|
Toxoplasma antibody igm
|
$107.26 |
$107.26 |
$107.26 |
$83.20
|
|
Tpmt gene com vrnts
|
$1,889.47 |
$1,889.47 |
$1,889.47 |
$381.55
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$331.30 |
$331.30 |
$331.30 |
$93.75
|
|
Transcath biopsy
|
$4,814.04 |
$4,814.04 |
$4,814.04 |
$4,298.05
|
|
Transferrin
|
$193.87 |
$193.87 |
$193.87 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$2,783.11 |
$2,783.11 |
$2,783.11 |
$988.24
|
|
Trauma partial team response w/critical care services level 4
|
$6,682.94 |
$6,682.94 |
$6,682.94 |
$5,941.07
|
|
Treat ankle dislocation
|
$14,251.16 |
$14,251.16 |
$14,251.16 |
$2,207.20
|
|
Treat finger fracture each
|
$8,546.69 |
$8,546.69 |
$8,546.69 |
$1,815.75
|
|
Treat foot dislocation
|
$1,824.10 |
$1,824.10 |
$1,824.10 |
$527.28
|
|
Treat fracture of radius
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,030.33
|
|
Treat fracture of ulna
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$766.72
|
|
Treat humerus fracture
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,950.60
|
|
Treat humerus fracture
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,045.35
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$251.82 |
$251.82 |
$251.82 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$284.80 |
$284.80 |
$284.80 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$939.68 |
$939.68 |
$939.68 |
$210.00
|
|
Treatment of fibula fracture 27780
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$558.75
|
|
Treatment of thigh fracture
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,893.86
|
|
Treatment of toe fracture 28510
|
$1,308.80 |
$1,308.80 |
$1,308.80 |
$371.40
|
|
Treat wrist dislocation
|
$1,814.51 |
$1,814.51 |
$1,814.51 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$167,938.69 |
$167,938.69 |
$167,938.69 |
$120,541.18
|
|
Treponema pallidum antibody
|
$319.63 |
$319.63 |
$319.63 |
$72.80
|
|
Trg gene rearrangement anal
|
$1,014.40 |
$1,014.40 |
$1,014.40 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$127.84 |
$127.84 |
$127.84 |
$48.22
|
|
Trichinella antibody
|
$173.47 |
$173.47 |
$173.47 |
$70.65
|
|
#tricyclicantidprssnt
|
$126.30 |
$126.30 |
$126.30 |
$57.08
|
|
Triglycerides
|
$149.84 |
$149.84 |
$149.84 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$329.87 |
$329.87 |
$329.87 |
$154.09
|
|
Trim nondyst nails
|
$354.15 |
$354.15 |
$354.15 |
$124.22
|
|
Trnscath plc stent crv crtd w/prtct
|
$20,458.74 |
$20,458.74 |
$20,458.74 |
$11,099.98
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$16,096.60 |
$16,096.60 |
$16,096.60 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$16,096.83 |
$16,096.83 |
$16,096.83 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$15,330.11 |
$15,330.11 |
$15,330.11 |
$15,408.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$11,064.59 |
$11,064.59 |
$11,064.59 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$11,365.26 |
$11,365.26 |
$11,365.26 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$11,365.63 |
$11,365.63 |
$11,365.63 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$11,004.47 |
$11,004.47 |
$11,004.47 |
$4,329.36
|
|
Troponin quantitative
|
$302.67 |
$302.67 |
$302.67 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$94,818.16 |
$94,818.16 |
$94,818.16 |
$32,426.20
|
|
Tx closed hip disl traumatic without anes
|
$2,256.73 |
$2,256.73 |
$2,256.73 |
$657.28
|
|
Tx closed tib shaft fx without manip
|
$1,366.45 |
$1,366.45 |
$1,366.45 |
$635.46
|
|
Tx l/r atrial fib addl
|
$38,661.30 |
$38,661.30 |
$38,661.30 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$63.33 |
$63.33 |
$63.33 |
$24.45
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,155.07 |
$1,155.07 |
$1,155.07 |
$403.26
|
|
Ultrasound breast complete
|
$1,011.61 |
$1,011.61 |
$1,011.61 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,011.61 |
$1,011.61 |
$1,011.61 |
$449.35
|
|
Ultrasound chest
|
$587.53 |
$587.53 |
$587.53 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,765.39 |
$1,765.39 |
$1,765.39 |
$340.14
|
|
Ultrasound encephalogram
|
$1,271.15 |
$1,271.15 |
