|
Surgical pathology level 4 gross & microscopic examination
|
$304.00 |
$304.00 |
$304.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$468.00 |
$468.00 |
$468.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$575.00 |
$575.00 |
$575.00 |
$718.00
|
|
Susceptibility enzyme detection per enzyme
|
$35.00 |
$35.00 |
$35.00 |
$35.70
|
|
Susceptibility mic per plate
|
$238.50 |
$238.50 |
$238.50 |
$106.00
|
|
Svc venogram s&i
|
$2,083.00 |
$2,083.00 |
$2,083.00 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$80.00 |
$80.00 |
$80.00 |
$41.60
|
|
System cardiomems hosp electronics
|
$13,118.62 |
$13,118.62 |
$13,118.62 |
$39,037.95
|
|
System pacing micra av
|
$8,453.36 |
$8,453.36 |
$8,453.36 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$16,721.46 |
$16,721.46 |
$16,721.46 |
$12,003.00
|
|
System sealant biosentry tract
|
$253.06 |
$253.06 |
$253.06 |
$889.35
|
|
T3 (triiodothyronine) free
|
$196.00 |
$196.00 |
$196.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$121.50 |
$121.50 |
$121.50 |
$93.52
|
|
T4 (thyroxine) free
|
$98.00 |
$98.00 |
$98.00 |
$85.20
|
|
T4 (thyroxine) total
|
$98.00 |
$98.00 |
$98.00 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$153.50 |
$153.50 |
$153.50 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$2,444.00 |
$2,444.00 |
$2,444.00 |
$2,246.30
|
|
Target gsa panel organ neop
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$1,655.52
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$60.00 |
$60.00 |
$60.00 |
$177.65
|
|
Tc-99m bicisate
|
$952.00 |
$952.00 |
$952.00 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$546.00 |
$546.00 |
$546.00 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$121.00 |
$121.00 |
$121.00 |
$302.40
|
|
Tc-99m maa
|
$946.00 |
$946.00 |
$946.00 |
$292.80
|
|
Tc-99m mebrofenin
|
$103.50 |
$103.50 |
$103.50 |
$157.65
|
|
Tc-99m medronate
|
$63.00 |
$63.00 |
$63.00 |
$111.01
|
|
Tc-99m mertiatide
|
$380.00 |
$380.00 |
$380.00 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$6.50 |
$6.50 |
$6.50 |
$6.60
|
|
Tc-99m oxidronate
|
$26.50 |
$26.50 |
$26.50 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$709.50 |
$709.50 |
$709.50 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$145.50 |
$145.50 |
$145.50 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$7.50 |
$7.50 |
$7.50 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$55.50 |
$55.50 |
$55.50 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$321.50 |
$321.50 |
$321.50 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$384.50 |
$384.50 |
$384.50 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$99.50 |
$99.50 |
$99.50 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$171.00 |
$171.00 |
$171.00 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$474.50 |
$474.50 |
$474.50 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$153.50 |
$153.50 |
$153.50 |
$176.40
|
|
T cells absolute cd 4 count
|
$497.00 |
$497.00 |
$497.00 |
$111.20
|
|
T cells total count
|
$162.50 |
$162.50 |
$162.50 |
$126.90
|
|
Tcran magn stim redetemine
|
$563.00 |
$563.00 |
$563.00 |
$457.60
|
|
Telethx isodose plan cplx
|
$905.50 |
$905.50 |
$905.50 |
$1,526.85
|
|
Telethx isodose plan simple
|
$788.00 |
$788.00 |
$788.00 |
$873.62
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,518.50 |
$2,518.50 |
$2,518.50 |
$2,139.67
|
|
Tert gene targeted seq alys
|
$168.00 |
$168.00 |
$168.00 |
$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
|
$50.00 |
$50.00 |
$50.00 |
$70.00
|
|
Test sock wrist disart/bel e
|
$172.84 |
$172.84 |
$172.84 |
$350.00
