|
Suspension sleeve lower ext
|
$77.60 |
$77.60 |
$77.60 |
$251.38
|
|
Svc venogram s&i
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$63.20 |
$63.20 |
$63.20 |
$125.40
|
|
Synvisc or synvisc-one
|
$54.71 |
$54.71 |
$54.71 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$6.80 |
$6.80 |
$6.80 |
$41.60
|
|
System cardiomems hosp electronics
|
$116,552.40 |
$116,552.40 |
$116,552.40 |
$39,037.95
|
|
System pacing micra av
|
$22,269.60 |
$22,269.60 |
$22,269.60 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,052.00 |
$6,052.00 |
$6,052.00 |
$12,003.00
|
|
System sealant biosentry tract
|
$695.20 |
$695.20 |
$695.20 |
$889.35
|
|
T3 (triiodothyronine) free
|
$71.20 |
$71.20 |
$71.20 |
$99.20
|
|
T3 (triiodothyronine) total
|
$34.00 |
$34.00 |
$34.00 |
$93.52
|
|
T4 (thyroxine) free
|
$52.40 |
$52.40 |
$52.40 |
$85.20
|
|
T4 (thyroxine) total
|
$28.40 |
$28.40 |
$28.40 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.82 |
$3.82 |
$3.82 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$39.60 |
$39.60 |
$39.60 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$728.00 |
$728.00 |
$728.00 |
$2,246.30
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2.14 |
$2.14 |
$2.14 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$60.80 |
$60.80 |
$60.80 |
$177.65
|
|
Tc-99m bicisate
|
$3,545.60 |
$3,545.60 |
$3,545.60 |
$1,969.45
|
|
Tc-99m exametazime diag
|
$421.60 |
$421.60 |
$421.60 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$221.92 |
$221.92 |
$221.92 |
$302.40
|
|
Tc-99m maa
|
$3,826.38 |
$3,826.38 |
$3,826.38 |
$292.80
|
|
Tc-99m mebrofenin
|
$164.12 |
$164.12 |
$164.12 |
$157.65
|
|
Tc-99m medronate
|
$143.20 |
$143.20 |
$143.20 |
$111.01
|
|
Tc-99m mertiatide
|
$783.60 |
$783.60 |
$783.60 |
$756.00
|
|
Tc-99m oxidronate
|
$35.60 |
$35.60 |
$35.60 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$473.42 |
$473.42 |
$473.42 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$331.60 |
$331.60 |
$331.60 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$24.00 |
$24.00 |
$24.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$58.40 |
$58.40 |
$58.40 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$1,782.30 |
$1,782.30 |
$1,782.30 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$112.40 |
$112.40 |
$112.40 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$235.20 |
$235.20 |
$235.20 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$97.60 |
$97.60 |
$97.60 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$955.60 |
$955.60 |
$955.60 |
$955.60
|
|
Tcd emboli detect without inj
|
$148.00 |
$148.00 |
$148.00 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$32.40 |
$32.40 |
$32.40 |
$176.40
|
|
T cells total count
|
$26.80 |
$26.80 |
$26.80 |
$126.90
|
|
Telethx isodose plan cplx
|
$494.40 |
$494.40 |
$494.40 |
$1,526.85
|
|
Telethx isodose plan simple
|
$494.40 |
$494.40 |
$494.40 |
$873.62
|
|
Temozolomide 100 mg intravenous solution
|
$33.36 |
$33.36 |
$33.36 |
$1,867.28
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$277.72 |
$277.72 |
$277.72 |
$15,245.38
|
|
Tension based scoliosis orth
|
$1,957.20 |
$1,957.20 |
$1,957.20 |
$3,528.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$31.88 |
$31.88 |
$31.88 |
$39.33
|
|
Term dev, passive hand mitt
|
$206.00 |
$206.00 |
$206.00 |
$406.00
|
|
Term dev, sport/rec/work att
|
$391.20 |
$391.20 |
$391.20 |
$879.20
|
|
Testicular imaging w/vasc flow
|
$518.40 |
$518.40 |
$518.40 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$105.60 |
$105.60 |
$105.60 |
$70.00
|
|
Test socket symes
|
$194.80 |
$194.80 |
$194.80 |
$324.80
|
|
Test sock wrist disart/bel e
|
$148.40 |
$148.40 |
$148.40 |
$350.00
|
|
Test stress cardiovascular tracing only
