|
Teaec w/wo patch graft iliofemoral
|
$1,617.33 |
$1,617.33 |
$1,617.33 |
$7,365.12
|
|
Team conf without pat by hc pro
|
$25.89 |
$25.89 |
$25.89 |
$112.86
|
|
Team conf w/pat by hc prof
|
$34.40 |
$34.40 |
$34.40 |
$107.10
|
|
Test stress cardiovascular tracing only
|
$281.66 |
$281.66 |
$281.66 |
$953.40
|
|
Theophylline therapeutic drug level
|
$6.62 |
$6.62 |
$6.62 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$24.31 |
$24.31 |
$24.31 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$21.59 |
$21.59 |
$21.59 |
$98.58
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$86.21 |
$86.21 |
$86.21 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$776.68 |
$776.68 |
$776.68 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$883.83 |
$883.83 |
$883.83 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$1,956.09 |
$1,956.09 |
$1,956.09 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,351.54 |
$5,351.54 |
$5,351.54 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$8,027.00 |
$8,027.00 |
$8,027.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$12,923.65 |
$12,923.65 |
$12,923.65 |
$21,413.60
|
|
Thromb/endar/neck inc/car/vert/subc35301
|
$4,157.85 |
$4,157.85 |
$4,157.85 |
$6,422.91
|
|
Thrombin time
|
$10.70 |
$10.70 |
$10.70 |
$54.18
|
|
Thromboendarterectomy common femoral
|
$1,617.33 |
$1,617.33 |
$1,617.33 |
$3,987.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$19.67 |
$19.67 |
$19.67 |
$62.01
|
|
Thyroglobulin antibody
|
$12.58 |
$12.58 |
$12.58 |
$82.50
|
|
Thyroid imaging
|
$224.93 |
$224.93 |
$224.93 |
$695.60
|
|
Thyroid mets imag whole body
|
$548.23 |
$548.23 |
$548.23 |
$1,524.99
|
|
Thyroid met uptake
|
$114.06 |
$114.06 |
$114.06 |
$407.40
|
|
Thyroid (TSH) Test
|
$50.51 |
$50.51 |
$50.51 |
$112.70
|
|
Thyroid Ultrasound
|
$203.89 |
$203.89 |
$203.89 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$6.93 |
$6.93 |
$6.93 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$11,516.54 |
$11,516.54 |
$11,516.54 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$7,609.74 |
$7,609.74 |
$7,609.74 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$6,169.78 |
$6,169.78 |
$6,169.78 |
$10,131.15
|
|
Tissue culture placenta
|
$149.35 |
$149.35 |
$149.35 |
$453.00
|
|
Tissue culture skin/biopsy
|
$139.87 |
$139.87 |
$139.87 |
$488.74
|
|
Tissue culture tumor
|
$146.47 |
$146.47 |
$146.47 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$43.22 |
$43.22 |
$43.22 |
$47.40
|
|
Tissue transglutaminase iga
|
$7.73 |
$7.73 |
$7.73 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$7.55 |
$7.55 |
$7.55 |
$120.60
|
|
Toe X-ray (both feet)
|
$58.48 |
$58.48 |
$58.48 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$16.85 |
$16.85 |
$16.85 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$16.64 |
$16.64 |
$16.64 |
$74.10
|
|
Total tau
|
$69.45 |
$69.45 |
$69.45 |
$312.50
|
|
Toxoplasma antibody igg
|
$8.25 |
$8.25 |
$8.25 |
$91.65
|
|
Toxoplasma antibody igm
|
$7.86 |
$7.86 |
$7.86 |
$87.75
|
|
Tp53 gene full gene sequence
|
$342.83 |
$342.83 |
$342.83 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$282.66 |
$282.66 |
$282.66 |
$804.00
|
|
Tpmt gene com vrnts
|
$150.05 |
$150.05 |
$150.05 |
$371.80
|
|
Transcath biopsy
|
$928.61 |
$928.61 |
$928.61 |
$4,285.93
|
|
Transcatheter bx s&i
|
$438.97 |
$438.97 |
$438.97 |
$1,950.85
|
|
Transferrin
|
$22.95 |
$22.95 |
$22.95 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$235.29 |
$235.29 |
$235.29 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$198.03 |
$198.03 |
$198.03 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$845.30 |
$845.30 |
$845.30 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$92.07 |
$92.07 |
$92.07 |
$940.80
|
|
Treponema pallidum antibody
|
$9.69 |
$9.69 |
$9.69 |
$72.05
|
|
Trg gene rearrangement anal
