|
Thyroid imaging
|
$766.20 |
$766.20 |
$766.20 |
$696.75
|
|
Thyroid mets imag whole body
|
$696.00 |
$696.00 |
$696.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$60.00 |
$60.00 |
$60.00 |
$112.67
|
|
Thyroid Ultrasound
|
$761.40 |
$761.40 |
$761.40 |
$588.50
|
|
Thyroid uptake measurement
|
$619.20 |
$619.20 |
$619.20 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$11,946.40 |
$11,946.40 |
$11,946.40 |
$4,152.21
|
|
Thyroxine binding globulin (tbg)
|
$63.60 |
$63.60 |
$63.60 |
$64.51
|
|
Tib/per revasc w/ather add-on 37233
|
$11,790.00 |
$11,790.00 |
$11,790.00 |
$10,165.00
|
|
Tigecycline injection
|
$3.60 |
$3.60 |
$3.60 |
$235.29
|
|
Tissue culture skin/biopsy
|
$956.40 |
$956.40 |
$956.40 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$33.00 |
$33.00 |
$33.00 |
$47.40
|
|
Tissue transglutaminase iga
|
$75.60 |
$75.60 |
$75.60 |
$44.80
|
|
Tixagev and cilgav inj
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$241.92
|
|
Tl-201 thallium diag per mci
|
$100.20 |
$100.20 |
$100.20 |
$80.10
|
|
Tobramycin comp unit
|
$820.00 |
$820.00 |
$820.00 |
$810.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$96.00 |
$96.00 |
$96.00 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$63.60 |
$63.60 |
$63.60 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$9,453.60 |
$9,453.60 |
$9,453.60 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$215.40 |
$215.40 |
$215.40 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$123.00 |
$123.00 |
$123.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$45.00 |
$45.00 |
$45.00 |
$74.10
|
|
Toxoplasma antibody igg
|
$56.40 |
$56.40 |
$56.40 |
$91.65
|
|
Toxoplasma antibody igm
|
$56.40 |
$56.40 |
$56.40 |
$88.00
|
|
Tpmt gene com vrnts
|
$477.00 |
$477.00 |
$477.00 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$875.20 |
$875.20 |
$875.20 |
$6,684.23
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$121.20 |
$121.20 |
$121.20 |
$103.20
|
|
Transferrin
|
$40.20 |
$40.20 |
$40.20 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$394.80 |
$394.80 |
$394.80 |
$560.92
|
|
Transvaginal Pregnancy Ultrasound
|
$242.40 |
$242.40 |
$242.40 |
$501.60
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$196.80 |
$196.80 |
$196.80 |
$5,846.40
|
|
Treat clavicle dislocation 23545
|
$379.80 |
$379.80 |
$379.80 |
$692.80
|
|
Treat elbow dislocation
|
$2,070.00 |
$2,070.00 |
$2,070.00 |
$2,311.20
|
|
Treat finger fracture each
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,592.00
|
|
Treat fracture of radius
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$1,821.60
|
|
Treat hip dislocation
|
$3,508.20 |
$3,508.20 |
$3,508.20 |
$2,211.05
|
|
Treat humerus fracture
|
$379.80 |
$379.80 |
$379.80 |
$1,790.00
|
|
Treat lower leg dislocation
|
$2,629.80 |
$2,629.80 |
$2,629.80 |
$532.60
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$231.60 |
$231.60 |
$231.60 |
$228.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$85.20 |
$85.20 |
$85.20 |
$147.48
|
|
Treatment of thigh fracture
|
$379.80 |
$379.80 |
$379.80 |
$1,790.00
|
|
Treat ulnar fracture
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$1,678.55
|
|
Treponema pallidum antibody
|
$36.00 |
$36.00 |
$36.00 |
$72.05
|
|
Trg gene rearrangement anal
|
$1,114.80 |
$1,114.80 |
$1,114.80 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$6.20 |
$6.20 |
$6.20 |
$43.00
|
|
Triamcinolone a inj prs-free
|
$367.80 |
$367.80 |
$367.80 |
$223.56
|
|
Triglycerides
|
$31.20 |
$31.20 |
$31.20 |
$58.05
|
|
Trim nail(s)
|
$84.60 |
$84.60 |
$84.60 |
$78.40
|
|
Trim nondyst nails
|
$109.20 |
$109.20 |
$109.20 |
$114.48
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,764.20 |
$5,764.20 |
$5,764.20 |
$5,139.20
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$951.60 |
