|
Thrombectmy crnry perq mechanical
|
$4,345.62 |
$4,345.62 |
$4,345.62 |
$3,580.00
|
|
Thrombin time
|
$6.11 |
$6.11 |
$6.11 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$9.76 |
$9.76 |
$9.76 |
$56.93
|
|
Thromboxane urine
|
$16.45 |
$16.45 |
$16.45 |
$70.40
|
|
Thyroglobulin antibody
|
$15.04 |
$15.04 |
$15.04 |
$86.40
|
|
Thyroid imaging
|
$450.73 |
$450.73 |
$450.73 |
$577.80
|
|
Thyroid mets imag whole body
|
$606.77 |
$606.77 |
$606.77 |
$1,320.00
|
|
Thyroid (TSH) Test
|
$22.09 |
$22.09 |
$22.09 |
$101.40
|
|
Thyroid Ultrasound
|
$188.94 |
$188.94 |
$188.94 |
$553.80
|
|
Thyroid uptake measurement
|
$343.57 |
$343.57 |
$343.57 |
$580.20
|
|
Thyrotropin releasing hormone
|
$80.37 |
$80.37 |
$80.37 |
$127.20
|
|
Tigecycline injection
|
$2.93 |
$2.93 |
$2.93 |
$7.44
|
|
Tilt table study
|
$511.36 |
$511.36 |
$511.36 |
$1,488.24
|
|
Tirofiban 12.5 mg/50 ml
|
$683.35 |
$683.35 |
$683.35 |
$696.08
|
|
Tissue culture placenta
|
$77.08 |
$77.08 |
$77.08 |
$470.00
|
|
Tissue culture skin/biopsy
|
$73.32 |
$73.32 |
$73.32 |
$626.77
|
|
Tissue culture tumor
|
$77.08 |
$77.08 |
$77.08 |
$605.60
|
|
Tissue exam koh skin/hair/nails
|
$19.74 |
$19.74 |
$19.74 |
$45.23
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$558.36 |
$558.36 |
$558.36 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$4,511.06 |
$4,511.06 |
$4,511.06 |
$6,727.80
|
|
Tissue transglutaminase iga
|
$7.99 |
$7.99 |
$7.99 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$119.05 |
$119.05 |
$119.05 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$36.66 |
$36.66 |
$36.66 |
$117.00
|
|
Tomosynthesis breast screen bilateral
|
$17.39 |
$17.39 |
$17.39 |
$77.46
|
|
Toxoplasma antibody igg
|
$15.04 |
$15.04 |
$15.04 |
$83.20
|
|
Toxoplasma antibody igm
|
$15.04 |
$15.04 |
$15.04 |
$85.80
|
|
Tpmt gene com vrnts
|
$82.25 |
$82.25 |
$82.25 |
$402.35
|
|
Transcath closure of asd
|
$13,721.65 |
$13,721.65 |
$13,721.65 |
$19,715.47
|
|
Transcatheter bx s&i
|
$971.49 |
$971.49 |
$971.49 |
$1,795.70
|
|
Transcutaneous hgb 88738
|
$2.82 |
$2.82 |
$2.82 |
$12.80
|
|
Transferrin
|
$26.79 |
$26.79 |
$26.79 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$591.26 |
$591.26 |
$591.26 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$177.88 |
$177.88 |
$177.88 |
$934.80
|
|
Trauma partial team response w/critical care services level 4
|
$4,230.00 |
$4,230.00 |
$4,230.00 |
$4,523.04
|
|
Tray bonemarrw oncontrol 102mm
|
$705.00 |
$705.00 |
$705.00 |
$1,094.25
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$77.55 |
$77.55 |
$77.55 |
$197.60
|
|
Treponema pallidum antibody
|
$13.63 |
$13.63 |
$13.63 |
$74.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$5.58 |
$5.58 |
$5.58 |
$28.90
|
|
Triglycerides
|
$25.85 |
$25.85 |
$25.85 |
$48.75
|
|
Trimethobenzamide hcl inj
|
$41.88 |
$41.88 |
$41.88 |
$105.89
|
|
Trnscath plc stent crv crtd w/prtct
|
$3,407.97 |
$3,407.97 |
$3,407.97 |
$9,767.25
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$6,685.75 |
$6,685.75 |
$6,685.75 |
$6,354.94
|
|
Troponin quantitative
|
$33.37 |
$33.37 |
$33.37 |
$112.80
|
|
Tte w or without contr, cont ecg
|
$973.84 |
$973.84 |
$973.84 |
$1,613.95
|
|
Tte w or without fol w/cont, com
|
$880.78 |
$880.78 |
$880.78 |
$930.42
|
|
Tte w or without fol w/cont, f/u
|
$648.13 |
$648.13 |
$648.13 |
$875.24
|
|
Tx atrial fib pulm vein isol
|
$19,345.67 |
$19,345.67 |
$19,345.67 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$536.27 |
$536.27 |
$536.27 |
$6,986.85
|
|
Ua w/micro/comp poc
|
$3.76 |
$3.76 |
$3.76 |
$25.72
|
|
Ugt1a1 gene analy common variants
|
$109.98 |
$109.98 |
$109.98 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$125.02 |
