|
T4 (thyroxine) free
|
$58.00 |
$58.00 |
$74.00 |
$65.00
|
|
T4 (thyroxine) total
|
$96.00 |
$96.00 |
$96.00 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$96.00 |
$96.00 |
$96.00 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$2,707.00 |
$2,707.00 |
$2,707.00 |
$1,928.40
|
|
Target gsa panel organ neop
|
$3,189.00 |
$3,189.00 |
$3,189.00 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$203.00 |
$203.00 |
$225.00 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$256.00 |
$256.00 |
$256.00 |
$178.40
|
|
Tc-99m medronate
|
$174.00 |
$174.00 |
$174.00 |
$120.35
|
|
Tc-99m sestamibi p study dose
|
$609.00 |
$609.00 |
$609.00 |
$221.60
|
|
Tc-99m sulfur colloid
|
$389.00 |
$389.00 |
$389.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$592.00 |
$592.00 |
$592.00 |
$198.05
|
|
T cells absolute cd4/cd8 including ratio
|
$170.00 |
$170.00 |
$355.00 |
$189.60
|
|
T cells absolute cd 4 count
|
$279.00 |
$279.00 |
$279.00 |
$120.25
|
|
T cells total count
|
$96.00 |
$96.00 |
$181.00 |
$126.90
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$35,039.34 |
$35,039.34 |
$35,039.34 |
$16,233.59
|
|
Test stress cardiovascular tracing only
|
$1,185.00 |
$1,185.00 |
$1,185.00 |
$1,016.00
|
|
Theophylline therapeutic drug level
|
$74.00 |
$74.00 |
$159.00 |
$101.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$61.00 |
$61.00 |
$61.00 |
$47.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$45.00 |
$45.00 |
$45.00 |
$25.80
|
|
Thrombectmy crnry perq mechanical
|
$4,682.00 |
$4,682.00 |
$4,682.00 |
$3,580.00
|
|
Thrombin time
|
$32.00 |
$32.00 |
$55.00 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$35.00 |
$35.00 |
$69.00 |
$56.93
|
|
Thyroglobulin antibody
|
$45.00 |
$45.00 |
$66.00 |
$86.40
|
|
Thyroid mets imag whole body
|
$1,805.00 |
$1,805.00 |
$1,805.00 |
$1,320.00
|
|
Thyroid (TSH) Test
|
$92.00 |
$92.00 |
$111.00 |
$101.40
|
|
Thyroid Ultrasound
|
$578.00 |
$578.00 |
$578.00 |
$553.80
|
|
Thyroxine binding globulin (tbg)
|
$119.00 |
$119.00 |
$119.00 |
$75.00
|
|
Tilt table study
|
$2,145.00 |
$2,145.00 |
$2,145.00 |
$1,488.24
|
|
Tissue culture placenta
|
$712.00 |
$712.00 |
$712.00 |
$470.00
|
|
Tissue culture skin/biopsy
|
$454.00 |
$454.00 |
$454.00 |
$626.77
|
|
Tissue exam koh skin/hair/nails
|
$86.00 |
$86.00 |
$86.00 |
$45.23
|
|
Tissue transglutaminase iga
|
$144.00 |
$144.00 |
$144.00 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$100.00 |
$100.00 |
$100.00 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$14.85 |
$14.85 |
$14.85 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$202.00 |
$202.00 |
$202.00 |
$117.00
|
|
Toxoplasma antibody igg
|
$132.00 |
$132.00 |
$132.00 |
$83.20
|
|
Toxoplasma antibody igm
|
$132.00 |
$132.00 |
$132.00 |
$85.80
|
|
Tpmt gene com vrnts
|
$457.00 |
$457.00 |
$457.00 |
$402.35
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$147.00 |
$147.00 |
$147.00 |
$90.35
|
|
Transferrin
|
$44.00 |
$44.00 |
$68.00 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$1,439.00 |
$1,439.00 |
$1,439.00 |
$988.24
|
|
Treat hand dislocation
|
$2,393.00 |
$2,393.00 |
$2,393.00 |
$1,591.20
|
|
Treat hip dislocation
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$2,644.00
|
|
Treat hip dislocation
|
$1,674.00 |
$1,674.00 |
$1,674.00 |
$3,493.90
|
|
Treat knee fracture(s)
|
$1,229.00 |
$1,229.00 |
$1,229.00 |
$669.60
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$137.00 |
$137.00 |
$137.00 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$137.00 |
$137.00 |
$137.00 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$137.00 |
$137.00 |
$157.00 |
$197.60
|
|
Treponema pallidum antibody
|
$68.00 |
$68.00 |
$124.00 |
$74.40
|
|
Trg gene rearrangement anal
