|
Tobramycin peak therapeutic drug level
|
$443.48 |
$443.48 |
$443.48 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$16,400.23 |
$16,400.23 |
$16,400.23 |
$5,790.85
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$276.29 |
$276.29 |
$276.29 |
$303.88
|
|
Toxoplasma antibody igg
|
$230.24 |
$230.24 |
$230.24 |
$84.35
|
|
Toxoplasma antibody igm
|
$230.56 |
$230.56 |
$230.56 |
$83.20
|
|
Transferrin
|
$204.16 |
$204.16 |
$204.16 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,453.69 |
$1,453.69 |
$1,453.69 |
$988.24
|
|
Treat finger fracture each
|
$21,567.36 |
$21,567.36 |
$21,567.36 |
$1,815.75
|
|
Treat fracture of radius
|
$21,567.36 |
$21,567.36 |
$21,567.36 |
$2,030.33
|
|
Treat fracture of ulna
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$766.72
|
|
Treat knee fracture 27530
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$580.20
|
|
Treat knuckle dislocation
|
$5,381.32 |
$5,381.32 |
$5,381.32 |
$1,893.86
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$632.05 |
$632.05 |
$632.05 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$53.26 |
$53.26 |
$53.26 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$556.14 |
$556.14 |
$556.14 |
$210.00
|
|
Treatment of ankle fracture 27786
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$580.00
|
|
Treatment of fibula fracture 27780
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$558.75
|
|
Treatment of heel fracture 28400
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$494.00
|
|
Treatment of toe fracture 28510
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$371.40
|
|
Treatment radiation delivery level 2
|
$885.55 |
$885.55 |
$885.55 |
$735.00
|
|
Treat toe dislocation
|
$3,926.72 |
$3,926.72 |
$3,926.72 |
$855.66
|
|
Treat ulnar fracture
|
$5,381.32 |
$5,381.32 |
$5,381.32 |
$1,861.60
|
|
Treat wrist dislocation
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$332,640.62 |
$332,640.62 |
$332,640.62 |
$120,541.18
|
|
Treponema pallidum antibody
|
$211.84 |
$211.84 |
$211.84 |
$72.80
|
|
Trg gene rearrangement anal
|
$3,224.00 |
$3,224.00 |
$3,224.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$502.20 |
$502.20 |
$502.20 |
$48.22
|
|
Triglycerides
|
$105.00 |
$105.00 |
$105.00 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$1,365.86 |
$1,365.86 |
$1,365.86 |
$154.09
|
|
Trim nondyst nails
|
$884.32 |
$884.32 |
$884.32 |
$124.22
|
|
Trmt of fracture (femoral shaft) 27500
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$777.00
|
|
Trnscath plc vas stent w/s&i ini vein
|
$93,130.72 |
$93,130.72 |
$93,130.72 |
$15,408.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$35,429.76 |
$35,429.76 |
$35,429.76 |
$4,969.90
|
|
Troponin quantitative
|
$645.18 |
$645.18 |
$645.18 |
$123.75
|
|
Tx closed hip disl traumatic without anes
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$657.28
|
|
Tx closed tib shaft fx without manip
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$635.46
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$4,499.12
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$403.26
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,301.76 |
$1,301.76 |
$1,301.76 |
$449.35
|
|
Ultrasound chest
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$459.55
|
|
Ultrasound exam k transpl w/doppler
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$545.82 |
$545.82 |
$545.82 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$2,079.86 |
$2,079.86 |
$2,079.86 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$2,476.12 |
$2,476.12 |
$2,476.12 |
$701.35
|
|
Ultrasound guide intraoperative
|
$1,185.19 |
$1,185.19 |
$1,185.19 |
$632.90
|
|
Ultrasound joint complete left
|
$1,811.16 |
$1,811.16 |
$1,811.16 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,705.22 |
$1,705.22 |
$1,705.22 |
$448.50
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$393.18 |
$393.18 |
$393.18 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$3,738.08 |
$3,738.08 |
$3,738.08 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,200.11 |
$1,200.11 |
