|
Tc-99m pentetate dtpa aerosol
|
$160.59 |
$160.59 |
$180.20 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$117.13 |
$117.13 |
$117.13 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$134.62 |
$134.62 |
$157.41 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$260.23 |
$381.07 |
$381.07 |
$221.60
|
|
Tc-99m sulfur colloid
|
$548.02 |
$548.02 |
$639.18 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$438.31 |
$438.31 |
$438.31 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$519.93 |
$519.93 |
$519.93 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$152.64 |
$152.64 |
$347.15 |
$186.00
|
|
T cells absolute cd 4 count
|
$86.92 |
$86.92 |
$162.71 |
$120.25
|
|
T cells total count
|
$121.90 |
$121.90 |
$233.73 |
$124.11
|
|
Tcranial magn stim tx deli
|
$882.45 |
$882.45 |
$882.45 |
$368.50
|
|
Tcranial magn stim tx plan
|
$912.13 |
$912.13 |
$912.13 |
$386.88
|
|
Tcran magn stim redetemine
|
$897.29 |
$897.29 |
$897.29 |
$417.06
|
|
Telavancin injection
|
$8.83 |
$8.83 |
$9.17 |
$1,216.45
|
|
Telehealth original site facility fee
|
$55.65 |
$55.65 |
$55.65 |
$60.80
|
|
Telethx isodose plan cplx
|
$893.05 |
$893.05 |
$4,756.22 |
$1,617.00
|
|
Telethx isodose plan simple
|
$717.62 |
$717.62 |
$1,449.02 |
$848.72
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$116.59 |
$116.59 |
$116.59 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$222.72 |
$222.72 |
$286.63 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$24.81 |
$24.81 |
$24.81 |
$46.10
|
|
Test for urine cystines
|
$15.37 |
$15.37 |
$15.37 |
$26.00
|
|
Test stress cardiovascular tracing only
|
$1,038.80 |
$1,038.80 |
$1,591.59 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$761.71 |
$761.71 |
$969.52 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$57.77 |
$57.77 |
$91.69 |
$108.00
|
|
Therapeutic procd strg endur
|
$86.39 |
$136.21 |
$136.21 |
$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
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.27 |
$9.27 |
$11.26 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,163.88 |
$1,163.88 |
$1,479.76 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$870.79 |
$870.79 |
$4,623.72 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,136.14 |
$9,838.92 |
$9,838.92 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$17,645.82 |
$19,882.42 |
$19,882.42 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$26,335.17 |
$30,137.39 |
$30,137.39 |
$24,605.30
|
|
Thrombin time
|
$24.91 |
$24.91 |
$47.17 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$49.82 |
$49.82 |
$64.13 |
$56.93
|
|
Thyroglobulin antibody
|
$51.41 |
$51.41 |
$147.34 |
$84.00
|
|
Thyroid imaging
|
$860.72 |
$860.72 |
$860.72 |
$670.80
|
|
Thyroid mets imag whole body
|
$1,898.46 |
$1,898.46 |
$2,540.82 |
$1,524.99
|
|
Thyroid met uptake
|
$949.23 |
$949.23 |
$949.23 |
$380.00
|
|
Thyroid (TSH) Test
|
$63.60 |
$63.60 |
$109.71 |
$120.00
|
|
Thyroid Ultrasound
|
$510.39 |
$510.39 |
$538.48 |
$589.96
|
|
Thyroid uptake measurement
|
$533.71 |
$533.71 |
$567.10 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,057.40 |
$3,057.40 |
$4,062.19 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$51.41 |
$51.41 |
$93.28 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$28,273.91 |
$28,273.91 |
$28,273.91 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$8,112.71 |
$8,112.71 |
$28,181.16 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$7,215.42 |
$7,215.42 |
$14,430.31 |
$10,406.14
|
|
Tigecycline injection
|
$3.94 |
$3.94 |
$4.30 |
$277.31
|
|
Tilt table study
|
$2,203.21 |
$2,203.21 |
$3,492.17 |
$1,495.00
|
|
Tissue culture placenta
|
$271.36 |
$271.36 |
$1,978.49 |
$520.91
|
|
Tissue culture skin/biopsy
|
$259.70 |
$259.70 |
$544.84 |
$558.87
|
|
