|
Splint rstrc wrst/cmc right med
|
$194.29 |
$194.29 |
$194.29 |
$73.11
|
|
St analysis behavior qualitative voice/resonance
|
$348.27 |
$348.27 |
$348.27 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$348.27 |
$348.27 |
$348.27 |
$313.96
|
|
St evaluate speech sound production
|
$348.27 |
$348.27 |
$348.27 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$348.27 |
$348.27 |
$348.27 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$531.12 |
$531.12 |
$531.12 |
$406.40
|
|
St evaluation swallow function
|
$348.27 |
$348.27 |
$348.27 |
$336.60
|
|
Strep b dna amp probe
|
$81.97 |
$81.97 |
$81.97 |
$139.20
|
|
Stress test pulmonary
|
$216.19 |
$216.19 |
$216.19 |
$327.20
|
|
St treatment speech individual
|
$230.30 |
$230.30 |
$230.30 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$240.31 |
$240.31 |
$240.31 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$54.55 |
$54.55 |
$54.55 |
$49.13
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$30.03 |
$30.03 |
$30.03 |
$91.67
|
|
Support clav 29.6-40.5in med
|
$25.48 |
$25.48 |
$25.48 |
$68.54
|
|
Surgical pathology level 1 gross examination only
|
$68.45 |
$68.45 |
$68.45 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$151.97 |
$151.97 |
$151.97 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$159.19 |
$159.19 |
$159.19 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$182.59 |
$182.59 |
$182.59 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$244.66 |
$244.66 |
$244.66 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$351.78 |
$351.78 |
$351.78 |
$790.00
|
|
Susceptibility mic per plate
|
$20.35 |
$20.35 |
$20.35 |
$94.38
|
|
T3 (triiodothyronine) free
|
$159.64 |
$159.64 |
$159.64 |
$89.82
|
|
T3 (triiodothyronine) total
|
$73.32 |
$73.32 |
$73.32 |
$94.90
|
|
T4 (thyroxine) free
|
$84.44 |
$84.44 |
$84.44 |
$81.60
|
|
T4 (thyroxine) total
|
$64.81 |
$64.81 |
$64.81 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$153.40 |
$153.40 |
$153.40 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$12,899.84 |
$12,899.84 |
$12,899.84 |
$1,928.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,091.68 |
$1,091.68 |
$1,091.68 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$86.26 |
$86.26 |
$86.26 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$191.75 |
$191.75 |
$191.75 |
$166.46
|
|
Tc-99m exame autol wbc diag per dose
|
$2,067.00 |
$2,067.00 |
$2,067.00 |
$2,393.40
|
|
Tc-99m labeled rbc
|
$384.28 |
$384.28 |
$384.28 |
$323.01
|
|
Tc-99m maa
|
$50.38 |
$50.38 |
$50.38 |
$312.06
|
|
Tc-99m mebrofenin
|
$206.18 |
$206.18 |
$206.18 |
$169.53
|
|
Tc-99m medronate
|
$78.07 |
$78.07 |
$78.07 |
$122.46
|
|
Tc-99m mertiatide
|
$492.25 |
$492.25 |
$492.25 |
$757.25
|
|
Tc-99m pentetate dtpa aerosol
|
$289.71 |
$289.71 |
$289.71 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$28.08 |
$28.08 |
$28.08 |
$28.08
|
|
Tc-99m sestamibi p study dose
|
$501.28 |
$501.28 |
$501.28 |
$221.60
|
|
Tc-99m sulfur colloid
|
$167.18 |
$167.18 |
$167.18 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$110.18 |
$110.18 |
$110.18 |
$186.00
|
|
T cells absolute cd 4 count
|
$289.38 |
$289.38 |
$289.38 |
$120.25
|
|
T cells total count
|
$143.52 |
$143.52 |
$143.52 |
$124.11
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,631.91 |
$7,631.91 |
$7,631.91 |
$17,652.73
|
|
Testicular imaging w/vasc flow
|
$890.63 |
$890.63 |
$890.63 |
$780.48
|
|
Tetanus immune globulin inj
|
$1,054.90 |
$1,054.90 |
$1,054.90 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$132.08 |
$132.08 |
$132.08 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$12.13 |
$12.13 |
$12.13 |
$38.64
|
|
Thrombin time
|
$52.78 |
$52.78 |
$52.78 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$84.57 |