|
$172.84 |
$172.84 |
$172.84 |
$455.70
|
|
Trichinella antibody
|
$9.04 |
$9.04 |
$9.04 |
$70.65
|
|
#tricyclicantidprssnt
|
$14.17 |
$14.17 |
$14.17 |
$50.54
|
|
Triglycerides
|
$24.33 |
$24.33 |
$24.33 |
$58.50
|
|
Trnscath plc stent crv crtd w/prtct
|
$3,457.96 |
$3,457.96 |
$3,457.96 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$2,813.26 |
$2,813.26 |
$2,813.26 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,344.33 |
$2,344.33 |
$2,344.33 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$3,516.66 |
$3,516.66 |
$3,516.66 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,760.24 |
$1,760.24 |
$1,760.24 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,183.55 |
$2,183.55 |
$2,183.55 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$858.75 |
$858.75 |
$858.75 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$741.36 |
$741.36 |
$741.36 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$1,256.22 |
$1,256.22 |
$1,256.22 |
$3,866.70
|
|
Troponin quantitative
|
$50.97 |
$50.97 |
$50.97 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$512.89 |
$512.89 |
$512.89 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$529.40 |
$529.40 |
$529.40 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$281.10 |
$281.10 |
$281.10 |
$1,178.00
|
|
Ugt1a1 gene analy common variants
|
$200.78 |
$200.78 |
$200.78 |
$438.75
|
|
Ultrasound breast complete
|
$217.35 |
$217.35 |
$217.35 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$167.32 |
$167.32 |
$167.32 |
$452.40
|
|
Ultrasound encephalogram
|
$255.99 |
$255.99 |
$255.99 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$192.51 |
$192.51 |
$192.51 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$219.42 |
$219.42 |
$219.42 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$269.10 |
$269.10 |
$269.10 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$211.14 |
$211.14 |
$211.14 |
$388.08
|
|
Ultrasound guide intraoperative
|
$234.26 |
$234.26 |
$234.26 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$167.67 |
$167.67 |
$167.67 |
$560.00
|
|
Ultrasound infant hips ltd without stress
|
$141.79 |
$141.79 |
$141.79 |
$311.25
|
|
Ultrasound joint complete left
|
$161.46 |
$161.46 |
$161.46 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$182.50 |
$182.50 |
$182.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$120.06 |
$120.06 |
$120.06 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$301.18 |
$301.18 |
$301.18 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$175.26 |
$175.26 |
$175.26 |
$425.60
|
|
Ultrasound spinal canal and contents
|
$270.48 |
$270.48 |
$270.48 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$252.88 |
$252.88 |
$252.88 |
$419.50
|
|
Unlisted hematology&coagj px
|
$10.89 |
$10.89 |
$10.89 |
$39.52
|
|
Unlisted transfusion med px
|
$52.26 |
$52.26 |
$52.26 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$435.60 |
$435.60 |
$435.60 |
$1,292.33
|
|
Upgrade pm system
|
$4,076.50 |
$4,076.50 |
$4,076.50 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$82.02 |
$82.02 |
$82.02 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$575.57 |
$575.57 |
$575.57 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$460.42 |
$460.42 |
$460.42 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$450.75 |
$450.75 |
$450.75 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$375.62 |
$375.62 |
$375.62 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$300.50 |
$300.50 |
$300.50 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$75.96 |
$75.96 |
$75.96 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$87.61 |
$87.61 |
$87.61 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$143.30 |
$143.30 |
$143.30 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$141.20 |
$141.20 |
$141.20 |
$607.20
|
