|
Tissue culture tumor
|
$740.00 |
$740.00 |
$740.00 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$22.50 |
$22.50 |
$22.50 |
$47.40
|
|
Tissue transglutaminase iga
|
$75.00 |
$75.00 |
$75.00 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$92.50 |
$92.50 |
$92.50 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$15.78 |
$15.78 |
$15.78 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$265.00 |
$265.00 |
$265.00 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$152.50 |
$152.50 |
$152.50 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$152.50 |
$152.50 |
$152.50 |
$74.10
|
|
Total tau
|
$312.50 |
$312.50 |
$312.50 |
$312.50
|
|
Toxoplasma antibody igg
|
$97.50 |
$97.50 |
$97.50 |
$91.65
|
|
Toxoplasma antibody igm
|
$90.00 |
$90.00 |
$90.00 |
$87.75
|
|
Tp53 gene trgt sequence alys
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$804.00
|
|
Tpmt gene com vrnts
|
$307.50 |
$307.50 |
$307.50 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$105.00 |
$105.00 |
$105.00 |
$102.27
|
|
Transcath biopsy
|
$3,330.00 |
$3,330.00 |
$3,330.00 |
$4,285.93
|
|
Transcatheter bx s&i
|
$1,580.00 |
$1,580.00 |
$1,580.00 |
$1,950.85
|
|
Transferrin
|
$70.00 |
$70.00 |
$70.00 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$405.00 |
$405.00 |
$405.00 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$350.00 |
$350.00 |
$350.00 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$254.55 |
$254.55 |
$254.55 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$207.31 |
$207.31 |
$207.31 |
$7,540.20
|
|
Treat clavicle dislocation 23545
|
$265.00 |
$265.00 |
$265.00 |
$692.80
|
|
Treat finger fracture each
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,592.00
|
|
Treat fracture of radius
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,790.00
|
|
Treat fracture of ulna
|
$270.00 |
$270.00 |
$270.00 |
$731.04
|
|
Treat hip dislocation
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,211.05
|
|
Treat knee fracture(s)
|
$270.00 |
$270.00 |
$270.00 |
$643.26
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$185.00 |
$185.00 |
$185.00 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$90.00 |
$90.00 |
$90.00 |
$147.48
|
|
Treatment of foot infection
|
$1,805.00 |
$1,805.00 |
$1,805.00 |
$2,939.13
|
|
Treatment of thigh fracture
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,790.00
|
|
Treat spinal cord lesion
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$1,337.00
|
|
Treat wrist dislocation
|
$270.00 |
$270.00 |
$270.00 |
$656.25
|
|
Treponema pallidum antibody
|
$80.00 |
$80.00 |
$80.00 |
$72.05
|
|
Trg gene rearrangement anal
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$455.70
|
|
Trichomonas assay w/optic
|
$70.00 |
$70.00 |
$70.00 |
$57.40
|
|
Triglycerides
|
$45.00 |
$45.00 |
$45.00 |
$58.50
|
|
Trimethobenzamide hcl inj
|
$199.70 |
$199.70 |
$199.70 |
$117.49
|
|
Trim nondyst nails
|
$90.00 |
$90.00 |
$90.00 |
$113.88
|
|
Trnscath plc stent crv crtd w/prtct
|
$3,205.00 |
$3,205.00 |
$3,205.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,470.00 |
$4,470.00 |
$4,470.00 |
$8,372.00
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$4,470.00 |
$4,470.00 |
$4,470.00 |
$8,776.32
|
|
Trnscath plc vas stent w/s&i ini vein
|
$7,725.00 |
$7,725.00 |
$7,725.00 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$2,510.00 |
$2,510.00 |
$2,510.00 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$4,640.00 |
$4,640.00 |
$4,640.00 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,795.00 |
$1,795.00 |
$1,795.00 |
$4,341.66
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$4,354.35
|
|
Trnscath tx thromblytc vein ini day
|
$3,760.00 |
$3,760.00 |
$3,760.00 |
$3,866.70
|
|
