|
Thyroid imaging
|
$2,759.72 |
$2,759.72 |
$2,759.72 |
$695.02
|
|
Thyroid mets imag whole body
|
$6,852.03 |
$6,852.03 |
$6,852.03 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$622.23 |
$622.23 |
$622.23 |
$111.00
|
|
Thyroid Ultrasound
|
$2,510.92 |
$2,510.92 |
$2,510.92 |
$588.50
|
|
Thyroid uptake measurement
|
$2,486.07 |
$2,486.07 |
$2,486.07 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$1,045.01 |
$1,045.01 |
$1,045.01 |
$64.35
|
|
Tigecycline injection
|
$946.44 |
$946.44 |
$946.44 |
$234.00
|
|
Tilt table study
|
$17,094.94 |
$17,094.94 |
$17,094.94 |
$1,507.01
|
|
Tissue culture placenta
|
$2,712.25 |
$2,712.25 |
$2,712.25 |
$457.00
|
|
Tissue culture skin/biopsy
|
$2,338.58 |
$2,338.58 |
$2,338.58 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$376.63 |
$376.63 |
$376.63 |
$47.20
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$878.00 |
$878.00 |
$878.00 |
$1,134.00
|
|
Tissue transglutaminase iga
|
$716.01 |
$716.01 |
$716.01 |
$44.16
|
|
Tl-201 thallium diag per mci
|
$535.01 |
$535.01 |
$535.01 |
$78.40
|
|
Tlso 2mod symphis-xipho pre
|
$4,963.00 |
$4,963.00 |
$4,963.00 |
$1,874.66
|
|
Tlso 2 shl symphys-stern cst
|
$1,955.36 |
$1,955.36 |
$1,955.36 |
$1,808.59
|
|
Tlso rigid lined custom fab
|
$8,026.00 |
$8,026.00 |
$8,026.00 |
$2,831.21
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$34.82 |
$34.82 |
$34.82 |
$152.36
|
|
Tobramycin non-comp unit
|
$163.49 |
$163.49 |
$163.49 |
$108.42
|
|
Tobramycin peak therapeutic drug level
|
$622.23 |
$622.23 |
$622.23 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$265.02 |
$265.02 |
$265.02 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$265.02 |
$265.02 |
$265.02 |
$72.68
|
|
Toxoplasma antibody igg
|
$829.16 |
$829.16 |
$829.16 |
$89.40
|
|
Toxoplasma antibody igm
|
$829.16 |
$829.16 |
$829.16 |
$87.00
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$40.03 |
$40.03 |
$40.03 |
$56.38
|
|
Transcatheter bx s&i
|
$1,935.70 |
$1,935.70 |
$1,935.70 |
$1,915.00
|
|
Transferrin
|
$422.76 |
$422.76 |
$422.76 |
$82.00
|
|
Trapezius sling
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$242.54
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$1,068.75 |
$1,068.75 |
$1,068.75 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$188.00 |
$188.00 |
$188.00 |
$145.51
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$299.67 |
$299.67 |
$299.67 |
$43.21
|
|
Trichinella antibody
|
$1,195.36 |
$1,195.36 |
$1,195.36 |
$70.20
|
|
Tx atrial fib pulm vein isol
|
$75,897.72 |
$75,897.72 |
$75,897.72 |
$29,030.54
|
|
Tx l/r atrial fib addl
|
$19,921.84 |
$19,921.84 |
$19,921.84 |
$6,769.00
|
|
Ultrasound breast complete
|
$1,326.44 |
$1,326.44 |
$1,326.44 |
$528.41
|
|
Ultrasound chest
|
$1,892.98 |
$1,892.98 |
$1,892.98 |
$460.85
|
|
Ultrasound encephalogram
|
$1,561.72 |
$1,561.72 |
$1,561.72 |
$488.80
|
|
Ultrasound joint complete left
|
$1,477.88 |
$1,477.88 |
$1,477.88 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$621.44 |
$621.44 |
$621.44 |
$425.45
|
|
Ultrasound ob >=14wks ea addl gest
|
$2,792.15 |
$2,792.15 |
$2,792.15 |
$407.20
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$2,277.00 |
$2,277.00 |
$2,277.00 |
$331.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$2,033.62 |
$2,033.62 |
$2,033.62 |
$425.60
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,892.98 |
$1,892.98 |
$1,892.98 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$575.19 |
$575.19 |
$575.19 |
$497.12
|
|
Ultrasound retroperitoneal limited
|
$1,895.70 |
$1,895.70 |
$1,895.70 |
$486.50
|
|
Ultrasound scrotum and contents
|
$2,183.71 |
$2,183.71 |
$2,183.71 |
$608.90
|
|
Ultrasound transvaginal non obstetric
|
$2,497.39 |
$2,497.39 |
$2,497.39 |
$558.35
|
|
Unsched dialysis esrd pt hos
|
$2,185.37 |
$2,185.37 |
$2,185.37 |
$1,268.17
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$11,386.28 |
$11,386.28 |
$11,386.28 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$7,178.46 |
