|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1,431.65 |
$1,431.65 |
$1,431.65 |
$404.20
|
|
Toxoplasma antibody igg
|
$2.74 |
$2.74 |
$2.74 |
$84.35
|
|
Toxoplasma antibody igm
|
$2.74 |
$2.74 |
$2.74 |
$83.20
|
|
Tp53 gene trgt sequence alys
|
$221.94 |
$221.94 |
$221.94 |
$919.10
|
|
Trabectedin 1 mg intravenous solution
|
$3,915.46 |
$3,915.46 |
$3,915.46 |
$7,403.70
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$44.67 |
$44.67 |
$44.67 |
$104.50
|
|
Transcath biopsy
|
$5,024.62 |
$5,024.62 |
$5,024.62 |
$4,298.05
|
|
Transcath closure of asd
|
$13,128.44 |
$13,128.44 |
$13,128.44 |
$18,772.00
|
|
Transcatheter bx s&i
|
$963.94 |
$963.94 |
$963.94 |
$1,875.96
|
|
Transcath occlusion cns
|
$3,591.87 |
$3,591.87 |
$3,591.87 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$1,400.69 |
$1,400.69 |
$1,400.69 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,318.32 |
$2,318.32 |
$2,318.32 |
$4,627.00
|
|
Transferrin
|
$94.53 |
$94.53 |
$94.53 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$849.40 |
$849.40 |
$849.40 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$1,875.81 |
$1,875.81 |
$1,875.81 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$1,736.89 |
$1,736.89 |
$1,736.89 |
$7,191.23
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$107.14 |
$107.14 |
$107.14 |
$4,500.03
|
|
Trauma partial team response w/critical care services level 4
|
$6,193.77 |
$6,193.77 |
$6,193.77 |
$5,455.00
|
|
Tray bonemarrw oncontrol 102mm
|
$768.57 |
$768.57 |
$768.57 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$307.98 |
$307.98 |
$307.98 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$218.66 |
$218.66 |
$218.66 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$388.54 |
$388.54 |
$388.54 |
$210.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$51,292.80 |
$51,292.80 |
$51,292.80 |
$101,032.80
|
|
Treponema pallidum antibody
|
$25.49 |
$25.49 |
$25.49 |
$72.80
|
|
Trg gene rearrangement anal
|
$71.24 |
$71.24 |
$71.24 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$59.74 |
$59.74 |
$59.74 |
$55.80
|
|
Triglycerides
|
$41.65 |
$41.65 |
$41.65 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$17.81 |
$17.81 |
$17.81 |
$128.00
|
|
Triptorelin pamoate
|
$7,210.86 |
$7,210.86 |
$7,210.86 |
$4,619.39
|
|
Trnscath plc stent crv crtd without prtct
|
$1,322.05 |
$1,322.05 |
$1,322.05 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$12,018.74 |
$12,018.74 |
$12,018.74 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$1,779.09 |
$1,779.09 |
$1,779.09 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,331.47 |
$2,331.47 |
$2,331.47 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$9,392.72 |
$9,392.72 |
$9,392.72 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,807.61 |
$4,807.61 |
$4,807.61 |
$4,969.90
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,631.67 |
$1,631.67 |
$1,631.67 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$987.77 |
$987.77 |
$987.77 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$930.51 |
$930.51 |
$930.51 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$1,431.38 |
$1,431.38 |
$1,431.38 |
$4,329.36
|
|
Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/<
|
$1,963.76 |
$1,963.76 |
$1,963.76 |
$2,986.34
|
|
Troponin quantitative
|
$170.98 |
$170.98 |
$170.98 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$18,098.53 |
$18,098.53 |
$18,098.53 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$3,257.86 |
$3,257.86 |
$3,257.86 |
$7,717.80
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$12,932.80 |
$12,932.80 |
$12,932.80 |
$17,191.88
|
|
Ultrasound abdomen aorta screening study aaa
|
$487.72 |
$487.72 |
$487.72 |
$403.26
|
|
Ultrasound chest
|
$513.48 |
$513.48 |
$513.48 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$539.24 |
$539.24 |
$539.24 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$168.79 |
$168.79 |
$168.79 |
$330.40
|
|
Ultrasound encephalogram
