
$813.43 |
$813.43 |
$889.80
|
|
Temozolomide
|
$64.37 |
$64.37 |
$64.37 |
$540.06
|
|
Temple bne implnt w/stimulat
|
$16,139.55 |
$16,139.55 |
$16,139.55 |
$10,725.79
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$9,031.44 |
$9,031.44 |
$9,031.44 |
$3,723.60
|
|
Tendon lngth upr a/e ea tdn
|
$3,671.74 |
$3,671.74 |
$3,671.74 |
$3,591.33
|
|
Tendon shortening
|
$2,777.50 |
$2,777.50 |
$2,777.50 |
$3,786.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$131.97 |
$131.97 |
$14,951.87 |
$14,951.87
|
|
Tenodesis biceps tdn at elbw
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$6,653.00
|
|
Tenolysis extensor tendon hand/finger each
|
$2,777.50 |
$2,777.50 |
$2,777.50 |
$2,811.20
|
|
Tenoplasty elbow to sho 1
|
$5,886.74 |
$5,886.74 |
$5,886.74 |
$7,807.24
|
|
Tenosynovectomy radic 26145
|
$2,254.85 |
$2,254.85 |
$2,254.85 |
$2,211.05
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$3,091.89 |
$3,091.89 |
$3,091.89 |
$3,545.97
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,089.96 |
$2,089.96 |
$2,089.96 |
$2,211.05
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$26.20 |
$26.20 |
$73.32 |
$39.33
|
|
Tert gene targeted seq alys
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$335.00
|
|
Test for chlorohydrocarbons
|
$71.04 |
$71.04 |
$71.04 |
$61.60
|
|
Test for urine cystines
|
$80.85 |
$80.85 |
$80.85 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$1,200.74 |
$1,200.74 |
$1,200.74 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$56.35 |
$56.35 |
$56.35 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$692.16 |
$692.16 |
$1,281.95 |
$949.70
|
|
Test urine urobilinogen
|
$5.36 |
$5.36 |
$5.36 |
$9.75
|
|
Tetanus immune globulin inj
|
$708.85 |
$708.85 |
$1,172.11 |
$1,285.36
|
