|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.21 |
$17.21 |
$17.21 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$838.80 |
$838.80 |
$838.80 |
$1,687.50
|
|
Thrombin time
|
$38.88 |
$38.88 |
$38.88 |
$53.76
|
|
Thyroglobulin antibody
|
$151.20 |
$151.20 |
$151.20 |
$81.90
|
|
Thyroid imaging
|
$645.12 |
$645.12 |
$645.12 |
$695.02
|
|
Thyroid (TSH) Test
|
$123.84 |
$123.84 |
$123.84 |
$112.70
|
|
Thyroid Ultrasound
|
$1,069.92 |
$1,069.92 |
$1,069.92 |
$589.96
|
|
Thyroid uptake measurement
|
$820.08 |
$820.08 |
$820.08 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$54.00 |
$54.00 |
$54.00 |
$64.51
|
|
Tissue culture skin/biopsy
|
$617.04 |
$617.04 |
$617.04 |
$499.20
|
|
Tissue exam koh skin/hair/nails
|
$106.56 |
$106.56 |
$106.56 |
$47.52
|
|
Tissue transglutaminase iga
|
$105.84 |
$105.84 |
$105.84 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$111.60 |
$111.60 |
$111.60 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$78.48 |
$78.48 |
$78.48 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$78.48 |
$78.48 |
$78.48 |
$68.90
|
|
Total tau
|
$511.20 |
$511.20 |
$511.20 |
$312.00
|
|
Toxoplasma antibody igg
|
$100.80 |
$100.80 |
$100.80 |
$89.57
|
|
Toxoplasma antibody igm
|
$100.80 |
$100.80 |
$100.80 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$1,634.40 |
$1,634.40 |
$1,634.40 |
$823.00
|
|
Tpmt gene com vrnts
|
$417.60 |
$417.60 |
$417.60 |
$373.00
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$77.76 |
$77.76 |
$77.76 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$0.09 |
$0.09 |
$0.09 |
$56.38
|
|
Transferrin
|
$77.04 |
$77.04 |
$77.04 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$883.44 |
$883.44 |
$883.44 |
$936.80
|
|
Treat ankle dislocation
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$2,321.50
|
|
Treat finger fracture each
|
$3,954.24 |
$3,954.24 |
$3,954.24 |
$1,592.00
|
|
Treat fracture of radius
|
$3,716.64 |
$3,716.64 |
$3,716.64 |
$1,790.00
|
|
Treat fracture of radius
|
$4,295.52 |
$4,295.52 |
$4,295.52 |
$1,849.00
|
|
Treat humerus fracture
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,772.97
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$282.24 |
$282.24 |
$282.24 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$270.00 |
$270.00 |
$270.00 |
$143.75
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$244.80 |
$244.80 |
$244.80 |
$203.49
|
|
Treatment of ankle fracture 27786
|
$360.72 |
$360.72 |
$360.72 |
$520.80
|
|
Treatment of penis lesion
|
$6,811.20 |
$6,811.20 |
$6,811.20 |
$3,515.40
|
|
Treatment of thigh fracture
|
$4,079.52 |
$4,079.52 |
$4,079.52 |
$1,698.58
|
|
Treat ulnar fracture
|
$3,954.24 |
$3,954.24 |
$3,954.24 |
$1,662.00
|
|
Treponema pallidum antibody
|
$82.80 |
$82.80 |
$82.80 |
$70.40
|
|
Trg gene rearrangement anal
|
$650.88 |
$650.88 |
$650.88 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$8.09 |
$8.09 |
$8.09 |
$43.09
|
|
Trichinella antibody
|
$66.24 |
$66.24 |
$66.24 |
$70.65
|
|
Trichomonas assay w/optic
|
$167.76 |
$167.76 |
$167.76 |
$56.70
|
|
Triglycerides
|
$75.60 |
$75.60 |
$75.60 |
$57.85
|
|
Troponin quantitative
|
$185.76 |
$185.76 |
$185.76 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$1,470.24 |
$1,470.24 |
$1,470.24 |
$2,006.88
|
|
Tte w or without fol w/con,stres
|
$1,470.24 |
$1,470.24 |
$1,470.24 |
$1,657.92
|
|
Tx closed hip disl traumatic without anes
|
$620.64 |
$620.64 |
$620.64 |
$581.07
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$5,248.08 |
$5,248.08 |
$5,248.08 |
$4,499.12
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$7,920.72 |
$7,920.72 |
$7,920.72 |
$4,499.12
|
|
Tympanometry & reflex thresh
|
$169.20 |
$169.20 |
$169.20 |
$170.99
|
|
Ugt1a1 gene analy common variants
|
$707.76 |
$707.76 |
$707.76 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$822.96 |
$822.96 |
