|
Tc-99m labeled rbc
|
$383.00 |
$383.00 |
$383.00 |
$302.40
|
|
Tc-99m maa
|
$299.50 |
$299.50 |
$299.50 |
$292.80
|
|
Tc-99m mebrofenin
|
$142.00 |
$142.00 |
$142.00 |
$157.65
|
|
Tc-99m medronate
|
$77.50 |
$77.50 |
$77.50 |
$111.01
|
|
Tc-99m mertiatide
|
$975.00 |
$975.00 |
$975.00 |
$756.00
|
|
Tc-99m oxidronate
|
$56.50 |
$56.50 |
$56.50 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$123.50 |
$123.50 |
$123.50 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$284.50 |
$284.50 |
$284.50 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$2.50 |
$2.50 |
$2.50 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$1,131.00 |
$1,131.00 |
$1,131.00 |
$274.45
|
|
Tc-99m sulfur colloid
|
$448.00 |
$448.00 |
$448.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$210.00 |
$210.00 |
$210.00 |
$190.80
|
|
T cells absolute cd4/cd8 including ratio
|
$299.00 |
$299.00 |
$299.00 |
$176.40
|
|
T cells absolute cd 4 count
|
$48.00 |
$48.00 |
$48.00 |
$111.20
|
|
T cells total count
|
$72.00 |
$72.00 |
$72.00 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$33,584.00 |
$33,584.00 |
$33,584.00 |
$40,114.80
|
|
Telehealth original site facility fee
|
$53.00 |
$53.00 |
$53.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$742.00 |
$742.00 |
$742.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$741.50 |
$741.50 |
$741.50 |
$873.62
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$15,245.38 |
$15,245.38 |
$15,245.38 |
$15,245.38
|
|
Tenolysis extensor tendon hand/finger each
|
$10,168.50 |
$10,168.50 |
$10,168.50 |
$2,811.20
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$0.70 |
$0.70 |
$0.70 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$1,586.00 |
$1,586.00 |
$1,586.00 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$923.50 |
$923.50 |
$923.50 |
$949.70
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$9,362.05 |
$9,362.05 |
$9,362.05 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$44.50 |
$44.50 |
$44.50 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$234.00 |
$234.00 |
$234.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$320.00 |
$320.00 |
$320.00 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$433.50 |
$433.50 |
$433.50 |
$529.08
|
|
Ther/proph/diag inj ia
|
$408.00 |
$408.00 |
$408.00 |
$240.35
|
|
Ther radiology tx plng cplx
|
$382.50 |
$382.50 |
$382.50 |
$332.00
|
|
Ther radiology tx plng intrm
|
$246.00 |
$246.00 |
$246.00 |
$224.00
|
|
Ther radiology tx plng smpl
|
$161.50 |
$161.50 |
$161.50 |
$148.80
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.15 |
$17.15 |
$17.15 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,910.50 |
$3,910.50 |
$3,910.50 |
$1,687.50
|
|
Throat x-ray & fluoroscopy
|
$557.00 |
$557.00 |
$557.00 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$1,605.00 |
$1,605.00 |
$1,605.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$4,444.50 |
$4,444.50 |
$4,444.50 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$20,108.50 |
$20,108.50 |
$20,108.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$31,931.50 |
$31,931.50 |
$31,931.50 |
$21,413.60
|
|
Thrombin time
|
$22.00 |
$22.00 |
$22.00 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$18,679.50 |
$18,679.50 |
$18,679.50 |
$3,980.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$41.50 |
$41.50 |
$41.50 |
$61.52
|
|
Thyroglobulin antibody
|
$122.00 |
$122.00 |
$122.00 |
$82.00
|
|
Thyroid imaging
|
$821.00 |
$821.00 |
$821.00 |
$695.02
|
|
Thyroid mets imag whole body
|
$1,455.00 |
$1,455.00 |
$1,455.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$122.00 |
$122.00 |
$122.00 |
$111.00
|
|
Thyroid Ultrasound
|
$532.50 |
$532.50 |
$532.50 |
$588.50
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,550.00 |
$4,550.00 |
$4,550.00 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$94.00 |
$94.00 |
$94.00 |
$64.35
|
|
