|
Test stress cardiovascular tracing only
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,073.02 |
$1,073.02 |
$1,073.02 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$252.00 |
$252.00 |
$252.00 |
$101.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$34.20 |
$34.20 |
$34.20 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.20 |
$34.20 |
$34.20 |
$47.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$42.07 |
$42.07 |
$42.07 |
$25.80
|
|
Throat x-ray & fluoroscopy
|
$349.80 |
$349.80 |
$349.80 |
$188.00
|
|
Thrombin time
|
$165.60 |
$165.60 |
$165.60 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$241.80 |
$241.80 |
$241.80 |
$56.93
|
|
Thyroglobulin antibody
|
$306.00 |
$306.00 |
$306.00 |
$86.40
|
|
Thyroid (TSH) Test
|
$235.20 |
$235.20 |
$235.20 |
$101.40
|
|
Thyroid Ultrasound
|
$621.00 |
$621.00 |
$621.00 |
$553.80
|
|
Thyroxine binding globulin (tbg)
|
$189.60 |
$189.60 |
$189.60 |
$75.00
|
|
Tissue culture skin/biopsy
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$626.77
|
|
Tissue transglutaminase iga
|
$25.80 |
$25.80 |
$25.80 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$39.35 |
$39.35 |
$39.35 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$334.80 |
$334.80 |
$334.80 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$41.24 |
$41.24 |
$41.24 |
$2,743.02
|
|
Tomosynthesis breast screen bilateral
|
$53.40 |
$53.40 |
$53.40 |
$77.46
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$200.93 |
$200.93 |
$200.93 |
$200.93
|
|
Toxoplasma antibody igg
|
$232.80 |
$232.80 |
$232.80 |
$83.20
|
|
Toxoplasma antibody igm
|
$243.60 |
$243.60 |
$243.60 |
$85.80
|
|
Transferrin
|
$262.20 |
$262.20 |
$262.20 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$988.24
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$14.09 |
$14.09 |
$14.09 |
$108.27
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$153.00 |
$153.00 |
$153.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$82.20 |
$82.20 |
$82.20 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$210.60 |
$210.60 |
$210.60 |
$197.60
|
|
Treponema pallidum antibody
|
$95.40 |
$95.40 |
$95.40 |
$74.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$44.00 |
$44.00 |
$44.00 |
$28.90
|
|
Triamcinolone a inj prs-free
|
$259.20 |
$259.20 |
$259.20 |
$696.00
|
|
Trichomonas assay w/optic
|
$96.60 |
$96.60 |
$96.60 |
$68.90
|
|
Triglycerides
|
$136.80 |
$136.80 |
$136.80 |
$48.75
|
|
Trimethobenzamide hcl inj
|
$120.73 |
$120.73 |
$120.73 |
$105.89
|
|
Troponin quantitative
|
$273.60 |
$273.60 |
$273.60 |
$112.80
|
|
Ua w/micro/comp poc
|
$82.20 |
$82.20 |
$82.20 |
$25.72
|
|
Ultrasound abdomen aorta screening study aaa
|
$421.80 |
$421.80 |
$421.80 |
$394.20
|
|
Ultrasound breast complete
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$952.80 |
$952.80 |
$952.80 |
$427.00
|
|
Ultrasound chest
|
$439.20 |
$439.20 |
$439.20 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$349.80 |
$349.80 |
$349.80 |
$340.03
|
|
Ultrasound elastography parenchyma
|
$547.20 |
$547.20 |
$547.20 |
$275.98
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$692.40 |
$692.40 |
$692.40 |
$428.68
|
|
Ultrasound guided needle placement supervision & interpretation
|
$654.00 |
$654.00 |
$654.00 |
$629.64
|
|
Ultrasound guide intraoperative
|
$646.80 |
$646.80 |
$646.80 |
$628.80
|
|
Ultrasound joint complete left
|
$534.00 |
$534.00 |
$534.00 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$480.60 |
$480.60 |
$480.60 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$508.80 |
