|
Tc-99m sulfur colloid
|
$1,107.44 |
$1,107.44 |
$1,107.44 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$2,746.96 |
$2,746.96 |
$2,746.96 |
$198.05
|
|
T cells absolute cd 4 count
|
$31.65 |
$31.65 |
$31.65 |
$120.25
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$51.79 |
$51.79 |
$51.79 |
$44.49
|
|
Testicular imaging w/vasc flow
|
$6,163.93 |
$6,163.93 |
$6,163.93 |
$780.48
|
|
Tetanus immune globulin inj
|
$1,982.87 |
$1,982.87 |
$1,982.87 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$939.66 |
$939.66 |
$939.66 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$370.49 |
$370.49 |
$370.49 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$183.07 |
$183.07 |
$183.07 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$6,731.52 |
$6,731.52 |
$6,731.52 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$80.38 |
$80.38 |
$80.38 |
$38.64
|
|
Throat x-ray & fluoroscopy
|
$2,538.67 |
$2,538.67 |
$2,538.67 |
$188.00
|
|
Thyroid imaging
|
$6,677.91 |
$6,677.91 |
$6,677.91 |
$670.80
|
|
Thyroid mets imag whole body
|
$9,615.69 |
$9,615.69 |
$9,615.69 |
$1,524.99
|
|
Thyroid Ultrasound
|
$3,995.77 |
$3,995.77 |
$3,995.77 |
$589.96
|
|
Thyroid uptake measurement
|
$5,516.17 |
$5,516.17 |
$5,516.17 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$14,356.04 |
$14,356.04 |
$14,356.04 |
$4,886.55
|
|
Thyroxine binding globulin (tbg)
|
$9.37 |
$9.37 |
$9.37 |
$63.60
|
|
Tigecycline injection
|
$541.61 |
$541.61 |
$541.61 |
$308.75
|
|
Tissue exam koh skin/hair/nails
|
$600.03 |
$600.03 |
$600.03 |
$47.40
|
|
Tl-201 thallium diag per mci
|
$3,376.55 |
$3,376.55 |
$3,376.55 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$40.80 |
$40.80 |
$40.80 |
$125.87
|
|
Tobramycin non-comp unit
|
$73.39 |
$73.39 |
$73.39 |
$107.07
|
|
Tomosynthesis breast diagnostic left
|
$173.53 |
$173.53 |
$173.53 |
$63.70
|
|
Tomosynthesis breast screen bilateral
|
$173.53 |
$173.53 |
$173.53 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$8,314.43 |
$8,314.43 |
$8,314.43 |
$303.88
|
|
Toxoplasma antibody igg
|
$117.17 |
$117.17 |
$117.17 |
$84.35
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$19.50 |
$19.50 |
$19.50 |
$82.60
|
|
Transcatheter bx s&i
|
$9,476.20 |
$9,476.20 |
$9,476.20 |
$1,875.96
|
|
Transferrin
|
$103.93 |
$103.93 |
$103.93 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,812.35 |
$1,812.35 |
$1,812.35 |
$988.24
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$256.36 |
$256.36 |
$256.36 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$256.36 |
$256.36 |
$256.36 |
$149.00
|
|
Treatment radiation delivery level 2
|
$152.58 |
$152.58 |
$152.58 |
$735.00
|
|
Treprostinil injection
|
$368.51 |
$368.51 |
$368.51 |
$528.60
|
|
Trg gene rearrangement anal
|
$174.91 |
$174.91 |
$174.91 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$170.29 |
$170.29 |
$170.29 |
$48.22
|
|
Trichinella antibody
|
$74.18 |
$74.18 |
$74.18 |
$70.65
|
|
Trichomonas assay w/optic
|
$92.51 |
$92.51 |
$92.51 |
$66.00
|
|
Tube drain vert dev st 5-40f
|
$59.55 |
$59.55 |
$59.55 |
$72.21
|
|
Tx atrial fib pulm vein isol
|
$89,088.09 |
$89,088.09 |
$89,088.09 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$5,568.02 |
$5,568.02 |
$5,568.02 |
$7,717.80
|
|
Ultrasound chest
|
$3,001.04 |
$3,001.04 |
$3,001.04 |
$459.55
|
|
Ultrasound encephalogram
|
$4,915.31 |
$4,915.31 |
$4,915.31 |
$481.60
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$3,227.64 |
$3,227.64 |
$3,227.64 |
$477.88
|
|
Ultrasound guide intraoperative
|
$6,637.35 |
$6,637.35 |
$6,637.35 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$9,224.34 |
$9,224.34 |
$9,224.34 |
$498.40
|
|
Ultrasound ob >=14wks ea addl gest
|
$5,513.01 |
$5,513.01 |
$5,513.01 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$5,011.81 |
$5,011.81 |
$5,011.81 |
$326.54
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,479.57 |
$1,479.57 |
$1,479.57 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$3,485.85 |