|
$442.00 |
$442.00 |
$442.00 |
$949.70
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$33.70 |
$33.70 |
$33.70 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$38.40 |
$38.40 |
$38.40 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$60.80 |
$60.80 |
$60.80 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$45.20 |
$45.20 |
$45.20 |
$50.00
|
|
Ther radiology tx plng cplx
|
$756.40 |
$756.40 |
$756.40 |
$332.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$36.28 |
$36.28 |
$36.28 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$751.20 |
$751.20 |
$751.20 |
$1,687.50
|
|
Thoracic pad
|
$66.00 |
$66.00 |
$66.00 |
$234.19
|
|
Thor rib belt custom fabrica
|
$77.20 |
$77.20 |
$77.20 |
$225.50
|
|
Thrombectmy crnry perq mechanical
|
$156.80 |
$156.80 |
$156.80 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,165.60 |
$9,165.60 |
$9,165.60 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$14,277.20 |
$14,277.20 |
$14,277.20 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$22,921.60 |
$22,921.60 |
$22,921.60 |
$21,413.60
|
|
Thrombin time
|
$31.60 |
$31.60 |
$31.60 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$5,479.20 |
$5,479.20 |
$5,479.20 |
$3,980.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$45.20 |
$45.20 |
$45.20 |
$61.52
|
|
Th/wght bear quad-lat brim m
|
$484.00 |
$484.00 |
$484.00 |
$1,695.23
|
|
Thyroglobulin antibody
|
$49.60 |
$49.60 |
$49.60 |
$82.00
|
|
Thyroid imaging
|
$478.80 |
$478.80 |
$478.80 |
$695.02
|
|
Thyroid mets imag whole body
|
$621.60 |
$621.60 |
$621.60 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$60.40 |
$60.40 |
$60.40 |
$111.00
|
|
Thyroid Ultrasound
|
$346.40 |
$346.40 |
$346.40 |
$588.50
|
|
Thyroid uptake measurement
|
$478.80 |
$478.80 |
$478.80 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,052.56 |
$3,052.56 |
$3,052.56 |
$4,112.43
|
|
Tibial length sock fx or equ
|
$76.80 |
$76.80 |
$76.80 |
$88.92
|
|
Tilt table study
|
$217.60 |
$217.60 |
$217.60 |
$1,507.01
|
|
Tirofiban 12.5 mg/50 ml
|
$9.53 |
$9.53 |
$9.53 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$271.03 |
$271.03 |
$271.03 |
$13,339.20
|
|
Tissue exam koh skin/hair/nails
|
$8.40 |
$8.40 |
$8.40 |
$47.20
|
|
Tissue transglutaminase iga
|
$20.80 |
$20.80 |
$20.80 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$42.00 |
$42.00 |
$42.00 |
$78.40
|
|
Tlso 2mod symphis-xipho pre
|
$545.20 |
$545.20 |
$545.20 |
$1,874.66
|
|
Tlso 2 shl symphys-stern cst
|
$614.00 |
$614.00 |
$614.00 |
$1,808.59
|
|
Tlso rigid plastic cust fab
|
$1,041.20 |
$1,041.20 |
$1,041.20 |
$2,347.16
|
|
Tlso rigid plastic custom fa
|
$975.20 |
$975.20 |
$975.20 |
$2,788.42
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$5.51 |
$5.51 |
$5.51 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$35.20 |
$35.20 |
$35.20 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$14.11 |
$14.11 |
$14.11 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$38.40 |
$38.40 |
$38.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$49.60 |
$49.60 |
$49.60 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$76.77 |
$76.77 |
$76.77 |
$325.00
|
|
Torsion ank & half solid sti
|
$66.00 |
$66.00 |
$66.00 |
$291.13
|
|
Torsion straight knee joint
|
$73.60 |
$73.60 |
$73.60 |
$253.84
|
|
Toxoplasma antibody igg
|
$38.80 |
$38.80 |
$38.80 |
$89.40
|
|
Toxoplasma antibody igm
|
$80.00 |
$80.00 |
$80.00 |
$87.00
|
|
Tpmt gene com vrnts
|
$192.80 |
$192.80 |
$192.80 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$552.29 |
$552.29 |
$552.29 |
$6,827.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$251.60 |
$251.60 |
$251.60 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$67.60 |
$67.60 |
$67.60 |
$101.25
|
