|
Therapy Exercise Session (each 15 minutes)
|
$15.38 |
$15.38 |
$15.38 |
$98.58
|
|
Ther nma rdctj intus/obstrcj
|
$461.63 |
$461.63 |
$461.63 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$3.18 |
$3.18 |
$3.18 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$132.50 |
$132.50 |
$132.50 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$472.82 |
$472.82 |
$472.82 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$706.99 |
$706.99 |
$706.99 |
$1,703.45
|
|
Throat x-ray & fluoroscopy
|
$178.08 |
$178.08 |
$178.08 |
$259.60
|
|
Thrombin time
|
$27.66 |
$27.66 |
$27.66 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$50.88 |
$50.88 |
$50.88 |
$62.01
|
|
Thyroglobulin antibody
|
$35.14 |
$35.14 |
$35.14 |
$82.50
|
|
Thyroid (TSH) Test
|
$25.38 |
$25.38 |
$25.38 |
$112.70
|
|
Thyroid Ultrasound
|
$277.82 |
$277.82 |
$277.82 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$21.15 |
$21.15 |
$21.15 |
$64.51
|
|
Tilt table study
|
$665.22 |
$665.22 |
$665.22 |
$1,561.82
|
|
Tissue culture placenta
|
$225.05 |
$225.05 |
$225.05 |
$453.00
|
|
Tissue culture skin/biopsy
|
$211.08 |
$211.08 |
$211.08 |
$488.74
|
|
Tissue culture tumor
|
$221.06 |
$221.06 |
$221.06 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$101.69 |
$101.69 |
$101.69 |
$47.40
|
|
Tissue transglutaminase iga
|
$21.59 |
$21.59 |
$21.59 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$14.12 |
$14.12 |
$14.12 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$23.03 |
$23.03 |
$23.03 |
$120.60
|
|
Toe X-ray (both feet)
|
$82.68 |
$82.68 |
$82.68 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$34.89 |
$34.89 |
$34.89 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$53.11 |
$53.11 |
$53.11 |
$74.10
|
|
Total tau
|
$211.97 |
$211.97 |
$211.97 |
$312.50
|
|
Toxoplasma antibody igg
|
$23.06 |
$23.06 |
$23.06 |
$91.65
|
|
Toxoplasma antibody igm
|
$21.96 |
$21.96 |
$21.96 |
$87.75
|
|
Tpmt gene com vrnts
|
$235.20 |
$235.20 |
$235.20 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$58.83 |
$58.83 |
$58.83 |
$102.27
|
|
Transferrin
|
$18.33 |
$18.33 |
$18.33 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$243.32 |
$243.32 |
$243.32 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$205.74 |
$205.74 |
$205.74 |
$499.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$50.43 |
$50.43 |
$50.43 |
$5,846.40
|
|
Trauma partial team response w/critical care services level 4
|
$1,855.62 |
$1,855.62 |
$1,855.62 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$233.44 |
$233.44 |
$233.44 |
$940.80
|
|
Treat spinal cord lesion
|
$388.17 |
$388.17 |
$388.17 |
$1,142.50
|
|
Treat spinal cord lesion
|
$388.17 |
$388.17 |
$388.17 |
$1,337.00
|
|
Treponema pallidum antibody
|
$27.08 |
$27.08 |
$27.08 |
$72.05
|
|
Trg gene rearrangement anal
|
$271.04 |
$271.04 |
$271.04 |
$455.70
|
|
Trichinella antibody
|
$25.25 |
$25.25 |
$25.25 |
$70.65
|
|
#tricyclicantidprssnt
|
$40.89 |
$40.89 |
$40.89 |
$50.54
|
|
Triglycerides
|
$20.21 |
$20.21 |
$20.21 |
$58.50
|
|
Trim nondyst nails
|
$18.84 |
$18.84 |
$18.84 |
$113.88
|
|
Troponin quantitative
|
$22.56 |
$22.56 |
$22.56 |
$127.60
|
|
Ugt1a1 gene analy common variants
|
$314.50 |
$314.50 |
$314.50 |
$438.75
|
|
Ultrasound breast complete
|
$317.24 |
$317.24 |
$317.24 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$259.95 |
$259.95 |
$259.95 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$150.92 |
$150.92 |
$150.92 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$164.47 |
$164.47 |
$164.47 |
$296.80
|
|
Ultrasound encephalogram
|
$244.55 |
$244.55 |
$244.55 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$176.79 |
$176.79 |
$176.79 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$232.85 |
