|
Tobramycin peak therapeutic drug level
|
$52.76 |
$52.76 |
$52.76 |
$120.60
|
|
Toe X-ray (both feet)
|
$176.36 |
$176.36 |
$176.36 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$84.37 |
$84.37 |
$84.37 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$84.37 |
$84.37 |
$84.37 |
$74.10
|
|
Total tau
|
$230.00 |
$230.00 |
$230.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$82.06 |
$82.06 |
$82.06 |
$91.65
|
|
Toxoplasma antibody igm
|
$68.50 |
$68.50 |
$68.50 |
$87.75
|
|
Tpmt gene com vrnts
|
$427.63 |
$427.63 |
$427.63 |
$371.80
|
|
Tprnl plmt biodegrdabl matrl
|
$11,538.11 |
$11,538.11 |
$11,538.11 |
$7,144.80
|
|
Transferrin
|
$39.94 |
$39.94 |
$39.94 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$493.27 |
$493.27 |
$493.27 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$717.31 |
$717.31 |
$717.31 |
$499.20
|
|
Treat ankle dislocation
|
$2,848.48 |
$2,848.48 |
$2,848.48 |
$2,360.00
|
|
Treat elbow dislocation
|
$2,848.48 |
$2,848.48 |
$2,848.48 |
$2,272.50
|
|
Treat elbow fracture
|
$4,219.38 |
$4,219.38 |
$4,219.38 |
$2,026.50
|
|
Treat finger fracture each
|
$1,383.84 |
$1,383.84 |
$1,383.84 |
$1,592.00
|
|
Treat fracture of radius
|
$2,848.48 |
$2,848.48 |
$2,848.48 |
$1,790.00
|
|
Treat hip dislocation
|
$4,283.02 |
$4,283.02 |
$4,283.02 |
$2,211.05
|
|
Treat humerus fracture
|
$4,283.02 |
$4,283.02 |
$4,283.02 |
$1,790.00
|
|
Treat knee fracture 27530
|
$658.55 |
$658.55 |
$658.55 |
$550.73
|
|
Treatment incomplete abortion completed surgically any trimester
|
$8,180.93 |
$8,180.93 |
$8,180.93 |
$3,928.20
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$218.17 |
$218.17 |
$218.17 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$115.74 |
$115.74 |
$115.74 |
$147.48
|
|
Treatment of ankle fracture 27786
|
$442.01 |
$442.01 |
$442.01 |
$523.20
|
|
Treatment of choroid lesion
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$1,253.20
|
|
Treatment of thigh fracture
|
$33.68 |
$33.68 |
$33.68 |
$549.00
|
|
Treatment of toe fracture 28510
|
$715.15 |
$715.15 |
$715.15 |
$371.40
|
|
Treat thigh fracture
|
$656.57 |
$656.57 |
$656.57 |
$618.80
|
|
Treat wrist dislocation
|
$436.82 |
$436.82 |
$436.82 |
$656.25
|
|
Treponema pallidum antibody
|
$42.13 |
$42.13 |
$42.13 |
$72.05
|
|
Trg gene rearrangement anal
|
$425.80 |
$425.80 |
$425.80 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$3.70 |
$3.70 |
$3.70 |
$43.09
|
|
Trichinella antibody
|
$39.99 |
$39.99 |
$39.99 |
$70.65
|
|
#tricyclicantidprssnt
|
$110.77 |
$110.77 |
$110.77 |
$50.54
|
|
Triglycerides
|
$74.73 |
$74.73 |
$74.73 |
$58.50
|
|
Trim nondyst nails
|
$141.04 |
$141.04 |
$141.04 |
$113.88
|
|
Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm
|
$2,048.16 |
$2,048.16 |
$2,048.16 |
$2,551.20
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm
|
$4,771.98 |
$4,771.98 |
$4,771.98 |
$2,837.09
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$4,771.98 |
$4,771.98 |
$4,771.98 |
$2,620.20
|
|
Troponin quantitative
|
$100.37 |
$100.37 |
$100.37 |
$127.60
|
|
Tte w or without contr, cont ecg
|
$2,312.04 |
$2,312.04 |
$2,312.04 |
$2,067.00
|
|
Tx closed tib fx proximal w/w/o manip w/skel trac
|
$5,565.22 |
$5,565.22 |
$5,565.22 |
$3,977.49
|
|
Tx closed tib shaft fx without manip
|
$463.22 |
$463.22 |
$463.22 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$514.01 |
$514.01 |
$514.01 |
$419.04
|
|
Tympanostomy/ven tube/loc/top anes 69433
|
$1,118.37 |
$1,118.37 |
$1,118.37 |
$911.43
|
|
Ugt1a1 gene analy common variants
|
$456.44 |
$456.44 |
$456.44 |
$438.75
|
|
Ultrasound breast complete
|
$882.15 |
$882.15 |
$882.15 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$356.52 |
$356.52 |
$356.52 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$262.25 |
$262.25 |
$262.25 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$287.69 |
$287.69 |
