|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,737.80 |
$2,737.80 |
$2,737.80 |
$1,703.45
|
|
Thrombin time
|
$240.50 |
$240.50 |
$240.50 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$81.25 |
$81.25 |
$81.25 |
$62.01
|
|
Thyroglobulin antibody
|
$111.15 |
$111.15 |
$111.15 |
$82.50
|
|
Thyroid imaging
|
$1,219.40 |
$1,219.40 |
$1,219.40 |
$695.60
|
|
Thyroid met imaging
|
$1,028.30 |
$1,028.30 |
$1,028.30 |
$838.25
|
|
Thyroid mets imag whole body
|
$1,985.75 |
$1,985.75 |
$1,985.75 |
$1,524.99
|
|
Thyroid met uptake
|
$546.00 |
$546.00 |
$546.00 |
$407.40
|
|
Thyroid (TSH) Test
|
$165.75 |
$165.75 |
$165.75 |
$112.70
|
|
Thyroid Ultrasound
|
$718.25 |
$718.25 |
$718.25 |
$588.50
|
|
Thyroid uptake measurement
|
$770.25 |
$770.25 |
$770.25 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$7,163.65 |
$7,163.65 |
$7,163.65 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$15.60 |
$15.60 |
$15.60 |
$64.51
|
|
Tigecycline injection
|
$16.25 |
$16.25 |
$16.25 |
$235.29
|
|
Tilt table study
|
$2,172.30 |
$2,172.30 |
$2,172.30 |
$1,561.82
|
|
Tirofiban 12.5 mg/50 ml
|
$44.20 |
$44.20 |
$44.20 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$845.65 |
$845.65 |
$845.65 |
$13,339.20
|
|
Tissue culture placenta
|
$215.80 |
$215.80 |
$215.80 |
$453.00
|
|
Tissue culture skin/biopsy
|
$562.90 |
$562.90 |
$562.90 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$196.95 |
$196.95 |
$196.95 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$31,844.15 |
$31,844.15 |
$31,844.15 |
$537.50
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$41,834.00 |
$41,834.00 |
$41,834.00 |
$830.41
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$76,424.40 |
$76,424.40 |
$76,424.40 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$40.95 |
$40.95 |
$40.95 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$71.50 |
$71.50 |
$71.50 |
$80.10
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$574.60 |
$574.60 |
$574.60 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$388.05 |
$388.05 |
$388.05 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$39.00 |
$39.00 |
$39.00 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$456.95 |
$456.95 |
$456.95 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$162.50 |
$162.50 |
$162.50 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$23.40 |
$23.40 |
$23.40 |
$316.84
|
|
Toripalimab-tpzi 240 mg/6 ml (40 mg/ml) intravenous solution
|
$383.50 |
$383.50 |
$383.50 |
$15,383.12
|
|
Total tau
|
$297.70 |
$297.70 |
$297.70 |
$312.50
|
|
Toxoplasma antibody igg
|
$35.10 |
$35.10 |
$35.10 |
$91.65
|
|
Toxoplasma antibody igm
|
$35.10 |
$35.10 |
$35.10 |
$87.75
|
|
Tp53 gene trgt sequence alys
|
$1,379.30 |
$1,379.30 |
$1,379.30 |
$804.00
|
|
Tpmt gene com vrnts
|
$456.95 |
$456.95 |
$456.95 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$1,911.00 |
$1,911.00 |
$1,911.00 |
$6,684.23
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$226.20 |
$226.20 |
$226.20 |
$102.27
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$206.05 |
$206.05 |
$206.05 |
$56.38
|
|
Transferrin
|
$446.55 |
$446.55 |
$446.55 |
$82.00
|
|
Transparent film <= 16 sq in
|
$5,064.15 |
$5,064.15 |
$5,064.15 |
$4.50
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$880.10 |
$880.10 |
$880.10 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$1,086.80 |
$1,086.80 |
$1,086.80 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$611.65 |
$611.65 |
$611.65 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$533.65 |
$533.65 |
$533.65 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$447.20 |
$447.20 |
$447.20 |
$5,846.40
|
|
Tray bonemarrw oncontrol 102mm
|
$2,813.20 |
$2,813.20 |
$2,813.20 |
$940.80
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$224.90 |
$224.90 |
$224.90 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$224.90 |
