|
Telavancin injection
|
$1,511.69 |
$1,511.69 |
$1,511.69 |
$1,191.80
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$135.00 |
$135.00 |
$135.00 |
$39.33
|
|
Test for chlorohydrocarbons
|
$400.30 |
$400.30 |
$400.30 |
$65.00
|
|
Tetanus immune globulin inj
|
$1,651.83 |
$1,651.83 |
$1,651.83 |
$1,285.36
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$206.30 |
$206.30 |
$206.30 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$174.72 |
$174.72 |
$174.72 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$1,003.64 |
$1,003.64 |
$1,003.64 |
$529.08
|
|
Thoracic control thoracic ba
|
$3,809.00 |
$3,809.00 |
$3,809.00 |
$387.41
|
|
Thromboxane urine
|
$577.63 |
$577.63 |
$577.63 |
$95.00
|
|
Thyroid imaging
|
$6,887.58 |
$6,887.58 |
$6,887.58 |
$695.02
|
|
Thyroid mets imag whole body
|
$8,763.32 |
$8,763.32 |
$8,763.32 |
$1,524.99
|
|
Thyroid uptake measurement
|
$4,440.69 |
$4,440.69 |
$4,440.69 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$6,523.23 |
$6,523.23 |
$6,523.23 |
$4,112.43
|
|
Tibial length sock fx or equ
|
$1,217.00 |
$1,217.00 |
$1,217.00 |
$88.92
|
|
Tissue culture skin/biopsy
|
$2,439.81 |
$2,439.81 |
$2,439.81 |
$484.00
|
|
Tissue culture tumor
|
$2,439.81 |
$2,439.81 |
$2,439.81 |
$483.36
|
|
Tlso 2mod symphis-xipho pre
|
$6,464.00 |
$6,464.00 |
$6,464.00 |
$1,874.66
|
|
Tlso rigid plastic cust fab
|
$9,953.00 |
$9,953.00 |
$9,953.00 |
$2,347.16
|
|
Tobramycin non-comp unit
|
$90.50 |
$90.50 |
$90.50 |
$108.42
|
|
Tomosynthesis breast diagnostic left
|
$75.16 |
$75.16 |
$75.16 |
$73.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$490.00 |
$490.00 |
$490.00 |
$325.00
|
|
Tpmt gene com vrnts
|
$781.78 |
$781.78 |
$781.78 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$11,057.31 |
$11,057.31 |
$11,057.31 |
$6,827.00
|
|
Transcatheter bx s&i
|
$15,124.90 |
$15,124.90 |
$15,124.90 |
$1,915.00
|
|
Trastuzumab 150 mg intravenous solution
|
$5,454.47 |
$5,454.47 |
$5,454.47 |
$3,141.85
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$957.20 |
$957.20 |
$957.20 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$898.80 |
$898.80 |
$898.80 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$512.29 |
$512.29 |
$512.29 |
$203.35
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$136,500.00 |
$136,500.00 |
$136,500.00 |
$73,346.25
|
|
Trh stimulation panel
|
$506.26 |
$506.26 |
$506.26 |
$117.75
|
|
Trichinella antibody
|
$1,059.32 |
$1,059.32 |
$1,059.32 |
$70.20
|
|
Trilaciclib 300 mg intravenous solution
|
$5,951.40 |
$5,951.40 |
$5,951.40 |
$4,043.12
|
|
Trimethobenzamide hcl inj
|
$137.40 |
$137.40 |
$137.40 |
$117.49
|
|
Tte w or without fol w/con,stres
|
$5,427.97 |
$5,427.97 |
$5,427.97 |
$1,632.80
|
|
Tte w or without fol w/cont, com
|
$5,427.97 |
$5,427.97 |
$5,427.97 |
$1,220.31
|
|
Tube drain vert dev st 5-40f
|
$99.00 |
$99.00 |
$99.00 |
$29.40
|
|
Tx atrial fib pulm vein isol
|
$117,169.38 |
$117,169.38 |
$117,169.38 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$2,471.61 |
$2,471.61 |
$2,471.61 |
$6,769.00
|
|
Ultrasound abdomen aorta screening study aaa
|
$674.47 |
$674.47 |
$674.47 |
$394.20
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$366.64 |
$366.64 |
$366.64 |
$338.00
|
|
Ultrasound elastography parenchyma
|
$410.48 |
$410.48 |
$410.48 |
$307.00
|
|
Ultrasound guide tissue ablation
|
$6,510.53 |
$6,510.53 |
$6,510.53 |
$560.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$12,992.44 |
$12,992.44 |
$12,992.44 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$11,290.87 |
$11,290.87 |
$11,290.87 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$10,260.29 |
$10,260.29 |
$10,260.29 |
$2,034.41
|
|
Urinalysis microscopic only
|
$386.94 |
$386.94 |
$386.94 |
$26.35
|
|
Urine Culture Test
|
$258.69 |
$258.69 |
$258.69 |
$81.50
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$5,874.40 |
$5,874.40 |
$5,874.40 |
$5,184.34
|
|
Vaccine dtap < 7 years im
|
$156.25 |
$156.25 |
$156.25 |
$68.19
|
|
Vaccine dtap-hep b-ipv im
|
$289.73 |
$289.73 |
$289.73 |
$164.63
|
|
Vaccine dtap-ipv/hib im
|
$302.58 |
$302.58 |
$302.58 |
$221.24
