|
Tp53 gene trgt sequence alys
|
$681.00 |
$681.00 |
$858.00 |
$919.10
|
|
Tpmt gene com vrnts
|
$119.18 |
$119.18 |
$150.15 |
$381.55
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$36.78 |
$36.78 |
$36.78 |
$104.50
|
|
Transabdom amnioinfus w/us
|
$256.97 |
$256.97 |
$256.97 |
$791.05
|
|
Transcath biopsy
|
$1,795.57 |
$1,795.57 |
$1,795.57 |
$4,298.05
|
|
Transcath closure of asd
|
$13,514.45 |
$13,514.45 |
$13,514.45 |
$18,772.00
|
|
Transcatheter bx s&i
|
$647.86 |
$647.86 |
$647.86 |
$1,875.96
|
|
Transcath mv repair init prosthesis
|
$9,229.82 |
$9,229.82 |
$9,229.82 |
$17,106.18
|
|
Transcath occlusion cns
|
$3,921.43 |
$3,921.43 |
$3,921.43 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$5,334.50 |
$5,334.50 |
$5,334.50 |
$12,427.79
|
|
Transferrin
|
$22.70 |
$22.70 |
$28.60 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$330.06 |
$330.06 |
$415.85 |
$988.24
|
|
Tray bonemarrw oncontrol 102mm
|
$680.55 |
$680.55 |
$680.55 |
$1,013.83
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$174.11 |
$174.11 |
$219.37 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$75.60 |
$75.60 |
$95.24 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$87.63 |
$87.63 |
$110.40 |
$210.00
|
|
Treponema pallidum antibody
|
$37.23 |
$37.23 |
$46.91 |
$72.80
|
|
Treprostinil injection
|
$1,371.08 |
$1,371.08 |
$1,371.08 |
$841.84
|
|
Trg gene rearrangement anal
|
$348.68 |
$348.68 |
$439.30 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$13.62 |
$13.62 |
$13.62 |
$55.80
|
|
Trichinella antibody
|
$45.86 |
$45.86 |
$57.78 |
$70.65
|
|
Triglycerides
|
$151.19 |
$151.19 |
$190.48 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$31.33 |
$31.33 |
$39.47 |
$128.00
|
|
Trnscath plc stent crv crtd without prtct
|
$1,179.04 |
$1,179.04 |
$1,179.04 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$2,312.00 |
$2,312.00 |
$2,312.00 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$3,150.31 |
$3,150.31 |
$3,150.31 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$2,642.51 |
$2,642.51 |
$2,642.51 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$5,504.98 |
$5,504.98 |
$5,504.98 |
$15,408.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$2,515.85 |
$2,515.85 |
$2,515.85 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,562.67 |
$1,562.67 |
$1,562.67 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$859.43 |
$859.43 |
$859.43 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,187.83 |
$2,187.83 |
$2,187.83 |
$4,329.36
|
|
Troponin quantitative
|
$266.96 |
$266.96 |
$336.34 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$22,610.11 |
$22,610.11 |
$22,610.11 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$8,365.86 |
$8,365.86 |
$8,365.86 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$112.37 |
$112.37 |
$141.57 |
$403.26
|
|
Ultrasound breast complete
|
$215.65 |
$215.65 |
$271.70 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$215.65 |
$215.65 |
$271.70 |
$449.35
|
|
Ultrasound chest
|
$236.77 |
$236.77 |
$298.30 |
$459.55
|
|
Ultrasound encephalogram
|
$241.31 |
$241.31 |
$304.02 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$311.68 |
$311.68 |
$392.68 |
$570.44
|
|
Ultrasound guidance for vascular access
|
$686.00 |
$686.00 |
$686.00 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$869.41 |
$869.41 |
$1,095.38 |
$701.35
|
|
Ultrasound guide intraoperative
|
$490.78 |
$490.78 |
$618.34 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$290.11 |
$290.11 |
$365.51 |
$403.00
|
|
Ultrasound joint complete left
|
$538.68 |
$538.68 |
$678.68 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$167.08 |
$167.08 |
$210.50 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$347.54 |
$347.54 |
$437.87 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$242.44 |
$242.44 |
$305.45 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$219.51 |