$224.90 |
$224.90 |
$147.48
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$666.25 |
$666.25 |
$666.25 |
$73,346.25
|
|
Treponema pallidum antibody
|
$40.95 |
$40.95 |
$40.95 |
$72.05
|
|
Treprostinil injection
|
$533.65 |
$533.65 |
$533.65 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$436.80 |
$436.80 |
$436.80 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$87.10 |
$87.10 |
$87.10 |
$43.09
|
|
Trichomonas assay w/optic
|
$105.30 |
$105.30 |
$105.30 |
$57.40
|
|
#tricyclicantidprssnt
|
$7.15 |
$7.15 |
$7.15 |
$50.54
|
|
Triglycerides
|
$54.60 |
$54.60 |
$54.60 |
$58.50
|
|
Trilaciclib 300 mg intravenous solution
|
$24.70 |
$24.70 |
$24.70 |
$4,043.12
|
|
Trimethobenzamide hcl inj
|
$420.55 |
$420.55 |
$420.55 |
$117.49
|
|
Triptorelin pamoate
|
$5,278.65 |
$5,278.65 |
$5,278.65 |
$4,619.39
|
|
Troponin quantitative
|
$347.75 |
$347.75 |
$347.75 |
$127.60
|
|
Truskin, per sq centimeter
|
$9,502.35 |
$9,502.35 |
$9,502.35 |
$1.00
|
|
Tte w or without contr, cont ecg
|
$2,978.95 |
$2,978.95 |
$2,978.95 |
$2,067.00
|
|
Tte w or without fol w/con,stres
|
$2,438.80 |
$2,438.80 |
$2,438.80 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$915.20 |
$915.20 |
$915.20 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$687.70 |
$687.70 |
$687.70 |
$1,178.00
|
|
Tube trach disp innr can 6 xlt
|
$22.75 |
$22.75 |
$22.75 |
$16.80
|
|
Tubular dressing
|
$38.35 |
$38.35 |
$38.35 |
$28.46
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$336.05 |
$336.05 |
$336.05 |
$21,992.26
|
|
Ugt1a1 gene analy common variants
|
$254.80 |
$254.80 |
$254.80 |
$438.75
|
|
Ultrasound breast complete
|
$716.30 |
$716.30 |
$716.30 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$573.30 |
$573.30 |
$573.30 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$588.25 |
$588.25 |
$588.25 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$250.90 |
$250.90 |
$250.90 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$404.30 |
$404.30 |
$404.30 |
$313.95
|
|
Ultrasound encephalogram
|
$936.65 |
$936.65 |
$936.65 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$494.00 |
$494.00 |
$494.00 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$732.55 |
$732.55 |
$732.55 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,708.20 |
$1,708.20 |
$1,708.20 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$92.30 |
$92.30 |
$92.30 |
$388.08
|
|
Ultrasound guide intraoperative
|
$976.95 |
$976.95 |
$976.95 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$267.80 |
$267.80 |
$267.80 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$1,032.85 |
$1,032.85 |
$1,032.85 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$616.20 |
$616.20 |
$616.20 |
$311.25
|
|
Ultrasound joint complete left
|
$391.30 |
$391.30 |
$391.30 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$328.90 |
$328.90 |
$328.90 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$818.35 |
$818.35 |
$818.35 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$732.55 |
$732.55 |
$732.55 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$922.35 |
$922.35 |
$922.35 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$732.55 |
$732.55 |
$732.55 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$557.40
|
|
Ultrasound transabd ea addl gest
|
$818.35 |
$818.35 |
$818.35 |
$419.50
|
|
Ultrasound trgt dyn mbubb 1st les
|
$724.75 |
$724.75 |
$724.75 |
$568.32
|
|
Ultrasound trgt dyn mbubb ea addl
|
$507.65 |
$507.65 |
$507.65 |
$348.00
|
|
Unlisted CT procedure
|
$2,415.40 |
$2,415.40 |
$2,415.40 |
$732.70
|
|
Unlisted maaa
|
$6,232.20 |
$6,232.20 |
$6,232.20 |
$235.20
|
|
Unlisted mr procedure
|
$202.80 |
$202.80 |
$202.80 |
$1,165.00
|
|
Unlisted procedure microbiology
|
$384.15 |
$384.15 |
$384.15 |
$530.00
|
|
Unlisted special svc px/rprt
|
$4,892.55 |
$4,892.55 |
$4,892.55 |
$90.00
|
