|
Tp53 gene full gene sequence
|
$349.20 |
$349.20 |
$349.20 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$118.80 |
$118.80 |
$118.80 |
$823.00
|
|
Tpmt gene com vrnts
|
$113.76 |
$113.76 |
$113.76 |
$373.00
|
|
Trabeculoplasty laser surg
|
$205.20 |
$205.20 |
$205.20 |
$1,224.00
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$13.81 |
$13.81 |
$13.81 |
$56.38
|
|
Transferrin
|
$58.32 |
$58.32 |
$58.32 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$527.04 |
$527.04 |
$527.04 |
$936.80
|
|
Trauma partial team response w/critical care services level 4
|
$5,399.28 |
$5,399.28 |
$5,399.28 |
$4,063.80
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$223.92 |
$223.92 |
$223.92 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$138.60 |
$138.60 |
$138.60 |
$143.75
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$432.36 |
$432.36 |
$432.36 |
$203.49
|
|
Treponema pallidum antibody
|
$119.88 |
$119.88 |
$119.88 |
$70.40
|
|
Trg gene rearrangement anal
|
$93.60 |
$93.60 |
$93.60 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$26.68 |
$26.68 |
$26.68 |
$43.09
|
|
Triamcinolone diacetate inj
|
$40.32 |
$40.32 |
$40.32 |
$3.60
|
|
Trichinella antibody
|
$34.16 |
$34.16 |
$34.16 |
$70.65
|
|
#tricyclicantidprssnt
|
$50.86 |
$50.86 |
$50.86 |
$50.40
|
|
Triglycerides
|
$53.64 |
$53.64 |
$53.64 |
$57.85
|
|
Troponin quantitative
|
$114.48 |
$114.48 |
$114.48 |
$127.20
|
|
Tympanometry & reflex thresh
|
$140.76 |
$140.76 |
$140.76 |
$170.99
|
|
Ua w/micro/comp poc
|
$16.20 |
$16.20 |
$16.20 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$83.57 |
$83.57 |
$83.57 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$369.00 |
$369.00 |
$369.00 |
$394.20
|
|
Ultrasound breast complete
|
$441.72 |
$441.72 |
$441.72 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$335.88 |
$335.88 |
$335.88 |
$452.00
|
|
Ultrasound chest
|
$424.08 |
$424.08 |
$424.08 |
$460.85
|
|
Ultrasound encephalogram
|
$142.92 |
$142.92 |
$142.92 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$48.60 |
$48.60 |
$48.60 |
$585.15
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$612.72 |
$612.72 |
$612.72 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$23.40 |
$23.40 |
$23.40 |
$388.08
|
|
Ultrasound guided needle placement supervision & interpretation
|
$744.12 |
$744.12 |
$744.12 |
$720.15
|
|
Ultrasound guide intraoperative
|
$245.88 |
$245.88 |
$245.88 |
$625.15
|
|
Ultrasound guide tissue ablation
|
$133.20 |
$133.20 |
$133.20 |
$560.00
|
|
Ultrasound infant hips ltd without stress
|
$338.76 |
$338.76 |
$338.76 |
$311.25
|
|
Ultrasound joint complete left
|
$399.24 |
$399.24 |
$399.24 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$331.56 |
$331.56 |
$331.56 |
$424.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$86.40 |
$86.40 |
$86.40 |
$393.86
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$69.84 |
$69.84 |
$69.84 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$358.92 |
$358.92 |
$358.92 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$262.08 |
$262.08 |
$262.08 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$333.00 |
$333.00 |
$333.00 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$211.68 |
$211.68 |
$211.68 |
$490.00
|
|
Ultrasound prostate/transrectal
|
$404.64 |
$404.64 |
$404.64 |
$549.95
|
|
Ultrasound retroperitoneal limited
|
$479.88 |
$479.88 |
$479.88 |
$479.60
|
|
Ultrasound scrotum and contents
|
$522.00 |
$522.00 |
$522.00 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$122.04 |
$122.04 |
$122.04 |
$459.00
|
|
Ultrasound transvaginal non obstetric
|
$433.08 |
$433.08 |
$433.08 |
$558.35
|
|
Unlisted misc path test
|
$3.37 |
$3.37 |
$3.37 |
$89.40
|
|
Unlisted procedure microbiology
|
$159.48 |
$159.48 |
$159.48 |
$490.70
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,233.08 |
$2,233.08 |
