|
Synch audio-only new low 30
|
$256.80 |
$256.80 |
$256.80 |
$117.00
|
|
Synch audio-only new mod 45
|
$381.60 |
$381.60 |
$381.60 |
$166.70
|
|
Synch audio-only new sf 15
|
$183.20 |
$183.20 |
$183.20 |
$67.80
|
|
Synthetic sentence id test
|
$115.20 |
$115.20 |
$115.20 |
$99.32
|
|
Synvisc or synvisc-one
|
$61.60 |
$61.60 |
$61.60 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$31.35 |
$31.35 |
$54.40 |
$42.24
|
|
System cardiomems hosp electronics
|
$37,905.11 |
$37,905.11 |
$37,905.11 |
$38,234.70
|
|
System pacing micra av
|
$7,050.29 |
$7,050.29 |
$19,076.82 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,390.20 |
$8,390.20 |
$32,518.75 |
$12,003.00
|
|
System sealant biosentry tract
|
$743.09 |
$743.09 |
$743.09 |
$890.03
|
|
T3 (triiodothyronine) free
|
$100.65 |
$100.65 |
$175.20 |
$100.00
|
|
T3 (triiodothyronine) total
|
$7.15 |
$7.15 |
$175.62 |
$93.52
|
|
T4 (thyroxine) free
|
$121.18 |
$121.18 |
$138.60 |
$87.30
|
|
T4 (thyroxine) total
|
$7.70 |
$7.70 |
$85.37 |
$68.40
|
|
Tacrol envarsus ex rel oral
|
$1.81 |
$1.81 |
$1.81 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.96 |
$1.96 |
$1.96 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$43.45 |
$43.45 |
$170.19 |
$122.40
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$372.35 |
$372.35 |
$601.04 |
$288.60
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$2.48 |
$2.48 |
$2.48 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$2,423.00 |
$2,423.00 |
$4,158.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,762.00 |
$3,762.00 |
$6,552.64 |
$3,762.00
|
|
Target gsa panel organ neop
|
$1,888.40 |
$1,888.40 |
$5,036.90 |
$1,749.44
|
|
Tavr perq femoral
|
$7,854.55 |
$7,854.55 |
$14,331.24 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.84 |
$1.84 |
$1.84 |
$937.50
|
|
Tbs dxa cal w/i&r fx risk
|
$66.40 |
$66.40 |
$66.40 |
$127.12
|
|
Tbs i&r fx rsk qhp
|
$40.80 |
$40.80 |
$40.80 |
$61.04
|
|
Tbs techl calculation only
|
$388.39 |
$388.39 |
$388.39 |
$153.60
|
|
Tbs techl prep&transmis data
|
$388.39 |
$388.39 |
$388.39 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$164.45 |
$164.45 |
$449.60 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$149.05 |
$149.05 |
$195.26 |
$181.80
|
|
Tc-99m arcitumomab
|
$2,894.10 |
$2,894.10 |
$2,894.10 |
$2,085.68
|
|
Tc-99m bicisate
|
$1,696.75 |
$1,696.75 |
$1,696.75 |
$1,984.80
|
|
Tc-99m exame autol wbc diag per dose
|
$1,463.55 |
$1,463.55 |
$1,463.55 |
$2,486.31
|
|
Tc-99m exametazime diag
|
$939.95 |
$939.95 |
$2,923.64 |
$2,135.70
|
|
Tc-99m gluceptate
|
$61.60 |
$61.60 |
$61.60 |
$31.35
|
|
Tc-99m labeled rbc
|
$267.30 |
$267.30 |
$951.34 |
$306.00
|
|
Tc-99m maa
|
$231.00 |
$231.00 |
$521.00 |
$306.60
|
|
Tc-99m mebrofenin
|
$143.55 |
$143.55 |
$726.33 |
$157.50
|
|
Tc-99m medronate
|
$67.65 |
$67.65 |
$562.76 |
$111.01
|
|
Tc-99m mertiatide
|
$551.10 |
$551.10 |
$1,031.08 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$9.60 |
$9.60 |
$12.65 |
$6.50
|
|
Tc-99m pentetate dtpa
|
$142.45 |
$142.45 |
$770.01 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$175.45 |
$175.45 |
$389.11 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$1.79 |
$1.79 |
$101.95 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$1.79 |
$1.79 |
$242.33 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$274.45 |
$274.45 |
$1,210.80 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$371.80 |
$371.80 |
$371.80 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$68.75 |
$68.75 |
$871.60 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$273.90 |
$273.90 |
$273.90 |
$192.08
|
|
Tc-99m tilmanocept diag
|
$545.60 |
$545.60 |
$545.60 |
$958.31
|
|
Tca peel dermal 15789
|
$262.40 |
$262.40 |
$262.40 |
$1,324.80
|
|
T cells absolute cd4/cd8 including ratio
|
$52.25 |
