|
Thyroid (TSH) Test
|
$98.40 |
$98.40 |
$98.40 |
$112.70
|
|
Thyroid Ultrasound
|
$783.20 |
$783.20 |
$783.20 |
$588.50
|
|
Thyroid uptake measurement
|
$876.80 |
$876.80 |
$876.80 |
$591.25
|
|
Tigecycline injection
|
$68.16 |
$68.16 |
$68.16 |
$235.29
|
|
Tirofiban 12.5 mg/50 ml
|
$228.24 |
$228.24 |
$228.24 |
$458.85
|
|
Tissue exam koh skin/hair/nails
|
$64.00 |
$64.00 |
$64.00 |
$47.40
|
|
Tissue transglutaminase iga
|
$52.80 |
$52.80 |
$52.80 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$61.04 |
$61.04 |
$61.04 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$88.00 |
$88.00 |
$88.00 |
$120.60
|
|
Toe X-ray (both feet)
|
$308.80 |
$308.80 |
$308.80 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$126.40 |
$126.40 |
$126.40 |
$74.10
|
|
Toxoplasma antibody igg
|
$148.80 |
$148.80 |
$148.80 |
$91.65
|
|
Toxoplasma antibody igm
|
$172.80 |
$172.80 |
$172.80 |
$87.75
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$126.40 |
$126.40 |
$126.40 |
$102.27
|
|
Transferrin
|
$105.60 |
$105.60 |
$105.60 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$693.60 |
$693.60 |
$693.60 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$748.00 |
$748.00 |
$748.00 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,356.00 |
$2,356.00 |
$2,356.00 |
$4,523.04
|
|
Treat clavicle dislocation 23545
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$692.80
|
|
Treat finger fracture each
|
$904.80 |
$904.80 |
$904.80 |
$1,592.00
|
|
Treat foot dislocation
|
$246.40 |
$246.40 |
$246.40 |
$405.60
|
|
Treat foot dislocation
|
$246.40 |
$246.40 |
$246.40 |
$534.05
|
|
Treat foot dislocation
|
$373.60 |
$373.60 |
$373.60 |
$445.80
|
|
Treat fracture of ulna
|
$1,832.80 |
$1,832.80 |
$1,832.80 |
$731.04
|
|
Treat knee fracture 27530
|
$412.80 |
$412.80 |
$412.80 |
$550.73
|
|
Treat lower leg dislocation
|
$1,048.00 |
$1,048.00 |
$1,048.00 |
$532.60
|
|
Treatment of ankle fracture 27786
|
$400.80 |
$400.80 |
$400.80 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$345.60 |
$345.60 |
$345.60 |
$501.20
|
|
Treatment of heel fracture 28400
|
$362.40 |
$362.40 |
$362.40 |
$473.00
|
|
Treatment of toe fracture 28510
|
$306.40 |
$306.40 |
$306.40 |
$371.40
|
|
Treat midfoot fracture each
|
$2,732.80 |
$2,732.80 |
$2,732.80 |
$1,884.74
|
|
Treponema pallidum antibody
|
$95.20 |
$95.20 |
$95.20 |
$72.05
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$65.65 |
$65.65 |
$65.65 |
$43.09
|
|
Triglycerides
|
$58.40 |
$58.40 |
$58.40 |
$58.50
|
|
Troponin quantitative
|
$174.40 |
$174.40 |
$174.40 |
$127.60
|
|
Tx closed hip disl traumatic without anes
|
$548.80 |
$548.80 |
$548.80 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$400.80 |
$400.80 |
$400.80 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$316.80 |
$316.80 |
$316.80 |
$419.04
|
|
Ua w/micro/comp poc
|
$52.80 |
$52.80 |
$52.80 |
$23.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$492.00 |
$492.00 |
$492.00 |
$338.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$662.40 |
$662.40 |
$662.40 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$931.20 |
$931.20 |
$931.20 |
$720.15
|
|
Ultrasound hips infant dynamic
|
$558.40 |
$558.40 |
$558.40 |
$403.88
|
|
Ultrasound joint complete left
|
$503.20 |
$503.20 |
$503.20 |
$557.99
|
|
Ultrasound ob >=14wks ea addl gest
|
$701.60 |
$701.60 |
$701.60 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$532.80 |
$532.80 |
$532.80 |
$334.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$568.80 |
$568.80 |
$568.80 |
$425.60
|
|
Unlisted gi px dx nuc med
|
$643.20 |
$643.20 |
$643.20 |
$995.00
|
|
Unlisted px forearm/wrist
|
$3,847.20 |
$3,847.20 |
$3,847.20 |
$859.50
|
|
Unlisted px hands/fingers
|
$2,298.40 |
$2,298.40 |
$2,298.40 |
