|
Support clav 29.6-40.5in med
|
$51.94 |
$51.94 |
$51.94 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$78.44 |
$78.44 |
$78.44 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$164.30 |
$164.30 |
$164.30 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$246.45 |
$246.45 |
$246.45 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$525.76 |
$525.76 |
$525.76 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$693.77 |
$693.77 |
$693.77 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$763.20 |
$763.20 |
$763.20 |
$790.00
|
|
Surgical trays
|
$41.34 |
$41.34 |
$41.34 |
$95.55
|
|
Susceptibility agar dilution per agent
|
$25.97 |
$25.97 |
$25.97 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$30.21 |
$30.21 |
$30.21 |
$34.48
|
|
Susceptibility mic per plate
|
$64.13 |
$64.13 |
$64.13 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$47.17 |
$47.17 |
$47.17 |
$48.30
|
|
Svc venogram s&i
|
$1,090.74 |
$1,090.74 |
$1,090.74 |
$1,908.00
|
|
Synthetic sentence id test
|
$57.24 |
$57.24 |
$57.24 |
$65.00
|
|
Synvisc or synvisc-one
|
$11.66 |
$11.66 |
$11.66 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$34.45 |
$34.45 |
$34.45 |
$44.85
|
|
T3 (triiodothyronine) free
|
$102.29 |
$102.29 |
$102.29 |
$89.82
|
|
T3 (triiodothyronine) total
|
$121.37 |
$121.37 |
$121.37 |
$94.90
|
|
T4 (thyroxine) free
|
$91.69 |
$91.69 |
$91.69 |
$81.60
|
|
T4 (thyroxine) total
|
$71.02 |
$71.02 |
$71.02 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.92 |
$2.92 |
$2.92 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$113.95 |
$113.95 |
$113.95 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$4,396.88 |
$4,396.88 |
$4,396.88 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$3,725.37 |
$3,725.37 |
$3,725.37 |
$3,385.00
|
|
Target gsa panel organ neop
|
$1,134.73 |
$1,134.73 |
$1,134.73 |
$1,913.00
|
|
Tavr perq femoral
|
$56,327.34 |
$56,327.34 |
$56,327.34 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.58 |
$1.58 |
$1.58 |
$959.55
|
|
Tbs techl calculation only
|
$115.54 |
$115.54 |
$115.54 |
$123.30
|
|
Tbs techl prep&transmis data
|
$115.54 |
$115.54 |
$115.54 |
$104.19
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$120.31 |
$120.31 |
$120.31 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$119.25 |
$119.25 |
$119.25 |
$166.46
|
|
Tc-99m exametazime diag
|
$3,733.85 |
$3,733.85 |
$3,733.85 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$238.50 |
$238.50 |
$238.50 |
$323.01
|
|
Tc-99m maa
|
$429.30 |
$429.30 |
$429.30 |
$312.06
|
|
Tc-99m mebrofenin
|
$219.42 |
$219.42 |
$219.42 |
$169.53
|
|
Tc-99m medronate
|
$153.70 |
$153.70 |
$153.70 |
$122.46
|
|
Tc-99m mertiatide
|
$1,225.36 |
$1,225.36 |
$1,225.36 |
$757.25
|
|
Tc-99m oxidronate
|
$1,202.57 |
$1,202.57 |
$1,202.57 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$369.41 |
$369.41 |
$369.41 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$180.20 |
$180.20 |
$180.20 |
$244.02
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$157.41 |
$157.41 |
$157.41 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$260.23 |
$260.23 |
$260.23 |
$221.60
|
|
Tc-99m sulfur colloid
|
$639.18 |
$639.18 |
$639.18 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$258.11 |
$258.11 |
$258.11 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$519.93 |
$519.93 |
$519.93 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$347.15 |
$347.15 |
$347.15 |
$186.00
|
|
T cells absolute cd 4 count
|
$162.71 |
$162.71 |
$162.71 |
$120.25
|
|
T cells total count
|
$233.73 |
$233.73 |
$233.73 |
$124.11
|
|
Telehealth original site facility fee
|
$55.65 |
$55.65 |
$55.65 |
$60.80
|
|
Telethx isodose plan cplx
|
$4,756.22 |
$4,756.22 |
$4,756.22 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,449.02 |
