|
Telethx isodose plan simple
|
$502.07 |
$502.07 |
$502.07 |
$813.43
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$27.25 |
$27.25 |
$27.25 |
$42.14
|
|
Test pathogen(s) for platelets reference
|
$474.78 |
$474.78 |
$474.78 |
$88.90
|
|
Test stress cardiovascular tracing only
|
$1,533.86 |
$1,533.86 |
$1,533.86 |
$1,025.64
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$30,192.82 |
$30,192.82 |
$30,192.82 |
$11,450.91
|
|
Theophylline therapeutic drug level
|
$144.21 |
$144.21 |
$144.21 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$115.06 |
$115.06 |
$115.06 |
$32.34
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,153.94 |
$3,153.94 |
$3,153.94 |
$1,748.50
|
|
Thrombin time
|
$68.26 |
$68.26 |
$68.26 |
$47.25
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$149.17 |
$149.17 |
$149.17 |
$57.50
|
|
Thyroglobulin antibody
|
$195.14 |
$195.14 |
$195.14 |
$85.15
|
|
Thyroid (TSH) Test
|
$289.46 |
$289.46 |
$289.46 |
$110.00
|
|
Thyroid Ultrasound
|
$1,337.54 |
$1,337.54 |
$1,337.54 |
$581.60
|
|
Thyroid uptake measurement
|
$1,283.51 |
$1,283.51 |
$1,283.51 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$309.92 |
$309.92 |
$309.92 |
$63.60
|
|
Tissue exam koh skin/hair/nails
|
$288.35 |
$288.35 |
$288.35 |
$47.20
|
|
Tissue transglutaminase iga
|
$435.65 |
$435.65 |
$435.65 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$84.74 |
$84.74 |
$84.74 |
$146.72
|
|
Tobramycin peak therapeutic drug level
|
$270.33 |
$270.33 |
$270.33 |
$115.80
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,434.99 |
$5,434.99 |
$5,434.99 |
$3,890.64
|
|
Tomosynthesis breast screen bilateral
|
$83.38 |
$83.38 |
$83.38 |
$73.00
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$279.80 |
$279.80 |
$279.80 |
$295.36
|
|
Toxoplasma antibody igg
|
$32.16 |
$32.16 |
$32.16 |
$85.80
|
|
Toxoplasma antibody igm
|
$109.33 |
$109.33 |
$109.33 |
$90.00
|
|
Transferrin
|
$212.63 |
$212.63 |
$212.63 |
$84.50
|
|
Transfusion blood/blood component(s)
|
$1,184.96 |
$1,184.96 |
$1,184.96 |
$1,005.00
|
|
Treat ankle dislocation
|
$14,526.54 |
$14,526.54 |
$14,526.54 |
$2,132.50
|
|
Treat elbow fracture
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$2,055.00
|
|
Treat fracture of radius
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$1,893.86
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$957.84 |
$957.84 |
$957.84 |
$203.49
|
|
Treatment of ankle fracture 27786
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$574.20
|
|
Treatment radiation delivery level 2
|
$1,913.64 |
$1,913.64 |
$1,913.64 |
$737.25
|
|
Treat toe dislocation
|
$1,578.53 |
$1,578.53 |
$1,578.53 |
$1,010.90
|
|
Treat wrist dislocation
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$777.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$298,493.03 |
$298,493.03 |
$298,493.03 |
$127,773.61
|
|
Treponema pallidum antibody
|
$122.02 |
$122.02 |
$122.02 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$156.41 |
$156.41 |
$156.41 |
$44.19
|
|
Triglycerides
|
$175.41 |
$175.41 |
$175.41 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$407.27 |
$407.27 |
$407.27 |
$128.00
|
|
Trim nondyst nails
|
$187.23 |
$187.23 |
$187.23 |
$121.55
|
|
Troponin quantitative
|
$330.36 |
$330.36 |
$330.36 |
$123.50
|
|
Tx open dstl phlngl fx f/t internal fixation ea
|
$16,876.11 |
$16,876.11 |
$16,876.11 |
$4,468.55
|
|
Ultrasound abdomen aorta screening study aaa
|
$781.57 |
$781.57 |
$781.57 |
$406.90
|
|
Ultrasound breast complete
|
$547.10 |
$547.10 |
$547.10 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$547.10 |
$547.10 |
$547.10 |
$470.00
|
|
Ultrasound chest
|
$610.46 |
$610.46 |
$610.46 |
$444.56
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,013.99 |
$1,013.99 |
$1,013.99 |
$340.14
|
|
Ultrasound elastography parenchyma
|
$370.88 |
$370.88 |
$370.88 |
$275.98
|
|
Ultrasound encephalogram
|
$441.83 |
$441.83 |
$441.83 |
$477.10
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$950.79 |
$950.79 |
$950.79 |
$477.10
|
|
Ultrasound guidance for vascular access
|
$1,986.98 |
$1,986.98 |
$1,986.98 |
