|
Thromboplastin time partial (ptt) substitution fractions each
|
$8.25 |
$8.25 |
$8.25 |
$56.93
|
|
Thyroglobulin antibody
|
$21.03 |
$21.03 |
$21.03 |
$84.00
|
|
Thyroid imaging
|
$429.83 |
$429.83 |
$429.83 |
$670.80
|
|
Thyroid mets imag whole body
|
$485.31 |
$485.31 |
$485.31 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$266.31 |
$266.31 |
$266.31 |
$120.00
|
|
Thyroid Ultrasound
|
$1,072.81 |
$1,072.81 |
$1,072.81 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$8.34 |
$8.34 |
$8.34 |
$63.60
|
|
Tissue culture skin/biopsy
|
$321.20 |
$321.20 |
$321.20 |
$558.87
|
|
Tissue culture tumor
|
$120.38 |
$120.38 |
$120.38 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$13.51 |
$13.51 |
$13.51 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$6,380.20 |
$6,380.20 |
$6,380.20 |
$3,638.47
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$14,021.84 |
$14,021.84 |
$14,021.84 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$7.01 |
$7.01 |
$7.01 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$46.72 |
$46.72 |
$46.72 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$734.68 |
$734.68 |
$734.68 |
$139.53
|
|
Tobramycin peak therapeutic drug level
|
$208.49 |
$208.49 |
$208.49 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$4,072.67
|
|
Tomosynthesis breast diagnostic left
|
$175.79 |
$175.79 |
$175.79 |
$76.50
|
|
Tomosynthesis breast screen bilateral
|
$160.60 |
$160.60 |
$160.60 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$383.23
|
|
Total tau
|
$193.71 |
$193.71 |
$193.71 |
$293.00
|
|
Toxoplasma antibody igg
|
$122.64 |
$122.64 |
$122.64 |
$84.35
|
|
Toxoplasma antibody igm
|
$5.84 |
$5.84 |
$5.84 |
$83.20
|
|
Tp53 gene full gene sequence
|
$147.97 |
$147.97 |
$147.97 |
$706.04
|
|
Tpmt gene com vrnts
|
$58.40 |
$58.40 |
$58.40 |
$381.55
|
|
Transabdom amnioinfus w/us
|
$662.26 |
$662.26 |
$662.26 |
$791.05
|
|
Transferrin
|
$163.52 |
$163.52 |
$163.52 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$3,338.15 |
$3,338.15 |
$3,338.15 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$3,358.00
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$3,358.00 |
$3,358.00 |
$3,358.00 |
$7,191.23
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$328.21 |
$328.21 |
$328.21 |
$4,500.03
|
|
Trauma partial team response w/critical care services level 4
|
$7,614.78 |
$7,614.78 |
$7,614.78 |
$5,455.00
|
|
Tray bonemarrw oncontrol 102mm
|
$1,013.83 |
$1,013.83 |
$1,013.83 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$102.79 |
$102.79 |
$102.79 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$74.76 |
$74.76 |
$74.76 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$419.32 |
$419.32 |
$419.32 |
$210.00
|
|
Treponema pallidum antibody
|
$139.25 |
$139.25 |
$139.25 |
$72.80
|
|
Trg gene rearrangement anal
|
$175.20 |
$175.20 |
$175.20 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$182.80 |
$182.80 |
$182.80 |
$49.63
|
|
Triamcinolone a inj prs-free
|
$3,804.18 |
$3,804.18 |
$3,804.18 |
$561.54
|
|
Trichinella antibody
|
$43.69 |
$43.69 |
$43.69 |
$70.65
|
|
Triglycerides
|
$176.96 |
$176.96 |
$176.96 |
$54.60
|
|
Trim nondyst nails
|
$64.83 |
$64.83 |
$64.83 |
$124.22
|
|
Triptorelin pamoate
|
$5,763.50 |
$5,763.50 |
$5,763.50 |
$4,619.39
|
|
Troponin quantitative
|
$334.05 |
$334.05 |
$334.05 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$952.51 |
$952.51 |
$952.51 |
$1,573.00
|
|
Tx closed hip disl traumatic without anes
|
$301.35 |
$301.35 |
$301.35 |
$657.28
|
|
Ua w/micro/comp poc
|
$5.26 |
$5.26 |
$5.26 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$119.30 |
$119.30 |
$119.30 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$302.52 |
$302.52 |
$302.52 |
$403.26
|
|
Ultrasound chest
|
$1,523.66 |
$1,523.66 |
$1,523.66 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$204.40 |