$822.96 |
$394.20
|
|
Ultrasound breast complete
|
$871.92 |
$871.92 |
$871.92 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$501.84 |
$501.84 |
$501.84 |
$452.00
|
|
Ultrasound chest
|
$601.20 |
$601.20 |
$601.20 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$453.60 |
$453.60 |
$453.60 |
$338.00
|
|
Ultrasound encephalogram
|
$668.88 |
$668.88 |
$668.88 |
$494.92
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,236.24 |
$1,236.24 |
$1,236.24 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$657.36 |
$657.36 |
$657.36 |
$388.08
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,152.72 |
$1,152.72 |
$1,152.72 |
$720.15
|
|
Ultrasound guide intraoperative
|
$768.96 |
$768.96 |
$768.96 |
$625.15
|
|
Ultrasound hips infant dynamic
|
$480.96 |
$480.96 |
$480.96 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$427.68 |
$427.68 |
$427.68 |
$311.25
|
|
Ultrasound joint complete left
|
$730.80 |
$730.80 |
$730.80 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$622.80 |
$622.80 |
$622.80 |
$424.00
|
|
Ultrasound ob >=14wks ea addl gest
|
$966.96 |
$966.96 |
$966.96 |
$393.86
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$484.56 |
$484.56 |
$484.56 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,283.76 |
$1,283.76 |
$1,283.76 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$995.04 |
$995.04 |
$995.04 |
$428.25
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$936.72 |
$936.72 |
$936.72 |
$452.10
|
|
Ultrasound pregnant uterus transvaginal
|
$956.88 |
$956.88 |
$956.88 |
$490.00
|
|
Ultrasound prostate/transrectal
|
$872.64 |
$872.64 |
$872.64 |
$549.95
|
|
Ultrasound retroperitoneal limited
|
$886.32 |
$886.32 |
$886.32 |
$479.60
|
|
Ultrasound scrotum and contents
|
$1,144.08 |
$1,144.08 |
$1,144.08 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$303.12 |
$303.12 |
$303.12 |
$459.00
|
|
Ultrasound transabd ea addl gest
|
$590.40 |
$590.40 |
$590.40 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$844.56 |
$844.56 |
$844.56 |
$558.35
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,278.96 |
$4,278.96 |
$4,278.96 |
$2,984.45
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,492.72 |
$3,492.72 |
$3,492.72 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,099.60 |
$3,099.60 |
$3,099.60 |
$2,034.41
|
|
Urea nitrogen
|
$56.88 |
$56.88 |
$56.88 |
$40.95
|
|
Urea nitrogen 24 hour urine
|
$90.00 |
$90.00 |
$90.00 |
$52.00
|
|
Urethrocystography void s&i
|
$1,030.32 |
$1,030.32 |
$1,030.32 |
$648.05
|
|
Uric acid blood
|
$100.80 |
$100.80 |
$100.80 |
$49.44
|
|
Uric acid urine
|
$45.36 |
$45.36 |
$45.36 |
$44.22
|
|
Urinalysis microscopic only
|
$38.88 |
$38.88 |
$38.88 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$48.24 |
$48.24 |
$48.24 |
$25.72
|
|
Urinalysis (with microscopy)
|
$110.88 |
$110.88 |
$110.88 |
$55.44
|
|
Urinalysis (without microscopy)
|
$59.04 |
$59.04 |
$59.04 |
$36.00
|
|
Urine Culture Test
|
$187.20 |
$187.20 |
$187.20 |
$81.27
|
|
Urine pregnancy test
|
$117.36 |
$117.36 |
$117.36 |
$67.80
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$100.69 |
$100.69 |
$100.69 |
$74.42
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$71.75 |
$71.75 |
$71.75 |
$47.88
|
|
Vaccine mmr live subcutaneous
|
$337.39 |
$337.39 |
$337.39 |
$213.00
|
|
Vaccine rabies im
|
$1,502.03 |
$1,502.03 |
$1,502.03 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$167.18 |
$167.18 |
$167.18 |
$132.88
|
|
Valproic acid total therapeutic drug level
|
$122.40 |
$122.40 |
$122.40 |
$114.48
|
|
Vancomycin 1,000 mg intravenous injection
|
$0.55 |
$0.55 |
$0.55 |
$246.70
|
|
Vancomycin peak therapeutic drug level
|
$122.40 |
$122.40 |
$122.40 |
$132.72
|
|
Varicella zoster antibody igg
|
$128.16 |
$128.16 |
$128.16 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$18.17 |
$18.17 |
$18.17 |
$325.80
|
