|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$87.60 |
$87.60 |
$87.60 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$4.20 |
$4.20 |
$4.20 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$0.60 |
$0.60 |
$0.60 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$318.60 |
$318.60 |
$318.60 |
|
|
Thrombectmy crnry perq mechanical
|
$0.60 |
$0.60 |
$0.60 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$0.60 |
$0.60 |
$0.60 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$0.60 |
$0.60 |
$0.60 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$0.60 |
$0.60 |
$0.60 |
|
|
Thrombin time
|
$16.20 |
$16.20 |
$16.20 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$38.40 |
$38.40 |
$38.40 |
|
|
Thyroglobulin antibody
|
$40.20 |
$40.20 |
$40.20 |
|
|
Thyroid mets imag whole body
|
$289.20 |
$289.20 |
$289.20 |
|
|
Thyroid (TSH) Test
|
$24.00 |
$24.00 |
$24.00 |
|
|
Thyroid Ultrasound
|
$447.00 |
$447.00 |
$447.00 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,199.00 |
$2,199.00 |
$2,199.00 |
|
|
Thyroxine binding globulin (tbg)
|
$24.00 |
$24.00 |
$24.00 |
|
|
Tib/per revasc stent & ather 37231
|
$0.60 |
$0.60 |
$0.60 |
|
|
Tib/per revasc stnt & ather
|
$0.60 |
$0.60 |
$0.60 |
|
|
Tib/per revasc w/ather add-on 37233
|
$0.60 |
$0.60 |
$0.60 |
|
|
Tigecycline injection
|
$58.20 |
$58.20 |
$58.20 |
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$190.20 |
$190.20 |
$190.20 |
|
|
Tissue culture skin/biopsy
|
$324.60 |
$324.60 |
$324.60 |
|
|
Tl-201 thallium diag per mci
|
$140.40 |
$140.40 |
$140.40 |
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$1.80 |
$1.80 |
$1.80 |
|
|
Tobramycin peak therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$7.20 |
$7.20 |
$7.20 |
|
|
Toe X-ray (both feet)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Tomosynthesis breast screen bilateral
|
$124.80 |
$124.80 |
$124.80 |
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$0.60 |
$0.60 |
$0.60 |
|
|
Toxoplasma antibody igg
|
$40.20 |
$40.20 |
$40.20 |
|
|
Toxoplasma antibody igm
|
$40.20 |
$40.20 |
$40.20 |
|
|
Trabectedin 1 mg intravenous solution
|
$386.40 |
$386.40 |
$386.40 |
|
|
Transcath closure of asd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Transcath closure of vsd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Transcatheter bx s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trans cath replace aortic valve 33366
|
$0.60 |
$0.60 |
$0.60 |
|
|
Transcath rmvl perm ldss pmkr rv
|
$0.60 |
$0.60 |
$0.60 |
|
|
Transferrin
|
$24.00 |
$24.00 |
$24.00 |
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$447.00 |
$447.00 |
$447.00 |
|
|
Transvaginal Pregnancy Ultrasound
|
$303.60 |
$303.60 |
$303.60 |
|
|
Trastuzumab 150 mg intravenous solution
|
$2,629.80 |
$2,629.80 |
$2,629.80 |
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$1,410.00 |
$1,410.00 |
$1,410.00 |
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$1,743.60 |
$1,743.60 |
$1,743.60 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$54.00 |
$54.00 |
$54.00 |
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$44.40 |
$44.40 |
$44.40 |
|
|
Treatment radiation delivery level 2
|
$433.80 |
$433.80 |
$433.80 |
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$156.00 |
$156.00 |
$156.00 |
|
|
Treponema pallidum antibody
|
$27.60 |
$27.60 |
$27.60 |
|
|
Trg gene rearrangement anal
|
$194.40 |
$194.40 |
$194.40 |
|
|
Triglycerides
|
$3.00 |
$3.00 |
$3.00 |
|
|
Trnscath plc stent crv crtd without prtct
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath plc stent crv crtd w/prtct
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath plc stnt ante carotid art
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath plc vas stent w/s&i ini vein
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath retrv pq vasc fb w/guide
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$0.60 |
$0.60 |
$0.60 |
|
|
Trnscath tx thromblytc vein ini day
|
$0.60 |
$0.60 |
$0.60 |
|
|
Troponin quantitative
|
$40.20 |
$40.20 |
$40.20 |
|
|
Tte w or without fol w/con,stres
|
$405.00 |
$405.00 |
$405.00 |
|
|
Tube drain vert dev st 5-40f
|
$29.40 |
$29.40 |
$29.40 |
|
|
Tube trach disp innr can 5 xlt
|
$645.60 |
$645.60 |
$645.60 |
|
|
Tube trach fen sz 6 uncuffed
|
$119.40 |
$119.40 |
$119.40 |
|
|
Tx atrial fib pulm vein isol
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ultrasound breast complete
|
$357.60 |
$357.60 |
$357.60 |
|
|
Ultrasound breast unilateral limited (both sides)
|
$268.20 |
$268.20 |
$268.20 |
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$106.80 |
$106.80 |
$106.80 |
|
|
Ultrasound elastography ea l target les
|
$142.80 |
$142.80 |
$142.80 |
|
|
Ultrasound elastography parenchyma
|
$321.60 |
$321.60 |
$321.60 |
|
|
Ultrasound encephalogram
|
$429.00 |
$429.00 |
$429.00 |
|
|
Ultrasound exam k transpl w/doppler
|
$607.80 |
$607.80 |
$607.80 |
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$250.20 |
$250.20 |
$250.20 |
|
|
Ultrasound Guidance for a Needle Procedure
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ultrasound guidance for vascular access
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ultrasound guide intraoperative
|
$196.20 |
$196.20 |
$196.20 |
|
|
Ultrasound hips infant dynamic
|
$553.80 |
$553.80 |
$553.80 |
|
|
Ultrasound infant hips ltd without stress
|
$393.00 |
$393.00 |
$393.00 |
|
|
Ultrasound joint complete left
|
$447.00 |
$447.00 |
$447.00 |
|
|
Ultrasound ob >=14wks ea addl gest
|
$214.20 |
$214.20 |
$214.20 |
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$106.80 |
$106.80 |
$106.80 |
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$429.00 |
$429.00 |
$429.00 |
|
|
Ultrasound pregnant uterus follow up per fetus
|
$357.60 |
$357.60 |
$357.60 |
|
|
Ultrasound prostate/transrectal
|
$303.60 |
$303.60 |
$303.60 |
|
|
Ultrasound spinal canal and contents
|
$411.00 |
$411.00 |
$411.00 |
|
|
Unlisted fluoroscopic px
|
$0.60 |
$0.60 |
$0.60 |
|
|
Unlisted mr procedure
|
$1,037.40 |
$1,037.40 |
$1,037.40 |
|
|
Unlisted procedure liver
|
$0.60 |
$0.60 |
$0.60 |
|
|
Unlisted px casting/strpg
|
$136.80 |
$136.80 |
$136.80 |
|
|
Unlisted transfusion med px
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
|
|
Unlisted ultrasound procedure
|
$0.60 |
$0.60 |
$0.60 |
|
|
Upgrade pm system
|
$0.60 |
$0.60 |
$0.60 |
|
|
Upper Arm (Humerus) X-ray (left side)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$140.40 |
$140.40 |
$140.40 |
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$107.40 |
$107.40 |
$107.40 |
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$442.20 |
$442.20 |
$442.20 |
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$388.80 |
$388.80 |
$388.80 |
|