|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$52.67 |
$52.67 |
$52.67 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,588.32 |
$1,588.32 |
$1,588.32 |
$1,687.50
|
|
Thrombin time
|
$32.40 |
$32.40 |
$32.40 |
$53.76
|
|
Thrombin time titer
|
$8.64 |
$8.64 |
$8.64 |
$17.60
|
|
Thyroglobulin antibody
|
$103.68 |
$103.68 |
$103.68 |
$82.00
|
|
Thyroid mets imag whole body
|
$1,509.84 |
$1,509.84 |
$1,509.84 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$137.52 |
$137.52 |
$137.52 |
$111.00
|
|
Thyroid Ultrasound
|
$1,052.64 |
$1,052.64 |
$1,052.64 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$103.68 |
$103.68 |
$103.68 |
$64.35
|
|
Tib/per revasc stent & ather 37231
|
$30,451.68 |
$30,451.68 |
$30,451.68 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$18,007.92 |
$18,007.92 |
$18,007.92 |
$11,078.70
|
|
Tib/per revasc w/ather add-on 37233
|
$17,150.40 |
$17,150.40 |
$17,150.40 |
$9,769.65
|
|
Tissue culture skin/biopsy
|
$750.96 |
$750.96 |
$750.96 |
$484.00
|
|
Tissue culture tumor
|
$1,638.00 |
$1,638.00 |
$1,638.00 |
$483.36
|
|
Tissue transglutaminase iga
|
$46.80 |
$46.80 |
$46.80 |
$44.16
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$13.44 |
$13.44 |
$13.44 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$167.76 |
$167.76 |
$167.76 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$22.95 |
$22.95 |
$22.95 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$140.40 |
$140.40 |
$140.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$140.40 |
$140.40 |
$140.40 |
$72.68
|
|
Total hysterectomy
|
$14,797.44 |
$14,797.44 |
$14,797.44 |
$3,001.70
|
|
Total tau
|
$511.20 |
$511.20 |
$511.20 |
$312.50
|
|
Toxoplasma antibody igg
|
$83.52 |
$83.52 |
$83.52 |
$89.40
|
|
Toxoplasma antibody igm
|
$83.52 |
$83.52 |
$83.52 |
$87.00
|
|
Tp53 gene trgt sequence alys
|
$1,349.28 |
$1,349.28 |
$1,349.28 |
$790.68
|
|
Tpmt gene com vrnts
|
$519.12 |
$519.12 |
$519.12 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$88.56 |
$88.56 |
$88.56 |
$101.25
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$1.06 |
$1.06 |
$1.06 |
$56.38
|
|
Transcatheter bx s&i
|
$5,098.32 |
$5,098.32 |
$5,098.32 |
$1,915.00
|
|
Transferrin
|
$200.16 |
$200.16 |
$200.16 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$799.20 |
$799.20 |
$799.20 |
$983.00
|
|
Transparent film >16<=48 in
|
$14.40 |
$14.40 |
$14.40 |
$12.95
|
|
Treat elbow fracture
|
$2,912.40 |
$2,912.40 |
$2,912.40 |
$1,919.13
|
|
Treat fracture of radius
|
$2,874.24 |
$2,874.24 |
$2,874.24 |
$1,790.00
|
|
Treat fracture of radius
|
$3,479.04 |
$3,479.04 |
$3,479.04 |
$1,849.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$241.92 |
$241.92 |
$241.92 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$242.64 |
$242.64 |
$242.64 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$206.64 |
$206.64 |
$206.64 |
$203.35
|
|
Treatment of penis lesion
|
$4,892.40 |
$4,892.40 |
$4,892.40 |
$3,515.40
|
|
Treatment of thigh fracture
|
$3,410.64 |
$3,410.64 |
$3,410.64 |
$1,748.40
|
|
Treponema pallidum antibody
|
$79.20 |
$79.20 |
$79.20 |
$70.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$24.76 |
$24.76 |
$24.76 |
$43.21
|
|
Trichomonas assay w/optic
|
$64.80 |
$64.80 |
$64.80 |
$55.50
|
|
Triglycerides
|
$72.00 |
$72.00 |
$72.00 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$641.66 |
$641.66 |
$641.66 |
$117.49
|
|
Trim nondyst nails
|
$121.68 |
$121.68 |
$121.68 |
$113.40
|
|
Trnscath retrv pq vasc fb w/guide
|
$3,682.80 |
$3,682.80 |
$3,682.80 |
$4,523.96
|
|
Troponin quantitative
|
$154.08 |
$154.08 |
$154.08 |
$127.20
|
|
Tte w or without fol w/con,stres
|
$2,303.28 |
$2,303.28 |
$2,303.28 |
$1,632.80
|
|
Tx closed hip disl traumatic without anes
|
$727.92 |
$727.92 |
$727.92 |
$581.07
|
|
Tx phalangeal shaft fx open prox/middle ea