|
$730.00 |
$730.00 |
$730.00 |
$474.50
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$43.00 |
$43.00 |
$43.00 |
$28.90
|
|
Trichinella antibody
|
$111.00 |
$111.00 |
$111.00 |
$56.55
|
|
Trichomonas assay w/optic
|
$65.00 |
$65.00 |
$65.00 |
$68.90
|
|
Triglycerides
|
$53.00 |
$53.00 |
$86.00 |
$48.75
|
|
Trim nondyst nails
|
$29.00 |
$29.00 |
$29.00 |
$124.22
|
|
Troponin quantitative
|
$38.00 |
$38.00 |
$71.00 |
$112.80
|
|
Ua w/micro/comp poc
|
$26.00 |
$26.00 |
$42.00 |
$25.72
|
|
Ultrasound chest
|
$395.00 |
$395.00 |
$395.00 |
$430.10
|
|
Ultrasound encephalogram
|
$354.00 |
$354.00 |
$354.00 |
$463.50
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$337.00 |
$337.00 |
$337.00 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$300.00 |
$300.00 |
$300.00 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$901.00 |
$901.00 |
$901.00 |
$629.64
|
|
Ultrasound guide tissue ablation
|
$840.00 |
$840.00 |
$840.00 |
$463.50
|
|
Ultrasound joint complete left
|
$931.00 |
$931.00 |
$931.00 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$833.00 |
$833.00 |
$833.00 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$588.00 |
$588.00 |
$588.00 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$436.00 |
$436.00 |
$436.00 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,049.00 |
$1,049.00 |
$1,049.00 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$505.00 |
$505.00 |
$505.00 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$551.00 |
$551.00 |
$551.00 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$646.00 |
$646.00 |
$646.00 |
$477.10
|
|
Ultrasound retroperitoneal limited
|
$382.00 |
$382.00 |
$382.00 |
$469.58
|
|
Ultrasound scrotum and contents
|
$510.00 |
$510.00 |
$510.00 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$459.00 |
$459.00 |
$459.00 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$735.00 |
$735.00 |
$735.00 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$819.00 |
$819.00 |
$819.00 |
$523.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$5,011.00 |
$5,011.00 |
$5,011.00 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,948.00 |
$3,948.00 |
$3,948.00 |
$1,794.00
|
|
Urea nitrogen
|
$45.00 |
$45.00 |
$63.00 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$86.00 |
$86.00 |
$86.00 |
$42.90
|
|
Urethrcystgrphy rtrgrde s&i
|
$23.00 |
$23.00 |
$888.00 |
$554.28
|
|
Urethrocystography void s&i
|
$88.00 |
$88.00 |
$690.00 |
$586.50
|
|
Uric acid blood
|
$25.00 |
$25.00 |
$45.00 |
$44.00
|
|
Uric acid urine
|
$63.00 |
$63.00 |
$63.00 |
$43.20
|
|
Urinalysis microscopic only
|
$13.00 |
$13.00 |
$20.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$17.00 |
$17.00 |
$37.00 |
$37.39
|
|
Urinalysis (without microscopy)
|
$42.00 |
$42.00 |
$75.00 |
$33.00
|
|
Urine Culture Test
|
$44.00 |
$44.00 |
$66.00 |
$63.84
|
|
Urine pregnancy test
|
$26.00 |
$26.00 |
$53.00 |
$57.00
|
|
Urography, antegrade
|
$513.00 |
$513.00 |
$513.00 |
$593.37
|
|
Vaccine dtap-hep b-ipv im
|
$0.01 |
$0.01 |
$0.01 |
$169.85
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$167.00 |
$167.00 |
$167.00 |
$162.07
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$0.01 |
$0.01 |
$0.01 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$641.10 |
$641.10 |
$641.10 |
$130.67
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$878.11 |
$878.11 |
$878.11 |
$195.69
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$2,309.10 |
$2,309.10 |
$2,309.10 |
$579.50
|
|
Vaccine tdap >=7 years im
|
$366.23 |
$366.23 |
$366.23 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$75.00 |
$75.00 |
$93.00 |
$100.80
|
|
Vancomycin peak therapeutic drug level
|
$197.00 |
$197.00 |
$197.00 |
$116.00
|
