|
Tb test cell mediated immunity antigen response gamma interferon
|
$294.00 |
$294.00 |
$294.00 |
$178.40
|
|
Tc-99m labeled rbc
|
$302.40 |
$302.40 |
$302.40 |
$312.70
|
|
Tc-99m maa
|
$258.60 |
$258.60 |
$258.60 |
$306.60
|
|
Tc-99m mebrofenin
|
$58.80 |
$58.80 |
$58.80 |
$169.53
|
|
Tc-99m medronate
|
$69.00 |
$69.00 |
$69.00 |
$120.35
|
|
Tc-99m mertiatide
|
$465.60 |
$465.60 |
$465.60 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.00 |
$10.00
|
|
Tc-99m pentetate dtpa
|
$222.60 |
$222.60 |
$222.60 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$190.80 |
$190.80 |
$190.80 |
$231.60
|
|
Tc-99m pertechnetate per mci
|
$17.40 |
$17.40 |
$17.40 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$55.80 |
$55.80 |
$55.80 |
$221.60
|
|
Tc-99m sulfur colloid
|
$150.60 |
$150.60 |
$150.60 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$231.00 |
$231.00 |
$231.00 |
$189.60
|
|
T cells absolute cd 4 count
|
$264.60 |
$264.60 |
$264.60 |
$120.25
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$240.21 |
$240.21 |
$240.21 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$39.33 |
$39.33 |
$39.33 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,161.00 |
$1,161.00 |
$1,161.00 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,073.02 |
$1,073.02 |
$1,073.02 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$140.40 |
$140.40 |
$140.40 |
$101.40
|
|
Therapeutic procd strg endur
|
$110.40 |
$110.40 |
$110.40 |
$72.39
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$35.40 |
$35.40 |
$35.40 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$35.40 |
$35.40 |
$35.40 |
$47.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$42.98 |
$42.98 |
$42.98 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,490.60 |
$2,490.60 |
$2,490.60 |
$1,658.70
|
|
Thrombin time
|
$116.40 |
$116.40 |
$116.40 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$145.80 |
$145.80 |
$145.80 |
$56.93
|
|
Thyroglobulin antibody
|
$195.60 |
$195.60 |
$195.60 |
$86.40
|
|
Thyroid imaging
|
$900.00 |
$900.00 |
$900.00 |
$577.80
|
|
Thyroid (TSH) Test
|
$236.40 |
$236.40 |
$236.40 |
$101.40
|
|
Thyroid Ultrasound
|
$505.20 |
$505.20 |
$505.20 |
$553.80
|
|
Thyroid uptake measurement
|
$583.80 |
$583.80 |
$583.80 |
$580.20
|
|
Tissue culture placenta
|
$230.40 |
$230.40 |
$230.40 |
$470.00
|
|
Tissue culture skin/biopsy
|
$991.20 |
$991.20 |
$991.20 |
$626.77
|
|
Tissue exam koh skin/hair/nails
|
$43.20 |
$43.20 |
$43.20 |
$45.23
|
|
Tissue transglutaminase iga
|
$26.40 |
$26.40 |
$26.40 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$24.60 |
$24.60 |
$24.60 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$39.35 |
$39.35 |
$39.35 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$232.20 |
$232.20 |
$232.20 |
$117.00
|
|
Tomosynthesis breast screen bilateral
|
$53.40 |
$53.40 |
$53.40 |
$77.46
|
|
Toxoplasma antibody igg
|
$165.00 |
$165.00 |
$165.00 |
$83.20
|
|
Toxoplasma antibody igm
|
$36.00 |
$36.00 |
$36.00 |
$85.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$63.60 |
$63.60 |
$63.60 |
$90.35
|
|
Transferrin
|
$79.80 |
$79.80 |
$79.80 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$814.80 |
$814.80 |
$814.80 |
$988.24
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$226.20 |
$226.20 |
$226.20 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$56.40 |
$56.40 |
$56.40 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$108.60 |
$108.60 |
$108.60 |
$197.60
|
|
Treponema pallidum antibody
|
$199.80 |
$199.80 |
$199.80 |
$74.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$177.22 |
$177.22 |
$177.22 |
$28.90
|
|
Triamcinolone a inj prs-free
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$696.00
|
|