$333.60
|
|
Ultrasound guided needle placement supervision & interpretation
|
$673.70 |
$673.70 |
$673.70 |
$670.02
|
|
Ultrasound guide intraoperative
|
$1,428.51 |
$1,428.51 |
$1,428.51 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$1,738.59 |
$1,738.59 |
$1,738.59 |
$395.20
|
|
Ultrasound joint complete left
|
$344.79 |
$344.79 |
$344.79 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,047.47 |
$1,047.47 |
$1,047.47 |
$449.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,092.05 |
$1,092.05 |
$1,092.05 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,320.23 |
$1,320.23 |
$1,320.23 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$1,629.08 |
$1,629.08 |
$1,629.08 |
$532.11
|
|
Ultrasound retroperitoneal limited
|
$1,112.24 |
$1,112.24 |
$1,112.24 |
$477.10
|
|
Ultrasound scrotum and contents
|
$1,529.40 |
$1,529.40 |
$1,529.40 |
$612.55
|
|
Ultrasound spinal canal and contents
|
$1,070.36 |
$1,070.36 |
$1,070.36 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$1,437.05 |
$1,437.05 |
$1,437.05 |
$561.60
|
|
Unlisted transfusion med px
|
$319.88 |
$319.88 |
$319.88 |
$141.35
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,894.89 |
$5,894.89 |
$5,894.89 |
$2,889.25
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$5,293.49 |
$5,293.49 |
$5,293.49 |
$2,303.95
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,811.27 |
$4,811.27 |
$4,811.27 |
$2,013.08
|
|
Urea nitrogen
|
$100.88 |
$100.88 |
$100.88 |
$43.60
|
|
Urea nitrogen 24 hour urine
|
$114.51 |
$114.51 |
$114.51 |
$49.40
|
|
Urethrocystography void s&i
|
$877.15 |
$877.15 |
$877.15 |
$622.05
|
|
Uric acid blood
|
$127.59 |
$127.59 |
$127.59 |
$46.20
|
|
Uric acid urine
|
$245.58 |
$245.58 |
$245.58 |
$46.75
|
|
Urinalysis (with microscopy)
|
$94.16 |
$94.16 |
$94.16 |
$47.45
|
|
Urinalysis (without microscopy)
|
$169.98 |
$169.98 |
$169.98 |
$37.80
|
|
Urine Culture Test
|
$115.67 |
$115.67 |
$115.67 |
$80.60
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$53,897.79 |
$53,897.79 |
$53,897.79 |
$7,241.17
|
|
Vaccine hepatitis a (hepa) adult im
|
$280.74 |
$280.74 |
$280.74 |
$166.44
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$793.25 |
$793.25 |
$793.25 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$410.27 |
$410.27 |
$410.27 |
$162.07
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,838.81 |
$1,838.81 |
$1,838.81 |
$686.00
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$553.72 |
$553.72 |
$553.72 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$249.70 |
$249.70 |
$249.70 |
$81.90
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$167.08 |
$167.08 |
$167.08 |
$47.88
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$142.26 |
$142.26 |
$142.26 |
$42.90
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$274.43 |
$274.43 |
$274.43 |
$55.50
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$1,047.09 |
$1,047.09 |
$1,047.09 |
$442.48
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$1,010.84 |
$1,010.84 |
$1,010.84 |
$411.74
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$713.29 |
$713.29 |
$713.29 |
$270.60
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,476.65 |
$1,476.65 |
$1,476.65 |
$633.56
|
|
Vaccine tdap >=7 years im
|
$386.32 |
$386.32 |
$386.32 |
$146.39
|
|
Vaccine td preservative free >= 7 years im
|
$319.36 |
$319.36 |
$319.36 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$219.44 |
$219.44 |
$219.44 |
$114.48
|
|
Vancomycin hcl injection
|
$333.90 |
$333.90 |
$333.90 |
$83.79
|
|
Vancomycin peak therapeutic drug level
|
$233.97 |
$233.97 |
$233.97 |
$123.20
|
|
Varicella zoster antibody igg
|
$97.51 |
$97.51 |
$97.51 |
$84.51
|
|
Vasopressin 20 unit/ml intravenous solution
|
$348.47 |
$348.47 |
$348.47 |
$451.92
|
|
Ventilator each subsequent day
|
$3,891.14 |
$3,891.14 |
$3,891.14 |
$1,268.82
|
|
Ventilator initial day
|
$4,594.20 |
$4,594.20 |
$4,594.20 |
$1,471.56
|
|
Vinblastine 1 mg/ml intravenous solution
|
$1,104.60 |
$1,104.60 |
$1,104.60 |
$177.38
|
|
Vincristine 1 mg/ml intravenous solution
|
$333.52 |
$333.52 |
$333.52 |
$111.30
|
