|
Tarlatamab-dlle 10 mg intravenous solution
|
$30,000.00 |
$30,000.00 |
$30,000.00 |
|
|
Tas congenital car anomal
|
$6,763.00 |
$6,763.00 |
$6,763.00 |
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$840.00 |
$849.50 |
$849.50 |
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$139.00 |
$139.00 |
$200.00 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$106.50 |
$198.00 |
$414.00 |
|
|
Tc-99m bicisate
|
$1,026.50 |
$1,622.00 |
$4,557.00 |
|
|
Tc-99m diag per dose
|
$71.00 |
$1,816.50 |
$1,816.50 |
|
|
Tc-99m disofenin
|
$114.50 |
$121.50 |
$142.40 |
|
|
Tc-99m exame autol wbc diag per dose
|
$2,386.50 |
$3,245.00 |
$5,634.00 |
|
|
Tc-99m exametazime diag
|
$1,089.00 |
$1,870.00 |
$3,245.00 |
|
|
Tc-99m graphite crucible
|
$411.00 |
$411.00 |
$411.00 |
|
|
Tc-99m labeled rbc
|
$31.00 |
$354.50 |
$2,046.00 |
|
|
Tc-99m maa
|
$7.50 |
$253.00 |
$861.50 |
|
|
Tc-99m mebrofenin
|
$83.50 |
$125.00 |
$306.00 |
|
|
Tc-99m medronate
|
$11.50 |
$64.50 |
$160.00 |
|
|
Tc-99m mertiatide
|
$420.00 |
$973.50 |
$2,939.50 |
|
|
Tc-99m oxidronate
|
$33.00 |
$77.00 |
$138.50 |
|
|
Tc-99m pentetate dtpa
|
$61.00 |
$123.50 |
$559.80 |
|
|
Tc-99m pentetate dtpa aerosol
|
$93.00 |
$226.50 |
$565.50 |
|
|
Tc-99m pertechnetate per mci
|
$2.50 |
$3.50 |
$1,098.00 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$64.00 |
$100.50 |
$343.50 |
|
|
Tc-99m sestamibi p study dose
|
$330.50 |
$727.00 |
$1,170.00 |
|
|
Tc-99m succimer (dmsa)
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
|
|
Tc-99m sulfur colloid
|
$64.50 |
$199.00 |
$448.00 |
|
|
Tc-99m tetrofosmin p study dose
|
$186.50 |
$210.00 |
$420.00 |
|
|
Tc-99m tilmanocept diag
|
$877.50 |
$946.50 |
$1,106.50 |
|
|
Tca peel dermal 15789
|
$944.00 |
$944.00 |
$944.00 |
|
|
Tcd emboli detect w/inj
|
$368.00 |
$368.00 |
$368.00 |
|
|
Tcd emboli detect without inj
|
$839.50 |
$839.50 |
$839.50 |
|
|
T cells absolute cd4/cd8 including ratio
|
$19.19 |
$218.00 |
$300.50 |
|
|
T cells absolute cd 4 count
|
$28.80 |
$32.00 |
$253.00 |
|
|
T cells total count
|
$19.19 |
$123.00 |
$287.00 |
|
|
Tcranial magn stim tx deli
|
$248.50 |
$248.50 |
$555.00 |
|
|
Tcranial magn stim tx plan
|
$350.50 |
$350.50 |
$697.00 |
|
|
Tcran magn stim redetemine
|
$685.00 |
$685.00 |
$685.00 |
|
|
Teaec w/wo patch graft iliofemoral
|
$1,101.00 |
$1,131.00 |
$1,809.60 |
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$33,584.00 |
$33,584.00 |
$33,584.00 |
|
|
Tee w or without fol w/cont,cong
|
$1,599.50 |
$1,599.50 |
$1,599.50 |
|
|
Telehealth original site facility fee
|
$32.40 |
$57.00 |
$104.00 |
|
|
Telethx isodose plan cplx
|
$384.00 |
$742.00 |
$1,348.50 |
|
|
Telethx isodose plan simple
|
$286.00 |
$484.00 |
$741.50 |
|
|
Temozolomide 100 mg intravenous solution
|
$7,786.35 |
$7,786.35 |
$7,786.35 |
|
|
Tendon lngth upr a/e ea tdn
|
$3,038.25 |
$3,038.25 |
$3,038.25 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$10,462.15 |
$15,242.06 |
$21,126.00 |
|
|
Tenodesis biceps tdn at elbw
|
$641.00 |
$655.00 |
$11,032.67 |
|
|
Tenolysis extensor tendon hand/finger each
|
$642.00 |
$1,027.20 |
$10,168.50 |
|
|
Tenosynovectomy radic 26145
|
$542.50 |
$546.50 |
$3,515.50 |
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$2,835.08 |
$2,835.08 |
$2,835.08 |
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$248.50 |
$1,848.50 |
$3,600.00 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$0.44 |
$0.75 |
$14.40 |
|
|
Test for chlorohydrocarbons
|
$123.00 |
$123.00 |
$123.00 |
|
|
Test for porphobilinogen
