|
Suscept studies macrobroth dilution ea
|
$20.00 |
$20.00 |
$20.00 |
$48.30
|
|
T3 (triiodothyronine) free
|
$725.00 |
$725.00 |
$725.00 |
$89.82
|
|
T3 (triiodothyronine) total
|
$181.00 |
$181.00 |
$181.00 |
$94.90
|
|
T4 (thyroxine) free
|
$272.00 |
$272.00 |
$272.00 |
$81.60
|
|
T4 (thyroxine) total
|
$324.00 |
$324.00 |
$324.00 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$897.00 |
$897.00 |
$897.00 |
$122.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$3,385.00
|
|
Target gsa panel organ neop
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$727.00 |
$727.00 |
$727.00 |
$166.46
|
|
Tc-99m disofenin
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$151.32
|
|
Tc-99m exametazime diag
|
$2,570.00 |
$2,570.00 |
$2,570.00 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$323.01
|
|
Tc-99m maa
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$312.06
|
|
Tc-99m mebrofenin
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$169.53
|
|
Tc-99m medronate
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$122.46
|
|
Tc-99m pentetate dtpa
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$245.85
|
|
Tc-99m pertechnetate per mci
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$1,340.00 |
$1,340.00 |
$1,340.00 |
$221.60
|
|
Tc-99m sulfur colloid
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$245.70
|
|
T cells absolute cd 4 count
|
$577.00 |
$577.00 |
$577.00 |
$120.25
|
|
T cells total count
|
$725.00 |
$725.00 |
$725.00 |
$124.11
|
|
Telehealth original site facility fee
|
$68.00 |
$68.00 |
$68.00 |
$60.80
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$312.00 |
$312.00 |
$312.00 |
$46.10
|
|
Tetanus immune globulin inj
|
$5,545.00 |
$5,545.00 |
$5,545.00 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$482.00 |
$482.00 |
$482.00 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$35.00 |
$35.00 |
$35.00 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$30.00 |
$30.00 |
$30.00 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$44.00 |
$44.00 |
$44.00 |
$35.72
|
|
Thrombin time
|
$228.00 |
$228.00 |
$228.00 |
$48.75
|
|
Thyroglobulin antibody
|
$359.00 |
$359.00 |
$359.00 |
$84.00
|
|
Thyroid imaging
|
$3,564.00 |
$3,564.00 |
$3,564.00 |
$670.80
|
|
Thyroid (TSH) Test
|
$458.00 |
$458.00 |
$458.00 |
$120.00
|
|
Thyroid Ultrasound
|
$3,089.00 |
$3,089.00 |
$3,089.00 |
$589.96
|
|
Thyroid uptake measurement
|
$3,850.00 |
$3,850.00 |
$3,850.00 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$419.00 |
$419.00 |
$419.00 |
$63.60
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$11,159.45 |
$11,159.45 |
$11,159.45 |
$14,271.00
|
|
Tissue culture tumor
|
$1,704.00 |
$1,704.00 |
$1,704.00 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$218.00 |
$218.00 |
$218.00 |
$47.40
|
|
Tl-201 thallium diag per mci
|
$1,179.00 |
$1,179.00 |
$1,179.00 |
$77.22
|
|
Tomosynthesis breast diagnostic left
|
$73.00 |
$73.00 |
$73.00 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$73.00 |
$73.00 |
$73.00 |
$73.45
|
|
Total tau
|
$293.00 |
$293.00 |
$293.00 |
$293.00
|
|
Toxoplasma antibody igg
|
$499.00 |
$499.00 |
$499.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$592.00 |
$592.00 |
$592.00 |
$83.20
|
|
Tp53 gene full gene sequence
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
$706.04
|
|
Tpmt gene com vrnts
|
$388.00 |
$388.00 |
$388.00 |
$381.55
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$336.00 |
$336.00 |
$336.00 |
$77.65
|
|
Transcutaneous carboxyhb
|
$70.00 |
$70.00 |
$70.00 |
$23.00
|
|
Transferrin
|
$232.00 |
$232.00 |
$232.00 |
$87.30
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$124.00 |
$124.00 |
$124.00 |
$55.80
|
|
Trichinella antibody
|
$885.00 |
$885.00 |
$885.00 |
$70.65
|
|
Troponin quantitative
|
$666.00 |
$666.00 |
$666.00 |