$1,271.15 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,283.70 |
$1,283.70 |
$1,283.70 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,151.36 |
$1,151.36 |
$1,151.36 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$1,712.27 |
$1,712.27 |
$1,712.27 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$1,643.70 |
$1,643.70 |
$1,643.70 |
$701.35
|
|
Ultrasound guide intraoperative
|
$994.43 |
$994.43 |
$994.43 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,265.94 |
$1,265.94 |
$1,265.94 |
$498.40
|
|
Ultrasound joint complete left
|
$783.47 |
$783.47 |
$783.47 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$506.54 |
$506.54 |
$506.54 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,101.59 |
$2,101.59 |
$2,101.59 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$1,374.33 |
$1,374.33 |
$1,374.33 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,222.69 |
$1,222.69 |
$1,222.69 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$530.35 |
$530.35 |
$530.35 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$601.19 |
$601.19 |
$601.19 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$704.72 |
$704.72 |
$704.72 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$608.56 |
$608.56 |
$608.56 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$1,121.05 |
$1,121.05 |
$1,121.05 |
$498.00
|
|
Ultrasound scrotum and contents
|
$1,145.83 |
$1,145.83 |
$1,145.83 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$2,101.59 |
$2,101.59 |
$2,101.59 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$1,266.72 |
$1,266.72 |
$1,266.72 |
$567.44
|
|
Unlisted transfusion med px
|
$313.82 |
$313.82 |
$313.82 |
$141.35
|
|
Unsched dialysis esrd pt hos
|
$2,605.24 |
$2,605.24 |
$2,605.24 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$7,256.12 |
$7,256.12 |
$7,256.12 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$4,561.11 |
$4,561.11 |
$4,561.11 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$4,251.74 |
$4,251.74 |
$4,251.74 |
$2,013.08
|
|
Upper Endoscopy (EGD, diagnostic)
|
$7,273.38 |
$7,273.38 |
$7,273.38 |
$1,588.59
|
|
Upper Endoscopy (EGD, with biopsy)
|
$8,408.35 |
$8,408.35 |
$8,408.35 |
$1,656.60
|
|
Urea nitrogen
|
$152.54 |
$152.54 |
$152.54 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$157.86 |
$157.86 |
$157.86 |
$50.00
|
|
Urethrcystgrphy rtrgrde s&i
|
$1,387.82 |
$1,387.82 |
$1,387.82 |
$574.40
|
|
Uric acid blood
|
$174.82 |
$174.82 |
$174.82 |
$46.64
|
|
Uric acid urine
|
$135.95 |
$135.95 |
$135.95 |
$46.75
|
|
Urinalysis (with microscopy)
|
$223.25 |
$223.25 |
$223.25 |
$48.14
|
|
Urinalysis (without microscopy)
|
$194.74 |
$194.74 |
$194.74 |
$38.99
|
|
Urine Culture Test
|
$311.53 |
$311.53 |
$311.53 |
$84.81
|
|
Urography, antegrade
|
$1,629.05 |
$1,629.05 |
$1,629.05 |
$593.37
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$28,690.98 |
$28,690.98 |
$28,690.98 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$227.96 |
$227.96 |
$227.96 |
$178.07
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$640.71 |
$640.71 |
$640.71 |
$218.40
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$332.28 |
$332.28 |
$332.28 |
$173.98
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$984.74 |
$984.74 |
$984.74 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$447.81 |
$447.81 |
$447.81 |
$157.41
|
|
Vaccine influenza inactivated adjuvant im
|
$202.96 |
$202.96 |
$202.96 |
$110.25
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$136.43 |
$136.43 |
$136.43 |
$48.29
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$116.44 |
$116.44 |
$116.44 |
$42.90
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$222.88 |
$222.88 |
$222.88 |
$103.88
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$563.38 |
$563.38 |
$563.38 |
$499.00
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$544.09 |
$544.09 |
$544.09 |
$408.70
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$385.73 |
$385.73 |
$385.73 |
$274.95
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$792.00 |
$792.00 |
$792.00 |
$715.41
|
|
Vaccine tdap >=7 years im
|
$313.00 |
$313.00 |
$313.00 |
$150.76
|