$204.40 |
$204.40 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$293.76 |
$293.76 |
$293.76 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$274.48 |
$274.48 |
$274.48 |
$284.25
|
|
Ultrasound encephalogram
|
$504.58 |
$504.58 |
$504.58 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$763.29 |
$763.29 |
$763.29 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$439.17 |
$439.17 |
$439.17 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$4,029.60 |
$4,029.60 |
$4,029.60 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,392.26 |
$1,392.26 |
$1,392.26 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$106.29 |
$106.29 |
$106.29 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$864.91 |
$864.91 |
$864.91 |
$321.35
|
|
Ultrasound ob >=14wks ea addl gest
|
$721.24 |
$721.24 |
$721.24 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$502.83 |
$502.83 |
$502.83 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$477.13 |
$477.13 |
$477.13 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,228.16 |
$1,228.16 |
$1,228.16 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,821.50 |
$1,821.50 |
$1,821.50 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$2,320.82 |
$2,320.82 |
$2,320.82 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$1,003.32 |
$1,003.32 |
$1,003.32 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,662.46 |
$2,662.46 |
$2,662.46 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$714.82 |
$714.82 |
$714.82 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$539.04 |
$539.04 |
$539.04 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,499.13 |
$1,499.13 |
$1,499.13 |
$567.44
|
|
Unlisted transfusion med px
|
$167.61 |
$167.61 |
$167.61 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$1,435.48 |
$1,435.48 |
$1,435.48 |
$1,480.70
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,101.04 |
$3,101.04 |
$3,101.04 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,733.71 |
$2,733.71 |
$2,733.71 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,834.93 |
$1,834.93 |
$1,834.93 |
$2,013.08
|
|
Urea nitrogen
|
$57.82 |
$57.82 |
$57.82 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$91.69 |
$91.69 |
$91.69 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$717.16 |
$717.16 |
$717.16 |
$574.40
|
|
Urethrocystography void s&i
|
$717.16 |
$717.16 |
$717.16 |
$634.50
|
|
Uric acid blood
|
$86.44 |
$86.44 |
$86.44 |
$46.64
|
|
Uric acid urine
|
$88.77 |
$88.77 |
$88.77 |
$46.75
|
|
Urinalysis microscopic only
|
$33.29 |
$33.29 |
$33.29 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$33.29 |
$33.29 |
$33.29 |
$25.72
|
|
Urinalysis (with microscopy)
|
$174.04 |
$174.04 |
$174.04 |
$48.14
|
|
Urinalysis (without microscopy)
|
$74.17 |
$74.17 |
$74.17 |
$38.99
|
|
Urinary reflex study
|
$105.71 |
$105.71 |
$105.71 |
$152.00
|
|
Urine Culture Test
|
$143.08 |
$143.08 |
$143.08 |
$84.81
|
|
Urine pregnancy test
|
$32.12 |
$32.12 |
$32.12 |
$66.40
|
|
Urography inf drip &/or bolus
|
$1,005.07 |
$1,005.07 |
$1,005.07 |
$641.69
|
|
Vaccine dtap < 7 years im
|
$107.46 |
$107.46 |
$107.46 |
$87.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$51.40 |
$51.40 |
$51.40 |
$45.33
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$249.37 |
$249.37 |
$249.37 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$102.20 |
$102.20 |
$102.20 |
$79.04
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$82.93 |
$82.93 |
$82.93 |
$48.29
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$595.68 |
$595.68 |
$595.68 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$331.13 |
$331.13 |
$331.13 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$471.88 |
$471.88 |
$471.88 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,086.83 |
$1,086.83 |
$1,086.83 |
$715.41
|