|
Tissue culture placenta
|
$51.78 |
$51.78 |
$51.78 |
$520.91
|
|
Tissue culture skin/biopsy
|
$107.91 |
$107.91 |
$107.91 |
$558.87
|
|
Tissue culture tumor
|
$51.78 |
$51.78 |
$51.78 |
$529.23
|
|
Tissue transglutaminase iga
|
$6.54 |
$6.54 |
$6.54 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$417.47 |
$417.47 |
$417.47 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$228.36 |
$228.36 |
$228.36 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$4,779.11 |
$4,779.11 |
$4,779.11 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$34.34 |
$34.34 |
$34.34 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$49.05 |
$49.05 |
$49.05 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$2,705.38 |
$2,705.38 |
$2,705.38 |
$404.20
|
|
Toxoplasma antibody igg
|
$5.45 |
$5.45 |
$5.45 |
$84.35
|
|
Toxoplasma antibody igm
|
$5.45 |
$5.45 |
$5.45 |
$83.20
|
|
Tp53 gene trgt sequence alys
|
$441.45 |
$441.45 |
$441.45 |
$919.10
|
|
Trabectedin 1 mg intravenous solution
|
$7,398.92 |
$7,398.92 |
$7,398.92 |
$7,403.70
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$38.15 |
$38.15 |
$38.15 |
$104.50
|
|
Transferrin
|
$63.77 |
$63.77 |
$63.77 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$3,120.67 |
$3,120.67 |
$3,120.67 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$3,544.68 |
$3,544.68 |
$3,544.68 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$3,281.99 |
$3,281.99 |
$3,281.99 |
$7,191.23
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$3,010.04 |
$3,010.04 |
$3,010.04 |
$4,500.03
|
|
Tray bonemarrw oncontrol 102mm
|
$1,619.74 |
$1,619.74 |
$1,619.74 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$395.67 |
$395.67 |
$395.67 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$145.52 |
$145.52 |
$145.52 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$407.66 |
$407.66 |
$407.66 |
$210.00
|
|
Treatment radiation delivery level 2
|
$1,087.28 |
$1,087.28 |
$1,087.28 |
$735.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$96,922.80 |
$96,922.80 |
$96,922.80 |
$101,032.80
|
|
Treponema pallidum antibody
|
$7.09 |
$7.09 |
$7.09 |
$72.80
|
|
Trg gene rearrangement anal
|
$141.70 |
$141.70 |
$141.70 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$35.43 |
$35.43 |
$35.43 |
$55.80
|
|
Triglycerides
|
$130.26 |
$130.26 |
$130.26 |
$54.60
|
|
Triptorelin pamoate
|
$12,549.72 |
$12,549.72 |
$12,549.72 |
$4,619.39
|
|
Troponin quantitative
|
$263.24 |
$263.24 |
$263.24 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$4,527.86 |
$4,527.86 |
$4,527.86 |
$1,876.20
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,087.28 |
$1,087.28 |
$1,087.28 |
$403.26
|
|
Ultrasound chest
|
$888.90 |
$888.90 |
$888.90 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$997.35 |
$997.35 |
$997.35 |
$340.14
|
|
Ultrasound encephalogram
|
$997.35 |
$997.35 |
$997.35 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$997.35 |
$997.35 |
$997.35 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$854.56 |
$854.56 |
$854.56 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$574.43 |
$574.43 |
$574.43 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$866.55 |
$866.55 |
$866.55 |
$701.35
|
|
Ultrasound hips infant dynamic
|
$755.92 |
$755.92 |
$755.92 |
$403.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$650.19 |
$650.19 |
$650.19 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$449.08 |
$449.08 |
$449.08 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,486.22 |
$1,486.22 |
$1,486.22 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,051.85 |
$1,051.85 |
$1,051.85 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,051.85 |
$1,051.85 |
$1,051.85 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,051.85 |
$1,051.85 |
$1,051.85 |
$485.48
|
|
Ultrasound scrotum and contents
|
$1,086.73 |
$1,086.73 |
$1,086.73 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$949.94 |
$949.94 |
