|
Test for chlorohydrocarbons
|
$254.81 |
$254.81 |
$254.81 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$329.15 |
$329.15 |
$329.15 |
$586.96
|
|
Test pathogen(s) for platelets reference
|
$146.37 |
$146.37 |
$146.37 |
$52.00
|
|
Test stress cardiovascular tracing only
|
$614.07 |
$614.07 |
$614.07 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,395.20 |
$1,395.20 |
$1,395.20 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$107.94 |
$107.94 |
$107.94 |
$101.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$28.62 |
$28.62 |
$28.62 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.54 |
$9.54 |
$9.54 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$633.65 |
$633.65 |
$633.65 |
$1,658.70
|
|
Thrombin time
|
$58.52 |
$58.52 |
$58.52 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$61.50 |
$61.50 |
$61.50 |
$56.93
|
|
Thyroglobulin antibody
|
$69.42 |
$69.42 |
$69.42 |
$86.40
|
|
Thyroid imaging
|
$370.16 |
$370.16 |
$370.16 |
$577.80
|
|
Thyroid (TSH) Test
|
$74.27 |
$74.27 |
$74.27 |
$101.40
|
|
Thyroid Ultrasound
|
$289.56 |
$289.56 |
$289.56 |
$553.80
|
|
Thyroid uptake measurement
|
$325.98 |
$325.98 |
$325.98 |
$580.20
|
|
Thyroxine binding globulin (tbg)
|
$90.36 |
$90.36 |
$90.36 |
$75.00
|
|
Tissue culture tumor
|
$492.41 |
$492.41 |
$492.41 |
$605.60
|
|
Tissue exam koh skin/hair/nails
|
$45.23 |
$45.23 |
$45.23 |
$45.23
|
|
Tissue transglutaminase iga
|
$21.09 |
$21.09 |
$21.09 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$209.88 |
$209.88 |
$209.88 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.08 |
$7.08 |
$7.08 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$149.93 |
$149.93 |
$149.93 |
$117.00
|
|
Tomosynthesis breast diagnostic left
|
$34.07 |
$34.07 |
$34.07 |
$53.92
|
|
Tomosynthesis breast screen bilateral
|
$32.45 |
$32.45 |
$32.45 |
$77.46
|
|
Toxoplasma antibody igg
|
$51.12 |
$51.12 |
$51.12 |
$83.20
|
|
Toxoplasma antibody igm
|
$71.34 |
$71.34 |
$71.34 |
$85.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,860.63 |
$1,860.63 |
$1,860.63 |
$1,522.95
|
|
Transferrin
|
$92.46 |
$92.46 |
$92.46 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$375.00 |
$375.00 |
$375.00 |
$988.24
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$66.14 |
$66.14 |
$66.14 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$53.34 |
$53.34 |
$53.34 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$75.56 |
$75.56 |
$75.56 |
$197.60
|
|
Treponema pallidum antibody
|
$119.52 |
$119.52 |
$119.52 |
$74.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$4.56 |
$4.56 |
$4.56 |
$28.90
|
|
Triglycerides
|
$42.81 |
$42.81 |
$42.81 |
$48.75
|
|
Troponin quantitative
|
$77.15 |
$77.15 |
$77.15 |
$112.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$178.85 |
$178.85 |
$178.85 |
$394.20
|
|
Ultrasound breast complete
|
$346.94 |
$346.94 |
$346.94 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$330.39 |
$330.39 |
$330.39 |
$427.00
|
|
Ultrasound chest
|
$218.07 |
$218.07 |
$218.07 |
$430.10
|
|
Ultrasound encephalogram
|
$199.89 |
$199.89 |
$199.89 |
$463.50
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$131.31 |
$131.31 |
$131.31 |
$428.68
|
|
Ultrasound guidance for vascular access
|
$222.23 |
$222.23 |
$222.23 |
$300.00
|
|
Ultrasound guided needle placement supervision & interpretation
|
$228.23 |
$228.23 |
$228.23 |
$629.64
|
|
Ultrasound infant hips ltd without stress
|
$126.59 |
$126.59 |
$126.59 |
$311.25
|
|
Ultrasound joint complete left
|
$301.68 |
$301.68 |
$301.68 |
$534.00
|
|
Ultrasound joint/nonvascular extremity limited left
|
$275.09 |
$275.09 |
$275.09 |
$426.60
|
|
Ultrasound ob >=14wks ea addl gest
|
$163.98 |
$163.98 |
$163.98 |
$431.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$199.83 |
$199.83 |
$199.83 |
$304.80
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$338.91 |
$338.91 |
$338.91 |
$680.71
|
|
