|
Suscept studies macrobroth dilution ea
|
$146.30 |
$146.30 |
$146.30 |
$48.30
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$41.25 |
$41.25 |
$41.25 |
$44.85
|
|
System sealant biosentry tract
|
$753.25 |
$753.25 |
$753.25 |
$900.00
|
|
T3 (triiodothyronine) free
|
$119.90 |
$119.90 |
$119.90 |
$89.82
|
|
T3 (triiodothyronine) total
|
$8.25 |
$8.25 |
$8.25 |
$94.90
|
|
T4 (thyroxine) free
|
$165.55 |
$165.55 |
$165.55 |
$81.60
|
|
T4 (thyroxine) total
|
$9.35 |
$9.35 |
$9.35 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$50.60 |
$50.60 |
$50.60 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$4,531.45 |
$4,531.45 |
$4,531.45 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$4,101.35 |
$4,101.35 |
$4,101.35 |
$3,385.00
|
|
Target gsa panel organ neop
|
$7,056.50 |
$7,056.50 |
$7,056.50 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$220.00 |
$220.00 |
$220.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$198.00 |
$198.00 |
$198.00 |
$166.46
|
|
Tc-99m disofenin
|
$231.00 |
$231.00 |
$231.00 |
$151.32
|
|
Tc-99m gluceptate
|
$224.40 |
$224.40 |
$224.40 |
$1,105.40
|
|
Tc-99m labeled rbc
|
$268.95 |
$268.95 |
$268.95 |
$323.01
|
|
Tc-99m maa
|
$238.15 |
$238.15 |
$238.15 |
$312.06
|
|
Tc-99m mebrofenin
|
$224.40 |
$224.40 |
$224.40 |
$169.53
|
|
Tc-99m medronate
|
$224.40 |
$224.40 |
$224.40 |
$122.46
|
|
Tc-99m mertiatide
|
$795.30 |
$795.30 |
$795.30 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$15.40 |
$15.40 |
$15.40 |
$8.00
|
|
Tc-99m pentetate dtpa
|
$224.40 |
$224.40 |
$224.40 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$224.40 |
$224.40 |
$224.40 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$11.55 |
$11.55 |
$11.55 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$224.40 |
$224.40 |
$224.40 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$374.00 |
$374.00 |
$374.00 |
$221.60
|
|
Tc-99m sulfur colloid
|
$224.40 |
$224.40 |
$224.40 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$238.15 |
$238.15 |
$238.15 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$61.60 |
$61.60 |
$61.60 |
$186.00
|
|
T cells total count
|
$61.60 |
$61.60 |
$61.60 |
$124.11
|
|
Telehealth original site facility fee
|
$70.40 |
$70.40 |
$70.40 |
$60.80
|
|
Telethx isodose plan cplx
|
$651.20 |
$651.20 |
$651.20 |
$1,617.00
|
|
Telethx isodose plan simple
|
$355.85 |
$355.85 |
$355.85 |
$848.72
|
|
Testicular imaging w/vasc flow
|
$762.30 |
$762.30 |
$762.30 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$648.45 |
$648.45 |
$648.45 |
$1,001.55
|
|
Theophylline therapeutic drug level
|
$226.60 |
$226.60 |
$226.60 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$46.20 |
$46.20 |
$46.20 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$46.20 |
$46.20 |
$46.20 |
$50.40
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,442.10 |
$1,442.10 |
$1,442.10 |
$1,804.00
|
|
Thrombin time
|
$43.45 |
$43.45 |
$43.45 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$93.50 |
$93.50 |
$93.50 |
$56.93
|
|
Thyroglobulin antibody
|
$10.45 |
$10.45 |
$10.45 |
$84.00
|
|
Thyroid (TSH) Test
|
$126.50 |
$126.50 |
$126.50 |
$120.00
|
|
Thyroid Ultrasound
|
$917.40 |
$917.40 |
$917.40 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$24.75 |
$24.75 |
$24.75 |
$63.60
|
|
Tissue culture placenta
|
$701.25 |
$701.25 |
$701.25 |
$520.91
|
|
Tissue culture skin/biopsy
|
$632.50 |
$632.50 |
$632.50 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$167.20 |
$167.20 |
$167.20 |
$47.40
|
|
Tissue transglutaminase iga
|
$53.35 |
$53.35 |
$53.35 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$53.35 |
$53.35 |
$53.35 |
$77.22
|
|
Tobramycin peak therapeutic drug level
|
$188.65 |
$188.65 |
$188.65 |