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$166.64 |
$166.64 |
$166.64 |
$155.16
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$120.66 |
$120.66 |
$120.66 |
$75.39
|
|
Vaccine influenza nos 0.5ml dose im
|
$142.75 |
$142.75 |
$142.75 |
$24.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$150.00 |
$150.00 |
$150.00 |
$31.03
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$150.00 |
$150.00 |
$150.00 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$560.00 |
$560.00 |
$560.00 |
$409.35
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$182.18 |
$182.18 |
$182.18 |
$310.93
|
|
Vaccine mmr live subcutaneous
|
$353.51 |
$353.51 |
$353.51 |
$211.68
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$886.68 |
$886.68 |
$886.68 |
$397.11
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$717.88 |
$717.88 |
$717.88 |
$414.46
|
|
Vaccine polio (ipv) subcutaneous/im
|
$158.94 |
$158.94 |
$158.94 |
$90.70
|
|
Vaccine rabies im
|
$1,620.78 |
$1,620.78 |
$1,620.78 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$361.44 |
$361.44 |
$361.44 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,665.09 |
$1,665.09 |
$1,665.09 |
$1,104.47
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$3,330.18 |
$3,330.18 |
$3,330.18 |
$997.44
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$91.85 |
$91.85 |
$91.85 |
$126.14
|
|
Vaccine td preservative free >= 7 years im
|
$155.10 |
$155.10 |
$155.10 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$630.96 |
$630.96 |
$630.96 |
$365.17
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$434.68 |
$434.68 |
$434.68 |
$24.12
|
|
Vancomycin hcl injection
|
$213.53 |
$213.53 |
$213.53 |
$154.40
|
|
Varicella-zoster immue globin im
|
$6,894.83 |
$6,894.83 |
$6,894.83 |
$3,816.19
|
|
Varus/valgus strap padded/li
|
$603.00 |
$603.00 |
$603.00 |
$115.53
|
|
Vasopressin 20 unit/ml intravenous solution
|
$743.32 |
$743.32 |
$743.32 |
$325.80
|
|
Vedolizumab 300 mg intravenous solution
|
$26,996.31 |
$26,996.31 |
$26,996.31 |
$18,732.33
|
|
Veeg cont 2-12 hrs
|
$2,597.97 |
$2,597.97 |
$2,597.97 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$4,862.78 |
$4,862.78 |
$4,862.78 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$1,068.18 |
$1,068.18 |
$1,068.18 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$1,843.87 |
$1,843.87 |
$1,843.87 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$1,068.18 |
$1,068.18 |
$1,068.18 |
$826.15
|
|
Vein x-ray liver
|
$14,986.95 |
$14,986.95 |
$14,986.95 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$6,421.99 |
$6,421.99 |
$6,421.99 |
$3,486.86
|
|
Vein x-ray liver w/hemodynam
|
$18,300.43 |
$18,300.43 |
$18,300.43 |
$3,483.84
|
|
Vein x-ray liver without hemodyn
|
$5,593.10 |
$5,593.10 |
$5,593.10 |
$2,452.80
|
|
Vein x-ray skull epidural
|
$11,186.21 |
$11,186.21 |
$11,186.21 |
$1,746.50
|
|
Vein x-ray spleen/liver
|
$5,813.95 |
$5,813.95 |
$5,813.95 |
$3,427.50
|
|
Venogram ext bil s&i
|
$4,998.74 |
$4,998.74 |
$4,998.74 |
$1,797.50
|
|
Venous sampling s&i
|
$17,220.89 |
$17,220.89 |
$17,220.89 |
$4,193.20
|
|
Vinblastine 1 mg/ml intravenous solution
|
$17.00 |
$17.00 |
$17.00 |
$165.00
|
|
Vinorelbine 10 mg/ml intravenous solution (wrapper)
|
$315.00 |
$315.00 |
$315.00 |
$223.55
|
|
Volume measurement urine timed
|
$112.64 |
$112.64 |
$112.64 |
$21.45
|
|
Warde 1005020 citrate 24 hour urine
|
$1,633.59 |
$1,633.59 |
$1,633.59 |
$97.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$698.05 |
$698.05 |
$698.05 |
$70.85
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$303.33 |
$303.33 |
$303.33 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$756.02 |
$756.02 |
$756.02 |
$72.50
|
|
Warde acetylcholine receptor blocking antibody
|
$1,103.93 |
$1,103.93 |
$1,103.93 |
$75.00
|
|
Warde adenosine deaminase pleural fluid
|
$849.70 |
$849.70 |
$849.70 |
$90.00
|
|
Warde anti-mullerian hormone
|
$320.02 |
$320.02 |
$320.02 |
$80.08
|
|
Warde calculus (stone) infrared
|
$265.38 |
$265.38 |
$265.38 |
$59.50
|
|
Warde clozapine therapeutic drug level
|
$167.29 |
$167.29 |
$167.29 |
$66.43
|
