|
Toxoplasma antibody igg
|
$110.40 |
$110.40 |
$110.40 |
$91.65
|
|
Toxoplasma antibody igm
|
$125.40 |
$125.40 |
$125.40 |
$88.00
|
|
Tpmt gene com vrnts
|
$477.00 |
$477.00 |
$477.00 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$822.00 |
$822.00 |
$822.00 |
$6,684.23
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$121.20 |
$121.20 |
$121.20 |
$103.20
|
|
Transferrin
|
$98.40 |
$98.40 |
$98.40 |
$82.00
|
|
Transparent film >16<=48 in
|
$2.40 |
$2.40 |
$2.40 |
$12.95
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$906.60 |
$906.60 |
$906.60 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$1,770.60 |
$1,770.60 |
$1,770.60 |
$501.60
|
|
Trastuzumab 150 mg intravenous solution
|
$235.20 |
$235.20 |
$235.20 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$224.40 |
$224.40 |
$224.40 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$205.20 |
$205.20 |
$205.20 |
$5,846.40
|
|
Treat clavicle dislocation 23545
|
$2,487.00 |
$2,487.00 |
$2,487.00 |
$692.80
|
|
Treat finger fracture each
|
$3,083.40 |
$3,083.40 |
$3,083.40 |
$1,592.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$316.80 |
$316.80 |
$316.80 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$119.40 |
$119.40 |
$119.40 |
$147.48
|
|
Treatment of thigh fracture
|
$2,829.60 |
$2,829.60 |
$2,829.60 |
$1,790.00
|
|
Treat toe dislocation
|
$2,802.60 |
$2,802.60 |
$2,802.60 |
$756.00
|
|
Treat toe fracture
|
$4,408.20 |
$4,408.20 |
$4,408.20 |
$3,839.54
|
|
Treat ulnar fracture
|
$2,421.60 |
$2,421.60 |
$2,421.60 |
$1,678.55
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$265.80 |
$265.80 |
$265.80 |
$73,346.25
|
|
Treponema pallidum antibody
|
$103.20 |
$103.20 |
$103.20 |
$72.05
|
|
Trg gene rearrangement anal
|
$1,114.20 |
$1,114.20 |
$1,114.20 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$10.20 |
$10.20 |
$10.20 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$21.00 |
$21.00 |
$21.00 |
$223.56
|
|
Trichomonas assay w/optic
|
$115.80 |
$115.80 |
$115.80 |
$57.40
|
|
Triglycerides
|
$254.40 |
$254.40 |
$254.40 |
$58.05
|
|
Trim nail(s)
|
$99.60 |
$99.60 |
$99.60 |
$78.40
|
|
Trim nondyst nails
|
$150.00 |
$150.00 |
$150.00 |
$114.48
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$13,400.40 |
$13,400.40 |
$13,400.40 |
$8,790.54
|
|
Trnscath plc vas stent w/s&i ini vein
|
$13,400.40 |
$13,400.40 |
$13,400.40 |
$14,558.70
|
|
Trnscath retrv pq vasc fb w/guide
|
$10,441.20 |
$10,441.20 |
$10,441.20 |
$4,766.40
|
|
Trnscath tx thromblytc vein ini day
|
$8,211.60 |
$8,211.60 |
$8,211.60 |
$3,866.70
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$3,752.40 |
$3,752.40 |
$3,752.40 |
$2,406.77
|
|
Troponin quantitative
|
$93.00 |
$93.00 |
$93.00 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,012.40 |
$2,012.40 |
$2,012.40 |
$2,075.90
|
|
Tube trach disp innr can 5 xlt
|
$395.40 |
$395.40 |
$395.40 |
$445.99
|
|
Tx closed hip disl traumatic without anes
|
$2,421.60 |
$2,421.60 |
$2,421.60 |
$586.80
|
|
Ua w/micro/comp poc
|
$22.80 |
$22.80 |
$22.80 |
$23.00
|
|
Ugt1a1 gene analy common variants
|
$1,240.20 |
$1,240.20 |
$1,240.20 |
$438.75
|
|
Ultrasound breast complete
|
$2,310.00 |
$2,310.00 |
$2,310.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$2,080.20 |
$2,080.20 |
$2,080.20 |
$452.40
|
|
Ultrasound dx ophth b-scan
|
$549.60 |
$549.60 |
$549.60 |
$296.80
|
|
Ultrasound exam k transpl w/doppler
|
$658.20 |
$658.20 |
$658.20 |
$575.40
|
|
Ultrasound Guidance for a Needle Procedure
|
$436.20 |
$436.20 |
$436.20 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$436.20 |
$436.20 |
$436.20 |
$388.08
|
|
Ultrasound joint complete left
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$557.99
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$189.00 |
$189.00 |
$189.00 |
$335.00
|
|
Unlisted CT procedure
|
$624.00 |
$624.00 |
$624.00 |
$732.70
|
|
Unlisted gi px dx nuc med
|
$550.80 |
$550.80 |
$550.80 |
$995.00
|
|
