|
Thyroglobulin antibody
|
$46.86 |
$46.86 |
$46.86 |
$82.00
|
|
Thyroid mets imag whole body
|
$571.34 |
$571.34 |
$571.34 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$141.02 |
$141.02 |
$141.02 |
$111.00
|
|
Thyroid Ultrasound
|
$726.66 |
$726.66 |
$726.66 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$13.20 |
$13.20 |
$13.20 |
$64.35
|
|
Tilt table study
|
$1,084.16 |
$1,084.16 |
$1,084.16 |
$1,507.01
|
|
Tissue culture placenta
|
$77.22 |
$77.22 |
$77.22 |
$457.00
|
|
Tissue culture skin/biopsy
|
$40.04 |
$40.04 |
$40.04 |
$484.00
|
|
Tissue culture tumor
|
$40.04 |
$40.04 |
$40.04 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$40.26 |
$40.26 |
$40.26 |
$47.20
|
|
Tissue transglutaminase iga
|
$16.72 |
$16.72 |
$16.72 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$38.50 |
$38.50 |
$38.50 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$6.54 |
$6.54 |
$6.54 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$155.54 |
$155.54 |
$155.54 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,682.73 |
$1,682.73 |
$1,682.73 |
$5,258.52
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$55.21 |
$55.21 |
$55.21 |
$325.00
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$5,280.00 |
$5,280.00 |
$5,280.00 |
$15,383.12
|
|
Total tau
|
$66.00 |
$66.00 |
$66.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$46.20 |
$46.20 |
$46.20 |
$89.40
|
|
Toxoplasma antibody igm
|
$18.92 |
$18.92 |
$18.92 |
$87.00
|
|
Tp53 gene full gene sequence
|
$140.80 |
$140.80 |
$140.80 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$178.20 |
$178.20 |
$178.20 |
$790.68
|
|
Tpmt gene com vrnts
|
$40.70 |
$40.70 |
$40.70 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$22,211.20 |
$22,211.20 |
$22,211.20 |
$7,144.80
|
|
Trabectedin 1 mg intravenous solution
|
$1,947.97 |
$1,947.97 |
$1,947.97 |
$6,827.00
|
|
Tracheostoma revision; simple, without flap rotation
|
$290.84 |
$290.84 |
$290.84 |
$3,837.72
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$12.02 |
$12.02 |
$12.02 |
$56.38
|
|
Transcath biopsy
|
$4,142.16 |
$4,142.16 |
$4,142.16 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,309.44 |
$1,309.44 |
$1,309.44 |
$1,915.00
|
|
Transcath occlusion non-cns
|
$8,656.78 |
$8,656.78 |
$8,656.78 |
$10,031.28
|
|
Transferrin
|
$82.28 |
$82.28 |
$82.28 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$753.94 |
$753.94 |
$753.94 |
$983.00
|
|
Trastuzumab 150 mg intravenous solution
|
$822.84 |
$822.84 |
$822.84 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$718.12 |
$718.12 |
$718.12 |
$7,540.20
|
|
Trauma partial team response w/critical care services level 4
|
$4,170.32 |
$4,170.32 |
$4,170.32 |
$4,523.04
|
|
Treat ectopic pregnancy
|
$504.68 |
$504.68 |
$504.68 |
$4,350.00
|
|
Treat ectopic pregnancy
|
$492.80 |
$492.80 |
$492.80 |
$6,707.99
|
|
Treatment incomplete abortion completed surgically any trimester
|
$201.30 |
$201.30 |
$201.30 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$200.42 |
$200.42 |
$200.42 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$150.26 |
$150.26 |
$150.26 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$62.70 |
$62.70 |
$62.70 |
$203.35
|
|
Treatment missed abortion completed surgically 1st trimester
|
$259.93 |
$259.93 |
$259.93 |
$3,982.44
|
|
Treatment radiation delivery level 2
|
$457.60 |
$457.60 |
$457.60 |
$767.65
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$17,138.88 |
$17,138.88 |
$17,138.88 |
$73,346.25
|
|
Treponema pallidum antibody
|
$43.34 |
$43.34 |
$43.34 |
$70.40
|
|
Trg gene rearrangement anal
|
$57.20 |
$57.20 |
$57.20 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$16.19 |
$16.19 |
$16.19 |
$43.21
|
|
#tricyclicantidprssnt
|
$12.76 |
$12.76 |
$12.76 |
$50.86
|
|
Triglycerides
|
$128.04 |
$128.04 |
$128.04 |
$58.05
|
|
Trnscath plc stent crv crtd w/prtct
|
$9,017.36 |
$9,017.36 |
$9,017.36 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$5,126.66 |