Trichomonas assay w/optic
|
$93.00 |
$93.00 |
$93.00 |
$68.90
|
|
Triglycerides
|
$78.60 |
$78.60 |
$78.60 |
$48.75
|
|
Troponin quantitative
|
$222.60 |
$222.60 |
$222.60 |
$112.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$381.60 |
$381.60 |
$381.60 |
$394.20
|
|
Ultrasound breast complete
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$592.80 |
$592.80 |
$592.80 |
$427.00
|
|
Ultrasound chest
|
$386.40 |
$386.40 |
$386.40 |
$430.10
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$517.20 |
$517.20 |
$517.20 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$239.40 |
$239.40 |
$239.40 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$434.40 |
$434.40 |
$434.40 |
$629.64
|
|
Ultrasound guide intraoperative
|
$687.00 |
$687.00 |
$687.00 |
$628.80
|
|
Ultrasound hips infant dynamic
|
$228.00 |
$228.00 |
$228.00 |
$395.20
|
|
Ultrasound joint complete left
|
$477.60 |
$477.60 |
$477.60 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$286.80 |
$286.80 |
$286.80 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$462.60 |
$462.60 |
$462.60 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$298.20 |
$298.20 |
$298.20 |
$304.80
|
|
Ultrasound pregnant uterus follow up per fetus
|
$476.40 |
$476.40 |
$476.40 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$506.40 |
$506.40 |
$506.40 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$369.60 |
$369.60 |
$369.60 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$670.20 |
$670.20 |
$670.20 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$434.40 |
$434.40 |
$434.40 |
$469.58
|
|
Ultrasound scrotum and contents
|
$554.40 |
$554.40 |
$554.40 |
$558.03
|
|
Ultrasound transvaginal non obstetric
|
$421.20 |
$421.20 |
$421.20 |
$523.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,187.00 |
$2,187.00 |
$2,187.00 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,456.40 |
$2,456.40 |
$2,456.40 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,845.60 |
$1,845.60 |
$1,845.60 |
$1,794.00
|
|
Urea nitrogen
|
$70.20 |
$70.20 |
$70.20 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$78.60 |
$78.60 |
$78.60 |
$42.90
|
|
Uric acid blood
|
$77.40 |
$77.40 |
$77.40 |
$44.00
|
|
Uric acid urine
|
$79.20 |
$79.20 |
$79.20 |
$43.20
|
|
Urinalysis microscopic only
|
$45.00 |
$45.00 |
$45.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$94.80 |
$94.80 |
$94.80 |
$37.39
|
|
Urinalysis (without microscopy)
|
$93.00 |
$93.00 |
$93.00 |
$33.00
|
|
Urine Culture Test
|
$137.40 |
$137.40 |
$137.40 |
$63.84
|
|
Urine pregnancy test
|
$108.60 |
$108.60 |
$108.60 |
$57.00
|
|
Vaccine dtap < 7 years im
|
$49.35 |
$49.35 |
$49.35 |
$66.69
|
|
Vaccine hepatitis a (hepa) adult im
|
$258.74 |
$258.74 |
$258.74 |
$163.15
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$175.91 |
$175.91 |
$175.91 |
$162.07
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$45.91 |
$45.91 |
$45.91 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$179.55 |
$179.55 |
$179.55 |
$130.67
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$47.88 |
$47.88 |
$47.88 |
$47.38
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$48.47 |
$48.47 |
$48.47 |
$29.60
|
|
Vaccine mmr live subcutaneous
|
$417.25 |
$417.25 |
$417.25 |
$222.36
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$166.40 |
$166.40 |
$166.40 |
$195.69
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$429.30 |
$429.30 |
$429.30 |
$393.25
|
|
Vaccine rabies im
|
$659.39 |
$659.39 |
$659.39 |
$800.00
|
|
Vaccine tdap >=7 years im
|
$122.69 |
$122.69 |
$122.69 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$120.13 |
$120.13 |
$120.13 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$361.57 |
$361.57 |
$361.57 |
$434.73
|