Unlisted px ant segment eye
|
$717.60 |
$717.60 |
$717.60 |
$2,698.92
|
|
Unlisted px casting/strpg
|
$102.60 |
$102.60 |
$102.60 |
$222.00
|
|
Unlisted px posterior segmnt
|
$4,036.20 |
$4,036.20 |
$4,036.20 |
$3,173.34
|
|
Unlisted transfusion med px
|
$761.40 |
$761.40 |
$761.40 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$962.40 |
$962.40 |
$962.40 |
$1,296.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$424.20 |
$424.20 |
$424.20 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,836.20 |
$2,836.20 |
$2,836.20 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,810.20 |
$1,810.20 |
$1,810.20 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$6,049.20 |
$6,049.20 |
$6,049.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$4,936.20 |
$4,936.20 |
$4,936.20 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,834.60 |
$3,834.60 |
$3,834.60 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$424.20 |
$424.20 |
$424.20 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$424.20 |
$424.20 |
$424.20 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,260.80 |
$2,260.80 |
$2,260.80 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$3,033.60 |
$3,033.60 |
$3,033.60 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$810.00 |
$810.00 |
$810.00 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$810.00 |
$810.00 |
$810.00 |
$607.20
|
|
Uppr gi scope w/submuc inj
|
$3,381.00 |
$3,381.00 |
$3,381.00 |
$1,872.00
|
|
Urea nitrogen
|
$46.20 |
$46.20 |
$46.20 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$104.40 |
$104.40 |
$104.40 |
$51.84
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,735.20 |
$1,735.20 |
$1,735.20 |
$584.00
|
|
Uric acid blood
|
$144.60 |
$144.60 |
$144.60 |
$49.32
|
|
Uric acid urine
|
$63.60 |
$63.60 |
$63.60 |
$44.52
|
|
Urinalysis (with microscopy)
|
$94.80 |
$94.80 |
$94.80 |
$55.20
|
|
Urinalysis (without microscopy)
|
$53.40 |
$53.40 |
$53.40 |
$35.91
|
|
Urine Culture Test
|
$74.40 |
$74.40 |
$74.40 |
$82.32
|
|
Urine pregnancy test
|
$66.60 |
$66.60 |
$66.60 |
$68.21
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$70.00 |
$70.00 |
$70.00 |
$5,205.00
|
|
Vaccine Administration (one shot)
|
$12.00 |
$12.00 |
$12.00 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$340.00 |
$340.00 |
$340.00 |
$224.25
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$31.20 |
$31.20 |
$31.20 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$81.00 |
$81.00 |
$81.00 |
$166.62
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$86.40 |
$86.40 |
$86.40 |
$155.16
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$12.00 |
$12.00 |
$12.00 |
$33.60
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$24.00 |
$24.00 |
$24.00 |
$82.71
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$116.00 |
$116.00 |
$116.00 |
$394.26
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$122.40 |
$122.40 |
$122.40 |
$327.37
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$75.00 |
$75.00 |
$75.00 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$144.00 |
$144.00 |
$144.00 |
$393.25
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$192.00 |
$192.00 |
$192.00 |
$563.36
|
|
Vaccine rabies im
|
$800.00 |
$800.00 |
$800.00 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$672.00 |
$672.00 |
$672.00 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,196.00 |
$1,196.00 |
$1,196.00 |
$1,105.21
|
|
Vaccine tdap >=7 years im
|
$42.40 |
$42.40 |
$42.40 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$55.80 |
$55.80 |
$55.80 |
$112.10
|
|
Vaginal bx
|
$97.80 |
$97.80 |
$97.80 |
$459.42
|
|
Valproic acid total therapeutic drug level
|
$115.80 |
$115.80 |
$115.80 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$0.60 |
$0.60 |
$0.60 |
$251.86
|
|
Vancomycin hcl injection
|
$33.60 |
$33.60 |
$33.60 |
$149.49
|
|
Vancomycin peak therapeutic drug level
|
$144.60 |
$144.60 |
$144.60 |
$135.60
|