|
T cells absolute cd 4 count
|
$63.94 |
$63.94 |
$63.94 |
$111.20
|
|
T cells total count
|
$65.66 |
$65.66 |
$65.66 |
$130.20
|
|
Telehealth original site facility fee
|
$23.86 |
$23.86 |
$23.86 |
$51.00
|
|
Testicular imaging w/vasc flow
|
$404.46 |
$404.46 |
$404.46 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$833.38 |
$833.38 |
$833.38 |
$953.40
|
|
Theophylline therapeutic drug level
|
$20.73 |
$20.73 |
$20.73 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$69.31 |
$69.31 |
$69.31 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$70.53 |
$70.53 |
$70.53 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$36.52 |
$36.52 |
$36.52 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.86 |
$34.86 |
$34.86 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$523.14 |
$523.14 |
$523.14 |
$538.88
|
|
Ther/proph/diag inj ia
|
$65.99 |
$65.99 |
$65.99 |
$247.33
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$197.78 |
$197.78 |
$197.78 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$488.05 |
$488.05 |
$488.05 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,340.82 |
$1,340.82 |
$1,340.82 |
$1,703.45
|
|
Thrombin time
|
$26.99 |
$26.99 |
$26.99 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$49.65 |
$49.65 |
$49.65 |
$62.01
|
|
Thyroglobulin antibody
|
$55.30 |
$55.30 |
$55.30 |
$82.50
|
|
Thyroid imaging
|
$420.66 |
$420.66 |
$420.66 |
$695.60
|
|
Thyroid (TSH) Test
|
$53.50 |
$53.50 |
$53.50 |
$112.70
|
|
Thyroid Ultrasound
|
$582.13 |
$582.13 |
$582.13 |
$588.50
|
|
Thyroid uptake measurement
|
$265.68 |
$265.68 |
$265.68 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$21.69 |
$21.69 |
$21.69 |
$64.51
|
|
Tissue culture placenta
|
$97.42 |
$97.42 |
$97.42 |
$453.00
|
|
Tissue culture skin/biopsy
|
$91.37 |
$91.37 |
$91.37 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$114.17 |
$114.17 |
$114.17 |
$47.40
|
|
Tissue transglutaminase iga
|
$33.98 |
$33.98 |
$33.98 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$23.62 |
$23.62 |
$23.62 |
$120.60
|
|
Toe X-ray (both feet)
|
$131.32 |
$131.32 |
$131.32 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$36.37 |
$36.37 |
$36.37 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$37.93 |
$37.93 |
$37.93 |
$74.10
|
|
Total tau
|
$217.38 |
$217.38 |
$217.38 |
$312.50
|
|
Toxoplasma antibody igg
|
$36.29 |
$36.29 |
$36.29 |
$91.65
|
|
Toxoplasma antibody igm
|
$34.56 |
$34.56 |
$34.56 |
$87.75
|
|
Tpmt gene com vrnts
|
$255.15 |
$255.15 |
$255.15 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$86.32 |
$86.32 |
$86.32 |
$102.27
|
|
Transferrin
|
$18.80 |
$18.80 |
$18.80 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$580.74 |
$580.74 |
$580.74 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$490.00 |
$490.00 |
$490.00 |
$499.20
|
|
Treponema pallidum antibody
|
$42.62 |
$42.62 |
$42.62 |
$72.05
|
|
Trg gene rearrangement anal
|
$294.03 |
$294.03 |
$294.03 |
$455.70
|
|
Trichinella antibody
|
$39.74 |
$39.74 |
$39.74 |
$70.65
|
|
#tricyclicantidprssnt
|
$41.93 |
$41.93 |
$41.93 |
$50.54
|
|
Triglycerides
|
$26.03 |
$26.03 |
$26.03 |
$58.50
|
|
Troponin quantitative
|
$66.52 |
$66.52 |
$66.52 |
$127.60
|
|
Ugt1a1 gene analy common variants
|
$341.17 |
$341.17 |
$341.17 |
$438.75
|
|
Ultrasound breast complete
|
$663.80 |
$663.80 |
$663.80 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$544.44 |
$544.44 |
$544.44 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$282.69 |
$282.69 |
$282.69 |
$338.00
|
|
Ultrasound encephalogram
|
$429.97 |
$429.97 |
$429.97 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$369.94 |
$369.94 |
$369.94 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$422.29 |
