|
Susceptibility enzyme detection per enzyme
|
$3.75 |
$3.75 |
$3.75 |
$35.40
|
|
Susceptibility mic per plate
|
$15.30 |
$15.30 |
$15.30 |
$104.65
|
|
Suscept studies macrobroth dilution ea
|
$7.20 |
$7.20 |
$7.20 |
$59.28
|
|
Svc venogram s&i
|
$429.15 |
$429.15 |
$429.15 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$23.40 |
$23.40 |
$23.40 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$7.65 |
$7.65 |
$7.65 |
$40.00
|
|
T3 (triiodothyronine) free
|
$29.55 |
$29.55 |
$29.55 |
$99.20
|
|
T3 (triiodothyronine) total
|
$24.90 |
$24.90 |
$24.90 |
$93.52
|
|
T4 (thyroxine) free
|
$15.75 |
$15.75 |
$15.75 |
$84.44
|
|
T4 (thyroxine) total
|
$12.15 |
$12.15 |
$12.15 |
$67.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.25 |
$0.25 |
$0.25 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$121.20
|
|
Target gsa panel hmtlmph neop
|
$832.20 |
$832.20 |
$832.20 |
$2,176.05
|
|
Target gsa panel organ/hmtlmph neop
|
$3,746.70 |
$3,746.70 |
$3,746.70 |
$3,746.70
|
|
Target gsa panel organ neop
|
$373.65 |
$373.65 |
$373.65 |
$1,655.52
|
|
Tbp gene detc abnor alleles
|
$107.70 |
$107.70 |
$107.70 |
$225.42
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$108.45 |
$108.45 |
$108.45 |
$176.28
|
|
Tc-99m exame autol wbc diag per dose
|
$902.70 |
$902.70 |
$902.70 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$512.70 |
$512.70 |
$512.70 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$209.85 |
$209.85 |
$209.85 |
$302.40
|
|
Tc-99m maa
|
$34.50 |
$34.50 |
$34.50 |
$288.75
|
|
Tc-99m mebrofenin
|
$37.05 |
$37.05 |
$37.05 |
$157.65
|
|
Tc-99m medronate
|
$19.05 |
$19.05 |
$19.05 |
$111.15
|
|
Tc-99m mertiatide
|
$256.05 |
$256.05 |
$256.05 |
$756.00
|
|
Tc-99m oxidronate
|
$19.05 |
$19.05 |
$19.05 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$46.05 |
$46.05 |
$46.05 |
$225.52
|
|
Tc-99m pertechnetate per mci
|
$3.75 |
$3.75 |
$3.75 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$121.65 |
$121.65 |
$121.65 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$46.95 |
$46.95 |
$46.95 |
$292.50
|
|
Tc-99m succimer (dmsa)
|
$157.35 |
$157.35 |
$157.35 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$45.75 |
$45.75 |
$45.75 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$154.35 |
$154.35 |
$154.35 |
$188.50
|
|
T cells absolute cd4/cd8 including ratio
|
$82.20 |
$82.20 |
$82.20 |
$175.00
|
|
T cells absolute cd 4 count
|
$46.80 |
$46.80 |
$46.80 |
$110.72
|
|
T cells total count
|
$66.00 |
$66.00 |
$66.00 |
$123.00
|
|
Telehealth original site facility fee
|
$22.95 |
$22.95 |
$22.95 |
$51.85
|
|
Telethx isodose plan cplx
|
$174.30 |
$174.30 |
$174.30 |
$1,522.19
|
|
Telethx isodose plan simple
|
$107.70 |
$107.70 |
$107.70 |
$861.03
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,446.87 |
$7,446.87 |
$7,446.87 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.78 |
$9.78 |
$9.78 |
$37.76
|
|
Test for chlorohydrocarbons
|
$6.45 |
$6.45 |
$6.45 |
$61.60
|
|
Test for urine cystines
|
$8.85 |
$8.85 |
$8.85 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$452.25 |
$452.25 |
$452.25 |
$890.63
|
|
Test pathogen(s) for platelets reference
|
$32.70 |
$32.70 |
$32.70 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$223.95 |
$223.95 |
$223.95 |
$951.60
|
|
Tetanus immune globulin inj
|
$677.46 |
$677.46 |
$677.46 |
$1,218.27
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$4,022.28 |
$4,022.28 |
$4,022.28 |
$8,737.05
|
|
Tgsap so/hl 51/< rna alys
|
$965.85 |
$965.85 |
$965.85 |
$4,029.05
|
|
Theophylline therapeutic drug level
|
$24.90 |
$24.90 |
$24.90 |
$108.00
|
|
Therapeutic procd strg endur
|
$79.05 |
$79.05 |
$79.05 |
$83.50
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$15.75 |
