|
Snrpn/ube3a gene
|
$46.14 |
$46.14 |
$46.14 |
$230.63
|
|
Sodium 24 hour urine
|
$8.14 |
$8.14 |
$8.14 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$10.85 |
$10.85 |
$10.85 |
$46.26
|
|
Special radiation treatment
|
$827.22 |
$827.22 |
$827.22 |
$2,052.00
|
|
Specific gravity body fluid
|
$1.13 |
$1.13 |
$1.13 |
$22.00
|
|
Specimen fat stain
|
$5.17 |
$5.17 |
$5.17 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$44.27 |
$44.27 |
$44.27 |
$384.80
|
|
Speech evaluation complex
|
$160.60 |
$160.60 |
$160.60 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$30.11 |
$30.11 |
$30.11 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$507.46 |
$507.46 |
$507.46 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$52.24 |
$52.24 |
$52.24 |
$251.00
|
|
Split blood or products
|
$104.75 |
$104.75 |
$104.75 |
$127.80
|
|
Sputum specimen collection
|
$104.75 |
$104.75 |
$104.75 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$43.58 |
$43.58 |
$43.58 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$43.58 |
$43.58 |
$43.58 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$10,129.89 |
$10,129.89 |
$10,129.89 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$19,853.33 |
$19,853.33 |
$19,853.33 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,269.93 |
$2,269.93 |
$2,269.93 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$8,585.78 |
$8,585.78 |
$8,585.78 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$6,466.84 |
$6,466.84 |
$6,466.84 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,191.59 |
$3,191.59 |
$3,191.59 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$8,840.18 |
$8,840.18 |
$8,840.18 |
$16,098.16
|
|
St evaluate speech sound production
|
$36.34 |
$36.34 |
$36.34 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$124.56 |
$124.56 |
$124.56 |
$400.00
|
|
Stimulants synthetic
|
$18.08 |
$18.08 |
$18.08 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$368.00 |
$368.00 |
$368.00 |
$1,345.40
|
|
Strep a ag ia
|
$10.56 |
$10.56 |
$10.56 |
$75.40
|
|
Strep b dna amp probe
|
$21.94 |
$21.94 |
$21.94 |
$124.15
|
|
Str markers specimen anal
|
$225.47 |
$225.47 |
$225.47 |
$756.60
|
|
Sulfonylurea screen qn-sendout
|
$20.11 |
$20.11 |
$20.11 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$12.82 |
$12.82 |
$12.82 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$29.54 |
$29.54 |
$29.54 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$76.26 |
$76.26 |
$76.26 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$116.33 |
$116.33 |
$116.33 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$260.14 |
$260.14 |
$260.14 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$392.05 |
$392.05 |
$392.05 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$13.66 |
$13.66 |
$13.66 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$11.59 |
$11.59 |
$11.59 |
$35.89
|
|
Susceptibility mic per plate
|
$57.40 |
$57.40 |
$57.40 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$23.80 |
$23.80 |
$23.80 |
$59.28
|
|
Svc venogram s&i
|
$275.63 |
$275.63 |
$275.63 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$73.18 |
$73.18 |
$73.18 |
$316.80
|
|
Swallowing Therapy Session
|
$59.40 |
$59.40 |
$59.40 |
$232.56
|
|
Sweat collection by iontophoresis
|
$32.72 |
$32.72 |
$32.72 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$8.84 |
$8.84 |
$8.84 |
$42.24
|
|
System pacing micra av
|
$10,863.64 |
$10,863.64 |
$10,863.64 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$33,946.24 |
$33,946.24 |
$33,946.24 |
$12,003.00
|
|
System sealant biosentry tract
|
$660.28 |
$660.28 |
$660.28 |
$889.35
|
|
T3 (triiodothyronine) free
|
$8.02 |
$8.02 |
$8.02 |
$100.32
|
|
T3 (triiodothyronine) total
|
$4.86 |
$4.86 |
$4.86 |
