|
Surgical pathology level 6 gross & microscopic examination
|
$4,818.56 |
$4,818.56 |
$4,818.56 |
$783.25
|
|
Suscept studies macrobroth dilution ea
|
$500.00 |
$500.00 |
$500.00 |
$51.50
|
|
Svc venogram s&i
|
$10,230.31 |
$10,230.31 |
$10,230.31 |
$1,890.50
|
|
T4 (thyroxine) total
|
$1,119.29 |
$1,119.29 |
$1,119.29 |
$76.05
|
|
Tacrol envarsus ex rel oral
|
$148.13 |
$148.13 |
$148.13 |
$3.20
|
|
Tacrolimus therapeutic drug level
|
$320.23 |
$320.23 |
$320.23 |
$122.50
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$2.67 |
$2.67 |
$2.67 |
$35.75
|
|
Tavr perq femoral
|
$124,242.25 |
$124,242.25 |
$124,242.25 |
$16,357.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$288.51 |
$288.51 |
$288.51 |
$165.10
|
|
Tc-99m pentetate dtpa
|
$2,026.43 |
$2,026.43 |
$2,026.43 |
$232.88
|
|
Tc-99m succimer (dmsa)
|
$2,777.29 |
$2,777.29 |
$2,777.29 |
$1,578.33
|
|
T cells absolute cd4/cd8 including ratio
|
$320.23 |
$320.23 |
$320.23 |
$179.40
|
|
T cells absolute cd 4 count
|
$690.31 |
$690.31 |
$690.31 |
$122.85
|
|
T cells total count
|
$500.00 |
$500.00 |
$500.00 |
$119.25
|
|
Temozolomide
|
$169.67 |
$169.67 |
$169.67 |
$488.25
|
|
Test pathogen(s) for platelets reference
|
$500.00 |
$500.00 |
$500.00 |
$78.40
|
|
Theophylline therapeutic drug level
|
$581.56 |
$581.56 |
$581.56 |
$108.00
|
|
Therapeutic procd strg endur
|
$349.11 |
$349.11 |
$349.11 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$111.19 |
$111.19 |
$111.19 |
$54.05
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$111.19 |
$111.19 |
$111.19 |
$48.00
|
|
Ther nma rdctj intus/obstrcj
|
$5,363.58 |
$5,363.58 |
$5,363.58 |
$524.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$10,137.50 |
$10,137.50 |
$10,137.50 |
$1,769.04
|
|
Thrombectomy/inf pq dialysis circuit
|
$10,094.49 |
$10,094.49 |
$10,094.49 |
$7,826.12
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$11,585.01 |
$11,585.01 |
$11,585.01 |
$14,875.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$29,927.79 |
$29,927.79 |
$29,927.79 |
$24,300.00
|
|
Thrombin time
|
$1,033.19 |
$1,033.19 |
$1,033.19 |
$48.10
|
|
Thyroglobulin antibody
|
$3,439.45 |
$3,439.45 |
$3,439.45 |
$85.15
|
|
Thyroid imaging
|
$5,436.03 |
$5,436.03 |
$5,436.03 |
$623.48
|
|
Thyroid mets imag whole body
|
$13,329.12 |
$13,329.12 |
$13,329.12 |
$1,520.70
|
|
Thyroid (TSH) Test
|
$1,499.95 |
$1,499.95 |
$1,499.95 |
$120.00
|
|
Thyroid uptake measurement
|
$3,994.23 |
$3,994.23 |
$3,994.23 |
$619.20
|
|
Thyroxine binding globulin (tbg)
|
$249.23 |
$249.23 |
$249.23 |
$63.72
|
|
Tigecycline injection
|
$1,072.74 |
$1,072.74 |
$1,072.74 |
$308.75
|
|
Tilt table study
|
$10,533.42 |
$10,533.42 |
$10,533.42 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$31.20 |
$31.20 |
$31.20 |
$360.60
|
|
Tissue culture skin/biopsy
|
$11,899.89 |
$11,899.89 |
$11,899.89 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$500.00 |
$500.00 |
$500.00 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$689.00 |
$689.00 |
$689.00 |
$2,516.07
|
|
Tomosynthesis breast screen bilateral
|
$1,789.33 |
$1,789.33 |
$1,789.33 |
$70.92
|
|
Total tau
|
$304.30 |
$304.30 |
$304.30 |
$293.00
|
|
Toxoplasma antibody igg
|
$1,229.56 |
$1,229.56 |
$1,229.56 |
$85.80
|
|
Toxoplasma antibody igm
|
$388.21 |
$388.21 |
$388.21 |
$87.75
|
|
Tpmt gene com vrnts
|
$1,018.09 |
$1,018.09 |
$1,018.09 |
$378.40
|
|
Transcath closure of asd
|
$44,915.51 |
$44,915.51 |
$44,915.51 |
$18,837.00
|
|
Transcath closure of vsd
|
$54,399.58 |
$54,399.58 |
$54,399.58 |
$18,798.65
|
|
Transcatheter bx s&i
|
$9,618.23 |
$9,618.23 |
$9,618.23 |
$1,873.30
|
|
Transcath rmvl perm ldss pmkr rv
|
$17,084.66 |
$17,084.66 |
$17,084.66 |
$4,468.80
|
|
Transferrin
|
$3,792.93 |
$3,792.93 |
$3,792.93 |
$85.56
|
|
Transfusion blood/blood component(s)
|
$1,074.49 |
$1,074.49 |
$1,074.49 |
$1,005.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$1,324.79 |
$1,324.79 |
$1,324.79 |
$241.24
