|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$30,137.39 |
$30,137.39 |
$30,137.39 |
$24,605.30
|
|
Thrombin time
|
$24.91 |
$24.91 |
$24.91 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$49.82 |
$49.82 |
$49.82 |
$56.93
|
|
Thyroglobulin antibody
|
$51.41 |
$51.41 |
$51.41 |
$84.00
|
|
Thyroid (TSH) Test
|
$63.60 |
$63.60 |
$63.60 |
$120.00
|
|
Thyroid Ultrasound
|
$510.39 |
$510.39 |
$510.39 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$51.41 |
$51.41 |
$51.41 |
$63.60
|
|
Tib/per revasc stnt & ather
|
$8,112.71 |
$8,112.71 |
$8,112.71 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$7,215.42 |
$7,215.42 |
$7,215.42 |
$10,406.14
|
|
Tilt table study
|
$2,203.21 |
$2,203.21 |
$2,203.21 |
$1,495.00
|
|
Tissue culture placenta
|
$271.36 |
$271.36 |
$271.36 |
$520.91
|
|
Tissue culture skin/biopsy
|
$259.70 |
$259.70 |
$259.70 |
$558.87
|
|
Tissue culture tumor
|
$283.02 |
$283.02 |
$283.02 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$24.38 |
$24.38 |
$24.38 |
$47.40
|
|
Tissue transglutaminase iga
|
$10.07 |
$10.07 |
$10.07 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$9.17 |
$9.17 |
$9.17 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$70.49 |
$70.49 |
$70.49 |
$121.55
|
|
Toxoplasma antibody igg
|
$50.35 |
$50.35 |
$50.35 |
$84.35
|
|
Toxoplasma antibody igm
|
$52.47 |
$52.47 |
$52.47 |
$83.20
|
|
Tpmt gene com vrnts
|
$1,368.99 |
$1,368.99 |
$1,368.99 |
$381.55
|
|
Transcath biopsy
|
$3,460.90 |
$3,460.90 |
$3,460.90 |
$4,298.05
|
|
Transcath closure of asd
|
$14,313.71 |
$14,313.71 |
$14,313.71 |
$18,772.00
|
|
Transcatheter bx s&i
|
$595.72 |
$595.72 |
$595.72 |
$1,875.96
|
|
Transcath mv repair addl prosthesis
|
$3,105.80 |
$3,105.80 |
$3,105.80 |
$5,118.10
|
|
Transcath mv repair init prosthesis
|
$6,211.60 |
$6,211.60 |
$6,211.60 |
$17,106.18
|
|
Transcath occlusion cns
|
$10,592.58 |
$10,592.58 |
$10,592.58 |
$8,944.39
|
|
Transcath occlusion non-cns
|
$36,369.66 |
$36,369.66 |
$36,369.66 |
$12,427.79
|
|
Transcath rmvl perm ldss pmkr rv
|
$6,500.45 |
$6,500.45 |
$6,500.45 |
$4,627.00
|
|
Transcutaneous hgb 88738
|
$10.60 |
$10.60 |
$10.60 |
$11.40
|
|
Transferrin
|
$42.93 |
$42.93 |
$42.93 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$305.81 |
$305.81 |
$305.81 |
$988.24
|
|
Transperi needle place pros
|
$5,796.08 |
$5,796.08 |
$5,796.08 |
$6,203.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$118.72 |
$118.72 |
$118.72 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$59.36 |
$59.36 |
$59.36 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$116.60 |
$116.60 |
$116.60 |
$210.00
|
|
Treponema pallidum antibody
|
$44.52 |
$44.52 |
$44.52 |
$72.80
|
|
Trg gene rearrangement anal
|
$279.31 |
$279.31 |
$279.31 |
$455.70
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$4.90 |
$4.90 |
$4.90 |
$55.80
|
|
Triamcinolone a inj prs-free
|
$39.28 |
$39.28 |
$39.28 |
$1,309.80
|
|
Trichinella antibody
|
$62.54 |
$62.54 |
$62.54 |
$70.65
|
|
Trichomonas assay w/optic
|
$45.58 |
$45.58 |
$45.58 |
$66.00
|
|
Triglycerides
|
$21.73 |
$21.73 |
$21.73 |
$54.60
|
|
Trnscath plc stent crv crtd w/prtct
|
$10,333.41 |
$10,333.41 |
$10,333.41 |
$11,099.98
|
|
Trnscath plc stnt ante carotid art
|
$3,507.54 |
$3,507.54 |
$3,507.54 |
$9,114.56
|
|
Trnscath plc vas stent w/s&i ea addl artery
|
$4,915.75 |
$4,915.75 |
$4,915.75 |
$8,244.55
|
|
Trnscath plc vas stent w/s&i ea addl vein
|
$4,448.82 |
$4,448.82 |
$4,448.82 |
$8,990.80
|
|
Trnscath plc vas stent w/s&i ini vein
|
$8,897.64 |
$8,897.64 |
$8,897.64 |
$15,408.00
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$3,460.90 |
$3,460.90 |
$3,460.90 |
$6,156.00
|
|
Trnscath tx thromblytc art/ven sbsq day
|
$1,739.46 |
$1,739.46 |
$1,739.46 |
$4,505.25
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$1,739.46 |
$1,739.46 |
$1,739.46 |
$4,793.13