$3,485.85 |
$3,485.85 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$3,168.99 |
$3,168.99 |
$3,168.99 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$4,585.09 |
$4,585.09 |
$4,585.09 |
$498.00
|
|
Ultrasound scrotum and contents
|
$5,015.62 |
$5,015.62 |
$5,015.62 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$4,142.08 |
$4,142.08 |
$4,142.08 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$2,867.26 |
$2,867.26 |
$2,867.26 |
$567.44
|
|
Unlisted mr procedure
|
$12,342.31 |
$12,342.31 |
$12,342.31 |
$1,032.20
|
|
Unlisted ultrasound procedure
|
$4,142.08 |
$4,142.08 |
$4,142.08 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$21,871.59 |
$21,871.59 |
$21,871.59 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$12,654.76 |
$12,654.76 |
$12,654.76 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$14,466.14 |
$14,466.14 |
$14,466.14 |
$2,013.08
|
|
Urea nitrogen 24 hour urine
|
$35.81 |
$35.81 |
$35.81 |
$50.00
|
|
Ureteral reflux study
|
$4,717.99 |
$4,717.99 |
$4,717.99 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$7,156.15 |
$7,156.15 |
$7,156.15 |
$574.40
|
|
Urethrocystography void s&i
|
$5,506.38 |
$5,506.38 |
$5,506.38 |
$634.50
|
|
Uric acid blood
|
$907.24 |
$907.24 |
$907.24 |
$46.64
|
|
Urinalysis microscopic only
|
$712.89 |
$712.89 |
$712.89 |
$26.35
|
|
Urinary bldr retent nuc study
|
$1,558.72 |
$1,558.72 |
$1,558.72 |
$309.22
|
|
Urine Culture Test
|
$1,940.19 |
$1,940.19 |
$1,940.19 |
$84.81
|
|
Urography inf drip &/or bolus
|
$6,249.43 |
$6,249.43 |
$6,249.43 |
$641.69
|
|
Vaccine hepatitis a (hepa) adult im
|
$80.00 |
$80.00 |
$80.00 |
$178.07
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$144.68 |
$144.68 |
$144.68 |
$40.01
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$320.29 |
$320.29 |
$320.29 |
$72.00
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$669.04 |
$669.04 |
$669.04 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$789.23 |
$789.23 |
$789.23 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$1,475.00 |
$1,475.00 |
$1,475.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$331.46 |
$331.46 |
$331.46 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,028.76 |
$1,028.76 |
$1,028.76 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$707.43 |
$707.43 |
$707.43 |
$385.45
|
|
Vaccine rabies im
|
$1,958.33 |
$1,958.33 |
$1,958.33 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$223.86 |
$223.86 |
$223.86 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$153.94 |
$153.94 |
$153.94 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$95.00 |
$95.00 |
$95.00 |
$447.80
|
|
Vanomycin dna amp probe
|
$253.39 |
$253.39 |
$253.39 |
$87.20
|
|
Vasopressin 20 unit/ml intravenous solution
|
$164.63 |
$164.63 |
$164.63 |
$394.13
|
|
Vein x-ray adrenal glands
|
$15,069.87 |
$15,069.87 |
$15,069.87 |
$3,999.60
|
|
Vein x-ray liver w/hemodynam
|
$25,247.41 |
$25,247.41 |
$25,247.41 |
$3,413.25
|
|
Vein x-ray liver without hemodyn
|
$23,136.01 |
$23,136.01 |
$23,136.01 |
$2,489.25
|
|
Vein x-ray spleen/liver
|
$23,136.01 |
$23,136.01 |
$23,136.01 |
$3,450.30
|
|
Venous sampling s&i
|
$9,082.63 |
$9,082.63 |
$9,082.63 |
$4,416.78
|
|
Venous thrombosis imaging
|
$5,620.67 |
$5,620.67 |
$5,620.67 |
$636.97
|
|
Ven thrombosis images bilat
|
$7,129.23 |
$7,129.23 |
$7,129.23 |
$779.56
|
|
Ventilator each subsequent day
|
$3,952.17 |
$3,952.17 |
$3,952.17 |
$1,305.92
|
|
Ventilator initial day
|
$5,883.38 |
$5,883.38 |
$5,883.38 |
$1,540.80
|
|
Vital capacity test
|
$467.97 |
$467.97 |
$467.97 |
$173.33
|
|
Volume measurement urine timed
|
$63.64 |
$63.64 |
$63.64 |
$21.45
|
|
Warde 1005020 citrate 24 hour urine
|
$10.00 |
$10.00 |
$10.00 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$8.15 |
$8.15 |
$8.15 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$5.70 |
$5.70 |
$5.70 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$22.56 |
$22.56 |
$22.56 |
$40.70
|
