|
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
|
|
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
|
|
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 mets imag whole body
|
$319.77 |
$319.77 |
$319.77 |
$1,524.99
|
|
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
|
$1,598.72 |
$1,598.72 |
$1,598.72 |
$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
|
|
Transcatheter bx s&i
|
$428.34 |
$428.34 |
$428.34 |
$1,915.00
|
|
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
|
$431.05 |
$431.05 |
$431.05 |
$940.80
|
|
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
|
$85.47 |
$85.47 |
$85.47 |
$58.05
|
|
Trimethobenzamide hcl inj
|
$116.20 |
$116.20 |
$116.20 |
$117.49
|
|
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
|
|
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 elastography ea l target les
|
$108.90 |
$108.90 |
$108.90 |
$180.00
|
|
Ultrasound elastography parenchyma
|
$122.43 |
$122.43 |
$122.43 |
$307.00
|
|
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
|
|
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
|
|
Urea nitrogen 24 hour urine
|
$14.19 |
$14.19 |
$14.19 |
$51.75
|
|
Urethrcystgrphy rtrgrde s&i
|
$142.56 |
$142.56 |
$142.56 |
$579.73
|
|
Urethrocystography void s&i
|
$157.08 |
$157.08 |
$157.08 |
$622.35
|
|
Uric acid blood
|
$14.85 |
$14.85 |
$14.85 |
$48.75
|
|
Uric acid urine
|
$44.22 |
$44.22 |
$44.22 |
$44.33
|
|
Urinalysis (with microscopy)
|
$10.56 |
$10.56 |
$10.56 |
$55.00
|
|
Urinalysis (without microscopy)
|
$7.59 |
$7.59 |
$7.59 |
$35.75
|
|
Urine Culture Test
|
$26.73 |
$26.73 |
$26.73 |
$81.50
|
|
Urine pregnancy test
|
$21.12 |
$21.12 |
$21.12 |
$67.20
|
|
Urography, antegrade
|
$186.12 |
$186.12 |
$186.12 |
$622.35
|
|
Use 1st target lesion
|
$108.90 |
$108.90 |
$108.90 |
$332.00
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$4,062.63 |
$4,062.63 |
$4,062.63 |
$5,184.34
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$166.10 |
$166.10 |
$166.10 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$94.05 |
$94.05 |
$94.05 |
$123.20
|
|
Vaccine dtap-ipv 4-6 years im
|
$94.05 |
$94.05 |
$94.05 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$164.02 |
$164.02 |
$164.02 |
$174.72
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$58.37 |
$58.37 |
$58.37 |
$70.26
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$25.23 |
$25.23 |
$25.23 |
$43.12
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$138.46 |
$138.46 |
$138.46 |
$155.16
|