|
Target gsa panel organ neop
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$1,655.52
|
|
Tas congenital car anomal
|
$2,554.50 |
$2,554.50 |
$2,554.50 |
$6,003.27
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$261.50 |
$261.50 |
$261.50 |
$177.65
|
|
Tc-99m bicisate
|
$1,695.50 |
$1,695.50 |
$1,695.50 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$219.00 |
$219.00 |
$219.00 |
$302.40
|
|
Tc-99m maa
|
$197.00 |
$197.00 |
$197.00 |
$292.80
|
|
Tc-99m mebrofenin
|
$96.50 |
$96.50 |
$96.50 |
$157.65
|
|
Tc-99m medronate
|
$58.50 |
$58.50 |
$58.50 |
$111.01
|
|
Tc-99m mertiatide
|
$341.50 |
$341.50 |
$341.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.00 |
$6.60
|
|
Tc-99m oxidronate
|
$35.00 |
$35.00 |
$35.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$166.00 |
$166.00 |
$166.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$191.50 |
$191.50 |
$191.50 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$43.00 |
$43.00 |
$43.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$73.50 |
$73.50 |
$73.50 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$183.50 |
$183.50 |
$183.50 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$358.00 |
$358.00 |
$358.00 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$78.00 |
$78.00 |
$78.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$159.00 |
$159.00 |
$159.00 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$657.00 |
$657.00 |
$657.00 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$206.50 |
$206.50 |
$206.50 |
$176.40
|
|
T cells absolute cd 4 count
|
$112.50 |
$112.50 |
$112.50 |
$111.20
|
|
T cells total count
|
$167.00 |
$167.00 |
$167.00 |
$126.90
|
|
Tcran magn stim redetemine
|
$620.50 |
$620.50 |
$620.50 |
$457.60
|
|
Telethx isodose plan cplx
|
$847.00 |
$847.00 |
$847.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$608.00 |
$608.00 |
$608.00 |
$873.62
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$741.00 |
$741.00 |
$741.00 |
$2,139.67
|
|
Tert gene targeted seq alys
|
$161.00 |
$161.00 |
$161.00 |
$335.00
|
|
Test for chlorohydrocarbons
|
$56.00 |
$56.00 |
$56.00 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$828.00 |
$828.00 |
$828.00 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$44.50 |
$44.50 |
$44.50 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$481.00 |
$481.00 |
$481.00 |
$949.70
|
|
Theophylline therapeutic drug level
|
$83.50 |
$83.50 |
$83.50 |
$108.00
|
|
Therapeutic procd strg endur
|
$81.00 |
$81.00 |
$81.00 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$29.50 |
$29.50 |
$29.50 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$24.00 |
$24.00 |
$24.00 |
$50.00
|
|
Ther/proph/diag inj ia
|
$321.50 |
$321.50 |
$321.50 |
$240.35
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,209.00 |
$2,209.00 |
$2,209.00 |
$1,687.50
|
|
Thoracotomy w/expl
|
$3,769.50 |
$3,769.50 |
$3,769.50 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$524.50 |
$524.50 |
$524.50 |
$2,138.76
|
|
Thor rib belt custom fabrica
|
$393.30 |
$393.30 |
$393.30 |
$225.50
|
|
Thrombectmy crnry perq mechanical
|
$6,229.00 |
$6,229.00 |
$6,229.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$7,755.00 |
$7,755.00 |
$7,755.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$15,671.00 |
$15,671.00 |
$15,671.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$23,753.00 |
$23,753.00 |
$23,753.00 |
$21,413.60
|
|
Thrombin time
|
$19.00 |
$19.00 |
$19.00 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$34.00 |
$34.00 |
$34.00 |
$61.52
|
|
Thyroglobulin antibody
|
$68.50 |
$68.50 |
$68.50 |
$82.00
|
|
Thyroid imaging
|
$903.50 |
$903.50 |
$903.50 |
$695.02
|
|
Thyroid met imaging
