|
Susceptibility enzyme detection per enzyme
|
$60.48 |
$60.48 |
$60.48 |
$34.48
|
|
Susceptibility mic per plate
|
$2,776.75 |
$2,776.75 |
$2,776.75 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$84.55 |
$84.55 |
$84.55 |
$48.30
|
|
Synvisc or synvisc-one
|
$2,432.19 |
$2,432.19 |
$2,432.19 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$31.52 |
$31.52 |
$31.52 |
$44.85
|
|
T3 (triiodothyronine) free
|
$328.40 |
$328.40 |
$328.40 |
$89.82
|
|
T3 (triiodothyronine) total
|
$49.25 |
$49.25 |
$49.25 |
$94.90
|
|
T4 (thyroxine) free
|
$248.62 |
$248.62 |
$248.62 |
$81.60
|
|
T4 (thyroxine) total
|
$182.52 |
$182.52 |
$182.52 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$47.68 |
$47.68 |
$47.68 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$4,505.93 |
$4,505.93 |
$4,505.93 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$220.00 |
$220.00 |
$220.00 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$147.99 |
$147.99 |
$147.99 |
$186.00
|
|
T cells absolute cd 4 count
|
$341.02 |
$341.02 |
$341.02 |
$120.25
|
|
T cells total count
|
$480.45 |
$480.45 |
$480.45 |
$124.11
|
|
Telethx isodose plan cplx
|
$1,794.37 |
$1,794.37 |
$1,794.37 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,083.84 |
$1,083.84 |
$1,083.84 |
$848.72
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$37.05 |
$37.05 |
$37.05 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$959.73 |
$959.73 |
$959.73 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$3,951.11 |
$3,951.11 |
$3,951.11 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$50,882.65 |
$50,882.65 |
$50,882.65 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$180.06 |
$180.06 |
$180.06 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$207.17 |
$207.17 |
$207.17 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$9,045.97 |
$9,045.97 |
$9,045.97 |
$1,804.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$82.39 |
$82.39 |
$82.39 |
$56.93
|
|
Thyroglobulin antibody
|
$202.60 |
$202.60 |
$202.60 |
$84.00
|
|
Thyroid (TSH) Test
|
$231.29 |
$231.29 |
$231.29 |
$120.00
|
|
Thyroid Ultrasound
|
$2,118.78 |
$2,118.78 |
$2,118.78 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$188.21 |
$188.21 |
$188.21 |
$63.60
|
|
Tissue transglutaminase iga
|
$40.05 |
$40.05 |
$40.05 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$140.30 |
$140.30 |
$140.30 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$205.40 |
$205.40 |
$205.40 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$9,151.26 |
$9,151.26 |
$9,151.26 |
$5,790.85
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$158.06 |
$158.06 |
$158.06 |
$303.88
|
|
Toxoplasma antibody igg
|
$183.24 |
$183.24 |
$183.24 |
$84.35
|
|
Toxoplasma antibody igm
|
$183.50 |
$183.50 |
$183.50 |
$83.20
|
|
Transferrin
|
$149.50 |
$149.50 |
$149.50 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$4,050.82 |
$4,050.82 |
$4,050.82 |
$988.24
|
|
Treat finger fracture each
|
$23,406.48 |
$23,406.48 |
$23,406.48 |
$1,815.75
|
|
Treat fracture of radius
|
$23,406.48 |
$23,406.48 |
$23,406.48 |
$2,030.33
|
|
Treat fracture of ulna
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$766.72
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$495.16 |
$495.16 |
$495.16 |
$210.00
|
|
Treatment of heel fracture 28400
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$494.00
|
|
Treatment radiation delivery level 2
|
$951.51 |
$951.51 |
$951.51 |
$735.00
|
|
Treat wrist bone fracture
|
$23,406.48 |
$23,406.48 |
$23,406.48 |
$1,907.64
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$141,028.76 |
$141,028.76 |
$141,028.76 |
$120,541.18
|
|
Treponema pallidum antibody
|
$168.60 |
$168.60 |
$168.60 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$317.62 |
$317.62 |
$317.62 |
$48.22
|
|
Triglycerides
|
$273.80 |
$273.80 |
$273.80 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$854.13 |
$854.13 |
$854.13 |
$154.09
|
|
Trim nondyst nails
|
$959.73 |
$959.73 |
$959.73 |
$124.22
|
|