|
|
Test stress cardiovascular tracing only
|
$751.00 |
$751.00 |
$751.00 |
$949.70
|
|
Theophylline therapeutic drug level
|
$150.00 |
$150.00 |
$150.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$106.50 |
$106.50 |
$106.50 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$34.00 |
$34.00 |
$34.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.00 |
$34.00 |
$34.00 |
$50.00
|
|
Ther/proph/diag inj ia
|
$286.00 |
$286.00 |
$286.00 |
$240.35
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,088.50 |
$3,088.50 |
$3,088.50 |
$1,687.50
|
|
Thoracotomy w/expl
|
$4,245.50 |
$4,245.50 |
$4,245.50 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$5,002.00 |
$5,002.00 |
$5,002.00 |
$2,138.76
|
|
Thor rib belt custom fabrica
|
$393.30 |
$393.30 |
$393.30 |
$225.50
|
|
Thrombectmy crnry perq mechanical
|
$6,048.50 |
$6,048.50 |
$6,048.50 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$10,295.50 |
$10,295.50 |
$10,295.50 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$20,804.00 |
$20,804.00 |
$20,804.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$31,533.00 |
$31,533.00 |
$31,533.00 |
$21,413.60
|
|
Thrombin time
|
$51.50 |
$51.50 |
$51.50 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$50.50 |
$50.50 |
$50.50 |
$61.52
|
|
Thyroglobulin antibody
|
$144.50 |
$144.50 |
$144.50 |
$82.00
|
|
Thyroid imaging
|
$613.50 |
$613.50 |
$613.50 |
$695.02
|
|
Thyroid met imaging
|
$813.50 |
$813.50 |
$813.50 |
$838.25
|
|
Thyroid mets imag whole body
|
$1,869.50 |
$1,869.50 |
$1,869.50 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$98.50 |
$98.50 |
$98.50 |
$111.00
|
|
Thyroid Ultrasound
|
$543.50 |
$543.50 |
$543.50 |
$588.50
|
|
Thyroid uptake measurement
|
$1,342.50 |
$1,342.50 |
$1,342.50 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$18.00 |
$18.00 |
$18.00 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$33,910.50 |
$33,910.50 |
$33,910.50 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$22,891.00 |
$22,891.00 |
$22,891.00 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$14,672.50 |
$14,672.50 |
$14,672.50 |
$9,769.65
|
|
Tilt table study
|
$1,186.50 |
$1,186.50 |
$1,186.50 |
$1,507.01
|
|
Tissue culture placenta
|
$360.00 |
$360.00 |
$360.00 |
$457.00
|
|
Tissue culture skin/biopsy
|
$1,317.50 |
$1,317.50 |
$1,317.50 |
$484.00
|
|
Tissue culture tumor
|
$949.00 |
$949.00 |
$949.00 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$103.00 |
$103.00 |
$103.00 |
$47.20
|
|
Tissue transglutaminase iga
|
$109.00 |
$109.00 |
$109.00 |
$44.16
|
|
Tixagev and cilgav inj
|
$75.25 |
$75.25 |
$75.25 |
$224.55
|
|
Tl-201 thallium diag per mci
|
$68.50 |
$68.50 |
$68.50 |
$78.40
|
|
Tlso 3mod sacro-scap pre
|
$987.91 |
$987.91 |
$987.91 |
$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
|
$177.00 |
$177.00 |
$177.00 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$42.50 |
$42.50 |
$42.50 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$63.50 |
$63.50 |
$63.50 |
$72.68
|
|
Torsion straight knee joint
|
$96.26 |
$96.26 |
$96.26 |
$253.84
|
|
Toxoplasma antibody igg
|
$198.50 |
$198.50 |
$198.50 |
$89.40
|
|
Toxoplasma antibody igm
|
$206.50 |
$206.50 |
$206.50 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$858.50 |
$858.50 |
$858.50 |
$790.68
|
|
Tpmt gene com vrnts
|
$389.50 |
$389.50 |
$389.50 |
$371.80
|
|
Trabeculoplasty laser surg
|
$951.00 |
$951.00 |
$951.00 |
$1,180.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$620.00 |
$620.00 |
$620.00 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$78.00 |
$78.00 |
$78.00 |
$101.25
|