Tilt table study
|
$1,022.00 |
$1,022.00 |
$1,022.00 |
$1,507.01
|
|
Tissue culture placenta
|
$862.00 |
$862.00 |
$862.00 |
$457.00
|
|
Tissue culture skin/biopsy
|
$823.50 |
$823.50 |
$823.50 |
$484.00
|
|
Tissue culture tumor
|
$864.00 |
$864.00 |
$864.00 |
$483.36
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$1,134.00 |
$1,134.00 |
$1,134.00 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$77.50 |
$77.50 |
$77.50 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$63.00 |
$63.00 |
$63.00 |
$78.40
|
|
Tlh uterus 250 g or less
|
$23,827.00 |
$23,827.00 |
$23,827.00 |
$11,533.76
|
|
Tlh w/t/o 250 g or less
|
$21,890.00 |
$21,890.00 |
$21,890.00 |
$12,320.22
|
|
Tlh w/t/o uterus over 250 g
|
$42,206.50 |
$42,206.50 |
$42,206.50 |
$12,320.22
|
|
Tobramycin non-comp unit
|
$81.66 |
$81.66 |
$81.66 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$94.50 |
$94.50 |
$94.50 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,660.97 |
$4,660.97 |
$4,660.97 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$613.50 |
$613.50 |
$613.50 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$750.00 |
$750.00 |
$750.00 |
$72.68
|
|
Tongue biopsy; posterior one-third 41105
|
$5,353.00 |
$5,353.00 |
$5,353.00 |
$3,544.29
|
|
Tonsillectomy (age 12+)
|
$5,671.00 |
$5,671.00 |
$5,671.00 |
$4,424.11
|
|
Tonsillectomy (child under 12)
|
$6,056.50 |
$6,056.50 |
$6,056.50 |
$5,339.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$34.06 |
$34.06 |
$34.06 |
$325.00
|
|
Total Hip Replacement
|
$17,504.50 |
$17,504.50 |
$17,504.50 |
$9,161.60
|
|
Total Knee Replacement
|
$14,543.50 |
$14,543.50 |
$14,543.50 |
$14,543.50
|
|
Total tau
|
$431.00 |
$431.00 |
$431.00 |
$312.50
|
|
Tot disc arthrp 1ntrspc crv
|
$41,238.00 |
$41,238.00 |
$41,238.00 |
$20,154.40
|
|
Toxoplasma antibody igg
|
$47.00 |
$47.00 |
$47.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$92.00 |
$92.00 |
$92.00 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$597.00 |
$597.00 |
$597.00 |
$790.68
|
|
Tpmt gene com vrnts
|
$175.00 |
$175.00 |
$175.00 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$5,719.00 |
$5,719.00 |
$5,719.00 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$18,446.70 |
$18,446.70 |
$18,446.70 |
$6,827.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$614.50 |
$614.50 |
$614.50 |
$1,420.44
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$59.50 |
$59.50 |
$59.50 |
$101.25
|
|
Transcath occlusion non-cns
|
$7,644.00 |
$7,644.00 |
$7,644.00 |
$10,031.28
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,980.50 |
$2,980.50 |
$2,980.50 |
$4,775.16
|
|
Transferrin
|
$80.00 |
$80.00 |
$80.00 |
$82.00
|
|
Transfer skin pedicle flap
|
$3,152.50 |
$3,152.50 |
$3,152.50 |
$3,209.30
|
|
Transfusion blood/blood component(s)
|
$861.00 |
$861.00 |
$861.00 |
$983.00
|
|
Transperi needle place pros
|
$871.63 |
$871.63 |
$871.63 |
$6,015.75
|
|
Transplant forearm tendon
|
$4,041.50 |
$4,041.50 |
$4,041.50 |
$3,591.33
|
|
Transplant hand tendon
|
$4,803.67 |
$4,803.67 |
$4,803.67 |
$3,821.05
|
|
Trastuzumab 150 mg intravenous solution
|
$12,218.02 |
$12,218.02 |
$12,218.02 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$9,084.33 |
$9,084.33 |
$9,084.33 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,196.50 |
$2,196.50 |
$2,196.50 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$682.97 |
$682.97 |
$682.97 |
$940.80
|
|
Treat big toe fracture
|
$7,417.00 |
$7,417.00 |
$7,417.00 |
$4,307.52
|
|
Treat ectopic pregnancy
|
$11,967.50 |
$11,967.50 |
$11,967.50 |
$6,707.99
|
|
Treat elbow dislocation
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$2,223.20
|
|
Treat elbow fracture
|
$2,354.00 |
$2,354.00 |
$2,354.00 |
$1,919.13
|
|
Treat eyelid by injection
|
$1,633.50 |
$1,633.50 |
$1,633.50 |
$481.44
|
|
Treat finger fracture each
|
$8,089.50 |
$8,089.50 |
$8,089.50 |
$4,132.02
|
