|
T cells total count
|
$118.00 |
$118.00 |
$118.00 |
$124.11
|
|
Telavancin injection
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$1,216.45
|
|
Test for chlorohydrocarbons
|
$71.00 |
$71.00 |
$71.00 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$4,814.00 |
$4,814.00 |
$4,814.00 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$5,413.00 |
$5,413.00 |
$5,413.00 |
$1,001.55
|
|
Test urine for porphyrins
|
$178.00 |
$178.00 |
$178.00 |
$27.30
|
|
Tetanus immune globulin inj
|
$1,915.00 |
$1,915.00 |
$1,915.00 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$778.00 |
$778.00 |
$778.00 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$152.00 |
$152.00 |
$152.00 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$114.00 |
$114.00 |
$114.00 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$2,580.00 |
$2,580.00 |
$2,580.00 |
$534.32
|
|
Thrombin time
|
$316.00 |
$316.00 |
$316.00 |
$48.75
|
|
Thyroglobulin antibody
|
$654.00 |
$654.00 |
$654.00 |
$84.00
|
|
Thyroid imaging
|
$3,869.00 |
$3,869.00 |
$3,869.00 |
$670.80
|
|
Thyroid mets imag whole body
|
$7,110.00 |
$7,110.00 |
$7,110.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$2,890.00 |
$2,890.00 |
$2,890.00 |
$120.00
|
|
Thyroid uptake measurement
|
$2,297.00 |
$2,297.00 |
$2,297.00 |
$653.60
|
|
Thyrotropin releasing hormone
|
$8,655.00 |
$8,655.00 |
$8,655.00 |
$55.45
|
|
Thyroxine binding globulin (tbg)
|
$542.00 |
$542.00 |
$542.00 |
$63.60
|
|
Tigecycline injection
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$308.75
|
|
Tissue culture placenta
|
$898.00 |
$898.00 |
$898.00 |
$520.91
|
|
Tissue culture skin/biopsy
|
$542.00 |
$542.00 |
$542.00 |
$558.87
|
|
Tissue culture tumor
|
$2,016.00 |
$2,016.00 |
$2,016.00 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$654.00 |
$654.00 |
$654.00 |
$47.40
|
|
Tl-201 thallium diag per mci
|
$2,732.00 |
$2,732.00 |
$2,732.00 |
$77.22
|
|
Tobramycin peak therapeutic drug level
|
$743.00 |
$743.00 |
$743.00 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$212.00 |
$212.00 |
$212.00 |
$63.70
|
|
Tomosynthesis breast screen bilateral
|
$135.00 |
$135.00 |
$135.00 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$10,695.00 |
$10,695.00 |
$10,695.00 |
$303.88
|
|
Toxoplasma antibody igg
|
$499.00 |
$499.00 |
$499.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$558.00 |
$558.00 |
$558.00 |
$83.20
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$21.61 |
$21.61 |
$21.61 |
$82.60
|
|
Transcatheter bx s&i
|
$8,096.00 |
$8,096.00 |
$8,096.00 |
$1,875.96
|
|
Transferrin
|
$393.00 |
$393.00 |
$393.00 |
$87.30
|
|
Trastuzumab 150 mg intravenous solution
|
$528.00 |
$528.00 |
$528.00 |
$3,401.26
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$955.00 |
$955.00 |
$955.00 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$955.00 |
$955.00 |
$955.00 |
$149.00
|
|
Trichinella antibody
|
$193.00 |
$193.00 |
$193.00 |
$70.65
|
|
Triptorelin pamoate
|
$22,324.00 |
$22,324.00 |
$22,324.00 |
$4,276.66
|
|
Tx atrial fib pulm vein isol
|
$72,149.00 |
$72,149.00 |
$72,149.00 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$11,575.00 |
$11,575.00 |
$11,575.00 |
$7,717.80
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$340.14
|
|
Ultrasound encephalogram
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$2,574.00 |
$2,574.00 |
$2,574.00 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$3,957.00 |
$3,957.00 |
$3,957.00 |
$477.88
|
|
Ultrasound guide intraoperative
|
$7,227.00 |
$7,227.00 |
$7,227.00 |
$632.90
|
|
Ultrasound ob >=14wks ea addl gest
|
$4,816.00 |
$4,816.00 |
$4,816.00 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,021.00 |
$1,021.00 |
$1,021.00 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$2,624.00 |
$2,624.00 |
$2,624.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$2,116.00 |
$2,116.00 |
$2,116.00 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$2,520.00 |
$2,520.00 |