Tissue culture tumor
|
$283.02 |
$283.02 |
$283.02 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$6.89 |
$24.38 |
$24.38 |
$47.40
|
|
Tissue transglutaminase iga
|
$10.07 |
$10.07 |
$10.07 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$9.17 |
$9.60 |
$38.39 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$70.49 |
$70.49 |
$128.26 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$10.64 |
$10.64 |
$873.97 |
$4,711.84
|
|
Tomosynthesis breast screen bilateral
|
$21.73 |
$21.73 |
$21.73 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1.52 |
$3.83 |
$16.07 |
$404.20
|
|
Toxoplasma antibody igg
|
$50.35 |
$50.35 |
$89.57 |
$84.35
|
|
Toxoplasma antibody igm
|
$52.47 |
$52.47 |
$93.81 |
$83.20
|
|
Tpmt gene com vrnts
|
$1,368.99 |
$1,368.99 |
$1,428.88 |
$381.55
|
|
Tprnl plmt biodegrdabl matrl
|
$8,208.11 |
$8,208.11 |
$8,208.11 |
$6,105.61
|
|
Trabectedin 1 mg intravenous solution
|
$527.70 |
$527.70 |
$657.58 |
$7,403.70
|
|
Transcath biopsy
|
$3,460.90 |
$3,460.90 |
$4,877.59 |
$4,298.05
|
|
Transcath closure of asd
|
$14,313.71 |
$14,313.71 |
$19,715.47 |
$18,772.00
|
|
Transcath closure of vsd
|
$16,398.73 |
$16,398.73 |
$16,398.73 |
$18,837.00
|
|
Transcatheter bx s&i
|
$595.72 |
$595.72 |
$1,268.82 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$3,105.80 |
$3,105.80 |
$15,183.44 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$6,211.60 |
$6,211.60 |
$30,366.88 |
$17,106.18
|
|
Transcath occlusion cns
|
$10,592.58 |
$10,592.58 |
$11,881.54 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$30,492.49 |
$36,369.66 |
$36,369.66 |
$12,427.79
|
|
Trans cath replace aortic valve 33366
|
$97,915.38 |
$97,915.38 |
$97,915.38 |
$17,848.35
|
|
Transcath rmvl perm ldss pmkr rv
|
$6,500.45 |
$6,500.45 |
$7,923.50 |
$4,627.00
|
|
Transcutaneous hgb 88738
|
$10.60 |
$10.60 |
$10.60 |
$11.40
|
|
Transferrin
|
$42.93 |
$42.93 |
$101.23 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$305.81 |
$305.81 |
$887.22 |
$988.24
|
|
Transperi needle place pros
|
$5,796.08 |
$5,796.08 |
$5,796.08 |
$6,203.00
|
|
Trastuzumab 150 mg intravenous solution
|
$163.86 |
$173.39 |
$173.39 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$147.64 |
$147.64 |
$765.98 |
$7,191.23
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$118.72 |
$118.72 |
$202.46 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$59.36 |
$59.36 |
$101.23 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$116.60 |
$116.60 |
$135.68 |
$210.00
|
|
Treatment missed abortion completed surgically 1st trimester
|
$905.24 |
$905.24 |
$928.56 |
$3,820.53
|
|
Treatment of miscarriage
|
$905.24 |
$905.24 |
$928.56 |
$4,146.69
|
|
Treatment radiation delivery level 2
|
$1,595.30 |
$1,595.30 |
$1,595.30 |
$735.00
|
|
Treponema pallidum antibody
|
$44.52 |
$44.52 |
$54.06 |
$72.80
|
|
Trg gene rearrangement anal
|
$279.31 |
$279.31 |
$899.41 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$5.23 |
$5.27 |
$5.42 |
$55.80
|
|
Trichinella antibody
|
$43.46 |
$62.54 |
$62.54 |
$70.65
|
|
Trichomonas assay w/optic
|
$25.44 |
$45.58 |
$45.58 |
$66.00
|
|
Triglycerides
|
$21.73 |
$21.73 |
$46.64 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$91.49 |
$91.49 |
$104.50 |
$128.00
|
|
Trim nail(s)
|
$130.38 |
$134.09 |
$134.09 |
$70.29
|
|
Trim nondyst nails
|
$134.09 |
$134.09 |
$167.48 |
$124.22
|
|
Triptorelin pamoate
|
$1,461.67 |
$1,461.67 |
$1,520.67 |
$4,619.39
|
|
Trnscath plc stent crv crtd without prtct
|
$7,103.06 |
$7,103.06 |
$7,103.06 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$10,333.41 |
$10,333.41 |
$14,984.69 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$3,507.54 |
$3,507.54 |
$6,047.83 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,915.75 |
$4,915.75 |
$6,231.21 |
$8,244.55
|