$508.80 |
$508.80 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$279.00 |
$279.00 |
$279.00 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$541.80 |
$541.80 |
$541.80 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$559.20 |
$559.20 |
$559.20 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$515.40 |
$515.40 |
$515.40 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$588.60 |
$588.60 |
$588.60 |
$477.10
|
|
Ultrasound retroperitoneal limited
|
$602.40 |
$602.40 |
$602.40 |
$469.58
|
|
Ultrasound scrotum and contents
|
$659.40 |
$659.40 |
$659.40 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$393.60 |
$393.60 |
$393.60 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$186.00 |
$186.00 |
$186.00 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$509.40 |
$509.40 |
$509.40 |
$523.20
|
|
Unlisted CT procedure
|
$685.20 |
$685.20 |
$685.20 |
$1,268.98
|
|
Unlisted orl service/px
|
$144.00 |
$144.00 |
$144.00 |
$153.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,278.00 |
$4,278.00 |
$4,278.00 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,565.20 |
$3,565.20 |
$3,565.20 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,851.80 |
$2,851.80 |
$2,851.80 |
$1,794.00
|
|
Urea nitrogen
|
$100.80 |
$100.80 |
$100.80 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$119.40 |
$119.40 |
$119.40 |
$42.90
|
|
Uric acid blood
|
$116.40 |
$116.40 |
$116.40 |
$44.00
|
|
Uric acid urine
|
$137.40 |
$137.40 |
$137.40 |
$43.20
|
|
Urinalysis microscopic only
|
$70.20 |
$70.20 |
$70.20 |
$25.72
|
|
Urinalysis qual/semiquant excpt ia
|
$73.20 |
$73.20 |
$73.20 |
$22.75
|
|
Urinalysis (with microscopy)
|
$127.20 |
$127.20 |
$127.20 |
$37.39
|
|
Urinalysis (without microscopy)
|
$114.00 |
$114.00 |
$114.00 |
$33.00
|
|
Urine Culture Test
|
$233.40 |
$233.40 |
$233.40 |
$63.84
|
|
Urine pregnancy test
|
$146.40 |
$146.40 |
$146.40 |
$57.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,183.44 |
$3,183.44 |
$3,183.44 |
$8,225.22
|
|
Vaccine dtap < 7 years im
|
$49.35 |
$49.35 |
$49.35 |
$66.69
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$48.82 |
$48.82 |
$48.82 |
$39.78
|
|
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 0.25ml dose im
|
$47.65 |
$47.65 |
$47.65 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$49.02 |
$49.02 |
$49.02 |
$29.60
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$228.96 |
$228.96 |
$228.96 |
$321.80
|
|
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 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
|
$313.70 |
$313.70 |
$313.70 |
$434.73
|
|
Valproic acid total therapeutic drug level
|
$324.60 |
$324.60 |
$324.60 |
$100.80
|
|
Vancomycin peak therapeutic drug level
|
$351.00 |
$351.00 |
$351.00 |
$116.00
|
|
Varicella zoster antibody igg
|
$308.40 |
$308.40 |
$308.40 |
$90.35
|
|
Vasopressin 20 unit/ml intravenous solution
|
$330.41 |
$330.41 |
$330.41 |
$330.41
|
|
Vedolizumab 300 mg intravenous solution
|
$46.29 |
$46.29 |
$46.29 |
$22,019.50
|
|
Veeg cont 2-12 hrs
|
$1,217.40 |
$1,217.40 |
$1,217.40 |
$1,303.97
|
|
Veeg ea 12-26hr cont mntr
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$3,447.00
|
|
Veeg intrmnt 2-12 hrs
|
$631.20 |
$631.20 |
$631.20 |
$870.22
|
|
Ventilator each subsequent day
|
$1,689.00 |
$1,689.00 |
$1,689.00 |
$1,138.50
|
|
Vinblastine 1 mg/ml intravenous solution
|
$202.14 |
$202.14 |
$202.14 |
$159.60
|
|
Vincristine 1 mg/ml intravenous solution
|
$191.12 |
$191.12 |
$191.12 |
$52.02
|