$232.85 |
$232.85 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$195.27 |
$195.27 |
$195.27 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$104.72 |
$104.72 |
$104.72 |
$388.08
|
|
Ultrasound guide intraoperative
|
$76.38 |
$76.38 |
$76.38 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$1,029.34 |
$1,029.34 |
$1,029.34 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$147.84 |
$147.84 |
$147.84 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$107.80 |
$107.80 |
$107.80 |
$311.25
|
|
Ultrasound joint complete left
|
$184.18 |
$184.18 |
$184.18 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$207.59 |
$207.59 |
$207.59 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$141.68 |
$141.68 |
$141.68 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$313.54 |
$313.54 |
$313.54 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$242.70 |
$242.70 |
$242.70 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$205.74 |
$205.74 |
$205.74 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$150.92 |
$150.92 |
$150.92 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$319.70 |
$319.70 |
$319.70 |
$419.50
|
|
Unlisted hematology&coagj px
|
$28.16 |
$28.16 |
$28.16 |
$39.52
|
|
Unlisted transfusion med px
|
$122.74 |
$122.74 |
$122.74 |
$147.50
|
|
Upper Arm (Humerus) X-ray (left side)
|
$125.61 |
$125.61 |
$125.61 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$599.10 |
$599.10 |
$599.10 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$479.18 |
$479.18 |
$479.18 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,218.18 |
$1,218.18 |
$1,218.18 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,015.31 |
$1,015.31 |
$1,015.31 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$811.95 |
$811.95 |
$811.95 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$148.93 |
$148.93 |
$148.93 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$158.47 |
$158.47 |
$158.47 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$468.52 |
$468.52 |
$468.52 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$410.22 |
$410.22 |
$410.22 |
$607.20
|
|
Urea nitrogen
|
$19.74 |
$19.74 |
$19.74 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$24.44 |
$24.44 |
$24.44 |
$52.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$246.45 |
$246.45 |
$246.45 |
$584.00
|
|
Urethrocystography void s&i
|
$246.45 |
$246.45 |
$246.45 |
$631.40
|
|
Uric acid blood
|
$6.58 |
$6.58 |
$6.58 |
$49.44
|
|
Uric acid urine
|
$33.84 |
$33.84 |
$33.84 |
$45.36
|
|
Urinalysis microscopic only
|
$5.28 |
$5.28 |
$5.28 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$3.70 |
$3.70 |
$3.70 |
$25.72
|
|
Urinalysis (with microscopy)
|
$5.28 |
$5.28 |
$5.28 |
$55.20
|
|
Urinalysis (without microscopy)
|
$56.50 |
$56.50 |
$56.50 |
$36.00
|
|
Urine Culture Test
|
$11.82 |
$11.82 |
$11.82 |
$83.00
|
|
Urine pregnancy test
|
$30.62 |
$30.62 |
$30.62 |
$68.78
|
|
Urography, antegrade
|
$246.98 |
$246.98 |
$246.98 |
$622.35
|
|
Urography inf drip &/or bolus
|
$553.32 |
$553.32 |
$553.32 |
$642.50
|
|
Vaccine Administration (one shot)
|
$21.06 |
$21.06 |
$21.06 |
$67.70
|
|
Valproic acid total therapeutic drug level
|
$24.91 |
$24.91 |
$24.91 |
$115.00
|
|
Vancomycin peak therapeutic drug level
|
$19.27 |
$19.27 |
$19.27 |
$136.13
|
|
Varicella zoster antibody igg
|
$19.40 |
$19.40 |
$19.40 |
$86.80
|
|
Venogram ext bil s&i
|
$202.46 |
$202.46 |
$202.46 |
$1,829.42
|
|
Venogram extremity supervision & interpretation unilateral
|
$173.31 |
$173.31 |
$173.31 |
$1,382.58
|
|
Ventilator each subsequent day
|
$358.90 |
$358.90 |
$358.90 |
$1,184.00
|
|
Ventilator Management (first day)
|
$501.38 |
$501.38 |
$501.38 |
$1,434.60
|