$125.02 |
$125.02 |
$394.20
|
|
Ultrasound breast complete
|
$152.28 |
$152.28 |
$152.28 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$176.72 |
$176.72 |
$176.72 |
$427.00
|
|
Ultrasound chest
|
$99.64 |
$99.64 |
$99.64 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$109.04 |
$109.04 |
$109.04 |
$340.03
|
|
Ultrasound elastography ea l target les
|
$129.72 |
$129.72 |
$129.72 |
$136.11
|
|
Ultrasound elastography parenchyma
|
$129.72 |
$129.72 |
$129.72 |
$275.98
|
|
Ultrasound encephalogram
|
$253.33 |
$253.33 |
$253.33 |
$463.50
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$133.48 |
$133.48 |
$133.48 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$196.93 |
$196.93 |
$196.93 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$490.21 |
$490.21 |
$490.21 |
$629.64
|
|
Ultrasound hips infant dynamic
|
$154.16 |
$154.16 |
$154.16 |
$395.20
|
|
Ultrasound joint complete left
|
$441.80 |
$441.80 |
$441.80 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$129.25 |
$129.25 |
$129.25 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$393.86 |
$393.86 |
$393.86 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$103.40 |
$103.40 |
$103.40 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$340.28 |
$340.28 |
$340.28 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$240.64 |
$240.64 |
$240.64 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$204.92 |
$204.92 |
$204.92 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$134.89 |
$134.89 |
$134.89 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$147.11 |
$147.11 |
$147.11 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$255.68 |
$255.68 |
$255.68 |
$469.58
|
|
Ultrasound scrotum and contents
|
$282.00 |
$282.00 |
$282.00 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$557.89 |
$557.89 |
$557.89 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$203.04 |
$203.04 |
$203.04 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$355.79 |
$355.79 |
$355.79 |
$523.20
|
|
Unlisted fluoroscopic px
|
$82.72 |
$82.72 |
$82.72 |
$256.00
|
|
Unlisted mr procedure
|
$346.39 |
$346.39 |
$346.39 |
$1,249.50
|
|
Unlisted orl service/px
|
$43.24 |
$43.24 |
$43.24 |
$153.60
|
|
Unlisted ultrasound procedure
|
$87.42 |
$87.42 |
$87.42 |
$335.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$360.49 |
$360.49 |
$360.49 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$287.17 |
$287.17 |
$287.17 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$233.59 |
$233.59 |
$233.59 |
$1,794.00
|
|
Urea nitrogen
|
$10.81 |
$10.81 |
$10.81 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$10.34 |
$10.34 |
$10.34 |
$42.90
|
|
Ureteral reflux study
|
$473.29 |
$473.29 |
$473.29 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$122.20 |
$122.20 |
$122.20 |
$554.28
|
|
Urethrocystography void s&i
|
$171.55 |
$171.55 |
$171.55 |
$586.50
|
|
Uric acid blood
|
$14.10 |
$14.10 |
$14.10 |
$44.00
|
|
Uric acid urine
|
$12.22 |
$12.22 |
$12.22 |
$43.20
|
|
Urinalysis microscopic only
|
$2.82 |
$2.82 |
$2.82 |
$25.72
|
|
Urinalysis qual/semiquant excpt ia
|
$10.81 |
$10.81 |
$10.81 |
$22.75
|
|
Urinalysis (with microscopy)
|
$8.93 |
$8.93 |
$8.93 |
$37.39
|
|
Urinalysis (without microscopy)
|
$8.93 |
$8.93 |
$8.93 |
$33.00
|
|
Urine pregnancy test
|
$9.40 |
$9.40 |
$9.40 |
$57.00
|
|
Urography, antegrade
|
$381.64 |
$381.64 |
$381.64 |
$593.37
|
|
Use 1st target lesion
|
$129.72 |
$129.72 |
$129.72 |
$252.00
|
|
Vaccine dtap < 7 years im
|
$31.83 |
$31.83 |
$31.83 |
$66.69
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$28.35 |
$28.35 |
$28.35 |
$29.60
|
|
Vaccine tdap >=7 years im
|
$72.03 |
$72.03 |
$72.03 |
$131.34
|