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$948.25 |
$948.25 |
$948.25 |
$155.00
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$238.01 |
$238.01 |
$238.01 |
$44.19
|
|
#tricyclicantidprssnt
|
$1,144.97 |
$1,144.97 |
$1,144.97 |
$53.86
|
|
Trimethobenzamide hcl inj
|
$204.39 |
$204.39 |
$204.39 |
$132.00
|
|
Trnscath retrv pq vasc fb w/guide
|
$18,308.04 |
$18,308.04 |
$18,308.04 |
$4,807.61
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$9,340.13 |
$9,340.13 |
$9,340.13 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$7,432.73 |
$7,432.73 |
$7,432.73 |
$4,779.00
|
|
Troponin quantitative
|
$1,522.59 |
$1,522.59 |
$1,522.59 |
$124.80
|
|
Tx atrial fib pulm vein isol
|
$63,870.54 |
$63,870.54 |
$63,870.54 |
$31,985.46
|
|
Tx l/r atrial fib addl
|
$34,759.97 |
$34,759.97 |
$34,759.97 |
$7,005.00
|
|
Unlisted fluoroscopic px
|
$3,307.35 |
$3,307.35 |
$3,307.35 |
$267.80
|
|
Unsched dialysis esrd pt hos
|
$4,942.07 |
$4,942.07 |
$4,942.07 |
$1,376.10
|
|
Upgrade pm system
|
$61,587.62 |
$61,587.62 |
$61,587.62 |
$12,324.60
|
|
Urea nitrogen
|
$635.94 |
$635.94 |
$635.94 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$744.69 |
$744.69 |
$744.69 |
$49.50
|
|
Ureteral reflux study
|
$5,519.16 |
$5,519.16 |
$5,519.16 |
$958.47
|
|
Urethrcystgrphy rtrgrde s&i
|
$4,579.41 |
$4,579.41 |
$4,579.41 |
$574.40
|
|
Urethrocystography void s&i
|
$9,217.16 |
$9,217.16 |
$9,217.16 |
$624.11
|
|
Uric acid blood
|
$714.47 |
$714.47 |
$714.47 |
$47.43
|
|
Urinalysis (with microscopy)
|
$670.68 |
$670.68 |
$670.68 |
$48.14
|
|
Urine Culture Test
|
$725.06 |
$725.06 |
$725.06 |
$84.81
|
|
Urine pregnancy test
|
$1,258.26 |
$1,258.26 |
$1,258.26 |
$66.40
|
|
Vaccine dtap < 7 years im
|
$2,027.94 |
$2,027.94 |
$2,027.94 |
$81.65
|
|
Vaccine dtap-ipv/hib im
|
$277.87 |
$277.87 |
$277.87 |
$242.83
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$177.68 |
$177.68 |
$177.68 |
$85.00
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$166.99 |
$166.99 |
$166.99 |
$42.90
|
|
Vaccine hepatitis a (hepa) adult im
|
$301.92 |
$301.92 |
$301.92 |
$177.68
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$98.35 |
$98.35 |
$98.35 |
$84.38
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$156.86 |
$156.86 |
$156.86 |
$162.07
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$1,065.85 |
$1,065.85 |
$1,065.85 |
$686.00
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$731.54 |
$731.54 |
$731.54 |
$426.80
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$366.29 |
$366.29 |
$366.29 |
$366.29
|
|
Vaccine mmr live subcutaneous
|
$44.07 |
$44.07 |
$44.07 |
$224.04
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$443.52 |
$443.52 |
$443.52 |
$271.97
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$641.71 |
$641.71 |
$641.71 |
$385.45
|
|
Vaccine polio (ipv) subcutaneous/im
|
$467.58 |
$467.58 |
$467.58 |
$119.17
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
$1,195.80
|
|
Vaccine tdap >=7 years im
|
$585.12 |
$585.12 |
$585.12 |
$148.00
|
|
Vaccine td preservative free >= 7 years im
|
$311.27 |
$311.27 |
$311.27 |
$131.77
|
|
Varicella-zoster immue globin im
|
$4,885.48 |
$4,885.48 |
$4,885.48 |
$2,359.90
|
|
Vein x-ray adrenal glands
|
$8,566.17 |
$8,566.17 |
$8,566.17 |
$3,976.70
|
|
Vein x-ray liver
|
$6,089.40 |
$6,089.40 |
$6,089.40 |
$3,282.45
|
|
Vein x-ray liver w/hemodynam
|
$4,016.70 |
$4,016.70 |
$4,016.70 |
$3,413.25
|
|
Vein x-ray liver w/hemodynam
|
$7,153.43 |
$7,153.43 |
$7,153.43 |
$3,368.95
|
|
Vein x-ray skull
|
$8,254.89 |
$8,254.89 |
$8,254.89 |
$2,301.09
|
|
Vein x-ray spleen/liver
|
$10,739.13 |
$10,739.13 |
$10,739.13 |
$3,324.60
|
|
Venous m-thrombectomy add-on
|
$4,388.84 |
$4,388.84 |
$4,388.84 |
$5,106.64
|
|
Venous sampling s&i
|
$9,051.05 |
$9,051.05 |
$9,051.05 |
$4,294.50
|
|
Ventilator each subsequent day
|
$2,673.98 |
$2,673.98 |
$2,673.98 |
$1,290.00
|
|
Ventilator initial day
|
$3,334.09 |
$3,334.09 |
$3,334.09 |
$1,478.40
|
