|
Temozolomide
|
$180.42 |
$180.42 |
$180.42 |
$588.46
|
|
Temozolomide 100 mg intravenous solution
|
$1,128.13 |
$1,128.13 |
$1,128.13 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,249.64 |
$2,249.64 |
$2,249.64 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,331.43 |
$9,331.43 |
$9,331.43 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$37.76 |
$37.76 |
$37.76 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$202.29 |
$202.29 |
$202.29 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$34.65 |
$34.65 |
$34.65 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$160.71 |
$160.71 |
$160.71 |
$949.70
|
|
Tetanus immune globulin inj
|
$625.75 |
$625.75 |
$625.75 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$47.19 |
$47.19 |
$47.19 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$14.19 |
$14.19 |
$14.19 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$14.19 |
$14.19 |
$14.19 |
$50.00
|
|
Ther/proph/diag inj ia
|
$107.58 |
$107.58 |
$107.58 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$11.79 |
$11.79 |
$11.79 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$974.16 |
$974.16 |
$974.16 |
$1,687.50
|
|
Thrombectmy crnry perq mechanical
|
$148.83 |
$148.83 |
$148.83 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,132.79 |
$2,132.79 |
$2,132.79 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$4,311.12 |
$4,311.12 |
$4,311.12 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$6,534.33 |
$6,534.33 |
$6,534.33 |
$21,413.60
|
|
Thrombin time
|
$65.01 |
$65.01 |
$65.01 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$40.26 |
$40.26 |
$40.26 |
$61.52
|
|
Thyroglobulin antibody
|
$20.46 |
$20.46 |
$20.46 |
$82.00
|
|
Thyroid imaging
|
$202.29 |
$202.29 |
$202.29 |
$695.02
|
|
Thyroid (TSH) Test
|
$55.77 |
$55.77 |
$55.77 |
$111.00
|
|
Thyroid Ultrasound
|
$151.80 |
$151.80 |
$151.80 |
$588.50
|
|
Thyroid uptake measurement
|
$202.29 |
$202.29 |
$202.29 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$22.44 |
$22.44 |
$22.44 |
$64.35
|
|
Tigecycline injection
|
$175.44 |
$175.44 |
$175.44 |
$234.00
|
|
Tirofiban 12.5 mg/50 ml
|
$552.72 |
$552.72 |
$552.72 |
$458.85
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$8,010.81 |
$8,010.81 |
$8,010.81 |
$13,339.20
|
|
Tissue culture placenta
|
$132.66 |
$132.66 |
$132.66 |
$457.00
|
|
Tissue culture skin/biopsy
|
$127.38 |
$127.38 |
$127.38 |
$484.00
|
|
Tissue transglutaminase iga
|
$10.56 |
$10.56 |
$10.56 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$22.93 |
$22.93 |
$22.93 |
$78.40
|
|
Tlso 2 shl symphys-stern cst
|
$4,047.45 |
$4,047.45 |
$4,047.45 |
$1,808.59
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$94.05 |
$94.05 |
$94.05 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$53.46 |
$53.46 |
$53.46 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,986.84 |
$2,986.84 |
$2,986.84 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$11.55 |
$11.55 |
$11.55 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$11.55 |
$11.55 |
$11.55 |
$72.68
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$335.75 |
$335.75 |
$335.75 |
$325.00
|
|
Toxoplasma antibody igg
|
$13.86 |
$13.86 |
$13.86 |
$89.40
|
|
Toxoplasma antibody igm
|
$13.53 |
$13.53 |
$13.53 |
$87.00
|
|
Trabectedin 1 mg intravenous solution
|
$3,877.89 |
$3,877.89 |
$3,877.89 |
$6,827.00
|
|
Transferrin
|
$41.91 |
$41.91 |
$41.91 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$118.47 |
$118.47 |
$118.47 |
$983.00
|
|
Trastuzumab 150 mg intravenous solution
|
$1,752.66 |
$1,752.66 |
$1,752.66 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$4,282.84 |
$4,282.84 |
$4,282.84 |
$7,540.20
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$3,813.75 |
$3,813.75 |
$3,813.75 |
$5,835.15
|
|
Tray bonemarrw oncontrol 102mm
|
$754.88 |
$754.88 |
$754.88 |
$940.80
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$67.32 |