$949.94 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$416.38 |
$416.38 |
$416.38 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,084.01 |
$1,084.01 |
$1,084.01 |
$567.44
|
|
Unlisted cytogenetic study
|
$250.70 |
$250.70 |
$250.70 |
$132.48
|
|
Unlisted procedure microbiology
|
$1,455.81 |
$1,455.81 |
$1,455.81 |
$487.50
|
|
Unlisted px abdomen muscskel
|
$4,496.25 |
$4,496.25 |
$4,496.25 |
$2,633.80
|
|
Unlisted transfusion med px
|
$177.13 |
$177.13 |
$177.13 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$1,155.95 |
$1,155.95 |
$1,155.95 |
$1,480.70
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,824.27 |
$3,824.27 |
$3,824.27 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,824.27 |
$3,824.27 |
$3,824.27 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,485.75 |
$2,485.75 |
$2,485.75 |
$2,013.08
|
|
Urea nitrogen
|
$64.31 |
$64.31 |
$64.31 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$116.63 |
$116.63 |
$116.63 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,110.71 |
$1,110.71 |
$1,110.71 |
$574.40
|
|
Urethrocystography void s&i
|
$1,110.71 |
$1,110.71 |
$1,110.71 |
$634.50
|
|
Uric acid blood
|
$71.40 |
$71.40 |
$71.40 |
$46.64
|
|
Uric acid urine
|
$98.10 |
$98.10 |
$98.10 |
$46.75
|
|
Urinalysis microscopic only
|
$120.45 |
$120.45 |
$120.45 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$52.32 |
$52.32 |
$52.32 |
$25.72
|
|
Urinalysis (with microscopy)
|
$70.85 |
$70.85 |
$70.85 |
$48.14
|
|
Urinalysis (without microscopy)
|
$70.85 |
$70.85 |
$70.85 |
$38.99
|
|
Urine Culture Test
|
$160.23 |
$160.23 |
$160.23 |
$84.81
|
|
Urine pregnancy test
|
$160.78 |
$160.78 |
$160.78 |
$66.40
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,662.40 |
$3,662.40 |
$3,662.40 |
$5,521.54
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$50,368.90 |
$50,368.90 |
$50,368.90 |
$56,553.85
|
|
Vaccine dtap < 7 years im
|
$61.04 |
$61.04 |
$61.04 |
$87.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$59.95 |
$59.95 |
$59.95 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$168.95 |
$168.95 |
$168.95 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$141.70 |
$141.70 |
$141.70 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$57.77 |
$57.77 |
$57.77 |
$79.04
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$47.42 |
$47.42 |
$47.42 |
$48.29
|
|
Vaccine mmr live subcutaneous
|
$188.03 |
$188.03 |
$188.03 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$268.14 |
$268.14 |
$268.14 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$516.66 |
$516.66 |
$516.66 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$617.49 |
$617.49 |
$617.49 |
$715.41
|
|
Vaccine rabies im
|
$867.64 |
$867.64 |
$867.64 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$101.92 |
$101.92 |
$101.92 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$86.66 |
$86.66 |
$86.66 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$169.50 |
$169.50 |
$169.50 |
$115.00
|
|
Vancomycin hcl injection
|
$600.05 |
$600.05 |
$600.05 |
$186.80
|
|
Vancomycin peak therapeutic drug level
|
$288.85 |
$288.85 |
$288.85 |
$126.79
|
|
Varicella zoster antibody igg
|
$8.32 |
$8.32 |
$8.32 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$3,168.09 |
$3,168.09 |
$3,168.09 |
$362.93
|
|
Vedolizumab 300 mg intravenous solution
|
$14,376.56 |
$14,376.56 |
$14,376.56 |
$20,730.98
|
|
Ventilator each subsequent day
|
$1,486.76 |
$1,486.76 |
$1,486.76 |
$1,305.92
|
|
Ventilator initial day
|
$2,066.64 |
$2,066.64 |
$2,066.64 |
$1,540.80
|
|
Version cephalic external
|
$369.51 |
$369.51 |
$369.51 |
$2,598.57
|
|
Very long chain fatty acids
|
$58.13 |
$58.13 |
$58.13 |
$140.40
|
|
Vinblastine 1 mg/ml intravenous solution
|
$8.72 |
$8.72 |
$8.72 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$75.21 |
$75.21 |
$75.21 |
$100.19
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$599.50 |
$599.50 |
$599.50 |
$226.75
|