Troponin quantitative
|
$72.50 |
$72.50 |
$72.50 |
$127.60
|
|
Tx atrial fib pulm vein isol
|
$26,405.00 |
$26,405.00 |
$26,405.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$270.00 |
$270.00 |
$270.00 |
$586.40
|
|
Tx l/r atrial fib addl
|
$4,020.00 |
$4,020.00 |
$4,020.00 |
$6,986.85
|
|
Tyms gene com variants
|
$175.00 |
$175.00 |
$175.00 |
$192.29
|
|
Ua w/micro/comp poc
|
$25.00 |
$25.00 |
$25.00 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$235.00 |
$235.00 |
$235.00 |
$438.75
|
|
Ultrasound breast complete
|
$555.00 |
$555.00 |
$555.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$440.00 |
$440.00 |
$440.00 |
$452.40
|
|
Ultrasound encephalogram
|
$520.00 |
$520.00 |
$520.00 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$515.00 |
$515.00 |
$515.00 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$330.00 |
$330.00 |
$330.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$940.00 |
$940.00 |
$940.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$240.00 |
$240.00 |
$240.00 |
$388.08
|
|
Ultrasound guide intraoperative
|
$725.00 |
$725.00 |
$725.00 |
$632.85
|
|
Ultrasound guide tissue ablation
|
$590.00 |
$590.00 |
$590.00 |
$560.00
|
|
Ultrasound hips infant dynamic
|
$440.00 |
$440.00 |
$440.00 |
$403.88
|
|
Ultrasound joint complete left
|
$675.00 |
$675.00 |
$675.00 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$402.50 |
$402.50 |
$402.50 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$402.50 |
$402.50 |
$402.50 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$350.00 |
$350.00 |
$350.00 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$865.00 |
$865.00 |
$865.00 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$357.50 |
$357.50 |
$357.50 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$530.00 |
$530.00 |
$530.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$415.00 |
$415.00 |
$415.00 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$645.00 |
$645.00 |
$645.00 |
$419.50
|
|
Unlisted chemotherapy px
|
$150.00 |
$150.00 |
$150.00 |
$149.15
|
|
Unlisted CT procedure
|
$390.00 |
$390.00 |
$390.00 |
$732.70
|
|
Unlisted fluoroscopic px
|
$457.50 |
$457.50 |
$457.50 |
$305.76
|
|
Unlisted procedure microbiology
|
$555.00 |
$555.00 |
$555.00 |
$530.00
|
|
Unlisted reprod med lab proc
|
$65.00 |
$65.00 |
$65.00 |
$70.00
|
|
Unlisted transfusion med px
|
$147.50 |
$147.50 |
$147.50 |
$147.50
|
|
Unlisted ultrasound procedure
|
$257.50 |
$257.50 |
$257.50 |
$332.16
|
|
Unsched dialysis esrd pt hos
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$1,292.33
|
|
Upgrade pm system
|
$9,280.00 |
$9,280.00 |
$9,280.00 |
$12,077.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$290.00 |
$290.00 |
$290.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,225.00 |
$1,225.00 |
$1,225.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,575.00 |
$2,575.00 |
$2,575.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$447.50 |
$447.50 |
$447.50 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$490.00 |
$490.00 |
$490.00 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$440.00 |
$440.00 |
$440.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$387.50 |
$387.50 |
$387.50 |
$607.20
|
|
Urea nitrogen
|
$37.50 |
$37.50 |
$37.50 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$37.50 |
$37.50 |
$37.50 |
$52.00
|
|
Urea nitrogen clearance
|
$65.00 |
$65.00 |
$65.00 |
$38.35
|
|
Ureteral embolization/occl
|
$2,730.00 |
$2,730.00 |
$2,730.00 |
$2,079.31
|
|
Ureteral reflux study
|
$1,165.00 |
$1,165.00 |
$1,165.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$510.00 |
$510.00 |
$510.00 |
$584.00
|
|
Urethrocystography void s&i
|
$695.00 |
$695.00 |
$695.00 |
$631.40
|