$219.51 |
$276.57 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,016.51 |
$1,016.51 |
$1,280.71 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$749.56 |
$749.56 |
$944.38 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$861.47 |
$861.47 |
$1,085.37 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$342.92 |
$342.92 |
$342.92 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$415.41 |
$415.41 |
$523.38 |
$498.00
|
|
Ultrasound scrotum and contents
|
$806.76 |
$806.76 |
$1,016.45 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$160.49 |
$160.49 |
$202.21 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$66.36 |
$66.36 |
$66.36 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$484.42 |
$484.42 |
$610.33 |
$567.44
|
|
Unlisted cv px dx nuc med
|
$288.52 |
$288.52 |
$288.52 |
$475.51
|
|
Unlisted misc path test
|
$30.42 |
$30.42 |
$38.33 |
$89.40
|
|
Unlisted procedure microbiology
|
$262.19 |
$262.19 |
$330.33 |
$487.50
|
|
Unlisted surgical path px
|
$12.26 |
$12.26 |
$15.45 |
$71.65
|
|
Unlisted transfusion med px
|
$1,787.63 |
$1,787.63 |
$2,252.25 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$749.79 |
$749.79 |
$944.66 |
$1,480.70
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,440.48 |
$2,440.48 |
$2,440.48 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,147.65 |
$2,147.65 |
$2,147.65 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,439.87 |
$1,439.87 |
$1,439.87 |
$2,013.08
|
|
Urea nitrogen
|
$92.62 |
$92.62 |
$116.69 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$62.43 |
$62.43 |
$78.65 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$460.13 |
$460.13 |
$579.73 |
$574.40
|
|
Urethrocystography void s&i
|
$460.13 |
$460.13 |
$579.73 |
$634.50
|
|
Uric acid blood
|
$118.27 |
$118.27 |
$149.01 |
$46.64
|
|
Uric acid urine
|
$55.62 |
$55.62 |
$70.07 |
$46.75
|
|
Urinalysis microscopic only
|
$3.64 |
$3.64 |
$4.58 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$31.33 |
$31.33 |
$39.47 |
$25.72
|
|
Urinalysis (with microscopy)
|
$106.47 |
$106.47 |
$134.14 |
$48.14
|
|
Urinalysis (without microscopy)
|
$110.33 |
$110.33 |
$139.00 |
$38.99
|
|
Urine Culture Test
|
$238.58 |
$238.58 |
$300.59 |
$84.81
|
|
Urine pregnancy test
|
$82.18 |
$82.18 |
$103.54 |
$66.40
|
|
Urography, antegrade
|
$583.62 |
$583.62 |
$735.31 |
$593.37
|
|
Vaccine dtap < 7 years im
|
$32.69 |
$32.69 |
$41.19 |
$87.80
|
|
Vaccine dtap-hep b-ipv im
|
$109.42 |
$109.42 |
$109.42 |
$193.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$21.57 |
$21.57 |
$21.57 |
$45.33
|
|
Vaccine hepatitis a (hepa) adult im
|
$90.12 |
$90.12 |
$90.12 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$79.80 |
$79.80 |
$84.22 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$32.24 |
$32.24 |
$32.24 |
$79.04
|
|
Vaccine influenza inactivated adjuvant im
|
$89.67 |
$89.67 |
$112.97 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$24.07 |
$24.07 |
$30.32 |
$48.29
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$290.11 |
$290.11 |
$290.11 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$180.92 |
$180.92 |
$180.92 |
$408.70
|
|
Vaccine mmr live subcutaneous
|
$95.80 |
$95.80 |
$120.70 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$143.24 |
$143.24 |
$180.47 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$276.04 |
$276.04 |
$276.04 |
$397.18
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$304.41 |
$304.41 |
$304.41 |
$715.41
|
|
Vaccine polio (ipv) subcutaneous/im
|
$45.18 |
$45.18 |
$45.18 |
$119.17
|
|
Vaccine rabies im
|
$463.77 |
$463.77 |
$655.80 |
$945.46
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$605.64 |
$605.64 |
$605.64 |
$1,196.00
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$605.64 |
$605.64 |
$605.64 |
$1,159.00
|
|
Vaccine tdap >=7 years im
|
$54.48 |
$54.48 |
$68.64 |
$150.76
|