$123.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$2,219.00 |
$2,219.00 |
$2,219.00 |
$403.26
|
|
Ultrasound chest
|
$2,755.00 |
$2,755.00 |
$2,755.00 |
$459.55
|
|
Ultrasound guided needle placement supervision & interpretation
|
$3,111.00 |
$3,111.00 |
$3,111.00 |
$701.35
|
|
Ultrasound joint complete left
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$1,352.00 |
$1,352.00 |
$1,352.00 |
$448.50
|
|
Ultrasound pregnant uterus limited >= 1 fetuses
|
$1,673.00 |
$1,673.00 |
$1,673.00 |
$459.00
|
|
Ultrasound pregnant uterus transvaginal
|
$1,709.00 |
$1,709.00 |
$1,709.00 |
$485.48
|
|
Ultrasound retroperitoneal limited
|
$3,437.00 |
$3,437.00 |
$3,437.00 |
$498.00
|
|
Ultrasound scrotum and contents
|
$2,956.00 |
$2,956.00 |
$2,956.00 |
$617.28
|
|
Ultrasound transvaginal non obstetric
|
$3,669.00 |
$3,669.00 |
$3,669.00 |
$567.44
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$13,226.00 |
$13,226.00 |
$13,226.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$11,071.00 |
$11,071.00 |
$11,071.00 |
$2,013.08
|
|
Urea nitrogen
|
$252.00 |
$252.00 |
$252.00 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$216.00 |
$216.00 |
$216.00 |
$50.00
|
|
Uric acid blood
|
$279.00 |
$279.00 |
$279.00 |
$46.64
|
|
Urinalysis qual/semiquant excpt ia
|
$87.00 |
$87.00 |
$87.00 |
$25.72
|
|
Urinalysis (with microscopy)
|
$177.00 |
$177.00 |
$177.00 |
$48.14
|
|
Urine Culture Test
|
$117.00 |
$117.00 |
$117.00 |
$84.81
|
|
Urine pregnancy test
|
$349.00 |
$349.00 |
$349.00 |
$66.40
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$3,121.00 |
$3,121.00 |
$3,121.00 |
$5,521.54
|
|
Vaccine dtap < 7 years im
|
$50.00 |
$50.00 |
$50.00 |
$87.80
|
|
Vaccine hepatitis a (hepa) adult im
|
$355.00 |
$355.00 |
$355.00 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$443.00 |
$443.00 |
$443.00 |
$173.98
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$308.00 |
$308.00 |
$308.00 |
$79.04
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$497.00 |
$497.00 |
$497.00 |
$686.67
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$217.00 |
$217.00 |
$217.00 |
$157.41
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$89.00 |
$89.00 |
$89.00 |
$48.29
|
|
Vaccine mmr live subcutaneous
|
$575.00 |
$575.00 |
$575.00 |
$224.04
|
|
Vaccine rabies im
|
$4,071.00 |
$4,071.00 |
$4,071.00 |
$945.46
|
|
Vaccine tdap >=7 years im
|
$244.00 |
$244.00 |
$244.00 |
$150.76
|
|
Vaccine td preservative free >= 7 years im
|
$128.00 |
$128.00 |
$128.00 |
$131.77
|
|
Vaccine varicella live subcutaneous
|
$564.00 |
$564.00 |
$564.00 |
$447.80
|
|
Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr
|
$169.00 |
$169.00 |
$169.00 |
$22.29
|
|
Valproic acid total therapeutic drug level
|
$509.00 |
$509.00 |
$509.00 |
$115.00
|
|
Very long chain fatty acids
|
$686.00 |
$686.00 |
$686.00 |
$140.40
|
|
Virus isolation addl studies ea
|
$61.00 |
$61.00 |
$61.00 |
$90.35
|
|
Vitamin b-12
|
$468.00 |
$468.00 |
$468.00 |
$94.90
|
|
Vitamin D Test
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$132.00
|
|
Volume measurement urine timed
|
$68.00 |
$68.00 |
$68.00 |
$21.45
|
|
Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr
|
$1,341.00 |
$1,341.00 |
$1,341.00 |
$215.60
|
|
Warde 1003990 aldosterone
|
$978.00 |
$978.00 |
$978.00 |
$145.60
|
|
Warde 1005020 citrate 24 hour urine
|
$592.00 |
$592.00 |
$592.00 |
$97.61
|
|
Warde 1005055 5-hiaa 24 hour urine
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
$72.50
|
|
Warde 1007138 vanillymandelic acid 24 hour urine
|
$507.00 |
$507.00 |
$507.00 |
$69.55
|
|
Warde 3004000 immunoglobulin subclass 1
|
$384.00 |
$384.00 |
$384.00 |
$40.70
|
|
Warde 3008005 oligoclonal bands
|
$676.00 |
$676.00 |
$676.00 |
$102.60
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$370.00 |
$370.00 |
$370.00 |
$63.05
|