|
|
Trnscath tx thromblytc vein ini day
|
$2,086.08 |
$2,086.08 |
$2,086.08 |
$4,329.36
|
|
Troponin quantitative
|
$73.14 |
$73.14 |
$73.14 |
$123.75
|
|
Tx atrial fib pulm vein isol
|
$18,348.60 |
$18,348.60 |
$18,348.60 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$9,174.30 |
$9,174.30 |
$9,174.30 |
$7,717.80
|
|
Ua w/micro/comp poc
|
$22.79 |
$22.79 |
$22.79 |
$24.45
|
|
Ugt1a1 gene analy common variants
|
$827.33 |
$827.33 |
$827.33 |
$438.75
|
|
Ultrasound abdomen aorta screening study aaa
|
$351.92 |
$351.92 |
$351.92 |
$403.26
|
|
Ultrasound chest
|
$347.15 |
$347.15 |
$347.15 |
$459.55
|
|
Ultrasound guidance for vascular access
|
$275.07 |
$275.07 |
$275.07 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$374.18 |
$374.18 |
$374.18 |
$701.35
|
|
Ultrasound guide intraoperative
|
$385.84 |
$385.84 |
$385.84 |
$632.90
|
|
Ultrasound hips infant dynamic
|
$249.10 |
$249.10 |
$249.10 |
$403.00
|
|
Ultrasound infant hips ltd without stress
|
$367.29 |
$367.29 |
$367.29 |
$321.35
|
|
Ultrasound joint complete left
|
$367.29 |
$367.29 |
$367.29 |
$556.14
|
|
Ultrasound joint/nonvascular extremity limited left
|
$286.73 |
$286.73 |
$286.73 |
$448.50
|
|
Ultrasound pregnant uterus follow up per fetus
|
$469.58 |
$469.58 |
$469.58 |
$450.75
|
|
Ultrasound retroperitoneal limited
|
$469.58 |
$469.58 |
$469.58 |
$498.00
|
|
Ultrasound spinal canal and contents
|
$367.29 |
$367.29 |
$367.29 |
$450.60
|
|
Ultrasound transvaginal non obstetric
|
$469.58 |
$469.58 |
$469.58 |
$567.44
|
|
Unlisted mr procedure
|
$1,028.20 |
$1,028.20 |
$1,028.20 |
$1,032.20
|
|
Unlisted transfusion med px
|
$225.78 |
$225.78 |
$225.78 |
$141.35
|
|
Upgrade pm system
|
$9,284.54 |
$9,284.54 |
$9,284.54 |
$12,324.60
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,441.07 |
$1,441.07 |
$1,441.07 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$1,391.25 |
$1,391.25 |
$1,391.25 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,337.19 |
$1,337.19 |
$1,337.19 |
$2,013.08
|
|
Urea nitrogen
|
$19.08 |
$19.08 |
$19.08 |
$45.10
|
|
Urea nitrogen 24 hour urine
|
$21.20 |
$21.20 |
$21.20 |
$50.00
|
|
Uric acid blood
|
$21.20 |
$21.20 |
$21.20 |
$46.64
|
|
Uric acid urine
|
$23.32 |
$23.32 |
$23.32 |
$46.75
|
|
Urinalysis microscopic only
|
$11.66 |
$11.66 |
$11.66 |
$26.35
|
|
Urinalysis (with microscopy)
|
$22.26 |
$22.26 |
$22.26 |
$48.14
|
|
Urinalysis (without microscopy)
|
$9.01 |
$9.01 |
$9.01 |
$38.99
|
|
Urine Culture Test
|
$39.22 |
$39.22 |
$39.22 |
$84.81
|
|
Urine pregnancy test
|
$39.75 |
$39.75 |
$39.75 |
$66.40
|
|
Urography, antegrade
|
$201.40 |
$201.40 |
$201.40 |
$593.37
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$111.37 |
$111.37 |
$111.37 |
$157.41
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$42.15 |
$42.15 |
$42.15 |
$40.01
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$132.74 |
$132.74 |
$132.74 |
$274.95
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$277.39 |
$277.39 |
$277.39 |
$397.18
|
|
Vaccine td preservative free >= 7 years im
|
$52.98 |
$52.98 |
$52.98 |
$131.77
|
|
Valproic acid total therapeutic drug level
|
$61.48 |
$61.48 |
$61.48 |
$115.00
|
|
Valvuloplasty aortic
|
$10,128.83 |
$10,128.83 |
$10,128.83 |
$7,324.85
|
|
Valvuloplasty mitral
|
$9,916.83 |
$9,916.83 |
$9,916.83 |
$10,435.39
|
|
Vancomycin peak therapeutic drug level
|
$68.90 |
$68.90 |
$68.90 |
$126.79
|
|
Varicella zoster antibody igg
|
$51.94 |
$51.94 |
$51.94 |
$82.55
|
|
Vein x-ray adrenal gland
|
$1,691.23 |
$1,691.23 |
$1,691.23 |
$2,489.25
|
|
Vein x-ray adrenal glands
|
$2,913.94 |
$2,913.94 |
$2,913.94 |
$3,999.60
|
|
Vein x-ray kidney
|
$1,691.23 |
$1,691.23 |
$1,691.23 |
$2,716.20
|
|
Vein x-ray liver
|
$1,921.78 |
$1,921.78 |
$1,921.78 |
$3,320.80
|
|
Vein x-ray liver w/hemodynam
|
$1,691.23 |
$1,691.23 |
$1,691.23 |
$3,413.25
|