$84.57 |
$84.57 |
$56.93
|
|
Thyroglobulin antibody
|
$124.02 |
$124.02 |
$124.02 |
$84.00
|
|
Thyroid imaging
|
$445.38 |
$445.38 |
$445.38 |
$670.80
|
|
Thyroid (TSH) Test
|
$61.56 |
$61.56 |
$61.56 |
$120.00
|
|
Thyroid Ultrasound
|
$441.55 |
$441.55 |
$441.55 |
$589.96
|
|
Thyroid uptake measurement
|
$556.73 |
$556.73 |
$556.73 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$158.28 |
$158.28 |
$158.28 |
$63.60
|
|
Tissue exam koh skin/hair/nails
|
$10.01 |
$10.01 |
$10.01 |
$47.40
|
|
Tissue transglutaminase iga
|
$24.51 |
$24.51 |
$24.51 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$91.46 |
$91.46 |
$91.46 |
$77.22
|
|
Tobramycin peak therapeutic drug level
|
$150.28 |
$150.28 |
$150.28 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$40.82 |
$40.82 |
$40.82 |
$63.70
|
|
Tomosynthesis breast screen bilateral
|
$40.82 |
$40.82 |
$40.82 |
$73.45
|
|
Toxoplasma antibody igg
|
$143.46 |
$143.46 |
$143.46 |
$84.35
|
|
Toxoplasma antibody igm
|
$166.40 |
$166.40 |
$166.40 |
$83.20
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$40.63 |
$40.63 |
$40.63 |
$93.75
|
|
Transferrin
|
$107.97 |
$107.97 |
$107.97 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$925.02 |
$925.02 |
$925.02 |
$988.24
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$59.02 |
$59.02 |
$59.02 |
$210.00
|
|
Treponema pallidum antibody
|
$90.48 |
$90.48 |
$90.48 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$23.21 |
$23.21 |
$23.21 |
$48.22
|
|
Trichinella antibody
|
$177.65 |
$177.65 |
$177.65 |
$70.65
|
|
Triglycerides
|
$54.28 |
$54.28 |
$54.28 |
$54.60
|
|
Troponin quantitative
|
$92.76 |
$92.76 |
$92.76 |
$123.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$333.26 |
$333.26 |
$333.26 |
$403.26
|
|
Ultrasound breast complete
|
$333.26 |
$333.26 |
$333.26 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$216.13 |
$216.13 |
$216.13 |
$449.35
|
|
Ultrasound guidance for vascular access
|
$288.08 |
$288.08 |
$288.08 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,299.87 |
$1,299.87 |
$1,299.87 |
$701.35
|
|
Ultrasound joint complete left
|
$613.73 |
$613.73 |
$613.73 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$290.75 |
$290.75 |
$290.75 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$434.33 |
$434.33 |
$434.33 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$434.33 |
$434.33 |
$434.33 |
$326.54
|
|
Ultrasound pregnant uterus follow up per fetus
|
$336.38 |
$336.38 |
$336.38 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$331.70 |
$331.70 |
$331.70 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$336.38 |
$336.38 |
$336.38 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$333.26 |
$333.26 |
$333.26 |
$498.00
|
|
Ultrasound scrotum and contents
|
$386.62 |
$386.62 |
$386.62 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$151.58 |
$151.58 |
$151.58 |
$567.44
|
|
Unlisted ultrasound procedure
|
$312.91 |
$312.91 |
$312.91 |
$321.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,486.90 |
$2,486.90 |
$2,486.90 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$2,291.84 |
$2,291.84 |
$2,291.84 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,096.84 |
$2,096.84 |
$2,096.84 |
$2,013.08
|
|
Urea nitrogen
|
$32.24 |
$32.24 |
$32.24 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$37.25 |
$37.25 |
$37.25 |
$50.00
|
|
Urea nitrogen clearance
|
$74.43 |
$74.43 |
$74.43 |
$33.57
|
|
Urethrocystography void s&i
|
$511.36 |
$511.36 |
$511.36 |
$634.50
|
|
Uric acid blood
|
$42.64 |
$42.64 |
$42.64 |
$46.64
|
|
Uric acid urine
|
$44.33 |
$44.33 |
$44.33 |
$46.75
|
|
Urinalysis microscopic only
|
$13.78 |
$13.78 |
$13.78 |
$26.35
|
|
Urinalysis (with microscopy)
|
$31.07 |
$31.07 |
$31.07 |
$48.14
|