$67.32 |
$67.32 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$20.79 |
$20.79 |
$20.79 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$110.88 |
$110.88 |
$110.88 |
$203.35
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$46,545.60 |
$46,545.60 |
$46,545.60 |
$73,346.25
|
|
Treponema pallidum antibody
|
$41.58 |
$41.58 |
$41.58 |
$70.40
|
|
Treprostinil injection
|
$2,318.46 |
$2,318.46 |
$2,318.46 |
$19,071.84
|
|
Trg gene rearrangement anal
|
$291.72 |
$291.72 |
$291.72 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$164.10 |
$164.10 |
$164.10 |
$43.21
|
|
Triglycerides
|
$19.14 |
$19.14 |
$19.14 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$116.20 |
$116.20 |
$116.20 |
$117.49
|
|
Trnscath retrv pq vasc fb w/guide
|
$1,041.15 |
$1,041.15 |
$1,041.15 |
$4,523.96
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$1,620.30 |
$1,620.30 |
$1,620.30 |
$5,069.50
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$819.72 |
$819.72 |
$819.72 |
$4,250.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$819.72 |
$819.72 |
$819.72 |
$4,250.25
|
|
Troponin quantitative
|
$32.67 |
$32.67 |
$32.67 |
$127.20
|
|
Tte w or without contr, cont ecg
|
$443.85 |
$443.85 |
$443.85 |
$2,012.40
|
|
Tx atrial fib pulm vein isol
|
$5,207.73 |
$5,207.73 |
$5,207.73 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$1,973.40 |
$1,973.40 |
$1,973.40 |
$6,769.00
|
|
Ublituximab-xiiy 25 mg/ml intravenous solution
|
$12,494.75 |
$12,494.75 |
$12,494.75 |
$20,945.01
|
|
Ultrasound abdomen aorta screening study aaa
|
$55.11 |
$55.11 |
$55.11 |
$394.20
|
|
Ultrasound breast complete
|
$312.84 |
$312.84 |
$312.84 |
$528.41
|
|
Ultrasound breast unilateral limited (both sides)
|
$208.56 |
$208.56 |
$208.56 |
$449.35
|
|
Ultrasound chest
|
$132.00 |
$132.00 |
$132.00 |
$460.85
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$55.11 |
$55.11 |
$55.11 |
$338.00
|
|
Ultrasound encephalogram
|
$144.54 |
$144.54 |
$144.54 |
$488.80
|
|
Ultrasound exam k transpl w/doppler
|
$178.86 |
$178.86 |
$178.86 |
$573.54
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$55.11 |
$55.11 |
$55.11 |
$469.50
|
|
Ultrasound guidance for vascular access
|
$99.33 |
$99.33 |
$99.33 |
$400.20
|
|
Ultrasound guided needle placement supervision & interpretation
|
$138.60 |
$138.60 |
$138.60 |
$720.15
|
|
Ultrasound guide intraoperative
|
$197.34 |
$197.34 |
$197.34 |
$632.85
|
|
Ultrasound joint/nonvascular extremity limited left
|
$169.62 |
$169.62 |
$169.62 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$268.29 |
$268.29 |
$268.29 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$218.46 |
$218.46 |
$218.46 |
$331.50
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$87.45 |
$87.45 |
$87.45 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$210.21 |
$210.21 |
$210.21 |
$497.12
|
|
Ultrasound prostate/transrectal
|
$210.21 |
$210.21 |
$210.21 |
$557.40
|
|
Ultrasound retroperitoneal limited
|
$73.26 |
$73.26 |
$73.26 |
$486.50
|
|
Ultrasound scrotum and contents
|
$113.85 |
$113.85 |
$113.85 |
$608.90
|
|
Ultrasound spinal canal and contents
|
$60.39 |
$60.39 |
$60.39 |
$463.00
|
|
Ultrasound transvaginal non obstetric
|
$92.07 |
$92.07 |
$92.07 |
$558.35
|
|
Unlisted maaa
|
$227.70 |
$227.70 |
$227.70 |
$235.20
|
|
Unlisted neurological dx px
|
$288.75 |
$288.75 |
$288.75 |
$242.50
|
|
Unlisted procedure microbiology
|
$118.80 |
$118.80 |
$118.80 |
$523.50
|
|
Unlisted ultrasound procedure
|
$158.73 |
$158.73 |
$158.73 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$654.72 |
$654.72 |
$654.72 |
$1,268.17
|
|
Upgrade pm system
|
$3,887.07 |
$3,887.07 |
$3,887.07 |
$12,077.00
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$953.70 |
$953.70 |
$953.70 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,034.41
|
|
Urea nitrogen
|
$13.20 |
$13.20 |
$13.20 |
$41.46
|