$15.75 |
$15.75 |
$55.98
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$12.00 |
$12.00 |
$12.00 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$72.45 |
$72.45 |
$72.45 |
$538.88
|
|
Ther/proph/diag inj ia
|
$53.70 |
$53.70 |
$53.70 |
$246.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$6.08 |
$6.08 |
$6.08 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$383.85 |
$383.85 |
$383.85 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$1,912.95 |
$1,912.95 |
$1,912.95 |
$2,138.76
|
|
Thrombectmy crnry perq mechanical
|
$1,468.65 |
$1,468.65 |
$1,468.65 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$7,648.35
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$5,352.15 |
$5,352.15 |
$5,352.15 |
$14,227.80
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$8,112.60 |
$8,112.60 |
$8,112.60 |
$21,249.26
|
|
Thrombin time
|
$10.05 |
$10.05 |
$10.05 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$1,069.65 |
$1,069.65 |
$1,069.65 |
$3,666.00
|
|
Thromboplastin inhibition
|
$16.80 |
$16.80 |
$16.80 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$11.40 |
$11.40 |
$11.40 |
$61.50
|
|
Thyroglobulin antibody
|
$27.75 |
$27.75 |
$27.75 |
$81.90
|
|
Thyroid imaging
|
$452.25 |
$452.25 |
$452.25 |
$695.02
|
|
Thyroid mets imag whole body
|
$452.25 |
$452.25 |
$452.25 |
$1,544.00
|
|
Thyroid (TSH) Test
|
$29.40 |
$29.40 |
$29.40 |
$112.67
|
|
Thyroid Ultrasound
|
$101.55 |
$101.55 |
$101.55 |
$588.50
|
|
Thyroid uptake measurement
|
$452.25 |
$452.25 |
$452.25 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$25.05 |
$25.05 |
$25.05 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$7,850.85 |
$7,850.85 |
$7,850.85 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$2,004.00 |
$2,004.00 |
$2,004.00 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$3,739.95 |
$3,739.95 |
$3,739.95 |
$10,103.80
|
|
Tigecycline injection
|
$211.38 |
$211.38 |
$211.38 |
$234.00
|
|
Tilt table study
|
$450.75 |
$450.75 |
$450.75 |
$1,551.60
|
|
Tissue culture skin/biopsy
|
$130.95 |
$130.95 |
$130.95 |
$498.40
|
|
Tissue exam koh skin/hair/nails
|
$7.20 |
$7.20 |
$7.20 |
$47.52
|
|
Tissue transglutaminase iga
|
$74.55 |
$74.55 |
$74.55 |
$44.60
|
|
Tl-201 thallium diag per mci
|
$44.85 |
$44.85 |
$44.85 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$142.03 |
$142.03 |
$142.03 |
$152.36
|
|
Tobramycin non-comp unit
|
$20.66 |
$20.66 |
$20.66 |
$105.75
|
|
Tobramycin peak therapeutic drug level
|
$28.35 |
$28.35 |
$28.35 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,770.85 |
$1,770.85 |
$1,770.85 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$74.10 |
$74.10 |
$74.10 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$74.10 |
$74.10 |
$74.10 |
$68.80
|
|
Total tau
|
$51.15 |
$51.15 |
$51.15 |
$312.00
|
|
Toxoplasma antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$89.40
|
|
Toxoplasma antibody igm
|
$25.20 |
$25.20 |
$25.20 |
$87.00
|
|
Tp53 gene full gene sequence
|
$823.80 |
$823.80 |
$823.80 |
$706.04
|
|
Tp53 gene known famil vrnt
|
$395.40 |
$395.40 |
$395.40 |
$395.40
|
|
Tp53 gene trgt sequence alys
|
$422.85 |
$422.85 |
$422.85 |
$823.00
|
|
Tpmt gene com vrnts
|
$224.40 |
$224.40 |
$224.40 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$1,163.70 |
$1,163.70 |
$1,163.70 |
$7,144.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$269.70 |
$269.70 |
$269.70 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$21.00 |
$21.00 |
$21.00 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$12.64 |
$12.64 |
$12.64 |
$55.69
|
|
Transabdom amnioinfus w/us
|
$195.75 |
$195.75 |
$195.75 |
$791.05
|
|
Transcath biopsy
|
$1,384.20 |
$1,384.20 |
$1,384.20 |
$4,285.93
|