$1,449.02 |
$1,449.02 |
$848.72
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$52.47 |
$52.47 |
$52.47 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$222.72 |
$222.72 |
$222.72 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$304.22 |
$304.22 |
$304.22 |
$3,839.54
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$294.68 |
$294.68 |
$294.68 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$24.81 |
$24.81 |
$24.81 |
$46.10
|
|
Test for chlorohydrocarbons
|
$25.97 |
$25.97 |
$25.97 |
$71.04
|
|
Test for porphobilinogen
|
$15.37 |
$15.37 |
$15.37 |
$33.57
|
|
Test for urine cystines
|
$27.03 |
$27.03 |
$27.03 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$345.56 |
$345.56 |
$345.56 |
$780.48
|
|
Testosterone undecanoate 1mg
|
$1.59 |
$1.59 |
$1.59 |
$1.99
|
|
Test stress cardiovascular tracing only
|
$1,591.59 |
$1,591.59 |
$1,591.59 |
$1,001.55
|
|
Test urine for porphyrins
|
$31.27 |
$31.27 |
$31.27 |
$27.30
|
|
Test urine urobilinogen
|
$11.66 |
$11.66 |
$11.66 |
$6.17
|
|
Tetanus immune globulin inj
|
$546.43 |
$546.43 |
$546.43 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$91.69 |
$91.69 |
$91.69 |
$108.00
|
|
Therapeutic procd strg endur
|
$86.39 |
$86.39 |
$86.39 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.25 |
$66.25 |
$66.25 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$66.25 |
$66.25 |
$66.25 |
$50.40
|
|
Therapy photodnmc lght dstr lsn skn by staff rx per day
|
$268.18 |
$268.18 |
$268.18 |
$283.20
|
|
Ther nma rdctj intus/obstrcj
|
$545.37 |
$545.37 |
$545.37 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.27 |
$9.27 |
$9.27 |
$35.72
|
|
Thiethylperazine maleate inj
|
$3.71 |
$3.71 |
$3.71 |
$3.71
|
|
Thigh/wght bear lacer molded
|
$356.69 |
$356.69 |
$356.69 |
$393.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,479.76 |
$1,479.76 |
$1,479.76 |
$1,804.00
|
|
Thor rib belt custom fabrica
|
$101.23 |
$101.23 |
$101.23 |
$219.09
|
|
Thrcspy w/diag bp lng nod uni
|
$918.49 |
$918.49 |
$918.49 |
$5,339.00
|
|
Thrombectmy crnry perq mechanical
|
$4,623.72 |
$4,623.72 |
$4,623.72 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,136.14 |
$9,136.14 |
$9,136.14 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$17,645.82 |
$17,645.82 |
$17,645.82 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$26,335.17 |
$26,335.17 |
$26,335.17 |
$24,605.30
|
|
Thrombin time
|
$47.17 |
$47.17 |
$47.17 |
$48.75
|
|
Thrombin time titer
|
$18.55 |
$18.55 |
$18.55 |
$9.10
|
|
Thrombomodulin
|
$124.02 |
$124.02 |
$124.02 |
$19.00
|
|
Thromboplastin inhibition
|
$147.87 |
$147.87 |
$147.87 |
$52.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$64.13 |
$64.13 |
$64.13 |
$56.93
|
|
Thyroglobulin antibody
|
$147.34 |
$147.34 |
$147.34 |
$84.00
|
|
Thyroid mets imag whole body
|
$2,540.82 |
$2,540.82 |
$2,540.82 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$109.71 |
$109.71 |
$109.71 |
$120.00
|
|
Thyroid Ultrasound
|
$538.48 |
$538.48 |
$538.48 |
$589.96
|
|
Thyroid uptake measurement
|
$567.10 |
$567.10 |
$567.10 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,057.40 |
$3,057.40 |
$3,057.40 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$93.28 |
$93.28 |
$93.28 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$34,190.30 |
$34,190.30 |
$34,190.30 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$28,181.16 |
$28,181.16 |
$28,181.16 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$3,083.01 |
$3,083.01 |
$3,083.01 |
$10,406.14
|
|
Tilt table study
|
$3,492.17 |
$3,492.17 |
$3,492.17 |
$1,495.00
|
|
Tissue culture placenta
|
$1,978.49 |
$1,978.49 |
$1,978.49 |
$520.91
|
|
Tissue culture skin/biopsy
|
$544.84 |
$544.84 |
$544.84 |
$558.87
|
|
Tissue culture tumor
|
$283.02 |
$283.02 |
$283.02 |
$529.23
|
