|
Tissue culture tumor
|
$203.34 |
$203.34 |
$203.34 |
$479.50
|
|
Tissue exam koh skin/hair/nails
|
$59.99 |
$59.99 |
$59.99 |
$47.40
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$13.65 |
$13.65 |
$13.65 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$15.75 |
$15.75 |
$15.75 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$11.27 |
$11.27 |
$11.27 |
$119.40
|
|
Toe X-ray (both feet)
|
$55.62 |
$55.62 |
$55.62 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$22.61 |
$22.61 |
$22.61 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$33.51 |
$33.51 |
$33.51 |
$74.10
|
|
Total tau
|
$103.73 |
$103.73 |
$103.73 |
$312.50
|
|
Toxoplasma antibody igg
|
$44.32 |
$44.32 |
$44.32 |
$91.65
|
|
Toxoplasma antibody igm
|
$16.02 |
$16.02 |
$16.02 |
$88.00
|
|
Tp53 gene trgt sequence alys
|
$427.25 |
$427.25 |
$427.25 |
$804.00
|
|
Tpmt gene com vrnts
|
$226.80 |
$226.80 |
$226.80 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$3,541.83 |
$3,541.83 |
$3,541.83 |
$7,144.80
|
|
Transcath biopsy
|
$3,054.35 |
$3,054.35 |
$3,054.35 |
$4,285.93
|
|
Transcath closure of asd
|
$16,484.47 |
$16,484.47 |
$16,484.47 |
$17,088.00
|
|
Transcatheter bx s&i
|
$745.89 |
$745.89 |
$745.89 |
$1,950.85
|
|
Transcath mv repair addl prosthesis
|
$4,150.84 |
$4,150.84 |
$4,150.84 |
$4,499.00
|
|
Transcath mv repair init prosthesis
|
$16,603.37 |
$16,603.37 |
$16,603.37 |
$13,093.20
|
|
Transcath occlusion cns
|
$2,319.48 |
$2,319.48 |
$2,319.48 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$2,203.26 |
$2,203.26 |
$2,203.26 |
$10,270.00
|
|
Transcath rmvl perm ldss pmkr rv
|
$18,243.41 |
$18,243.41 |
$18,243.41 |
$4,822.00
|
|
Transcrv abltj utrn fibrd rf
|
$4,951.42 |
$4,951.42 |
$4,951.42 |
$8,750.72
|
|
Transferrin
|
$8.97 |
$8.97 |
$8.97 |
$82.00
|
|
Transperi needle place pros
|
$3,237.62 |
$3,237.62 |
$3,237.62 |
$6,015.75
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$252.72 |
$252.72 |
$252.72 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$244.98 |
$244.98 |
$244.98 |
$501.60
|
|
Trauma partial team response w/critical care services level 4
|
$3,571.20 |
$3,571.20 |
$3,571.20 |
$4,471.50
|
|
Tray bonemarrw oncontrol 102mm
|
$175.23 |
$175.23 |
$175.23 |
$940.80
|
|
Treatment radiation delivery level 2
|
$462.10 |
$462.10 |
$462.10 |
$830.70
|
|
Treat spinal cord lesion
|
$745.15 |
$745.15 |
$745.15 |
$1,337.00
|
|
Treponema pallidum antibody
|
$19.76 |
$19.76 |
$19.76 |
$72.05
|
|
Trg gene rearrangement anal
|
$261.36 |
$261.36 |
$261.36 |
$455.70
|
|
Trichinella antibody
|
$18.42 |
$18.42 |
$18.42 |
$70.65
|
|
#tricyclicantidprssnt
|
$20.01 |
$20.01 |
$20.01 |
$50.54
|
|
Triglycerides
|
$4.14 |
$4.14 |
$4.14 |
$58.05
|
|
Trim nondyst nails
|
$64.40 |
$64.40 |
$64.40 |
$114.48
|
|
Trml dstrj ios bvn 1st 2 l/s
|
$5,617.90 |
$5,617.90 |
$5,617.90 |
$15,258.00
|
|
Trml dstrj ios bvn ea addl
|
$2,054.86 |
$2,054.86 |
$2,054.86 |
$7,354.00
|
|
Trnscath plc stent crv crtd w/prtct
|
$7,516.75 |
$7,516.75 |
$7,516.75 |
$9,767.25
|
|
Trnscath plc stnt ante carotid art
|
$4,169.17 |
$4,169.17 |
$4,169.17 |
$6,046.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,651.04 |
$4,651.04 |
$4,651.04 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$3,245.22 |
$3,245.22 |
$3,245.22 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$8,761.65 |
$8,761.65 |
$8,761.65 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,675.68 |
$3,675.68 |
$3,675.68 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$9,512.61 |
$9,512.61 |
$9,512.61 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$5,624.15 |
$5,624.15 |
$5,624.15 |
$4,350.00
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$4,660.87 |
$4,660.87 |
$4,660.87 |
$4,379.34
|
|
Trnscath tx thromblytc vein ini day
|
$6,248.61 |
$6,248.61 |
$6,248.61 |
$3,866.70
|
|
Troponin quantitative
|
$8.74 |
$8.74 |
$8.74 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$653.45 |
