|
Tobramycin peak therapeutic drug level
|
$91.65 |
$91.65 |
$91.65 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,890.64 |
$3,890.64 |
$3,890.64 |
$2,743.02
|
|
Tomosynthesis breast diagnostic left
|
$161.85 |
$161.85 |
$161.85 |
$53.92
|
|
Tomosynthesis breast screen bilateral
|
$117.65 |
$117.65 |
$117.65 |
$77.46
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$416.00 |
$416.00 |
$416.00 |
$200.93
|
|
Total tau
|
$538.85 |
$538.85 |
$538.85 |
$282.60
|
|
Toxoplasma antibody igg
|
$79.30 |
$79.30 |
$79.30 |
$83.20
|
|
Toxoplasma antibody igm
|
$79.30 |
$79.30 |
$79.30 |
$85.80
|
|
Tpmt gene com vrnts
|
$399.75 |
$399.75 |
$399.75 |
$402.35
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$81.25 |
$81.25 |
$81.25 |
$90.35
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$102.37 |
$102.37 |
$102.37 |
$77.65
|
|
Transcath biopsy
|
$3,524.30 |
$3,524.30 |
$3,524.30 |
$4,285.93
|
|
Transferrin
|
$83.85 |
$83.85 |
$83.85 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$2,305.55 |
$2,305.55 |
$2,305.55 |
$988.24
|
|
Trastuzumab 150 mg intravenous solution
|
$4,564.88 |
$4,564.88 |
$4,564.88 |
$934.80
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$11,145.43 |
$11,145.43 |
$11,145.43 |
$43.28
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$9,925.41 |
$9,925.41 |
$9,925.41 |
$108.27
|
|
Trauma partial team response w/critical care services level 4
|
$5,079.10 |
$5,079.10 |
$5,079.10 |
$4,523.04
|
|
Treatment incomplete abortion completed surgically any trimester
|
$6,004.76 |
$6,004.76 |
$6,004.76 |
$3,916.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$90.35 |
$90.35 |
$90.35 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$113.10 |
$113.10 |
$113.10 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$287.95 |
$287.95 |
$287.95 |
$197.60
|
|
Treatment missed abortion completed surgically 1st trimester
|
$5,491.11 |
$5,491.11 |
$5,491.11 |
$3,820.53
|
|
Treatment radiation delivery level 2
|
$37,216.40 |
$37,216.40 |
$37,216.40 |
$737.25
|
|
Treponema pallidum antibody
|
$94.90 |
$94.90 |
$94.90 |
$74.40
|
|
Trg gene rearrangement anal
|
$481.65 |
$481.65 |
$481.65 |
$474.50
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$220.01 |
$220.01 |
$220.01 |
$28.90
|
|
Trichinella antibody
|
$95.55 |
$95.55 |
$95.55 |
$56.55
|
|
Trichomonas assay w/optic
|
$70.85 |
$70.85 |
$70.85 |
$68.90
|
|
Triglycerides
|
$215.15 |
$215.15 |
$215.15 |
$48.75
|
|
Trnscath plc stent crv crtd without prtct
|
$14,737.45 |
$14,737.45 |
$14,737.45 |
$7,944.75
|
|
Trnscath plc stent crv crtd w/prtct
|
$5,233.80 |
$5,233.80 |
$5,233.80 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$9,365.20 |
$9,365.20 |
$9,365.20 |
$9,418.42
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$8,305.70 |
$8,305.70 |
$8,305.70 |
$9,565.92
|
|
Trnscath plc vas stent w/s&i ini vein
|
$17,467.45 |
$17,467.45 |
$17,467.45 |
$15,873.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$4,969.90 |
$4,969.90 |
$4,969.90 |
$5,555.55
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$6,217.25 |
$6,217.25 |
$6,217.25 |
$6,354.94
|
|
Troponin quantitative
|
$145.60 |
$145.60 |
$145.60 |
$112.80
|
|
Tte w or without contr, cont ecg
|
$1,463.80 |
$1,463.80 |
$1,463.80 |
$1,613.95
|
|
Tte w or without fol w/con,stres
|
$1,907.10 |
$1,907.10 |
$1,907.10 |
$1,108.76
|
|
Ua w/micro/comp poc
|
$16.90 |
$16.90 |
$16.90 |
$25.72
|
|
Ugt1a1 gene analy common variants
|
$651.95 |
$651.95 |
$651.95 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$501.80 |
$501.80 |
$501.80 |
$394.20
|
|
Ultrasound breast complete
|
$910.65 |
$910.65 |
$910.65 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$596.05 |
$596.05 |
$596.05 |
$427.00
|
|
Ultrasound chest
|
$930.15 |
$930.15 |
$930.15 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$778.70 |
$778.70 |
$778.70 |
$340.03
|
|
Ultrasound encephalogram
|
$613.60 |
$613.60 |
$613.60 |
$463.50
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$403.00 |
$403.00 |
