|
Thyroid (TSH) Test
|
$1,421.51 |
$1,421.51 |
$1,421.51 |
$120.00
|
|
Thyroid Ultrasound
|
$4,898.08 |
$4,898.08 |
$4,898.08 |
$589.96
|
|
Thyroid uptake measurement
|
$4,826.21 |
$4,826.21 |
$4,826.21 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$7,030.00 |
$7,030.00 |
$7,030.00 |
$4,886.55
|
|
Thyroxine binding globulin (tbg)
|
$11.00 |
$11.00 |
$11.00 |
$63.60
|
|
Tigecycline injection
|
$761.00 |
$761.00 |
$761.00 |
$308.75
|
|
Tilt table study
|
$4,420.81 |
$4,420.81 |
$4,420.81 |
$1,495.00
|
|
Tissue culture skin/biopsy
|
$217.00 |
$217.00 |
$217.00 |
$558.87
|
|
Tissue culture tumor
|
$418.00 |
$418.00 |
$418.00 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$770.65 |
$770.65 |
$770.65 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$4,531.00 |
$4,531.00 |
$4,531.00 |
$4,293.26
|
|
Tl-201 thallium diag per mci
|
$941.02 |
$941.02 |
$941.02 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$31.00 |
$31.00 |
$31.00 |
$125.87
|
|
Tobramycin non-comp unit
|
$386.32 |
$386.32 |
$386.32 |
$107.07
|
|
Tobramycin peak therapeutic drug level
|
$247.00 |
$247.00 |
$247.00 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$62.56 |
$62.56 |
$62.56 |
$63.70
|
|
Tomosynthesis breast screen bilateral
|
$62.56 |
$62.56 |
$62.56 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$6,455.00 |
$6,455.00 |
$6,455.00 |
$303.88
|
|
Toxoplasma antibody igg
|
$23.00 |
$23.00 |
$23.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$23.00 |
$23.00 |
$23.00 |
$83.20
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$299.57 |
$299.57 |
$299.57 |
$82.60
|
|
Transcatheter bx s&i
|
$21,242.76 |
$21,242.76 |
$21,242.76 |
$1,875.96
|
|
Transferrin
|
$247.00 |
$247.00 |
$247.00 |
$87.30
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$149.00
|
|
Treatment radiation delivery level 2
|
$1,433.00 |
$1,433.00 |
$1,433.00 |
$735.00
|
|
Treprostinil injection
|
$8,401.00 |
$8,401.00 |
$8,401.00 |
$528.60
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$754.00 |
$754.00 |
$754.00 |
$48.22
|
|
Trichinella antibody
|
$137.00 |
$137.00 |
$137.00 |
$70.65
|
|
Trichomonas assay w/optic
|
$101.76 |
$101.76 |
$101.76 |
$66.00
|
|
#tricyclicantidprssnt
|
$7.00 |
$7.00 |
$7.00 |
$57.08
|
|
Triglycerides
|
$746.69 |
$746.69 |
$746.69 |
$54.60
|
|
Triptorelin pamoate
|
$11,158.00 |
$11,158.00 |
$11,158.00 |
$4,276.66
|
|
Troponin quantitative
|
$1,601.19 |
$1,601.19 |
$1,601.19 |
$123.75
|
|
Tube drain vert dev st 5-40f
|
$58.56 |
$58.56 |
$58.56 |
$72.21
|
|
Ua w/micro/comp poc
|
$343.40 |
$343.40 |
$343.40 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,227.18 |
$1,227.18 |
$1,227.18 |
$403.26
|
|
Ultrasound chest
|
$4,898.08 |
$4,898.08 |
$4,898.08 |
$459.55
|
|
Ultrasound elastography parenchyma
|
$370.02 |
$370.02 |
$370.02 |
$284.25
|
|
Ultrasound encephalogram
|
$2,012.47 |
$2,012.47 |
$2,012.47 |
$481.60
|
|
Ultrasound guide intraoperative
|
$1,006.24 |
$1,006.24 |
$1,006.24 |
$632.90
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,100.32 |
$2,100.32 |
$2,100.32 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,687.71 |
$1,687.71 |
$1,687.71 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$6,653.67 |
$6,653.67 |
$6,653.67 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$2,829.71 |
$2,829.71 |
$2,829.71 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$2,689.95 |
$2,689.95 |
$2,689.95 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$2,647.36 |
$2,647.36 |
$2,647.36 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$4,119.45 |
$4,119.45 |
$4,119.45 |
$545.16
|
|
Ultrasound scrotum and contents
|
$5,737.94 |
$5,737.94 |
$5,737.94 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$4,790.27 |
$4,790.27 |
$4,790.27 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$2,100.32 |
$2,100.32 |
$2,100.32 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$2,647.36 |