|
$5,689.44 |
$5,689.44 |
$5,689.44 |
$4,499.12
|
|
Ugt1a1 gene analy common variants
|
$524.16 |
$524.16 |
$524.16 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$679.68 |
$679.68 |
$679.68 |
$394.20
|
|
Ultrasound breast complete
|
$760.32 |
$760.32 |
$760.32 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$604.80 |
$604.80 |
$604.80 |
$449.35
|
|
Ultrasound chest
|
$868.32 |
$868.32 |
$868.32 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$313.92 |
$313.92 |
$313.92 |
$338.00
|
|
Ultrasound elastography ea l target les
|
$209.52 |
$209.52 |
$209.52 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$295.92 |
$295.92 |
$295.92 |
$307.00
|
|
Ultrasound encephalogram
|
$570.24 |
$570.24 |
$570.24 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$303.12 |
$303.12 |
$303.12 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$540.72 |
$540.72 |
$540.72 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$219.60 |
$219.60 |
$219.60 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$936.72 |
$936.72 |
$936.72 |
$720.15
|
|
Ultrasound guide intraoperative
|
$472.32 |
$472.32 |
$472.32 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$754.56 |
$754.56 |
$754.56 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$358.56 |
$358.56 |
$358.56 |
$311.25
|
|
Ultrasound joint complete left
|
$815.76 |
$815.76 |
$815.76 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$709.20 |
$709.20 |
$709.20 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,042.56 |
$1,042.56 |
$1,042.56 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$190.80 |
$190.80 |
$190.80 |
$331.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$581.04 |
$581.04 |
$581.04 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$319.68 |
$319.68 |
$319.68 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$377.28 |
$377.28 |
$377.28 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$889.20 |
$889.20 |
$889.20 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$690.48 |
$690.48 |
$690.48 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$898.56 |
$898.56 |
$898.56 |
$486.50
|
|
Ultrasound scrotum and contents
|
$1,092.96 |
$1,092.96 |
$1,092.96 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$499.68 |
$499.68 |
$499.68 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$624.96 |
$624.96 |
$624.96 |
$421.00
|
|
Ultrasound transvaginal non obstetric
|
$922.32 |
$922.32 |
$922.32 |
$558.35
|
|
Umbilical artery cath newborn 36660
|
$133.92 |
$133.92 |
$133.92 |
$206.64
|
|
Unlisted maaa
|
$662.40 |
$662.40 |
$662.40 |
$235.20
|
|
Unlisted procedure microbiology
|
$17.28 |
$17.28 |
$17.28 |
$523.50
|
|
Unlisted transfusion med px
|
$48.24 |
$48.24 |
$48.24 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$979.92 |
$979.92 |
$979.92 |
$1,268.17
|
|
Upgrade pm system
|
$24,157.44 |
$24,157.44 |
$24,157.44 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,127.84 |
$5,127.84 |
$5,127.84 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,857.04 |
$3,857.04 |
$3,857.04 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,273.84 |
$3,273.84 |
$3,273.84 |
$2,034.41
|
|
Urea nitrogen
|
$77.76 |
$77.76 |
$77.76 |
$41.46
|
|
Urea nitrogen 24 hour urine
|
$105.12 |
$105.12 |
$105.12 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$774.00 |
$774.00 |
$774.00 |
$579.73
|
|
Urethrocystography void s&i
|
$1,329.12 |
$1,329.12 |
$1,329.12 |
$622.35
|
|
Uric acid blood
|
$54.00 |
$54.00 |
$54.00 |
$48.75
|
|
Uric acid urine
|
$51.84 |
$51.84 |
$51.84 |
$44.33
|
|
Urinalysis qual/semiquant excpt ia
|
$43.20 |
$43.20 |
$43.20 |
$25.72
|
|
Urinalysis (with microscopy)
|
$74.16 |
$74.16 |
$74.16 |
$55.00
|
|
Urinalysis (without microscopy)
|
$46.08 |
$46.08 |
$46.08 |
$35.75
|
|
Urine Culture Test
|
$93.60 |
$93.60 |
$93.60 |
$81.50
|