Ultrasound pregnant uterus follow up per fetus
|
$211.22 |
$211.22 |
$211.22 |
$393.32
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$86.70 |
$86.70 |
$86.70 |
$434.20
|
|
Ultrasound pregnant uterus transvaginal
|
$372.18 |
$372.18 |
$372.18 |
$477.10
|
|
Ultrasound prostate/transrectal
|
$190.08 |
$190.08 |
$190.08 |
$515.63
|
|
Ultrasound retroperitoneal limited
|
$252.51 |
$252.51 |
$252.51 |
$469.58
|
|
Ultrasound scrotum and contents
|
$333.84 |
$333.84 |
$333.84 |
$558.03
|
|
Ultrasound spinal canal and contents
|
$376.25 |
$376.25 |
$376.25 |
$415.00
|
|
Ultrasound transabd ea addl gest
|
$209.88 |
$209.88 |
$209.88 |
$424.80
|
|
Ultrasound transvaginal non obstetric
|
$370.23 |
$370.23 |
$370.23 |
$523.20
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,383.93 |
$1,383.93 |
$1,383.93 |
$2,590.50
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,152.21 |
$1,152.21 |
$1,152.21 |
$2,001.87
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$976.83 |
$976.83 |
$976.83 |
$1,794.00
|
|
Upper Endoscopy (EGD, diagnostic)
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,760.00
|
|
Upper Endoscopy (EGD, with biopsy)
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,760.00
|
|
Uppr gi scope w/submuc inj
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,247.13
|
|
Urea nitrogen
|
$32.96 |
$32.96 |
$32.96 |
$38.25
|
|
Urea nitrogen 24 hour urine
|
$32.96 |
$32.96 |
$32.96 |
$42.90
|
|
Urethrocystography void s&i
|
$254.57 |
$254.57 |
$254.57 |
$586.50
|
|
Uric acid blood
|
$42.81 |
$42.81 |
$42.81 |
$44.00
|
|
Uric acid urine
|
$57.39 |
$57.39 |
$57.39 |
$43.20
|
|
Urinalysis (with microscopy)
|
$48.14 |
$48.14 |
$48.14 |
$37.39
|
|
Urinalysis (without microscopy)
|
$34.80 |
$34.80 |
$34.80 |
$33.00
|
|
Urine Culture Test
|
$36.56 |
$36.56 |
$36.56 |
$63.84
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$275.10 |
$275.10 |
$275.10 |
$233.60
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$275.10 |
$275.10 |
$275.10 |
$240.91
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$247.16 |
$247.16 |
$247.16 |
$255.20
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$165.50 |
$165.50 |
$165.50 |
$171.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$370.74 |
$370.74 |
$370.74 |
$109.60
|
|
Vaccine dtap < 7 years im
|
$61.08 |
$61.08 |
$61.08 |
$66.69
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$157.41 |
$157.41 |
$157.41 |
$130.67
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$44.18 |
$44.18 |
$44.18 |
$47.38
|
|
Vaccine mmr live subcutaneous
|
$203.79 |
$203.79 |
$203.79 |
$222.36
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$251.64 |
$251.64 |
$251.64 |
$195.69
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$579.50 |
$579.50 |
$579.50 |
$579.50
|
|
Vaccine rabies im
|
$889.58 |
$889.58 |
$889.58 |
$800.00
|
|
Vaccine tdap >=7 years im
|
$101.06 |
$101.06 |
$101.06 |
$131.34
|
|
Valproic acid total therapeutic drug level
|
$82.74 |
$82.74 |
$82.74 |
$100.80
|
|
Vancomycin peak therapeutic drug level
|
$85.62 |
$85.62 |
$85.62 |
$116.00
|
|
Varicella zoster antibody igg
|
$75.56 |
$75.56 |
$75.56 |
$90.35
|
|
Vasopressin 20 unit/ml intravenous solution
|
$8.70 |
$8.70 |
$8.70 |
$330.41
|
|
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture)
|
$1,417.76 |
$1,417.76 |
$1,417.76 |
$123.00
|
|
Venogram ext bil s&i
|
$1,338.96 |
$1,338.96 |
$1,338.96 |
$1,697.72
|
|
Venogram extremity supervision & interpretation unilateral
|
$1,338.96 |
$1,338.96 |
$1,338.96 |
$1,270.23
|
|
Ventilator each subsequent day
|
$474.42 |
$474.42 |
$474.42 |
$1,138.50
|
|
Ventilator initial day
|
$509.54 |
$509.54 |
$509.54 |
$1,331.00
|
|
Virus isolation addl studies ea
|
$39.20 |
$39.20 |
$39.20 |
$90.35
|
|
Vital capacity test
|
$77.82 |
$77.82 |
$77.82 |
$170.00
|
|
Vitamin b-12
|
$50.55 |
$50.55 |
$50.55 |
$89.70
|
|
Vitamin D Test
|
$81.87 |
$81.87 |
$81.87 |
$132.60
|