$2,647.36 |
$2,647.36 |
$567.44
|
|
Unlisted fluoroscopic px
|
$0.11 |
$0.11 |
$0.11 |
$324.85
|
|
Unlisted ultrasound procedure
|
$2,113.87 |
$2,113.87 |
$2,113.87 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$11,044.88 |
$11,044.88 |
$11,044.88 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$10,193.04 |
$10,193.04 |
$10,193.04 |
$2,013.08
|
|
Urea nitrogen 24 hour urine
|
$736.04 |
$736.04 |
$736.04 |
$50.00
|
|
Ureteral reflux study
|
$3,352.79 |
$3,352.79 |
$3,352.79 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$4,884.77 |
$4,884.77 |
$4,884.77 |
$574.40
|
|
Urethrocystography void s&i
|
$4,630.55 |
$4,630.55 |
$4,630.55 |
$634.50
|
|
Uric acid blood
|
$762.66 |
$762.66 |
$762.66 |
$46.64
|
|
Uric acid urine
|
$762.66 |
$762.66 |
$762.66 |
$46.75
|
|
Urinalysis (without microscopy)
|
$580.32 |
$580.32 |
$580.32 |
$38.99
|
|
Urine Culture Test
|
$479.16 |
$479.16 |
$479.16 |
$84.81
|
|
Use 1st target lesion
|
$370.02 |
$370.02 |
$370.02 |
$245.30
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$473.00 |
$473.00 |
$473.00 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$501.00 |
$501.00 |
$501.00 |
$79.04
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$109.00 |
$109.00 |
$109.00 |
$40.01
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,006.31 |
$1,006.31 |
$1,006.31 |
$499.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$605.00 |
$605.00 |
$605.00 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$750.86 |
$750.86 |
$750.86 |
$349.15
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,249.00 |
$1,249.00 |
$1,249.00 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$1,103.30 |
$1,103.30 |
$1,103.30 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$758.00 |
$758.00 |
$758.00 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$801.00 |
$801.00 |
$801.00 |
$397.18
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$800.72 |
$800.72 |
$800.72 |
$385.45
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$768.15 |
$768.15 |
$768.15 |
$715.41
|
|
Vaccine rabies im
|
$1,519.00 |
$1,519.00 |
$1,519.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$332.00 |
$332.00 |
$332.00 |
$150.76
|
|
Valproic acid total therapeutic drug level
|
$275.52 |
$275.52 |
$275.52 |
$115.00
|
|
Vancomycin peak therapeutic drug level
|
$1,192.58 |
$1,192.58 |
$1,192.58 |
$126.79
|
|
Vasopressin 20 unit/ml intravenous solution
|
$378.38 |
$378.38 |
$378.38 |
$394.13
|
|
Vein x-ray adrenal glands
|
$24,525.01 |
$24,525.01 |
$24,525.01 |
$3,999.60
|
|
Vein x-ray liver
|
$24,386.58 |
$24,386.58 |
$24,386.58 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$24,386.58 |
$24,386.58 |
$24,386.58 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$24,386.58 |
$24,386.58 |
$24,386.58 |
$3,439.84
|
|
Vein x-ray liver without hemodyn
|
$24,386.58 |
$24,386.58 |
$24,386.58 |
$2,489.25
|
|
Vein x-ray skull
|
$23,675.83 |
$23,675.83 |
$23,675.83 |
$2,301.09
|
|
Vein x-ray skull epidural
|
$23,675.83 |
$23,675.83 |
$23,675.83 |
$1,344.60
|
|
Vein x-ray spleen/liver
|
$21,019.15 |
$21,019.15 |
$21,019.15 |
$3,450.30
|
|
Venogram ext bil s&i
|
$11,632.94 |
$11,632.94 |
$11,632.94 |
$1,838.28
|
|
Venous sampling s&i
|
$22,304.90 |
$22,304.90 |
$22,304.90 |
$4,416.78
|
|
Ven thrombosis images bilat
|
$4,787.61 |
$4,787.61 |
$4,787.61 |
$779.56
|
|
Ventilator each subsequent day
|
$2,623.40 |
$2,623.40 |
$2,623.40 |
$1,305.92
|
|
Ventilator initial day
|
$2,748.52 |
$2,748.52 |
$2,748.52 |
$1,540.80
|
|
Vincristine 1 mg/ml intravenous solution
|
$305.00 |
$305.00 |
$305.00 |
$104.79
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$2,233.00 |
$2,233.00 |
$2,233.00 |
$245.36
|
|
Virus isolation addl studies ea
|
$254.00 |
$254.00 |
$254.00 |
$90.35
|
|
Vital capacity test
|
$589.63 |
$589.63 |
$589.63 |
$173.33
|
|
Vitamin D Test
|
$356.00 |
$356.00 |
$356.00 |
$132.00
|
