|
Tomosynthesis breast screen bilateral
|
$113.00 |
$113.00 |
$113.00 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$8,879.00 |
$8,879.00 |
$8,879.00 |
$303.88
|
|
Total tau
|
$544.00 |
$544.00 |
$544.00 |
$293.00
|
|
Toxoplasma antibody igg
|
$335.00 |
$335.00 |
$335.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$529.00 |
$529.00 |
$529.00 |
$83.20
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$216.00 |
$216.00 |
$216.00 |
$93.75
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$958.00 |
$958.00 |
$958.00 |
$82.60
|
|
Transcatheter bx s&i
|
$15,215.00 |
$15,215.00 |
$15,215.00 |
$1,875.96
|
|
Transferrin
|
$67.00 |
$67.00 |
$67.00 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$2,410.00 |
$2,410.00 |
$2,410.00 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$10,245.00 |
$10,245.00 |
$10,245.00 |
$3,401.26
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$356.00 |
$356.00 |
$356.00 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$356.00 |
$356.00 |
$356.00 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$541.00 |
$541.00 |
$541.00 |
$210.00
|
|
Treponema pallidum antibody
|
$271.00 |
$271.00 |
$271.00 |
$72.80
|
|
Treprostinil injection
|
$3,980.00 |
$3,980.00 |
$3,980.00 |
$528.60
|
|
Trichomonas assay w/optic
|
$47.00 |
$47.00 |
$47.00 |
$66.00
|
|
Triglycerides
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$54.60
|
|
Troponin quantitative
|
$262.00 |
$262.00 |
$262.00 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$104,062.00 |
$104,062.00 |
$104,062.00 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$38,431.00 |
$38,431.00 |
$38,431.00 |
$7,717.80
|
|
Ultrasound chest
|
$1,237.00 |
$1,237.00 |
$1,237.00 |
$459.55
|
|
Ultrasound encephalogram
|
$922.00 |
$922.00 |
$922.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$751.00 |
$751.00 |
$751.00 |
$570.44
|
|
Ultrasound guidance for vascular access
|
$3,777.00 |
$3,777.00 |
$3,777.00 |
$340.22
|
|
Ultrasound guide intraoperative
|
$1,867.00 |
$1,867.00 |
$1,867.00 |
$632.90
|
|
Ultrasound joint complete left
|
$3,473.00 |
$3,473.00 |
$3,473.00 |
$556.14
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$4,525.00 |
$4,525.00 |
$4,525.00 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,297.00 |
$1,297.00 |
$1,297.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$4,525.00 |
$4,525.00 |
$4,525.00 |
$450.75
|
|
Ultrasound pregnant uterus transvaginal
|
$1,229.00 |
$1,229.00 |
$1,229.00 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$3,753.00 |
$3,753.00 |
$3,753.00 |
$498.00
|
|
Ultrasound scrotum and contents
|
$4,155.00 |
$4,155.00 |
$4,155.00 |
$617.28
|
|
Ultrasound transabd ea addl gest
|
$1,297.00 |
$1,297.00 |
$1,297.00 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$3,992.00 |
$3,992.00 |
$3,992.00 |
$567.44
|
|
Unit mobile power mpu
|
$53,520.00 |
$53,520.00 |
$53,520.00 |
$17,052.34
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$10,300.00 |
$10,300.00 |
$10,300.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$8,319.00 |
$8,319.00 |
$8,319.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$7,205.00 |
$7,205.00 |
$7,205.00 |
$2,013.08
|
|
Urea nitrogen
|
$261.00 |
$261.00 |
$261.00 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$74.00 |
$74.00 |
$74.00 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$3,995.00 |
$3,995.00 |
$3,995.00 |
$574.40
|
|
Urethrocystography void s&i
|
$6,544.00 |
$6,544.00 |
$6,544.00 |
$634.50
|
|
Uric acid blood
|
$825.00 |
$825.00 |
$825.00 |
$46.64
|
|
Uric acid urine
|
$15.00 |
$15.00 |
$15.00 |
$46.75
|
|
Urinalysis (with microscopy)
|
$1,555.00 |
$1,555.00 |
$1,555.00 |
$48.14
|
|
Urinalysis (without microscopy)
|
$966.00 |
$966.00 |
$966.00 |
$38.99
|
|
Urine Culture Test
|
$477.00 |
$477.00 |
$477.00 |
$84.81
|
|
Urine pregnancy test
|
$239.00 |
$239.00 |
$239.00 |
$66.40
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$137.00 |
$137.00 |