$52.25 |
$304.80 |
$185.28
|
|
T cells absolute cd 4 count
|
$119.20 |
$119.20 |
$119.20 |
$111.20
|
|
T cells total count
|
$52.25 |
$52.25 |
$257.60 |
$132.63
|
|
Tcranial magn stim tx deli
|
$374.55 |
$374.55 |
$374.55 |
$389.22
|
|
Tcranial magn stim tx plan
|
$411.40 |
$411.40 |
$411.40 |
$437.22
|
|
Tcran magn stim redetemine
|
$275.55 |
$275.55 |
$2,344.80 |
$457.60
|
|
Teaec w/wo patch graft iliofemoral
|
$15,284.00 |
$15,284.00 |
$15,284.00 |
$6,120.00
|
|
Team conf without pat by hc pro
|
$100.00 |
$100.00 |
$100.00 |
$110.62
|
|
Team conf without pat by phys
|
$160.80 |
$160.80 |
$160.80 |
$139.05
|
|
Team conf w/pat by hc prof
|
$235.64 |
$235.64 |
$235.64 |
$105.70
|
|
Tee w or without fol w/cont,cong
|
$786.50 |
$786.50 |
$2,929.28 |
$2,101.65
|
|
Telehealth original site facility fee
|
$35.75 |
$35.75 |
$35.75 |
$51.00
|
|
Telethx isodose plan cplx
|
$388.85 |
$388.85 |
$388.85 |
$1,526.85
|
|
Telethx isodose plan simple
|
$276.65 |
$276.65 |
$276.65 |
$889.80
|
|
Tendon lngth upr a/e ea tdn
|
$3,232.00 |
$3,232.00 |
$3,232.00 |
$3,591.33
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$268.32 |
$268.32 |
$268.32 |
$14,951.87
|
|
Tenodesis biceps tdn at elbw
|
$5,772.00 |
$5,772.00 |
$5,772.00 |
$6,653.00
|
|
Tenolysis triceps
|
$4,387.20 |
$4,387.20 |
$4,387.20 |
$4,350.00
|
|
Tenoplasty elbow to sho 1
|
$5,385.60 |
$5,385.60 |
$5,385.60 |
$7,807.24
|
|
Tenosynovectomy radic 26145
|
$2,362.40 |
$2,362.40 |
$2,362.40 |
$2,211.05
|
|
Tenotomy hip flexor open
|
$5,366.40 |
$5,366.40 |
$5,366.40 |
$3,342.87
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$4,328.44 |
$4,328.44 |
$4,328.44 |
$2,211.05
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$77.88 |
$77.88 |
$77.88 |
$39.33
|
|
Test for chlorohydrocarbons
|
$36.07 |
$36.07 |
$36.07 |
$61.60
|
|
Testicular imaging w/vasc flow
|
$765.60 |
$765.60 |
$1,630.56 |
$842.56
|
|
Testosterone pellet 75 mg
|
$147.20 |
$147.20 |
$147.20 |
$102.40
|
|
Test pathogen(s) for platelets reference
|
$147.02 |
$147.02 |
$147.02 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$490.60 |
$490.60 |
$1,033.17 |
$949.70
|
|
Tetanus ig im
|
$120.00 |
$120.00 |
$120.00 |
$250.88
|
|
Tgsap so/hl 51/< rna alys
|
$8,339.20 |
$8,339.20 |
$8,339.20 |
$4,563.00
|
|
Theophylline therapeutic drug level
|
$120.00 |
$120.00 |
$195.25 |
$108.00
|
|
Therapeutic procd strg endur
|
$95.74 |
$95.74 |
$95.74 |
$85.68
|
|
Therapy activation ipnss
|
$371.20 |
$371.20 |
$371.20 |
$226.24
|
|
Therapy activity per session >= 45 minutes
|
$138.00 |
$138.00 |
$138.00 |
$191.50
|
|
Therapy Activity Training (each 15 minutes)
|
$120.45 |
$120.45 |
$185.60 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$120.45 |
$120.45 |
$171.85 |
$98.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$69.85 |
$69.85 |
$99.52 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.40 |
$34.40 |
$62.70 |
$50.00
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$381.60 |
$381.60 |
$381.60 |
$314.50
|
|
Ther fx nasal inf turbinate
|
$600.00 |
$600.00 |
$600.00 |
$3,837.72
|
|
Ther nma rdctj intus/obstrcj
|
$943.20 |
$943.20 |
$1,012.00 |
$534.32
|
|
Ther/proph/diag inj ia
|
$236.50 |
$236.50 |
$236.50 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$55.64 |
$55.64 |
$55.64 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$371.25 |
$371.25 |
$542.11 |
$311.15
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,713.60 |
$3,713.60 |
$4,391.72 |
$1,748.50
|
|
Thoracic aortic graft 33875
|
$17,044.00 |
$17,044.00 |
$17,044.00 |
$5,329.20
|
|
Thoracic lymphadenect/thoracotomy 38746
|
$1,691.20 |
$1,691.20 |
$1,691.20 |
$499.80
|
|
Thoracoscop w/esoph musc exc
|
$7,800.80 |
$7,800.80 |
$7,800.80 |
$2,999.20
|
|
Thoracoscopy bilobectomy 32670
|
$5,704.00 |
$5,704.00 |
$5,704.00 |
$3,910.40
|