|
$413.50 |
$413.50 |
$413.50 |
$838.25
|
|
Thyroid mets imag whole body
|
$864.50 |
$864.50 |
$864.50 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$77.00 |
$77.00 |
$77.00 |
$111.00
|
|
Thyroid Ultrasound
|
$454.00 |
$454.00 |
$454.00 |
$588.50
|
|
Thyroid uptake measurement
|
$703.50 |
$703.50 |
$703.50 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$66.00 |
$66.00 |
$66.00 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$19,374.50 |
$19,374.50 |
$19,374.50 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$6,722.50 |
$6,722.50 |
$6,722.50 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$3,882.00 |
$3,882.00 |
$3,882.00 |
$9,769.65
|
|
Tilt table study
|
$619.50 |
$619.50 |
$619.50 |
$1,507.01
|
|
Tissue culture placenta
|
$305.50 |
$305.50 |
$305.50 |
$457.00
|
|
Tissue culture skin/biopsy
|
$292.00 |
$292.00 |
$292.00 |
$484.00
|
|
Tissue culture tumor
|
$788.00 |
$788.00 |
$788.00 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$21.50 |
$21.50 |
$21.50 |
$47.20
|
|
Tissue transglutaminase iga
|
$52.50 |
$52.50 |
$52.50 |
$44.16
|
|
Tixagev and cilgav inj
|
$75.25 |
$75.25 |
$75.25 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$75.50 |
$75.50 |
$75.50 |
$78.40
|
|
Tlso 3mod sacro-scap pre
|
$661.36 |
$661.36 |
$661.36 |
$2,117.57
|
|
Tlso rigid lined custom fab
|
$1,252.35 |
$1,252.35 |
$1,252.35 |
$2,831.21
|
|
Tlso rigid lined pre one pie
|
$800.06 |
$800.06 |
$800.06 |
$2,110.02
|
|
Tlso rigid plastic cust fab
|
$1,344.46 |
$1,344.46 |
$1,344.46 |
$2,347.16
|
|
Tobramycin peak therapeutic drug level
|
$88.00 |
$88.00 |
$88.00 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$82.50 |
$82.50 |
$82.50 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$82.50 |
$82.50 |
$82.50 |
$72.68
|
|
Torsion straight knee joint
|
$96.26 |
$96.26 |
$96.26 |
$253.84
|
|
Toxoplasma antibody igg
|
$65.00 |
$65.00 |
$65.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$15.50 |
$15.50 |
$15.50 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$823.00 |
$823.00 |
$823.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$373.00 |
$373.00 |
$373.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$8,525.50 |
$8,525.50 |
$8,525.50 |
$7,144.80
|
|
Trabeculoplasty laser surg
|
$897.00 |
$897.00 |
$897.00 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$539.00 |
$539.00 |
$539.00 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$69.50 |
$69.50 |
$69.50 |
$101.25
|
|
Transabdom amnioinfus w/us
|
$279.50 |
$279.50 |
$279.50 |
$678.70
|
|
Transcath biopsy
|
$3,277.00 |
$3,277.00 |
$3,277.00 |
$4,285.93
|
|
Transcath closure of asd
|
$8,740.50 |
$8,740.50 |
$8,740.50 |
$16,741.40
|
|
Transcath closure of vsd
|
$8,740.50 |
$8,740.50 |
$8,740.50 |
$17,115.04
|
|
Transcatheter bx s&i
|
$2,047.50 |
$2,047.50 |
$2,047.50 |
$1,915.00
|
|
Transcath mv repair addl prosthesis
|
$11,782.00 |
$11,782.00 |
$11,782.00 |
$4,385.00
|
|
Transcath mv repair init prosthesis
|
$23,315.00 |
$23,315.00 |
$23,315.00 |
$12,418.00
|
|
Transcath occlusion cns
|
$3,417.00 |
$3,417.00 |
$3,417.00 |
$7,157.76
|
|
Transcath occlusion non-cns
|
$8,072.50 |
$8,072.50 |
$8,072.50 |
$10,031.28
|
|
Transcath rmvl perm ldss pmkr rv
|
$12,229.00 |
$12,229.00 |
$12,229.00 |
$4,775.16
|
|
Transferrin
|
$56.50 |
$56.50 |
$56.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,084.50 |
$1,084.50 |
$1,084.50 |
$983.00
|
|
Transparent film >16<=48 in
|
$1.08 |
$1.08 |
$1.08 |
$12.95
|
|
Transplt autol hct/donor
|
$931.00 |
$931.00 |
$931.00 |
$3,786.00
|
|
Trauma partial team response w/critical care services level 4
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$155.77 |
$155.77 |
$155.77 |
$940.80
|
