|
Thyroglobulin antibody
|
$87.20 |
$87.20 |
$87.20 |
$82.50
|
|
Thyroid imaging
|
$956.80 |
$956.80 |
$956.80 |
$695.60
|
|
Thyroid (TSH) Test
|
$81.60 |
$81.60 |
$81.60 |
$112.70
|
|
Thyroid Ultrasound
|
$680.00 |
$680.00 |
$680.00 |
$588.50
|
|
Tirofiban 12.5 mg/50 ml
|
$196.76 |
$196.76 |
$196.76 |
$458.85
|
|
Tissue exam koh skin/hair/nails
|
$44.80 |
$44.80 |
$44.80 |
$47.40
|
|
Tissue transglutaminase iga
|
$50.40 |
$50.40 |
$50.40 |
$44.80
|
|
Tl-201 thallium diag per mci
|
$78.40 |
$78.40 |
$78.40 |
$80.10
|
|
Tobramycin peak therapeutic drug level
|
$84.80 |
$84.80 |
$84.80 |
$120.60
|
|
Toe X-ray (both feet)
|
$231.20 |
$231.20 |
$231.20 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$68.00 |
$68.00 |
$68.00 |
$74.10
|
|
Toxoplasma antibody igg
|
$82.40 |
$82.40 |
$82.40 |
$91.65
|
|
Toxoplasma antibody igm
|
$108.80 |
$108.80 |
$108.80 |
$87.75
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$100.00 |
$100.00 |
$100.00 |
$102.27
|
|
Transferrin
|
$65.60 |
$65.60 |
$65.60 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$695.20 |
$695.20 |
$695.20 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$654.40 |
$654.40 |
$654.40 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$1,463.20 |
$1,463.20 |
$1,463.20 |
$4,523.04
|
|
Treat finger fracture each
|
$989.60 |
$989.60 |
$989.60 |
$1,592.00
|
|
Treat foot dislocation
|
$376.80 |
$376.80 |
$376.80 |
$405.60
|
|
Treat foot dislocation
|
$427.20 |
$427.20 |
$427.20 |
$534.05
|
|
Treat foot dislocation
|
$361.60 |
$361.60 |
$361.60 |
$445.80
|
|
Treat fracture of ulna
|
$1,259.20 |
$1,259.20 |
$1,259.20 |
$731.04
|
|
Treat knee fracture 27530
|
$433.60 |
$433.60 |
$433.60 |
$550.73
|
|
Treat lower leg dislocation
|
$977.60 |
$977.60 |
$977.60 |
$532.60
|
|
Treatment incomplete abortion completed surgically any trimester
|
$3,348.80 |
$3,348.80 |
$3,348.80 |
$3,928.20
|
|
Treatment of ankle fracture 27786
|
$421.60 |
$421.60 |
$421.60 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$378.40 |
$378.40 |
$378.40 |
$501.20
|
|
Treatment of heel fracture 28400
|
$380.80 |
$380.80 |
$380.80 |
$473.00
|
|
Treatment of toe fracture 28510
|
$322.40 |
$322.40 |
$322.40 |
$371.40
|
|
Treat midfoot fracture each
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$1,884.74
|
|
Treponema pallidum antibody
|
$68.80 |
$68.80 |
$68.80 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$61.42 |
$61.42 |
$61.42 |
$43.09
|
|
Triglycerides
|
$28.80 |
$28.80 |
$28.80 |
$58.50
|
|
Trmt of fracture (femoral shaft) 27500
|
$381.60 |
$381.60 |
$381.60 |
$754.80
|
|
Troponin quantitative
|
$82.40 |
$82.40 |
$82.40 |
$127.60
|
|
Tx closed tib shaft fx without manip
|
$421.60 |
$421.60 |
$421.60 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$387.20 |
$387.20 |
$387.20 |
$419.04
|
|
Ua w/micro/comp poc
|
$35.20 |
$35.20 |
$35.20 |
$23.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$647.20 |
$647.20 |
$647.20 |
$476.94
|
|
Ultrasound joint complete left
|
$623.20 |
$623.20 |
$623.20 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$630.40 |
$630.40 |
$630.40 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$456.00 |
$456.00 |
$456.00 |
$334.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$496.00 |
$496.00 |
$496.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$687.20 |
$687.20 |
$687.20 |
$557.40
|
|
Unlisted px foot/toes
|
$2,301.60 |
$2,301.60 |
$2,301.60 |
$1,239.20
|
|
Unlisted px forearm/wrist
|
$3,521.60 |
$3,521.60 |
$3,521.60 |
$859.50
|
|
Unlisted px hands/fingers
|
$336.80 |
$336.80 |
$336.80 |
$354.20
|
|
Unlisted px leg/ankle
|
$381.60 |
$381.60 |
$381.60 |
$882.30
|
|
Unlisted px pelvis/hip joint
|
$4,119.20 |
$4,119.20 |
$4,119.20 |
$3,251.90
|
|
Upper Arm (Humerus) X-ray (left side)
|
