|
Toxoplasma antibody igm
|
$117.45 |
$117.45 |
$117.45 |
$83.20
|
|
Tpmt gene com vrnts
|
$223.38 |
$223.38 |
$223.38 |
$381.55
|
|
Trabectedin 1 mg intravenous solution
|
$1,364.85 |
$1,364.85 |
$1,364.85 |
$6,133.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$61.92 |
$61.92 |
$61.92 |
$93.75
|
|
Transabdom amnioinfus w/us
|
$904.50 |
$904.50 |
$904.50 |
$791.05
|
|
Transcath closure of asd
|
$9,609.84 |
$9,609.84 |
$9,609.84 |
$18,772.00
|
|
Transcath closure of vsd
|
$4,510.80 |
$4,510.80 |
$4,510.80 |
$18,837.00
|
|
Transcatheter bx s&i
|
$957.87 |
$957.87 |
$957.87 |
$1,875.96
|
|
Transferrin
|
$105.12 |
$105.12 |
$105.12 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,081.98 |
$1,081.98 |
$1,081.98 |
$988.24
|
|
Transplt autol hct/donor
|
$615.60 |
$615.60 |
$615.60 |
$3,665.25
|
|
Trastuzumab 150 mg intravenous solution
|
$1,664.46 |
$1,664.46 |
$1,664.46 |
$3,401.26
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$1,465.02 |
$1,465.02 |
$1,465.02 |
$3,600.00
|
|
Trauma partial team response w/critical care services level 4
|
$3,357.54 |
$3,357.54 |
$3,357.54 |
$5,941.07
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$35.46 |
$35.46 |
$35.46 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$51.48 |
$51.48 |
$51.48 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$47.34 |
$47.34 |
$47.34 |
$210.00
|
|
Treponema pallidum antibody
|
$124.74 |
$124.74 |
$124.74 |
$72.80
|
|
Treprostinil injection
|
$1,183.95 |
$1,183.95 |
$1,183.95 |
$528.60
|
|
Trg gene rearrangement anal
|
$370.44 |
$370.44 |
$370.44 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$14.49 |
$14.49 |
$14.49 |
$48.22
|
|
Triamcinolone a inj prs-free
|
$223.56 |
$223.56 |
$223.56 |
$225.43
|
|
Trichinella antibody
|
$54.99 |
$54.99 |
$54.99 |
$70.65
|
|
Triglycerides
|
$58.05 |
$58.05 |
$58.05 |
$54.60
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,436.29 |
$3,436.29 |
$3,436.29 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$3,436.29 |
$3,436.29 |
$3,436.29 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$3,436.29 |
$3,436.29 |
$3,436.29 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$3,436.29 |
$3,436.29 |
$3,436.29 |
$4,329.36
|
|
Troponin quantitative
|
$74.25 |
$74.25 |
$74.25 |
$123.75
|
|
Tte w or without contr, cont ecg
|
$1,974.24 |
$1,974.24 |
$1,974.24 |
$1,608.73
|
|
Tte w or without fol w/con,stres
|
$1,875.24 |
$1,875.24 |
$1,875.24 |
$1,446.48
|
|
Tube trach disp innr can 5 xlt
|
$218.25 |
$218.25 |
$218.25 |
$460.58
|
|
Tube trach fen sz 6 uncuffed
|
$213.48 |
$213.48 |
$213.48 |
$132.40
|
|
Tx atrial fib pulm vein isol
|
$9,910.98 |
$9,910.98 |
$9,910.98 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$1,508.58 |
$1,508.58 |
$1,508.58 |
$7,717.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$262.62 |
$262.62 |
$262.62 |
$403.26
|
|
Ultrasound breast complete
|
$157.05 |
$157.05 |
$157.05 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$265.68 |
$265.68 |
$265.68 |
$449.35
|
|
Ultrasound chest
|
$258.12 |
$258.12 |
$258.12 |
$459.55
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$76.95 |
$76.95 |
$76.95 |
$340.14
|
|
Ultrasound dx ophth b-scan
|
$224.55 |
$224.55 |
$224.55 |
$330.40
|
|
Ultrasound elastography parenchyma
|
$594.45 |
$594.45 |
$594.45 |
$284.25
|
|
Ultrasound encephalogram
|
$207.45 |
$207.45 |
$207.45 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$421.92 |
$421.92 |
$421.92 |
$570.44
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$687.69 |
$687.69 |
$687.69 |
$477.88
|
|
Ultrasound guidance for vascular access
|
$300.96 |
$300.96 |
$300.96 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$629.64 |
$629.64 |
$629.64 |
$701.35
|
|
Ultrasound guide intraoperative
|
$381.33 |
$381.33 |
$381.33 |
$632.90
|
|
Ultrasound guide tissue ablation
|
$1,672.74 |
$1,672.74 |
$1,672.74 |
$498.40
|
|
Ultrasound hips infant dynamic