$5,126.66 |
$5,126.66 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,700.06 |
$2,700.06 |
$2,700.06 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$8,300.82 |
$8,300.82 |
$8,300.82 |
$15,330.11
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,174.60 |
$3,174.60 |
$3,174.60 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,194.40 |
$3,194.40 |
$3,194.40 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,731.84 |
$1,731.84 |
$1,731.84 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$2,138.40 |
$2,138.40 |
$2,138.40 |
$4,250.25
|
|
Troponin quantitative
|
$218.68 |
$218.68 |
$218.68 |
$127.20
|
|
Tx atrial fib pulm vein isol
|
$14,388.22 |
$14,388.22 |
$14,388.22 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$3,669.82 |
$3,669.82 |
$3,669.82 |
$6,769.00
|
|
Ua w/micro/comp poc
|
$22.22 |
$22.22 |
$22.22 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$51.07 |
$51.07 |
$51.07 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$432.96 |
$432.96 |
$432.96 |
$394.20
|
|
Ultrasound breast complete
|
$634.04 |
$634.04 |
$634.04 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$751.74 |
$751.74 |
$751.74 |
$449.35
|
|
Ultrasound chest
|
$612.70 |
$612.70 |
$612.70 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$560.12 |
$560.12 |
$560.12 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$212.30 |
$212.30 |
$212.30 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$424.16 |
$424.16 |
$424.16 |
$307.00
|
|
Ultrasound encephalogram
|
$603.90 |
$603.90 |
$603.90 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$625.90 |
$625.90 |
$625.90 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$850.30 |
$850.30 |
$850.30 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$255.42 |
$255.42 |
$255.42 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$574.20 |
$574.20 |
$574.20 |
$720.15
|
|
Ultrasound guide intraoperative
|
$220.44 |
$220.44 |
$220.44 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$628.98 |
$628.98 |
$628.98 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$501.16 |
$501.16 |
$501.16 |
$311.25
|
|
Ultrasound joint complete left
|
$603.90 |
$603.90 |
$603.90 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$733.26 |
$733.26 |
$733.26 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$250.80 |
$250.80 |
$250.80 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$250.80 |
$250.80 |
$250.80 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$411.62 |
$411.62 |
$411.62 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$464.42 |
$464.42 |
$464.42 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$432.96 |
$432.96 |
$432.96 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$190.08 |
$190.08 |
$190.08 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$432.96 |
$432.96 |
$432.96 |
$486.50
|
|
Ultrasound scrotum and contents
|
$628.54 |
$628.54 |
$628.54 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$841.28 |
$841.28 |
$841.28 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$432.96 |
$432.96 |
$432.96 |
$558.35
|
|
Unlisted fluoroscopic px
|
$103.40 |
$103.40 |
$103.40 |
$305.76
|
|
Unlisted surgical path px
|
$23.32 |
$23.32 |
$23.32 |
$217.75
|
|
Unsched dialysis esrd pt hos
|
$749.76 |
$749.76 |
$749.76 |
$1,268.17
|
|
Upgrade pm system
|
$13,510.20 |
$13,510.20 |
$13,510.20 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,938.32 |
$2,938.32 |
$2,938.32 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,705.12 |
$2,705.12 |
$2,705.12 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,661.34 |
$2,661.34 |
$2,661.34 |
$2,034.41
|
|
Urea nitrogen
|
$154.22 |
$154.22 |
$154.22 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$75.02 |
$75.02 |
$75.02 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$276.10 |
$276.10 |
$276.10 |
$579.73
|
|
Urethrocystography void s&i
|
$859.54 |
$859.54 |
$859.54 |
$622.35
|