$93.52
|
|
T4 (thyroxine) free
|
$23.96 |
$23.96 |
$23.96 |
$89.60
|
|
T4 (thyroxine) total
|
$6.33 |
$6.33 |
$6.33 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$7.23 |
$7.23 |
$7.23 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$78.04 |
$78.04 |
$78.04 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$578.28 |
$578.28 |
$578.28 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$2,222.59 |
$2,222.59 |
$2,222.59 |
$3,746.70
|
|
Target gsa panel organ neop
|
$455.20 |
$455.20 |
$455.20 |
$1,701.91
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$51.00 |
$51.00 |
$51.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$31.62 |
$31.62 |
$31.62 |
$179.95
|
|
Tc-99m bicisate
|
$796.40 |
$796.40 |
$796.40 |
$2,070.00
|
|
Tc-99m exame autol wbc diag per dose
|
$1,150.62 |
$1,150.62 |
$1,150.62 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$512.41 |
$512.41 |
$512.41 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$114.94 |
$114.94 |
$114.94 |
$306.00
|
|
Tc-99m maa
|
$20.81 |
$20.81 |
$20.81 |
$312.06
|
|
Tc-99m mebrofenin
|
$36.20 |
$36.20 |
$36.20 |
$157.65
|
|
Tc-99m medronate
|
$64.13 |
$64.13 |
$64.13 |
$111.01
|
|
Tc-99m mertiatide
|
$172.13 |
$172.13 |
$172.13 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$41.99 |
$41.99 |
$41.99 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$40.00 |
$40.00 |
$40.00 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$0.36 |
$0.36 |
$0.36 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$50.30 |
$50.30 |
$50.30 |
$287.20
|
|
Tc-99m sulfur colloid
|
$38.73 |
$38.73 |
$38.73 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$162.90 |
$162.90 |
$162.90 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$434.31 |
$434.31 |
$434.31 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$23.97 |
$23.97 |
$23.97 |
$184.00
|
|
T cells absolute cd 4 count
|
$13.77 |
$13.77 |
$13.77 |
$111.20
|
|
T cells total count
|
$19.38 |
$19.38 |
$19.38 |
$130.20
|
|
Testicular imaging w/vasc flow
|
$290.58 |
$290.58 |
$290.58 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$181.26 |
$181.26 |
$181.26 |
$953.40
|
|
Thaw preserved stem cells
|
$272.13 |
$272.13 |
$272.13 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$4.86 |
$4.86 |
$4.86 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$28.98 |
$28.98 |
$28.98 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$25.74 |
$25.74 |
$25.74 |
$98.58
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$79.55 |
$79.55 |
$79.55 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$937.09 |
$937.09 |
$937.09 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$821.29 |
$821.29 |
$821.29 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$1,507.15 |
$1,507.15 |
$1,507.15 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$4,646.95 |
$4,646.95 |
$4,646.95 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$6,970.15 |
$6,970.15 |
$6,970.15 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$11,222.10 |
$11,222.10 |
$11,222.10 |
$21,413.60
|
|
Thrombin time
|
$11.87 |
$11.87 |
$11.87 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$21.84 |
$21.84 |
$21.84 |
$62.01
|
|
Thyroglobulin antibody
|
$16.32 |
$16.32 |
$16.32 |
$82.50
|
|
Thyroid imaging
|
$209.02 |
$209.02 |
$209.02 |
$695.60
|
|
Thyroid mets imag whole body
|
$509.44 |
$509.44 |
$509.44 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$37.06 |
$37.06 |
$37.06 |
$112.70
|
|
Thyroid Ultrasound
|
$161.34 |
$161.34 |
$161.34 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$5.08 |
$5.08 |
$5.08 |
$64.51
|
|
Tib/per revasc stent & ather 37231
|
$10,000.25 |
$10,000.25 |
$10,000.25 |
$21,249.26
|
|
Tib/per revasc stnt & ather
|
$6,607.84 |
$6,607.84 |
$6,607.84 |
$11,078.70
|