|
$208.62 |
$208.62 |
$208.62 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$266.22 |
$266.22 |
$266.22 |
$321.35
|
|
Ultrasound joint complete left
|
$362.25 |
$362.25 |
$362.25 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$316.35 |
$316.35 |
$316.35 |
$448.50
|
|
Ultrasound ob >=14wks ea addl gest
|
$330.66 |
$330.66 |
$330.66 |
$454.11
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$224.55 |
$224.55 |
$224.55 |
$326.54
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$778.41 |
$778.41 |
$778.41 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$322.92 |
$322.92 |
$322.92 |
$450.75
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$506.79 |
$506.79 |
$506.79 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$604.62 |
$604.62 |
$604.62 |
$485.48
|
|
Ultrasound prostate/transrectal
|
$331.29 |
$331.29 |
$331.29 |
$545.16
|
|
Ultrasound retroperitoneal limited
|
$283.23 |
$283.23 |
$283.23 |
$498.00
|
|
Ultrasound scrotum and contents
|
$532.53 |
$532.53 |
$532.53 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$283.23 |
$283.23 |
$283.23 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$441.63 |
$441.63 |
$441.63 |
$425.10
|
|
Ultrasound transvaginal non obstetric
|
$265.68 |
$265.68 |
$265.68 |
$567.44
|
|
Unlisted cytopathology px
|
$104.58 |
$104.58 |
$104.58 |
$71.65
|
|
Unlisted mr procedure
|
$1,222.20 |
$1,222.20 |
$1,222.20 |
$1,032.20
|
|
Unlisted neurological dx px
|
$295.02 |
$295.02 |
$295.02 |
$185.15
|
|
Unlisted procedure microbiology
|
$317.07 |
$317.07 |
$317.07 |
$487.50
|
|
Unlisted surgical path px
|
$87.48 |
$87.48 |
$87.48 |
$71.65
|
|
Unlisted transfusion med px
|
$242.73 |
$242.73 |
$242.73 |
$141.35
|
|
Unlisted ultrasound procedure
|
$114.57 |
$114.57 |
$114.57 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$625.95 |
$625.95 |
$625.95 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$2,556.09 |
$2,556.09 |
$2,556.09 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,821.96 |
$1,821.96 |
$1,821.96 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,271.34 |
$1,271.34 |
$1,271.34 |
$2,013.08
|
|
Urea nitrogen
|
$64.26 |
$64.26 |
$64.26 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$40.86 |
$40.86 |
$40.86 |
$50.00
|
|
Ureteral reflux study
|
$1,026.81 |
$1,026.81 |
$1,026.81 |
$961.20
|
|
Urethrcystgrphy rtrgrde s&i
|
$595.26 |
$595.26 |
$595.26 |
$574.40
|
|
Urethrocystography void s&i
|
$698.58 |
$698.58 |
$698.58 |
$634.50
|
|
Uric acid blood
|
$47.43 |
$47.43 |
$47.43 |
$46.64
|
|
Uric acid urine
|
$42.39 |
$42.39 |
$42.39 |
$46.75
|
|
Urinalysis microscopic only
|
$18.09 |
$18.09 |
$18.09 |
$26.35
|
|
Urinalysis (with microscopy)
|
$90.27 |
$90.27 |
$90.27 |
$48.14
|
|
Urinalysis (without microscopy)
|
$50.49 |
$50.49 |
$50.49 |
$38.99
|
|
Urine Culture Test
|
$53.28 |
$53.28 |
$53.28 |
$84.81
|
|
Urine flow measurement 51736
|
$81.63 |
$81.63 |
$81.63 |
$152.54
|
|
Urine pregnancy test
|
$50.49 |
$50.49 |
$50.49 |
$66.40
|
|
Urography, antegrade
|
$637.38 |
$637.38 |
$637.38 |
$593.37
|
|
Use 1st target lesion
|
$594.45 |
$594.45 |
$594.45 |
$245.30
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$29,976.57 |
$29,976.57 |
$29,976.57 |
$6,892.54
|
|
Vaccine hepatitis a (hepa) adult im
|
$107.10 |
$107.10 |
$107.10 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$98.37 |
$98.37 |
$98.37 |
$173.98
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$52.11 |
$52.11 |
$52.11 |
$306.24
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$63.54 |
$63.54 |
$63.54 |
$79.04
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$31.68 |
$31.68 |
$31.68 |
$157.41
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$56.97 |
$56.97 |
$56.97 |
$42.90
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$24.57 |
$24.57 |
$24.57 |
$26.40
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$56.97 |
$56.97 |
$56.97 |
$40.01
|