$2,520.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,634.00 |
$1,634.00 |
$1,634.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,735.00 |
$1,735.00 |
$1,735.00 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$3,344.00 |
$3,344.00 |
$3,344.00 |
$498.00
|
|
Ultrasound scrotum and contents
|
$3,509.00 |
$3,509.00 |
$3,509.00 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$3,961.00 |
$3,961.00 |
$3,961.00 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$1,634.00 |
$1,634.00 |
$1,634.00 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,861.00 |
$1,861.00 |
$1,861.00 |
$567.44
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$20,973.00 |
$20,973.00 |
$20,973.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$14,945.00 |
$14,945.00 |
$14,945.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$7,130.00 |
$7,130.00 |
$7,130.00 |
$2,013.08
|
|
Urea nitrogen
|
$423.00 |
$423.00 |
$423.00 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$423.00 |
$423.00 |
$423.00 |
$50.00
|
|
Ureteral reflux study
|
$4,676.00 |
$4,676.00 |
$4,676.00 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$2,435.00 |
$2,435.00 |
$2,435.00 |
$574.40
|
|
Urethrocystography void s&i
|
$3,293.00 |
$3,293.00 |
$3,293.00 |
$634.50
|
|
Uric acid blood
|
$527.00 |
$527.00 |
$527.00 |
$46.64
|
|
Uric acid urine
|
$614.00 |
$614.00 |
$614.00 |
$46.75
|
|
Urinalysis qual/semiquant excpt ia
|
$564.00 |
$564.00 |
$564.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$991.00 |
$991.00 |
$991.00 |
$48.14
|
|
Urine Culture Test
|
$620.00 |
$620.00 |
$620.00 |
$84.81
|
|
Urine pregnancy test
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$66.40
|
|
Urography inf drip &/or bolus
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$641.69
|
|
Vaccine dtap < 7 years im
|
$704.00 |
$704.00 |
$704.00 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$995.00 |
$995.00 |
$995.00 |
$193.83
|
|
Vaccine hepatitis a (hepa) adult im
|
$712.00 |
$712.00 |
$712.00 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$8,731.00 |
$8,731.00 |
$8,731.00 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$419.00 |
$419.00 |
$419.00 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$175.70 |
$175.70 |
$175.70 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$436.00 |
$436.00 |
$436.00 |
$157.41
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$152.00 |
$152.00 |
$152.00 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$120.00 |
$120.00 |
$120.00 |
$40.01
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$205.00 |
$205.00 |
$205.00 |
$72.00
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$1,188.14 |
$1,188.14 |
$1,188.14 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,568.00 |
$1,568.00 |
$1,568.00 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$727.00 |
$727.00 |
$727.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$877.00 |
$877.00 |
$877.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,995.00 |
$1,995.00 |
$1,995.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,882.72 |
$1,882.72 |
$1,882.72 |
$385.45
|
|
Vaccine polio (ipv) subcutaneous/im
|
$639.00 |
$639.00 |
$639.00 |
$119.17
|
|
Vaccine rabies im
|
$4,108.00 |
$4,108.00 |
$4,108.00 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$3,768.23 |
$3,768.23 |
$3,768.23 |
$1,196.00
|
|
Vaccine td preservative free >= 7 years im
|
$234.00 |
$234.00 |
$234.00 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$694.00 |
$694.00 |
$694.00 |
$115.00
|
|
Vancomycin 750 mg intravenous solution
|
$14.12 |
$14.12 |
$14.12 |
$129.78
|
|
Vancomycin peak therapeutic drug level
|
$795.00 |
$795.00 |
$795.00 |
$126.79
|
|
Varicella-zoster immue globin im
|
$3,971.00 |
$3,971.00 |
$3,971.00 |
$2,372.84
|
|
Venogram ext bil s&i
|
$5,162.00 |
$5,162.00 |
$5,162.00 |
$1,838.28
|
|
Vinblastine 1 mg/ml intravenous solution
|
$981.00 |
$981.00 |
$981.00 |
$186.71
|
|
Vincristine 1 mg/ml intravenous solution
|
$946.00 |
$946.00 |
$946.00 |
$104.79
|