$137.00 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$418.70 |
$418.70 |
$418.70 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$215.82 |
$215.82 |
$215.82 |
$173.98
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$77.33 |
$77.33 |
$77.33 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$140.00 |
$140.00 |
$140.00 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$198.00 |
$198.00 |
$198.00 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$807.00 |
$807.00 |
$807.00 |
$349.15
|
|
Vaccine mmr live subcutaneous
|
$703.00 |
$703.00 |
$703.00 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$529.00 |
$529.00 |
$529.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$1,427.00 |
$1,427.00 |
$1,427.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$385.45
|
|
Vaccine rabies im
|
$2,873.00 |
$2,873.00 |
$2,873.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$274.00 |
$274.00 |
$274.00 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$208.00 |
$208.00 |
$208.00 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$920.32 |
$920.32 |
$920.32 |
$447.80
|
|
Vad battery clip set hmii 14-v li-ion
|
$6,047.00 |
$6,047.00 |
$6,047.00 |
$1,683.99
|
|
Vad univ batt charger hm 1440
|
$48,168.00 |
$48,168.00 |
$48,168.00 |
$14,929.92
|
|
Valproic acid total therapeutic drug level
|
$1,663.00 |
$1,663.00 |
$1,663.00 |
$115.00
|
|
Vancomycin 750 mg intravenous solution
|
$39.00 |
$39.00 |
$39.00 |
$129.78
|
|
Varicella zoster antibody igg
|
$295.00 |
$295.00 |
$295.00 |
$82.55
|
|
Varicella-zoster immue globin im
|
$4,271.00 |
$4,271.00 |
$4,271.00 |
$2,372.84
|
|
Vasopressin 20 unit/ml intravenous solution
|
$258.00 |
$258.00 |
$258.00 |
$394.13
|
|
Vedolizumab 300 mg intravenous solution
|
$44,609.00 |
$44,609.00 |
$44,609.00 |
$23,003.79
|
|
Vein x-ray adrenal glands
|
$18,676.00 |
$18,676.00 |
$18,676.00 |
$3,999.60
|
|
Vein x-ray kidney
|
$18,676.00 |
$18,676.00 |
$18,676.00 |
$2,716.20
|
|
Vein x-ray liver
|
$18,676.00 |
$18,676.00 |
$18,676.00 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$16,992.00 |
$16,992.00 |
$16,992.00 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$18,676.00 |
$18,676.00 |
$18,676.00 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$5,292.00 |
$5,292.00 |
$5,292.00 |
$2,489.25
|
|
Vein x-ray skull
|
$17,184.00 |
$17,184.00 |
$17,184.00 |
$2,301.09
|
|
Venogram ext bil s&i
|
$5,689.00 |
$5,689.00 |
$5,689.00 |
$1,838.28
|
|
Venous sampling s&i
|
$18,544.00 |
$18,544.00 |
$18,544.00 |
$4,416.78
|
|
Ventilator each subsequent day
|
$2,467.00 |
$2,467.00 |
$2,467.00 |
$1,305.92
|
|
Ventilator initial day
|
$3,684.00 |
$3,684.00 |
$3,684.00 |
$1,540.80
|
|
Vinblastine 1 mg/ml intravenous solution
|
$38.00 |
$38.00 |
$38.00 |
$186.71
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$4,977.00 |
$4,977.00 |
$4,977.00 |
$245.36
|
|
Virus isolation addl studies ea
|
$225.00 |
$225.00 |
$225.00 |
$90.35
|
|
Vital capacity test
|
$381.00 |
$381.00 |
$381.00 |
$173.33
|
|
Vitamin b-12
|
$185.00 |
$185.00 |
$185.00 |
$94.90
|
|
Vitamin D Test
|
$417.00 |
$417.00 |
$417.00 |
$132.00
|
|
Volume measurement urine timed
|
$50.00 |
$50.00 |
$50.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$1,184.00 |
$1,184.00 |
$1,184.00 |
$224.40
|
|
Warde 1003990 aldosterone
|
$220.00 |
$220.00 |
$220.00 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$153.00 |
$153.00 |
$153.00 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$74.00 |
$74.00 |
$74.00 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$85.00 |
$85.00 |
$85.00 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$156.00 |
$156.00 |
$156.00 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$97.00 |
$97.00 |
$97.00 |
$102.60
|
|
Warde 3016000 west nile virus antibody
|
$255.00 |
$255.00 |
$255.00 |
$68.80
|
|
Warde 3016000 west nile virus antibody igg
|
$90.00 |
$90.00 |
$90.00 |
$69.00
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$52.00 |
$52.00 |
$52.00 |
$63.05
|