$422.29 |
$422.29 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$342.02 |
$342.02 |
$342.02 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$182.88 |
$182.88 |
$182.88 |
$388.08
|
|
Ultrasound guide intraoperative
|
$159.14 |
$159.14 |
$159.14 |
$632.85
|
|
Ultrasound hips infant dynamic
|
$270.82 |
$270.82 |
$270.82 |
$403.88
|
|
Ultrasound infant hips ltd without stress
|
$164.03 |
$164.03 |
$164.03 |
$311.25
|
|
Ultrasound ob >=14wks ea addl gest
|
$493.49 |
$493.49 |
$493.49 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$270.82 |
$270.82 |
$270.82 |
$334.50
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$598.88 |
$598.88 |
$598.88 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$506.05 |
$506.05 |
$506.05 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$313.40 |
$313.40 |
$313.40 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$249.19 |
$249.19 |
$249.19 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$669.38 |
$669.38 |
$669.38 |
$419.50
|
|
Unlisted hematology&coagj px
|
$27.47 |
$27.47 |
$27.47 |
$39.52
|
|
Unlisted transfusion med px
|
$202.88 |
$202.88 |
$202.88 |
$147.50
|
|
Upper Arm (Humerus) X-ray (left side)
|
$181.70 |
$181.70 |
$181.70 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,036.35 |
$1,036.35 |
$1,036.35 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$829.08 |
$829.08 |
$829.08 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,710.79 |
$1,710.79 |
$1,710.79 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,425.65 |
$1,425.65 |
$1,425.65 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,140.52 |
$1,140.52 |
$1,140.52 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$278.72 |
$278.72 |
$278.72 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$296.41 |
$296.41 |
$296.41 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$643.20 |
$643.20 |
$643.20 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$602.46 |
$602.46 |
$602.46 |
$607.20
|
|
Urea nitrogen
|
$20.73 |
$20.73 |
$20.73 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$25.06 |
$25.06 |
$25.06 |
$52.00
|
|
Urea nitrogen clearance
|
$34.22 |
$34.22 |
$34.22 |
$38.35
|
|
Ureteral reflux study
|
$447.12 |
$447.12 |
$447.12 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$404.68 |
$404.68 |
$404.68 |
$584.00
|
|
Urethrocystography void s&i
|
$462.03 |
$462.03 |
$462.03 |
$631.40
|
|
Uric acid blood
|
$6.75 |
$6.75 |
$6.75 |
$49.44
|
|
Uric acid urine
|
$34.70 |
$34.70 |
$34.70 |
$45.36
|
|
Urinalysis microscopic only
|
$4.81 |
$4.81 |
$4.81 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$3.37 |
$3.37 |
$3.37 |
$25.72
|
|
Urinalysis (with microscopy)
|
$26.45 |
$26.45 |
$26.45 |
$55.20
|
|
Urinalysis (without microscopy)
|
$25.49 |
$25.49 |
$25.49 |
$36.00
|
|
Urine Culture Test
|
$35.05 |
$35.05 |
$35.05 |
$83.00
|
|
Urine pregnancy test
|
$27.90 |
$27.90 |
$27.90 |
$68.78
|
|
Urography, antegrade
|
$462.57 |
$462.57 |
$462.57 |
$622.35
|
|
Vaccine Administration (one shot)
|
$57.23 |
$57.23 |
$57.23 |
$67.70
|
|
Valproic acid total therapeutic drug level
|
$31.81 |
$31.81 |
$31.81 |
$115.00
|
|
Vancomycin peak therapeutic drug level
|
$19.76 |
$19.76 |
$19.76 |
$136.13
|
|
Varicella zoster antibody igg
|
$30.53 |
$30.53 |
$30.53 |
$86.80
|
|
Venogram ext bil s&i
|
$486.15 |
$486.15 |
$486.15 |
$1,829.42
|
|
Venogram extremity supervision & interpretation unilateral
|
$323.74 |
$323.74 |
$323.74 |
$1,382.58
|
|
Ventilator each subsequent day
|
$429.75 |
$429.75 |
$429.75 |
$1,184.00
|
|
Ventilator Management (first day)
|
$550.46 |
$550.46 |
$550.46 |
$1,434.60
|
|
Version cephalic external
|
$423.27 |
$423.27 |
$423.27 |
$2,361.75
|
