|
Tcd emboli detect w/inj
|
$3,592.60 |
$3,592.60 |
$3,592.60 |
$404.68
|
|
Tcd emboli detect without inj
|
$3,592.60 |
$3,592.60 |
$3,592.60 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$3,143.25 |
$3,143.25 |
$3,143.25 |
$186.00
|
|
T cells absolute cd 4 count
|
$327.67 |
$327.67 |
$327.67 |
$120.25
|
|
T cells total count
|
$451.36 |
$451.36 |
$451.36 |
$124.11
|
|
Tee w or without fol w/cont,cong
|
$14,192.20 |
$14,192.20 |
$14,192.20 |
$1,432.00
|
|
Telavancin injection
|
$6,203.12 |
$6,203.12 |
$6,203.12 |
$1,216.45
|
|
Telethx isodose plan cplx
|
$31,701.45 |
$31,701.45 |
$31,701.45 |
$1,617.00
|
|
Telethx isodose plan simple
|
$22,454.30 |
$22,454.30 |
$22,454.30 |
$848.72
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$9,746.24 |
$9,746.24 |
$9,746.24 |
$2,791.41
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$1,425.20 |
$1,425.20 |
$1,425.20 |
$44.49
|
|
Test for porphobilinogen
|
$1,073.07 |
$1,073.07 |
$1,073.07 |
$33.57
|
|
Testicular imaging w/vasc flow
|
$10,547.00 |
$10,547.00 |
$10,547.00 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$8,602.00 |
$8,602.00 |
$8,602.00 |
$1,001.55
|
|
Test urine for porphyrins
|
$977.59 |
$977.59 |
$977.59 |
$27.30
|
|
Tetanus immune globulin inj
|
$7,999.60 |
$7,999.60 |
$7,999.60 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$923.88 |
$923.88 |
$923.88 |
$108.00
|
|
Therapeutic procd strg endur
|
$1,321.10 |
$1,321.10 |
$1,321.10 |
$81.36
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$325.50 |
$325.50 |
$325.50 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$285.50 |
$285.50 |
$285.50 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$4,430.80 |
$4,430.80 |
$4,430.80 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$505.68 |
$505.68 |
$505.68 |
$38.64
|
|
Thrombin time
|
$858.24 |
$858.24 |
$858.24 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$1,192.96 |
$1,192.96 |
$1,192.96 |
$56.93
|
|
Thyroglobulin antibody
|
$1,930.76 |
$1,930.76 |
$1,930.76 |
$84.00
|
|
Thyroid imaging
|
$12,375.50 |
$12,375.50 |
$12,375.50 |
$670.80
|
|
Thyroid mets imag whole body
|
$11,704.50 |
$11,704.50 |
$11,704.50 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$1,417.01 |
$1,417.01 |
$1,417.01 |
$120.00
|
|
Thyroid uptake measurement
|
$2,813.50 |
$2,813.50 |
$2,813.50 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$1,495.13 |
$1,495.13 |
$1,495.13 |
$63.60
|
|
Tigecycline injection
|
$2,473.52 |
$2,473.52 |
$2,473.52 |
$308.75
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$30,845.36 |
$30,845.36 |
$30,845.36 |
$16,843.32
|
|
Tissue amnio epifix inj 100mg
|
$190.00 |
$190.00 |
$190.00 |
$5,081.76
|
|
Tissue culture skin/biopsy
|
$2,399.48 |
$2,399.48 |
$2,399.48 |
$558.87
|
|
Tissue culture tumor
|
$2,838.36 |
$2,838.36 |
$2,838.36 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$255.52 |
$255.52 |
$255.52 |
$47.40
|
|
Tl-201 thallium diag per mci
|
$674.00 |
$674.00 |
$674.00 |
$77.22
|
|
Tobramycin non-comp unit
|
$3,286.08 |
$3,286.08 |
$3,286.08 |
$107.07
|
|
Toxoplasma antibody igg
|
$680.30 |
$680.30 |
$680.30 |
$84.35
|
|
Toxoplasma antibody igm
|
$813.75 |
$813.75 |
$813.75 |
$83.20
|
|
Tp53 gene trgt sequence alys
|
$3,615.76 |
$3,615.76 |
$3,615.76 |
$919.10
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$597.00 |
$597.00 |
$597.00 |
$93.75
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$1,649.00 |
$1,649.00 |
$1,649.00 |
$82.60
|
|
Transcatheter bx s&i
|
$12,922.80 |
$12,922.80 |
$12,922.80 |
$1,875.96
|
|
Transferrin
|
$1,406.70 |
$1,406.70 |
$1,406.70 |
$87.30
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$2,532.20 |
$2,532.20 |
$2,532.20 |
$241.15
|
|
Treatment radiation delivery level 2
|
$8,517.30 |
$8,517.30 |
$8,517.30 |
$735.00
|
|
Trichinella antibody
|
$882.65 |
$882.65 |
$882.65 |
$70.65
|
|
Triglycerides
|
$711.76 |
$711.76 |
$711.76 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$505.68 |
$505.68 |
$505.68 |
$154.09
|
|
Tte w or without fol w/cont, com
|
$7,994.80 |
$7,994.80 |
$7,994.80 |
$1,453.15
|
|
