|
Temozolomide 100 mg intravenous solution
|
$6.40 |
$6.40 |
$6.40 |
$3,129.70
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$67.44 |
$67.44 |
$67.44 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$283.80 |
$283.80 |
$283.80 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$26.96 |
$26.96 |
$26.96 |
$46.10
|
|
Tert gene targeted seq alys
|
$80.00 |
$80.00 |
$80.00 |
$304.59
|
|
Test for chlorohydrocarbons
|
$46.80 |
$46.80 |
$46.80 |
$71.04
|
|
Test for urine cystines
|
$22.00 |
$22.00 |
$22.00 |
$26.00
|
|
Testosterone undecanoate 1mg
|
$3.40 |
$3.40 |
$3.40 |
$1.99
|
|
Test stress cardiovascular tracing only
|
$1,598.80 |
$1,598.80 |
$1,598.80 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$457.44 |
$457.44 |
$457.44 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$20.65 |
$20.65 |
$20.65 |
$9,460.16
|
|
Theophylline therapeutic drug level
|
$70.56 |
$70.56 |
$70.56 |
$108.00
|
|
Ther nma rdctj intus/obstrcj
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$13.48 |
$13.48 |
$13.48 |
$35.72
|
|
Thrombin time
|
$115.92 |
$115.92 |
$115.92 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$29.88 |
$29.88 |
$29.88 |
$56.93
|
|
Thyroglobulin antibody
|
$32.52 |
$32.52 |
$32.52 |
$84.00
|
|
Thyroid imaging
|
$1,396.00 |
$1,396.00 |
$1,396.00 |
$670.80
|
|
Thyroid mets imag whole body
|
$3,200.80 |
$3,200.80 |
$3,200.80 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$59.04 |
$59.04 |
$59.04 |
$120.00
|
|
Thyroid Ultrasound
|
$916.40 |
$916.40 |
$916.40 |
$589.96
|
|
Thyroid uptake measurement
|
$1,146.40 |
$1,146.40 |
$1,146.40 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$1,522.40 |
$1,522.40 |
$1,522.40 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$29.16 |
$29.16 |
$29.16 |
$63.60
|
|
Tigecycline injection
|
$2.40 |
$2.40 |
$2.40 |
$277.31
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$182.92 |
$182.92 |
$182.92 |
$14,271.00
|
|
Tissue culture placenta
|
$144.00 |
$144.00 |
$144.00 |
$520.91
|
|
Tissue culture skin/biopsy
|
$144.00 |
$144.00 |
$144.00 |
$558.87
|
|
Tissue culture tumor
|
$144.00 |
$144.00 |
$144.00 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$10.36 |
$10.36 |
$10.36 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$285.76 |
$285.76 |
$285.76 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$21.60 |
$21.60 |
$21.60 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$139.20 |
$139.20 |
$139.20 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$17.84 |
$17.84 |
$17.84 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$139.36 |
$139.36 |
$139.36 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$7.88 |
$7.88 |
$7.88 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$78.80 |
$78.80 |
$78.80 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$78.80 |
$78.80 |
$78.80 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$54.40 |
$54.40 |
$54.40 |
$404.20
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$44.33 |
$44.33 |
$44.33 |
$18,599.40
|
|
Toxoplasma antibody igg
|
$67.60 |
$67.60 |
$67.60 |
$84.35
|
|
Toxoplasma antibody igm
|
$82.00 |
$82.00 |
$82.00 |
$83.20
|
|
Trabectedin 1 mg intravenous solution
|
$289.56 |
$289.56 |
$289.56 |
$7,403.70
|
|
Transferrin
|
$36.84 |
$36.84 |
$36.84 |
$87.30
|
|
Trastuzumab 150 mg intravenous solution
|
$155.24 |
$155.24 |
$155.24 |
$3,900.04
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$66.08 |
$66.08 |
$66.08 |
$7,191.23
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$95.83 |
$95.83 |
$95.83 |
$4,500.03
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$3,883.65 |
$3,883.65 |
$3,883.65 |
$101,032.80
|
|
Treponema pallidum antibody
|
$23.56 |
$23.56 |
$23.56 |
$72.80
|
|
Trg gene rearrangement anal