$2,233.08 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,545.48 |
$1,545.48 |
$1,545.48 |
$2,034.41
|
|
Urea nitrogen
|
$40.32 |
$40.32 |
$40.32 |
$40.95
|
|
Urea nitrogen 24 hour urine
|
$168.12 |
$168.12 |
$168.12 |
$52.00
|
|
Urea nitrogen clearance
|
$2.12 |
$2.12 |
$2.12 |
$45.12
|
|
Urethrcystgrphy rtrgrde s&i
|
$418.32 |
$418.32 |
$418.32 |
$584.00
|
|
Urethrocystography void s&i
|
$816.12 |
$816.12 |
$816.12 |
$648.05
|
|
Uric acid blood
|
$48.96 |
$48.96 |
$48.96 |
$49.44
|
|
Uric acid urine
|
$34.56 |
$34.56 |
$34.56 |
$44.22
|
|
Urinalysis microscopic only
|
$30.60 |
$30.60 |
$30.60 |
$26.46
|
|
Urinalysis (with microscopy)
|
$30.60 |
$30.60 |
$30.60 |
$55.44
|
|
Urinalysis (without microscopy)
|
$28.80 |
$28.80 |
$28.80 |
$36.00
|
|
Urine Culture Test
|
$103.32 |
$103.32 |
$103.32 |
$81.27
|
|
Urine pregnancy test
|
$62.64 |
$62.64 |
$62.64 |
$67.80
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$153.00 |
$153.00 |
$153.00 |
$224.25
|
|
Vaccine dtap < 7 years im
|
$37.08 |
$37.08 |
$37.08 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$106.20 |
$106.20 |
$106.20 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$81.72 |
$81.72 |
$81.72 |
$105.95
|
|
Vaccine dtap-ipv/hib im
|
$107.64 |
$107.64 |
$107.64 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$24.84 |
$24.84 |
$24.84 |
$71.62
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$38.52 |
$38.52 |
$38.52 |
$42.90
|
|
Vaccine hepatitis a (hepa) adult im
|
$70.56 |
$70.56 |
$70.56 |
$168.95
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$285.84 |
$285.84 |
$285.84 |
$218.40
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$48.60 |
$48.60 |
$48.60 |
$80.75
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$43.92 |
$43.92 |
$43.92 |
$84.75
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$82.44 |
$82.44 |
$82.44 |
$154.78
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$48.60 |
$48.60 |
$48.60 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$47.39 |
$47.39 |
$47.39 |
$74.42
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$183.60 |
$183.60 |
$183.60 |
$576.48
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$155.16 |
$155.16 |
$155.16 |
$279.66
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$37.80 |
$37.80 |
$37.80 |
$143.20
|
|
Vaccine influenza inactivated adjuvant im
|
$162.36 |
$162.36 |
$162.36 |
$106.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$31.98 |
$31.98 |
$31.98 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$19.80 |
$19.80 |
$19.80 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$53.28 |
$53.28 |
$53.28 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$22.32 |
$22.32 |
$22.32 |
$30.00
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$24.12 |
$24.12 |
$24.12 |
$33.60
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$19.80 |
$19.80 |
$19.80 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$22.32 |
$22.32 |
$22.32 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$65.88 |
$65.88 |
$65.88 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$33.12 |
$33.12 |
$33.12 |
$76.50
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$142.56 |
$142.56 |
$142.56 |
$395.24
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$117.00 |
$117.00 |
$117.00 |
$407.20
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$137.52 |
$137.52 |
$137.52 |
$337.91
|
|
Vaccine mmr live subcutaneous
|
$120.96 |
$120.96 |
$120.96 |
$213.00
|
|
Vaccine mmrv live subcutaneous
|
$35.64 |
$35.64 |
$35.64 |
$424.32
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$91.08 |
$91.08 |
$91.08 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$156.24 |
$156.24 |
$156.24 |
$397.11
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$268.20 |
$268.20 |
$268.20 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$41.40 |
$41.40 |
$41.40 |
$90.70
|