Trnscath tx thromblytc vein ini day
|
$38,450.98 |
$38,450.98 |
$38,450.98 |
$4,329.36
|
|
Troponin quantitative
|
$512.64 |
$512.64 |
$512.64 |
$123.75
|
|
Tx closed hip disl traumatic without anes
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$657.28
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,925.54 |
$1,925.54 |
$1,925.54 |
$403.26
|
|
Ultrasound chest
|
$1,925.54 |
$1,925.54 |
$1,925.54 |
$459.55
|
|
Ultrasound exam k transpl w/doppler
|
$1,925.54 |
$1,925.54 |
$1,925.54 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,925.54 |
$1,925.54 |
$1,925.54 |
$477.88
|
|
Ultrasound joint complete left
|
$1,925.54 |
$1,925.54 |
$1,925.54 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$2,287.86 |
$2,287.86 |
$2,287.86 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,112.60 |
$1,112.60 |
$1,112.60 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,032.47 |
$1,032.47 |
$1,032.47 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$4,056.83 |
$4,056.83 |
$4,056.83 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$858.96 |
$858.96 |
$858.96 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,273.45 |
$1,273.45 |
$1,273.45 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,840.65 |
$1,840.65 |
$1,840.65 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$1,780.66 |
$1,780.66 |
$1,780.66 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,372.40 |
$2,372.40 |
$2,372.40 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$2,268.77 |
$2,268.77 |
$2,268.77 |
$567.44
|
|
Unlisted transfusion med px
|
$436.19 |
$436.19 |
$436.19 |
$141.35
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$8,794.33 |
$8,794.33 |
$8,794.33 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$7,553.79 |
$7,553.79 |
$7,553.79 |
$2,013.08
|
|
Urea nitrogen
|
$50.30 |
$50.30 |
$50.30 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$19.31 |
$19.31 |
$19.31 |
$50.00
|
|
Uric acid blood
|
$136.89 |
$136.89 |
$136.89 |
$46.64
|
|
Uric acid urine
|
$64.68 |
$64.68 |
$64.68 |
$46.75
|
|
Urinalysis (with microscopy)
|
$194.58 |
$194.58 |
$194.58 |
$48.14
|
|
Urinalysis (without microscopy)
|
$184.75 |
$184.75 |
$184.75 |
$38.99
|
|
Urine Culture Test
|
$356.88 |
$356.88 |
$356.88 |
$84.81
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$90,839.33 |
$90,839.33 |
$90,839.33 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$583.52 |
$583.52 |
$583.52 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$1,679.61 |
$1,679.61 |
$1,679.61 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$860.54 |
$860.54 |
$860.54 |
$173.98
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$3,089.61 |
$3,089.61 |
$3,089.61 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$1,167.35 |
$1,167.35 |
$1,167.35 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$517.13 |
$517.13 |
$517.13 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$340.44 |
$340.44 |
$340.44 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$287.35 |
$287.35 |
$287.35 |
$42.90
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$570.02 |
$570.02 |
$570.02 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,755.10 |
$1,755.10 |
$1,755.10 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,693.99 |
$1,693.99 |
$1,693.99 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$1,192.45 |
$1,192.45 |
$1,192.45 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,479.16 |
$2,479.16 |
$2,479.16 |
$715.41
|
|
Vaccine tdap >=7 years im
|
$809.33 |
$809.33 |
$809.33 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$666.11 |
$666.11 |
$666.11 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$172.42 |
$172.42 |
$172.42 |
$115.00
|
|
Vancomycin hcl injection
|
$1,239.28 |
$1,239.28 |
$1,239.28 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$207.42 |
$207.42 |
$207.42 |
$126.79
|
|
Varicella zoster antibody igg
|
$44.73 |
$44.73 |
$44.73 |
$82.55
|
|
Vasopressin 20 unit/ml intravenous solution
|
$1,594.18 |
$1,594.18 |
$1,594.18 |
$394.13
|