$951.60 |
$951.60 |
$4,350.00
|
|
Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/<
|
$3,178.80 |
$3,178.80 |
$3,178.80 |
$2,406.77
|
|
Troponin quantitative
|
$75.60 |
$75.60 |
$75.60 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$2,012.40 |
$2,012.40 |
$2,012.40 |
$2,075.90
|
|
Tte w or without fol w/con,stres
|
$2,782.80 |
$2,782.80 |
$2,782.80 |
$1,632.80
|
|
Tube trach disp innr can 5 xlt
|
$189.00 |
$189.00 |
$189.00 |
$445.99
|
|
Tube trach disp innr can 6 xlt
|
$81.60 |
$81.60 |
$81.60 |
$16.80
|
|
Tube trach fen sz 6 uncuffed
|
$60.00 |
$60.00 |
$60.00 |
$155.98
|
|
Tx closed hip disl traumatic without anes
|
$379.80 |
$379.80 |
$379.80 |
$586.80
|
|
Ultrasound breast complete
|
$403.20 |
$403.20 |
$403.20 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$403.20 |
$403.20 |
$403.20 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$179.40 |
$179.40 |
$179.40 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$527.40 |
$527.40 |
$527.40 |
$296.80
|
|
Ultrasound exam k transpl w/doppler
|
$277.20 |
$277.20 |
$277.20 |
$575.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$425.40 |
$425.40 |
$425.40 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,242.00 |
$1,242.00 |
$1,242.00 |
$720.15
|
|
Ultrasound guidance for vascular access
|
$67.20 |
$67.20 |
$67.20 |
$388.08
|
|
Ultrasound joint complete left
|
$1,524.60 |
$1,524.60 |
$1,524.60 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$171.00 |
$171.00 |
$171.00 |
$409.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$110.40 |
$110.40 |
$110.40 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,582.80 |
$1,582.80 |
$1,582.80 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$227.40 |
$227.40 |
$227.40 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$303.00 |
$303.00 |
$303.00 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$595.80 |
$595.80 |
$595.80 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$677.40 |
$677.40 |
$677.40 |
$421.00
|
|
Unlisted CT procedure
|
$624.00 |
$624.00 |
$624.00 |
$732.70
|
|
Unlisted procedure microbiology
|
$128.40 |
$128.40 |
$128.40 |
$530.00
|
|
Unlisted procedure rectum
|
$131.40 |
$131.40 |
$131.40 |
$1,223.20
|
|
Unlisted px casting/strpg
|
$226.20 |
$226.20 |
$226.20 |
$222.00
|
|
Unlisted px external ear
|
$85.20 |
$85.20 |
$85.20 |
$325.68
|
|
Unlisted px posterior segmnt
|
$4,036.20 |
$4,036.20 |
$4,036.20 |
$3,173.34
|
|
Unlisted px small intestine
|
$942.60 |
$942.60 |
$942.60 |
$2,118.35
|
|
Unlisted transfusion med px
|
$378.00 |
$378.00 |
$378.00 |
$147.50
|
|
Unsched dialysis esrd pt hos
|
$738.00 |
$738.00 |
$738.00 |
$1,296.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$215.40 |
$215.40 |
$215.40 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,688.40 |
$1,688.40 |
$1,688.40 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,130.80 |
$3,130.80 |
$3,130.80 |
$2,392.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,796.00 |
$2,796.00 |
$2,796.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$478.80 |
$478.80 |
$478.80 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$215.40 |
$215.40 |
$215.40 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,872.60 |
$1,872.60 |
$1,872.60 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$580.80 |
$580.80 |
$580.80 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$580.80 |
$580.80 |
$580.80 |
$607.20
|
|
Uppr gi scope w/submuc inj
|
$3,258.00 |
$3,258.00 |
$3,258.00 |
$1,872.00
|
|
Urea nitrogen
|
$16.20 |
$16.20 |
$16.20 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$36.60 |
$36.60 |
$36.60 |
$51.84
|
|
Urethrcystgrphy rtrgrde s&i
|
$474.60 |
$474.60 |
$474.60 |
$584.00
|
|
Urethrocystography void s&i
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$634.50
|