Tte w or without fol w/cont, f/u
|
$5,605.05 |
$5,605.05 |
$5,605.05 |
$934.93
|
|
Tube drain vert dev st 5-40f
|
$174.00 |
$174.00 |
$174.00 |
$72.21
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,784.75 |
$1,784.75 |
$1,784.75 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$5,902.60 |
$5,902.60 |
$5,902.60 |
$284.25
|
|
Ultrasound hips infant dynamic
|
$3,562.90 |
$3,562.90 |
$3,562.90 |
$403.00
|
|
Ultrasound transabd ea addl gest
|
$1,315.60 |
$1,315.60 |
$1,315.60 |
$425.10
|
|
Unlisted mr procedure
|
$8,556.90 |
$8,556.90 |
$8,556.90 |
$1,032.20
|
|
Unsched dialysis esrd pt hos
|
$6,799.21 |
$6,799.21 |
$6,799.21 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$24,552.00 |
$24,552.00 |
$24,552.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$23,489.95 |
$23,489.95 |
$23,489.95 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$19,355.60 |
$19,355.60 |
$19,355.60 |
$2,013.08
|
|
Urea nitrogen 24 hour urine
|
$1,137.62 |
$1,137.62 |
$1,137.62 |
$50.00
|
|
Urea nitrogen clearance
|
$814.84 |
$814.84 |
$814.84 |
$33.57
|
|
Urethrcystgrphy rtrgrde s&i
|
$5,525.85 |
$5,525.85 |
$5,525.85 |
$574.40
|
|
Uric acid blood
|
$1,176.68 |
$1,176.68 |
$1,176.68 |
$46.64
|
|
Urinalysis microscopic only
|
$333.10 |
$333.10 |
$333.10 |
$26.35
|
|
Urinalysis (with microscopy)
|
$915.74 |
$915.74 |
$915.74 |
$48.14
|
|
Urine Culture Test
|
$977.59 |
$977.59 |
$977.59 |
$84.81
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$9,928.80 |
$9,928.80 |
$9,928.80 |
$6,892.54
|
|
Vaccine dtap < 7 years im
|
$809.20 |
$809.20 |
$809.20 |
$87.80
|
|
Vaccine dtap-ipv/hib im
|
$306.88 |
$306.88 |
$306.88 |
$248.80
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$156.24 |
$156.24 |
$156.24 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$179.76 |
$179.76 |
$179.76 |
$79.04
|
|
Vaccine influenza nos 0.5ml dose im
|
$193.76 |
$193.76 |
$193.76 |
$36.80
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$1,044.40 |
$1,044.40 |
$1,044.40 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$776.16 |
$776.16 |
$776.16 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$4,777.36 |
$4,777.36 |
$4,777.36 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$2,558.64 |
$2,558.64 |
$2,558.64 |
$224.04
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$861.84 |
$861.84 |
$861.84 |
$385.45
|
|
Vaccine polio (ipv) subcutaneous/im
|
$1,755.60 |
$1,755.60 |
$1,755.60 |
$119.17
|
|
Vaccine rabies im
|
$10,641.68 |
$10,641.68 |
$10,641.68 |
$945.46
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$986.78 |
$986.78 |
$986.78 |
$624.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,772.40 |
$1,772.40 |
$1,772.40 |
$1,196.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,772.40 |
$1,772.40 |
$1,772.40 |
$1,159.00
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$2,755.20 |
$2,755.20 |
$2,755.20 |
$108.00
|
|
Vaccine tdap >=7 years im
|
$1,354.64 |
$1,354.64 |
$1,354.64 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$1,029.84 |
$1,029.84 |
$1,029.84 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$1,472.24 |
$1,472.24 |
$1,472.24 |
$447.80
|
|
Valproic acid total therapeutic drug level
|
$1,572.71 |
$1,572.71 |
$1,572.71 |
$115.00
|
|
Vancomycin 750 mg intravenous solution
|
$22.40 |
$22.40 |
$22.40 |
$129.78
|
|
Varicella-zoster immue globin im
|
$12,259.52 |
$12,259.52 |
$12,259.52 |
$2,372.84
|
|
Vasopressin 20 unit/ml intravenous solution
|
$451.92 |
$451.92 |
$451.92 |
$394.13
|
|
Vedolizumab 300 mg intravenous solution
|
$44,596.16 |
$44,596.16 |
$44,596.16 |
$23,003.79
|
|
Veeg intrmnt 2-12 hrs
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$904.90
|
|
Veeg unmon 12-26 hrs
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$1,411.20
|
|
Veeg unmon 2-12 hrs
|
$13,759.35 |
$13,759.35 |
$13,759.35 |
$704.79
|
|
Vein x-ray adrenal glands
|
$8,071.80 |
$8,071.80 |
$8,071.80 |
$3,999.60
|
|
Vein x-ray liver
|
$11,238.15 |
$11,238.15 |
$11,238.15 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$8,148.25 |
$8,148.25 |
$8,148.25 |
$3,413.25
|