$403.00 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$464.10 |
$464.10 |
$464.10 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,246.70 |
$1,246.70 |
$1,246.70 |
$629.64
|
|
Ultrasound guide intraoperative
|
$581.10 |
$581.10 |
$581.10 |
$628.80
|
|
Ultrasound guide tissue ablation
|
$1,005.55 |
$1,005.55 |
$1,005.55 |
$463.50
|
|
Ultrasound infant hips ltd without stress
|
$404.95 |
$404.95 |
$404.95 |
$311.25
|
|
Ultrasound joint complete left
|
$697.45 |
$697.45 |
$697.45 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,116.70 |
$1,116.70 |
$1,116.70 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$473.85 |
$473.85 |
$473.85 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$434.20 |
$434.20 |
$434.20 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$624.00 |
$624.00 |
$624.00 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$278.85 |
$278.85 |
$278.85 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$440.05 |
$440.05 |
$440.05 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$529.10 |
$529.10 |
$529.10 |
$477.10
|
|
Ultrasound retroperitoneal limited
|
$711.75 |
$711.75 |
$711.75 |
$469.58
|
|
Ultrasound scrotum and contents
|
$964.60 |
$964.60 |
$964.60 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$861.90 |
$861.90 |
$861.90 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$812.50 |
$812.50 |
$812.50 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$898.95 |
$898.95 |
$898.95 |
$523.20
|
|
Unlisted laparoscopic liver biopy 47379
|
$12,696.07 |
$12,696.07 |
$12,696.07 |
$6,307.38
|
|
Unlisted laparoscopic procedure 49659
|
$14,986.80 |
$14,986.80 |
$14,986.80 |
$6,838.32
|
|
Unlisted laparoscopic reduction intestine 44238
|
$12,312.88 |
$12,312.88 |
$12,312.88 |
$4,981.62
|
|
Unlisted laps px appendix
|
$12,312.88 |
$12,312.88 |
$12,312.88 |
$3,617.40
|
|
Unlisted laps px ovidct ovry
|
$8,238.28 |
$8,238.28 |
$8,238.28 |
$4,713.11
|
|
Unlisted laps px ureter
|
$22,421.15 |
$22,421.15 |
$22,421.15 |
$6,376.26
|
|
Unlisted neurological dx px
|
$152.10 |
$152.10 |
$152.10 |
$176.93
|
|
Unlisted procedure microbiology
|
$72.80 |
$72.80 |
$72.80 |
$384.15
|
|
Unlisted px arthroscopy
|
$31,179.63 |
$31,179.63 |
$31,179.63 |
$11,433.76
|
|
Unlisted px palate uvula
|
$12,031.97 |
$12,031.97 |
$12,031.97 |
$243.44
|
|
Unlisted transfusion med px
|
$178.75 |
$178.75 |
$178.75 |
$113.36
|
|
Unlisted ultrasound procedure
|
$313.30 |
$313.30 |
$313.30 |
$335.00
|
|
Unsched dialysis esrd pt hos
|
$980.20 |
$980.20 |
$980.20 |
$980.20
|
|
Upgrade pm system
|
$25,624.30 |
$25,624.30 |
$25,624.30 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$3,978.00 |
$3,978.00 |
$3,978.00 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,215.55 |
$3,215.55 |
$3,215.55 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,796.95 |
$2,796.95 |
$2,796.95 |
$1,794.00
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,963.48 |
$2,963.48 |
$2,963.48 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$2,990.38 |
$2,990.38 |
$2,990.38 |
$1,760.00
|
|
Urea nitrogen
|
$45.50 |
$45.50 |
$45.50 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$37.70 |
$37.70 |
$37.70 |
$42.90
|
|
Ureteral reflux study
|
$940.55 |
$940.55 |
$940.55 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$985.40 |
$985.40 |
$985.40 |
$554.28
|
|
Urethrocystography void s&i
|
$525.20 |
$525.20 |
$525.20 |
$586.50
|
|
Uric acid blood
|
$16.25 |
$16.25 |
$16.25 |
$44.00
|
|
Uric acid urine
|
$76.05 |
$76.05 |
$76.05 |
$43.20
|
|
Urinalysis microscopic only
|
$16.25 |
$16.25 |
$16.25 |
$25.72
|
|
Urinalysis (with microscopy)
|
$11.05 |
$11.05 |
$11.05 |
$37.39
|
|
Urinalysis (without microscopy)
|
$160.55 |
$160.55 |
$160.55 |
$33.00
|
|
Urine Culture Test
|
$28.60 |
$28.60 |
$28.60 |
$63.84
|
|
Urine pregnancy test
|
$137.80 |
$137.80 |
$137.80 |
$57.00
|
|
Urography, antegrade
|
$665.60 |
$665.60 |
$665.60 |
$593.37
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$10,536.54 |
$10,536.54 |
$10,536.54 |
$8,225.22
|