|
$590.47 |
$590.47 |
$590.47 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$527.18 |
$527.18 |
$527.18 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$590.47 |
$590.47 |
$590.47 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$382.23 |
$382.23 |
$382.23 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$512.11 |
$512.11 |
$512.11 |
$701.35
|
|
Ultrasound guide intraoperative
|
$289.90 |
$289.90 |
$289.90 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$405.80 |
$405.80 |
$405.80 |
$403.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$323.32 |
$323.32 |
$323.32 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$220.85 |
$220.85 |
$220.85 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$765.29 |
$765.29 |
$765.29 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$513.48 |
$513.48 |
$513.48 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$513.48 |
$513.48 |
$513.48 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$513.48 |
$513.48 |
$513.48 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$513.48 |
$513.48 |
$513.48 |
$498.00
|
|
Ultrasound scrotum and contents
|
$513.48 |
$513.48 |
$513.48 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$590.47 |
$590.47 |
$590.47 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$244.96 |
$244.96 |
$244.96 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$513.48 |
$513.48 |
$513.48 |
$567.44
|
|
Unit mobile power mpu
|
$13,812.34 |
$13,812.34 |
$13,812.34 |
$16,315.20
|
|
Unlisted CT procedure
|
$920.92 |
$920.92 |
$920.92 |
$1,043.00
|
|
Unlisted cytogenetic study
|
$126.04 |
$126.04 |
$126.04 |
$132.48
|
|
Unlisted procedure microbiology
|
$731.91 |
$731.91 |
$731.91 |
$487.50
|
|
Unlisted procedure spine
|
$7,704.34 |
$7,704.34 |
$7,704.34 |
$4,706.35
|
|
Unlisted psychiatric service/proc 90899
|
$91.79 |
$91.79 |
$91.79 |
$96.48
|
|
Unlisted transfusion med px
|
$89.05 |
$89.05 |
$89.05 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$774.60 |
$774.60 |
$774.60 |
$1,480.70
|
|
Upgrade pm system
|
$3,514.33 |
$3,514.33 |
$3,514.33 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,295.58 |
$2,295.58 |
$2,295.58 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,364.35 |
$2,364.35 |
$2,364.35 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,492.21 |
$1,492.21 |
$1,492.21 |
$2,013.08
|
|
Urea nitrogen
|
$27.40 |
$27.40 |
$27.40 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$58.37 |
$58.37 |
$58.37 |
$50.00
|
|
Ureteral embolization/occl
|
$597.60 |
$597.60 |
$597.60 |
$3,041.22
|
|
Urethrcystgrphy rtrgrde s&i
|
$667.47 |
$667.47 |
$667.47 |
$574.40
|
|
Urethrocystography void s&i
|
$667.47 |
$667.47 |
$667.47 |
$634.50
|
|
Uric acid blood
|
$49.32 |
$49.32 |
$49.32 |
$46.64
|
|
Uric acid urine
|
$49.32 |
$49.32 |
$49.32 |
$46.75
|
|
Urinalysis microscopic only
|
$13.98 |
$13.98 |
$13.98 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$4.11 |
$4.11 |
$4.11 |
$25.72
|
|
Urinalysis (with microscopy)
|
$34.80 |
$34.80 |
$34.80 |
$48.14
|
|
Urinalysis (without microscopy)
|
$29.60 |
$29.60 |
$29.60 |
$38.99
|
|
Urine Culture Test
|
$55.35 |
$55.35 |
$55.35 |
$84.81
|
|
Urine pregnancy test
|
$68.78 |
$68.78 |
$68.78 |
$66.40
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$2,104.32 |
$2,104.32 |
$2,104.32 |
$5,521.54
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$180.02 |
$180.02 |
$180.02 |
$239.85
|
|
Vaccine dtap < 7 years im
|
$41.38 |
$41.38 |
$41.38 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$235.37 |
$235.37 |
$235.37 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$16.72 |
$16.72 |
$16.72 |
$45.33
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$45.49 |
$45.49 |
$45.49 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$81.66 |
$81.66 |
$81.66 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$60.83 |
$60.83 |
$60.83 |
$79.04
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$27.13 |
$27.13 |
$27.13 |
$48.29
|