$653.45 |
$653.45 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$430.15 |
$430.15 |
$430.15 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$472.50 |
$472.50 |
$472.50 |
$1,254.50
|
|
Tte w or without fol w/cont, f/u
|
$362.25 |
$362.25 |
$362.25 |
$1,178.00
|
|
Tx atrial fib pulm vein isol
|
$37,873.67 |
$37,873.67 |
$37,873.67 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$2,321.70 |
$2,321.70 |
$2,321.70 |
$6,986.85
|
|
Ugt1a1 gene analy common variants
|
$303.26 |
$303.26 |
$303.26 |
$438.75
|
|
Ultrasound breast complete
|
$298.07 |
$298.07 |
$298.07 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$231.71 |
$231.71 |
$231.71 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$142.12 |
$142.12 |
$142.12 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$107.84 |
$107.84 |
$107.84 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$221.75 |
$221.75 |
$221.75 |
$313.95
|
|
Ultrasound encephalogram
|
$191.89 |
$191.89 |
$191.89 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$249.40 |
$249.40 |
$249.40 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$275.39 |
$275.39 |
$275.39 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$222.86 |
$222.86 |
$222.86 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$190.23 |
$190.23 |
$190.23 |
$388.08
|
|
Ultrasound guide intraoperative
|
$290.33 |
$290.33 |
$290.33 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$594.48 |
$594.48 |
$594.48 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$197.97 |
$197.97 |
$197.97 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$140.46 |
$140.46 |
$140.46 |
$311.25
|
|
Ultrasound joint complete left
|
$275.39 |
$275.39 |
$275.39 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$167.01 |
$167.01 |
$167.01 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$114.47 |
$114.47 |
$114.47 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$565.72 |
$565.72 |
$565.72 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$203.50 |
$203.50 |
$203.50 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$492.17 |
$492.17 |
$492.17 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$296.41 |
$296.41 |
$296.41 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$390.42 |
$390.42 |
$390.42 |
$421.00
|
|
Unlisted hematology&coagj px
|
$16.07 |
$16.07 |
$16.07 |
$39.52
|
|
Unlisted procedure microbiology
|
$238.82 |
$238.82 |
$238.82 |
$530.00
|
|
Unlisted px foot/toes
|
$206.07 |
$206.07 |
$206.07 |
$1,239.20
|
|
Unlisted transfusion med px
|
$113.36 |
$113.36 |
$113.36 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$342.54 |
$342.54 |
$342.54 |
$1,296.00
|
|
Upgrade pm system
|
$8,809.03 |
$8,809.03 |
$8,809.03 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$59.84 |
$59.84 |
$59.84 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$476.62 |
$476.62 |
$476.62 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$381.09 |
$381.09 |
$381.09 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$445.30 |
$445.30 |
$445.30 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$371.23 |
$371.23 |
$371.23 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$296.87 |
$296.87 |
$296.87 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$56.67 |
$56.67 |
$56.67 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$69.70 |
$69.70 |
$69.70 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$145.73 |
$145.73 |
$145.73 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$127.42 |
$127.42 |
$127.42 |
$607.20
|
|
Urea nitrogen
|
$15.41 |
$15.41 |
$15.41 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$11.96 |
$11.96 |
$11.96 |
$51.84
|
|
Ureteral reflux study
|
$393.22 |
$393.22 |
$393.22 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$228.45 |
$228.45 |
$228.45 |
$584.00
|
|
Urethrocystography void s&i
|
$182.69 |
$182.69 |
$182.69 |
$634.50
|