$354.20
|
|
Upper Arm (Humerus) X-ray (left side)
|
$308.80 |
$308.80 |
$308.80 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,324.80 |
$4,324.80 |
$4,324.80 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$3,603.20 |
$3,603.20 |
$3,603.20 |
$2,369.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$3,200.00 |
$3,200.00 |
$3,200.00 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$400.80 |
$400.80 |
$400.80 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$488.00 |
$488.00 |
$488.00 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$2,482.40 |
$2,482.40 |
$2,482.40 |
$1,824.75
|
|
Upper GI Barium X-ray (barium and gas)
|
$928.00 |
$928.00 |
$928.00 |
$660.40
|
|
Urea nitrogen
|
$58.40 |
$58.40 |
$58.40 |
$42.25
|
|
Urea nitrogen 24 hour urine
|
$56.80 |
$56.80 |
$56.80 |
$52.00
|
|
Ureteral reflux study
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$918.40 |
$918.40 |
$918.40 |
$584.00
|
|
Uric acid blood
|
$58.40 |
$58.40 |
$58.40 |
$49.44
|
|
Uric acid urine
|
$59.20 |
$59.20 |
$59.20 |
$45.36
|
|
Urinalysis microscopic only
|
$36.00 |
$36.00 |
$36.00 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$68.00 |
$68.00 |
$68.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$52.00 |
$52.00 |
$52.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$41.60 |
$41.60 |
$41.60 |
$36.00
|
|
Urine Culture Test
|
$74.40 |
$74.40 |
$74.40 |
$83.00
|
|
Urine pregnancy test
|
$66.40 |
$66.40 |
$66.40 |
$68.78
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,128.34 |
$3,128.34 |
$3,128.34 |
$5,205.00
|
|
Vaccine Administration (one shot)
|
$100.00 |
$100.00 |
$100.00 |
$67.70
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$229.80 |
$229.80 |
$229.80 |
$236.50
|
|
Vaccine dtap-ipv 4-6 years im
|
$95.49 |
$95.49 |
$95.49 |
$105.95
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$203.88 |
$203.88 |
$203.88 |
$231.56
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$85.45 |
$85.45 |
$85.45 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$243.76 |
$243.76 |
$243.76 |
$274.93
|
|
Vaccine influenza inactivated adjuvant im
|
$56.80 |
$56.80 |
$56.80 |
$110.25
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$32.11 |
$32.11 |
$32.11 |
$82.71
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$287.72 |
$287.72 |
$287.72 |
$397.11
|
|
Vaccine rabies im
|
$518.56 |
$518.56 |
$518.56 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$493.46 |
$493.46 |
$493.46 |
$538.84
|
|
Vaccine tdap >=7 years im
|
$84.94 |
$84.94 |
$84.94 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$75.88 |
$75.88 |
$75.88 |
$112.10
|
|
Valproic acid total therapeutic drug level
|
$121.60 |
$121.60 |
$121.60 |
$115.00
|
|
Vancomycin 1,000 mg intravenous injection
|
$69.21 |
$69.21 |
$69.21 |
$259.05
|
|
Vancomycin 750 mg intravenous solution
|
$78.02 |
$78.02 |
$78.02 |
$90.33
|
|
Vancomycin peak therapeutic drug level
|
$100.80 |
$100.80 |
$100.80 |
$136.13
|
|
Varicella zoster antibody igg
|
$54.40 |
$54.40 |
$54.40 |
$86.80
|
|
Vedolizumab 300 mg intravenous solution
|
$14,953.49 |
$14,953.49 |
$14,953.49 |
$18,732.33
|
|
Ven thrombosis images bilat
|
$1,593.60 |
$1,593.60 |
$1,593.60 |
$796.50
|
|
Ventilator each subsequent day
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
$1,184.00
|
|
Ventilator Management (first day)
|
$1,679.20 |
$1,679.20 |
$1,679.20 |
$1,434.60
|
|
Video Swallow Study (Modified Barium Swallow)
|
$724.00 |
$724.00 |
$724.00 |
$524.50
|
|
Virus isolation addl studies ea
|
$153.60 |
$153.60 |
$153.60 |
$79.34
|
|
Vitamin b-12
|
$108.00 |
$108.00 |
$108.00 |
$100.28
|
|
Vitamin D Test
|
$132.00 |
$132.00 |
$132.00 |
$132.00
|
|
Walking (Gait) Training (each 15 minutes)
|
$117.60 |
$117.60 |
$117.60 |
$87.50
|