$312.00 |
$312.00 |
$312.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,263.20 |
$2,263.20 |
$2,263.20 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,902.40 |
$1,902.40 |
$1,902.40 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,056.00 |
$4,056.00 |
$4,056.00 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$2,735.20 |
$2,735.20 |
$2,735.20 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$331.20 |
$331.20 |
$331.20 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$375.20 |
$375.20 |
$375.20 |
$381.60
|
|
Urea nitrogen
|
$25.60 |
$25.60 |
$25.60 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$32.00 |
$32.00 |
$32.00 |
$52.00
|
|
Ureteral reflux study
|
$1,225.60 |
$1,225.60 |
$1,225.60 |
$952.50
|
|
Uric acid blood
|
$36.80 |
$36.80 |
$36.80 |
$49.44
|
|
Uric acid urine
|
$36.00 |
$36.00 |
$36.00 |
$45.36
|
|
Urinalysis microscopic only
|
$16.00 |
$16.00 |
$16.00 |
$26.46
|
|
Urinalysis (with microscopy)
|
$31.20 |
$31.20 |
$31.20 |
$55.20
|
|
Urinalysis (without microscopy)
|
$24.80 |
$24.80 |
$24.80 |
$36.00
|
|
Urine Culture Test
|
$42.40 |
$42.40 |
$42.40 |
$83.00
|
|
Urine pregnancy test
|
$30.40 |
$30.40 |
$30.40 |
$68.78
|
|
Vaccine Administration (one shot)
|
$98.40 |
$98.40 |
$98.40 |
$67.70
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$236.64 |
$236.64 |
$236.64 |
$236.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$60.60 |
$60.60 |
$60.60 |
$149.21
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$28.32 |
$28.32 |
$28.32 |
$48.59
|
|
Vaccine rabies im
|
$574.93 |
$574.93 |
$574.93 |
$858.95
|
|
Vaccine tdap >=7 years im
|
$85.68 |
$85.68 |
$85.68 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$79.88 |
$79.88 |
$79.88 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$71.20 |
$71.20 |
$71.20 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$70.25 |
$70.25 |
$70.25 |
$259.05
|
|
Vancomycin 750 mg intravenous solution
|
$91.42 |
$91.42 |
$91.42 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$76.00 |
$76.00 |
$76.00 |
$136.13
|
|
Varicella zoster antibody igg
|
$54.40 |
$54.40 |
$54.40 |
$86.80
|
|
Vasopressin 20 unit/ml intravenous solution
|
$61.78 |
$61.78 |
$61.78 |
$325.80
|
|
Ventilator each subsequent day
|
$1,236.80 |
$1,236.80 |
$1,236.80 |
$1,184.00
|
|
Ventilator Management (first day)
|
$1,511.20 |
$1,511.20 |
$1,511.20 |
$1,434.60
|
|
Virus isolation addl studies ea
|
$102.40 |
$102.40 |
$102.40 |
$79.34
|
|
Vitamin b-12
|
$73.60 |
$73.60 |
$73.60 |
$100.28
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$132.00
|
|
Volume measurement urine timed
|
$16.80 |
$16.80 |
$16.80 |
$21.64
|
|
Walking (Gait) Training (each 15 minutes)
|
$116.00 |
$116.00 |
$116.00 |
$87.50
|
|
Warde 1003990 aldosterone
|
$264.00 |
$264.00 |
$264.00 |
$144.73
|
|
Warde 1005020 citrate 24 hour urine
|
$74.40 |
$74.40 |
$74.40 |
$100.10
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$46.40 |
$46.40 |
$46.40 |
$64.08
|
|
Warde 1006955 catecholamines fractionated 24 hour urine
|
$84.00 |
$84.00 |
$84.00 |
$113.10
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$68.80 |
$68.80 |
$68.80 |
$70.85
|
|
Warde 1015200 kappa light chain free
|
$53.60 |
$53.60 |
$53.60 |
$65.20
|
|
Warde 3004000 immunoglobulin subclass 1
|
$72.00 |
$72.00 |
$72.00 |
$39.36
|
|
Warde 3008005 oligoclonal bands
|
$71.20 |
$71.20 |
$71.20 |
$108.50
|
|
Warde 3016000 west nile virus antibody
|
$60.80 |
$60.80 |
$60.80 |
$71.60
|
|
Warde 3016000 west nile virus antibody igg
|
$70.40 |
$70.40 |
$70.40 |
$70.74
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$46.40 |
$46.40 |
$46.40 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$72.00 |
$72.00 |
$72.00 |
$73.60
|
|
Warde 3400852 arsenic
|
$107.20 |
$107.20 |
$107.20 |
$101.00
|