$7,178.46 |
$7,178.46 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$6,245.49 |
$6,245.49 |
$6,245.49 |
$2,034.41
|
|
Urea nitrogen 24 hour urine
|
$346.85 |
$346.85 |
$346.85 |
$51.75
|
|
Urea nitrogen clearance
|
$464.46 |
$464.46 |
$464.46 |
$42.25
|
|
Ureteral reflux study
|
$3,457.91 |
$3,457.91 |
$3,457.91 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$726.84 |
$726.84 |
$726.84 |
$579.73
|
|
Urethrocystography void s&i
|
$1,378.68 |
$1,378.68 |
$1,378.68 |
$622.35
|
|
Uric acid blood
|
$529.95 |
$529.95 |
$529.95 |
$48.75
|
|
Urinalysis microscopic only
|
$337.92 |
$337.92 |
$337.92 |
$26.35
|
|
Urinalysis qual/semiquant excpt ia
|
$256.05 |
$256.05 |
$256.05 |
$25.72
|
|
Urinalysis (with microscopy)
|
$562.70 |
$562.70 |
$562.70 |
$55.00
|
|
Urine Culture Test
|
$549.31 |
$549.31 |
$549.31 |
$81.50
|
|
Urine pregnancy test
|
$774.08 |
$774.08 |
$774.08 |
$67.20
|
|
Urography inf drip &/or bolus
|
$3,649.23 |
$3,649.23 |
$3,649.23 |
$642.50
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$288.33 |
$288.33 |
$288.33 |
$43.12
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$244.78 |
$244.78 |
$244.78 |
$75.39
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$557.36 |
$557.36 |
$557.36 |
$143.20
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$158.62 |
$158.62 |
$158.62 |
$33.60
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$1,269.40 |
$1,269.40 |
$1,269.40 |
$409.35
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$992.01 |
$992.01 |
$992.01 |
$310.93
|
|
Vaccine mmr live subcutaneous
|
$1,058.88 |
$1,058.88 |
$1,058.88 |
$211.68
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$370.04 |
$370.04 |
$370.04 |
$251.64
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$1,314.41 |
$1,314.41 |
$1,314.41 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,547.02 |
$1,547.02 |
$1,547.02 |
$563.36
|
|
Vaccine tdap >=7 years im
|
$867.79 |
$867.79 |
$867.79 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$176.93 |
$176.93 |
$176.93 |
$112.10
|
|
Vaccine varicella live subcutaneous
|
$1,435.01 |
$1,435.01 |
$1,435.01 |
$365.17
|
|
Valproic acid total therapeutic drug level
|
$1,312.97 |
$1,312.97 |
$1,312.97 |
$114.72
|
|
Vancomycin peak therapeutic drug level
|
$558.25 |
$558.25 |
$558.25 |
$136.13
|
|
Veeg cont 2-12 hrs
|
$2,898.11 |
$2,898.11 |
$2,898.11 |
$1,540.00
|
|
Veeg ea 12-26hr cont mntr
|
$5,424.58 |
$5,424.58 |
$5,424.58 |
$3,225.60
|
|
Veeg intrmnt 2-12 hrs
|
$1,510.52 |
$1,510.52 |
$1,510.52 |
$961.00
|
|
Veeg unmon 12-26 hrs
|
$2,898.11 |
$2,898.11 |
$2,898.11 |
$1,671.09
|
|
Veeg unmon 2-12 hrs
|
$1,510.52 |
$1,510.52 |
$1,510.52 |
$826.15
|
|
Vein x-ray adrenal glands
|
$13,486.35 |
$13,486.35 |
$13,486.35 |
$3,935.00
|
|
Vein x-ray liver
|
$8,622.19 |
$8,622.19 |
$8,622.19 |
$3,305.50
|
|
Vein x-ray liver w/hemodynam
|
$8,622.19 |
$8,622.19 |
$8,622.19 |
$3,486.86
|
|
Venous sampling s&i
|
$14,332.53 |
$14,332.53 |
$14,332.53 |
$4,193.20
|
|
Ventilator each subsequent day
|
$12,553.24 |
$12,553.24 |
$12,553.24 |
$1,204.00
|
|
Ventilator initial day
|
$15,436.61 |
$15,436.61 |
$15,436.61 |
$1,431.43
|
|
Viper venom prothrombin time
|
$911.04 |
$911.04 |
$911.04 |
$85.80
|
|
Virus isolation addl studies ea
|
$291.79 |
$291.79 |
$291.79 |
$77.50
|
|
Vital capacity test
|
$547.38 |
$547.38 |
$547.38 |
$170.00
|
|
Vitamin b-12
|
$468.92 |
$468.92 |
$468.92 |
$100.00
|
|
Vkorc1 gene
|
$491.25 |
$491.25 |
$491.25 |
$176.80
|
|
Volume measurement urine timed
|
$99.74 |
$99.74 |
$99.74 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$2,376.13 |
$2,376.13 |
$2,376.13 |
$165.81
|
|
Warde 1005020 citrate 24 hour urine
|
$1,113.48 |
$1,113.48 |
$1,113.48 |
$97.50
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$549.31 |
$549.31 |
$549.31 |
$63.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$588.00 |
$588.00 |
$588.00 |
$70.85
|
|
Warde 3004000 immunoglobulin subclass 1
|
$702.64 |
$702.64 |
$702.64 |
$39.00
|