$287.69 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$204.91 |
$204.91 |
$204.91 |
$313.95
|
|
Ultrasound encephalogram
|
$477.92 |
$477.92 |
$477.92 |
$494.92
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$493.27 |
$493.27 |
$493.27 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$308.82 |
$308.82 |
$308.82 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$292.32 |
$292.32 |
$292.32 |
$388.08
|
|
Ultrasound guide intraoperative
|
$320.76 |
$320.76 |
$320.76 |
$632.85
|
|
Ultrasound joint complete left
|
$261.93 |
$261.93 |
$261.93 |
$557.99
|
|
Ultrasound nrv&acc strux 1xtr compre
|
$251.86 |
$251.86 |
$251.86 |
$277.80
|
|
Ultrasound ob >=14wks ea addl gest
|
$360.83 |
$360.83 |
$360.83 |
$407.20
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$668.49 |
$668.49 |
$668.49 |
$698.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$801.23 |
$801.23 |
$801.23 |
$425.60
|
|
Ultrasound spinal canal and contents
|
$474.10 |
$474.10 |
$474.10 |
$463.00
|
|
Unlisted misc path test
|
$105.80 |
$105.80 |
$105.80 |
$89.40
|
|
Unlisted procedure microbiology
|
$977.50 |
$977.50 |
$977.50 |
$530.00
|
|
Unlisted ultrasound procedure
|
$199.93 |
$199.93 |
$199.93 |
$332.16
|
|
Upper Arm (Humerus) X-ray (left side)
|
$208.72 |
$208.72 |
$208.72 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,199.23 |
$1,199.23 |
$1,199.23 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,057.03 |
$3,057.03 |
$3,057.03 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,642.74 |
$2,642.74 |
$2,642.74 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,282.34 |
$2,282.34 |
$2,282.34 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$261.14 |
$261.14 |
$261.14 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$291.77 |
$291.77 |
$291.77 |
$381.60
|
|
Upper GI Barium X-ray (barium and gas)
|
$489.83 |
$489.83 |
$489.83 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$391.87 |
$391.87 |
$391.87 |
$607.20
|
|
Urea nitrogen
|
$54.94 |
$54.94 |
$54.94 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$54.94 |
$54.94 |
$54.94 |
$52.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$548.60 |
$548.60 |
$548.60 |
$584.00
|
|
Uric acid blood
|
$55.68 |
$55.68 |
$55.68 |
$49.44
|
|
Uric acid urine
|
$65.93 |
$65.93 |
$65.93 |
$45.36
|
|
Urinalysis microscopic only
|
$80.59 |
$80.59 |
$80.59 |
$26.46
|
|
Urinalysis (with microscopy)
|
$80.30 |
$80.30 |
$80.30 |
$55.20
|
|
Urinalysis (without microscopy)
|
$52.76 |
$52.76 |
$52.76 |
$36.00
|
|
Urine Culture Test
|
$72.55 |
$72.55 |
$72.55 |
$83.00
|
|
Urine pregnancy test
|
$84.24 |
$84.24 |
$84.24 |
$68.78
|
|
Vaccine Administration (one shot)
|
$62.26 |
$62.26 |
$62.26 |
$67.70
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$184.16 |
$184.16 |
$184.16 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$169.03 |
$169.03 |
$169.03 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$191.10 |
$191.10 |
$191.10 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$122.85 |
$122.85 |
$122.85 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$91.57 |
$91.57 |
$91.57 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$46.85 |
$46.85 |
$46.85 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$101.67 |
$101.67 |
$101.67 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$73.05 |
$73.05 |
$73.05 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$205.71 |
$205.71 |
$205.71 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$144.44 |
$144.44 |
$144.44 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$41.94 |
$41.94 |
$41.94 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$19.17 |
$19.17 |
$19.17 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$58.44 |
$58.44 |
$58.44 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$368.60 |
$368.60 |
$368.60 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$43.62 |
$43.62 |
$43.62 |
$78.25
|