|
$90.00 |
$90.00 |
$90.00 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$10.56 |
$10.56 |
$10.56 |
$55.80
|
|
Trichinella antibody
|
$18.35 |
$18.35 |
$18.35 |
$70.65
|
|
Triglycerides
|
$17.08 |
$17.08 |
$17.08 |
$54.60
|
|
Trilaciclib 300 mg intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$5.39
|
|
Triptorelin pamoate
|
$490.76 |
$490.76 |
$490.76 |
$4,619.39
|
|
Troponin quantitative
|
$90.16 |
$90.16 |
$90.16 |
$123.75
|
|
Ua w/micro/comp poc
|
$5.40 |
$5.40 |
$5.40 |
$24.45
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$76.84 |
$76.84 |
$76.84 |
$17,191.88
|
|
Ultrasound abdomen aorta screening study aaa
|
$382.40 |
$382.40 |
$382.40 |
$403.26
|
|
Ultrasound breast complete
|
$740.80 |
$740.80 |
$740.80 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$370.40 |
$370.40 |
$370.40 |
$449.35
|
|
Ultrasound chest
|
$378.40 |
$378.40 |
$378.40 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$568.00 |
$568.00 |
$568.00 |
$340.14
|
|
Ultrasound elastography ea l target les
|
$406.00 |
$406.00 |
$406.00 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$502.40 |
$502.40 |
$502.40 |
$284.25
|
|
Ultrasound encephalogram
|
$637.60 |
$637.60 |
$637.60 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,319.60 |
$1,319.60 |
$1,319.60 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$236.80 |
$236.80 |
$236.80 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$262.00 |
$262.00 |
$262.00 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$576.40 |
$576.40 |
$576.40 |
$701.35
|
|
Ultrasound hips infant dynamic
|
$1,158.80 |
$1,158.80 |
$1,158.80 |
$403.00
|
|
Ultrasound joint complete left
|
$887.60 |
$887.60 |
$887.60 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$582.40 |
$582.40 |
$582.40 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$398.00 |
$398.00 |
$398.00 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$234.40 |
$234.40 |
$234.40 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,299.20 |
$1,299.20 |
$1,299.20 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$348.00 |
$348.00 |
$348.00 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$483.20 |
$483.20 |
$483.20 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$336.00 |
$336.00 |
$336.00 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$974.40 |
$974.40 |
$974.40 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
$498.00
|
|
Ultrasound scrotum and contents
|
$926.40 |
$926.40 |
$926.40 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$838.40 |
$838.40 |
$838.40 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$861.20 |
$861.20 |
$861.20 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$1,068.00 |
$1,068.00 |
$1,068.00 |
$567.44
|
|
Ultrasound trgt dyn mbubb 1st les
|
$387.20 |
$387.20 |
$387.20 |
$479.72
|
|
Unlisted fluoroscopic px
|
$95.80 |
$95.80 |
$95.80 |
$324.85
|
|
Unlisted transfusion med px
|
$200.04 |
$200.04 |
$200.04 |
$141.35
|
|
Upgrade pm system
|
$28,872.00 |
$28,872.00 |
$28,872.00 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,567.60 |
$1,567.60 |
$1,567.60 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,552.80 |
$1,552.80 |
$1,552.80 |
$2,013.08
|
|
Urea nitrogen
|
$18.72 |
$18.72 |
$18.72 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$15.36 |
$15.36 |
$15.36 |
$50.00
|
|
Urea nitrogen clearance
|
$8.52 |
$8.52 |
$8.52 |
$33.57
|
|
Ureteral reflux study
|
$734.40 |
$734.40 |
$734.40 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$503.20 |
$503.20 |
$503.20 |
$574.40
|
|
Urethrocystography void s&i
|
$742.40 |
$742.40 |
$742.40 |
$634.50
|
|
Uric acid blood
|
$20.00 |
$20.00 |
$20.00 |
$46.64
|
|
Uric acid urine
|
$24.40 |
$24.40 |
$24.40 |
$46.75
|