|
$19.00 |
$19.00 |
$19.00 |
|
|
Testicular imaging w/vasc flow
|
$918.50 |
$921.50 |
$2,227.50 |
|
|
Testosterone pellet 75 mg
|
$1,012.50 |
$1,012.50 |
$1,012.50 |
|
|
Test stress cardiovascular tracing only
|
$207.00 |
$694.50 |
$1,916.50 |
|
|
Tetanus immune globulin inj
|
$1,210.21 |
$1,210.21 |
$2,253.60 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$33.50 |
$50.50 |
$14,011.20 |
|
|
Tgsap so/hl 51/< rna alys
|
$3,481.50 |
$3,481.50 |
$3,481.50 |
|
|
Thaw preserved stem cells
|
$1,889.51 |
$1,889.51 |
$1,889.51 |
|
|
Theophylline therapeutic drug level
|
$16.00 |
$77.00 |
$175.50 |
|
|
Therapeutic procd strg endur
|
$30.50 |
$54.40 |
$201.00 |
|
|
Therapy activation ipnss
|
$124.50 |
$124.50 |
$124.50 |
|
|
Therapy activity per session >= 45 minutes
|
$79.00 |
$121.50 |
$142.50 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$41.50 |
$144.00 |
$412.00 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$31.00 |
$58.50 |
$320.00 |
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$329.00 |
$329.00 |
$354.00 |
|
|
Ther fx nasal inf turbinate
|
$235.80 |
$1,898.00 |
$5,027.50 |
|
|
Ther nma rdctj intus/obstrcj
|
$433.50 |
$433.50 |
$449.50 |
|
|
Ther/proph/diag inj ia
|
$166.50 |
$184.00 |
$408.00 |
|
|
Ther radiology tx plng cplx
|
$382.50 |
$460.00 |
$643.00 |
|
|
Ther radiology tx plng intrm
|
$246.00 |
$310.00 |
$433.50 |
|
|
Ther radiology tx plng smpl
|
$161.50 |
$235.50 |
$289.00 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$2.50 |
$6.20 |
$54.94 |
|
|
Thorabd diaphr hern repair
|
$1,548.50 |
$1,619.50 |
$2,591.20 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$601.00 |
$1,615.00 |
$8,569.00 |
|
|
Thoracoscopy lymph node exc
|
$8,456.67 |
$8,456.67 |
$8,456.67 |
|
|
Thoracoscopy remove segment
|
$16,913.34 |
$16,913.34 |
$16,913.34 |
|
|
Thoracoscopy surgical 32650
|
$2,845.75 |
$2,845.75 |
$2,845.75 |
|
|
Thoracoscopy w/bx med space
|
$18,511.27 |
$18,511.27 |
$18,511.27 |
|
|
Thoracoscopy w/mediast exc
|
$16,287.67 |
$16,287.67 |
$16,287.67 |
|
|
Thoracoscopy w/wedge resect
|
$10,855.50 |
$10,855.50 |
$10,855.50 |
|
|
Thoracoscopy w w resect addl 32667
|
$3,618.50 |
$3,618.50 |
$3,618.50 |
|
|
Thoracotomy w/expl
|
$8,883.50 |
$8,883.50 |
$8,883.50 |
|
|
Thoracotomy with cardiac massage
|
$3,200.50 |
$3,200.50 |
$3,200.50 |
|
|
Thorax spine fusion
|
$10,937.76 |
$10,937.76 |
$10,937.76 |
|
|
Thorcscpy w/biop pleura
|
$4,020.00 |
$4,020.00 |
$5,468.00 |
|
|
Throat x-ray & fluoroscopy
|
$557.00 |
$557.00 |
$557.50 |
|
|
Thrombectmy crnry perq mechanical
|
$1,605.00 |
$3,552.50 |
$7,528.80 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$380.00 |
$608.00 |
$5,308.50 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$455.50 |
$728.80 |
$20,108.50 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$526.00 |
$841.60 |
$31,931.50 |
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$1,206.00 |
$1,238.00 |
$2,668.20 |
|
|
Thrombin time
|
$13.00 |
$25.00 |
$119.50 |
|
|
Thrombin time titer
|
$29.00 |
$29.00 |
$29.00 |
|
|
Thromboendarterectomy common femoral
|
$167.00 |
$892.50 |
$18,679.50 |
|
|
Thromboendarterectomy including patch graft if preformed;
|
$968.00 |
$992.00 |
$2,390.40 |
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$1,376.50 |
$1,416.00 |
$2,265.60 |
|
|
Thromboendarterectomy sfa
|
$1,192.50 |
$1,225.00 |
$1,960.00 |
|
|
Thromboplastin inhibition
|
$46.80 |
$46.80 |
$93.90 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$33.00 |
$132.50 |
$244.00 |
|