$121.55
|
|
Tomosynthesis breast screen bilateral
|
$26.40 |
$26.40 |
$26.40 |
$73.45
|
|
Total tau
|
$275.00 |
$275.00 |
$275.00 |
$293.00
|
|
Toxoplasma antibody igg
|
$13.20 |
$13.20 |
$13.20 |
$84.35
|
|
Toxoplasma antibody igm
|
$13.20 |
$13.20 |
$13.20 |
$83.20
|
|
Tp53 gene full gene sequence
|
$2,630.65 |
$2,630.65 |
$2,630.65 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$1,082.40 |
$1,082.40 |
$1,082.40 |
$919.10
|
|
Tpmt gene com vrnts
|
$227.70 |
$227.70 |
$227.70 |
$381.55
|
|
Transferrin
|
$15.40 |
$15.40 |
$15.40 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,054.90 |
$1,054.90 |
$1,054.90 |
$988.24
|
|
Trauma partial team response w/critical care services level 4
|
$5,104.55 |
$5,104.55 |
$5,104.55 |
$5,455.00
|
|
Treat foot dislocation
|
$970.20 |
$970.20 |
$970.20 |
$527.28
|
|
Treat fracture of radius
|
$1,881.55 |
$1,881.55 |
$1,881.55 |
$2,030.33
|
|
Treat humerus fracture
|
$1,580.15 |
$1,580.15 |
$1,580.15 |
$1,950.60
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$130.90 |
$130.90 |
$130.90 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$101.20 |
$101.20 |
$101.20 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$241.45 |
$241.45 |
$241.45 |
$210.00
|
|
Treatment of toe fracture 28510
|
$261.80 |
$261.80 |
$261.80 |
$371.40
|
|
Treatment radiation delivery level 2
|
$613.25 |
$613.25 |
$613.25 |
$735.00
|
|
Treat sternum fracture
|
$223.30 |
$223.30 |
$223.30 |
$423.00
|
|
Treat toe dislocation
|
$2,030.05 |
$2,030.05 |
$2,030.05 |
$855.66
|
|
Treat ulnar fracture
|
$1,837.55 |
$1,837.55 |
$1,837.55 |
$1,861.60
|
|
Treponema pallidum antibody
|
$140.25 |
$140.25 |
$140.25 |
$72.80
|
|
Trg gene rearrangement anal
|
$630.30 |
$630.30 |
$630.30 |
$455.70
|
|
Trichinella antibody
|
$82.50 |
$82.50 |
$82.50 |
$70.65
|
|
Trichomonas assay w/optic
|
$75.90 |
$75.90 |
$75.90 |
$66.00
|
|
#tricyclicantidprssnt
|
$57.75 |
$57.75 |
$57.75 |
$57.08
|
|
Triglycerides
|
$96.80 |
$96.80 |
$96.80 |
$54.60
|
|
Troponin quantitative
|
$171.60 |
$171.60 |
$171.60 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$869.55 |
$869.55 |
$869.55 |
$1,582.75
|
|
Tx closed hip disl traumatic without anes
|
$425.15 |
$425.15 |
$425.15 |
$657.28
|
|
Tx closed tib shaft fx without manip
|
$1,414.60 |
$1,414.60 |
$1,414.60 |
$635.46
|
|
Tympanometry & reflex thresh
|
$88.00 |
$88.00 |
$88.00 |
$173.18
|
|
Ugt1a1 gene analy common variants
|
$866.80 |
$866.80 |
$866.80 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$551.65 |
$551.65 |
$551.65 |
$403.26
|
|
Ultrasound breast complete
|
$588.50 |
$588.50 |
$588.50 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,097.25 |
$1,097.25 |
$1,097.25 |
$449.35
|
|
Ultrasound chest
|
$707.30 |
$707.30 |
$707.30 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$836.00 |
$836.00 |
$836.00 |
$340.14
|
|
Ultrasound encephalogram
|
$454.85 |
$454.85 |
$454.85 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$939.40 |
$939.40 |
$939.40 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$359.70 |
$359.70 |
$359.70 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$746.35 |
$746.35 |
$746.35 |
$701.35
|
|
Ultrasound hips infant dynamic
|
$1,010.90 |
$1,010.90 |
$1,010.90 |
$403.00
|
|
Ultrasound joint complete left
|
$710.05 |
$710.05 |
$710.05 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$505.45 |
$505.45 |
$505.45 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$871.20 |
$871.20 |
$871.20 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$454.30 |
$454.30 |
$454.30 |
$326.54
|
|
Ultrasound pregnant uterus follow up per fetus
|
$592.35 |
$592.35 |
$592.35 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$657.80 |
$657.80 |
$657.80 |
$459.00
|