$1,200.11 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$2,328.30 |
$2,328.30 |
$2,328.30 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$2,277.77 |
$2,277.77 |
$2,277.77 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$2,562.41 |
$2,562.41 |
$2,562.41 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,775.03 |
$2,775.03 |
$2,775.03 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$2,603.33 |
$2,603.33 |
$2,603.33 |
$567.44
|
|
Unlisted transfusion med px
|
$401.92 |
$401.92 |
$401.92 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$2,293.99 |
$2,293.99 |
$2,293.99 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$6,725.99 |
$6,725.99 |
$6,725.99 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$5,306.71 |
$5,306.71 |
$5,306.71 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,863.99 |
$4,863.99 |
$4,863.99 |
$2,013.08
|
|
Urea nitrogen
|
$63.20 |
$63.20 |
$63.20 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$88.96 |
$88.96 |
$88.96 |
$50.00
|
|
Uric acid blood
|
$178.21 |
$178.21 |
$178.21 |
$46.64
|
|
Uric acid urine
|
$81.28 |
$81.28 |
$81.28 |
$46.75
|
|
Urinalysis (with microscopy)
|
$176.05 |
$176.05 |
$176.05 |
$48.14
|
|
Urinalysis (without microscopy)
|
$96.79 |
$96.79 |
$96.79 |
$38.99
|
|
Urine Culture Test
|
$387.61 |
$387.61 |
$387.61 |
$84.81
|
|
Urine pregnancy test
|
$331.02 |
$331.02 |
$331.02 |
$66.40
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$162,903.58 |
$162,903.58 |
$162,903.58 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$930.24 |
$930.24 |
$930.24 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$2,694.72 |
$2,694.72 |
$2,694.72 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$1,376.19 |
$1,376.19 |
$1,376.19 |
$173.98
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$5,528.96 |
$5,528.96 |
$5,528.96 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,870.08 |
$1,870.08 |
$1,870.08 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$823.36 |
$823.36 |
$823.36 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$538.94 |
$538.94 |
$538.94 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$453.47 |
$453.47 |
$453.47 |
$42.90
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$908.51 |
$908.51 |
$908.51 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$3,135.60 |
$3,135.60 |
$3,135.60 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$3,025.99 |
$3,025.99 |
$3,025.99 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$2,126.50 |
$2,126.50 |
$2,126.50 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$4,434.15 |
$4,434.15 |
$4,434.15 |
$715.41
|
|
Vaccine tdap >=7 years im
|
$1,293.75 |
$1,293.75 |
$1,293.75 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$1,063.19 |
$1,063.19 |
$1,063.19 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$216.64 |
$216.64 |
$216.64 |
$115.00
|
|
Vancomycin hcl injection
|
$1,113.26 |
$1,113.26 |
$1,113.26 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$99.49 |
$99.49 |
$99.49 |
$126.79
|
|
Varicella zoster antibody igg
|
$49.70 |
$49.70 |
$49.70 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,416.71 |
$1,416.71 |
$1,416.71 |
$394.13
|
|
Veeg ea 12-26hr cont mntr
|
$15,021.76 |
$15,021.76 |
$15,021.76 |
$3,332.45
|
|
Venogram ext bil s&i
|
$6,080.06 |
$6,080.06 |
$6,080.06 |
$1,838.28
|
|
Venogram extremity supervision & interpretation unilateral
|
$4,342.90 |
$4,342.90 |
$4,342.90 |
$1,326.00
|
|
Venous mech thrombectomy
|
$93,130.72 |
$93,130.72 |
$93,130.72 |
$8,869.50
|
|
Ventilator each subsequent day
|
$6,610.40 |
$6,610.40 |
$6,610.40 |
$1,305.92
|
|
Ventilator initial day
|
$6,610.40 |
$6,610.40 |
$6,610.40 |
$1,540.80
|
|
Vinblastine 1 mg/ml intravenous solution
|
$1,094.71 |
$1,094.71 |
$1,094.71 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$328.55 |
$328.55 |
$328.55 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$532.52 |
$532.52 |
$532.52 |
$245.36
|
|
Virus isolation addl studies ea
|
$323.20 |
$323.20 |
$323.20 |
$90.35
|
|
Vital capacity test
|
$2,253.12 |
$2,253.12 |
$2,253.12 |
$173.33
|