|
Rpr aa hrn 1st 3-10 ncr/strn
|
$1,498.90 |
$1,498.90 |
$1,498.90 |
$3,849.30
|
|
Rpr aa hrn 1st 3-10 rdc
|
$1,476.80 |
$1,476.80 |
$1,476.80 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$863.20 |
$863.20 |
$863.20 |
$4,000.83
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$934.70 |
$934.70 |
$934.70 |
$6,397.53
|
|
Rpr aa hrn rcr > 10 ncr/strn
|
$1,914.25 |
$1,914.25 |
$1,914.25 |
$3,104.80
|
|
Rpr aa hrn rcr > 10 rdc
|
$1,792.05 |
$1,792.05 |
$1,792.05 |
$2,217.60
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$1,498.90 |
$1,498.90 |
$1,498.90 |
$2,148.00
|
|
Rpr aa hrn rcr 3-10 rdc
|
$1,498.90 |
$1,498.90 |
$1,498.90 |
$4,000.83
|
|
Rpr aa hrn rcr < 3 ncr/strn
|
$934.70 |
$934.70 |
$934.70 |
$2,665.00
|
|
Rpr aa hrn rcr < 3 rdc
|
$863.20 |
$863.20 |
$863.20 |
$3,856.84
|
|
Rsv assay w/optic
|
$111.15 |
$111.15 |
$111.15 |
$64.13
|
|
Rubella antibody igg
|
$44.20 |
$44.20 |
$44.20 |
$73.05
|
|
Rubeola antibody igg
|
$47.45 |
$47.45 |
$47.45 |
$80.00
|
|
Russell viper venom diluted
|
$111.15 |
$111.15 |
$111.15 |
$73.03
|
|
Sarscov coronavirus ag ia
|
$70.20 |
$70.20 |
$70.20 |
$65.00
|
|
Sarscov & inf vir a&b ag ia
|
$104.00 |
$104.00 |
$104.00 |
$104.00
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$67.60 |
$67.60 |
$67.60 |
$79.20
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$888.55 |
$888.55 |
$888.55 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$508.95 |
$508.95 |
$508.95 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$658.45 |
$658.45 |
$658.45 |
$788.40
|
|
Scan duplex extremity veins unilateral/limited study
|
$557.70 |
$557.70 |
$557.70 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$718.25 |
$718.25 |
$718.25 |
$957.18
|
|
Scr c/v cyto,thinlayer,rescr
|
$68.90 |
$68.90 |
$68.90 |
$76.70
|
|
Screening Colonoscopy (average risk)
|
$625.95 |
$625.95 |
$625.95 |
$1,093.16
|
|
Screening Colonoscopy (high risk)
|
$625.95 |
$625.95 |
$625.95 |
$1,575.00
|
|
Screening prostate cancer PSA
|
$58.50 |
$58.50 |
$58.50 |
$96.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$150.15 |
$150.15 |
$150.15 |
$194.35
|
|
Sedimentation rate erythrocyte automated
|
$25.35 |
$25.35 |
$25.35 |
$37.80
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$32.50 |
$32.50 |
$32.50 |
$59.89
|
|
Semen analysis presence/motility
|
$114.40 |
$114.40 |
$114.40 |
$79.92
|
|
Serial casting application 97139app
|
$57.85 |
$57.85 |
$57.85 |
$67.42
|
|
Sertraline (zoloft) - sendout
|
$250.25 |
$250.25 |
$250.25 |
$178.33
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$171.60 |
$171.60 |
$171.60 |
$286.89
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$206.05 |
$206.05 |
$206.05 |
$442.22
|
|
Shoulder X-ray
|
$497.90 |
$497.90 |
$497.90 |
$307.20
|
|
Sickling rbc
|
$37.05 |
$37.05 |
$37.05 |
$53.40
|
|
Sigmoidoscopy and biopsy
|
$364.00 |
$364.00 |
$364.00 |
$1,351.63
|
|
Sinus CT scan (with and without contrast)
|
$1,485.90 |
$1,485.90 |
$1,485.90 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,280.50 |
$1,280.50 |
$1,280.50 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$1,018.55 |
$1,018.55 |
$1,018.55 |
$1,151.00
|
|
Skin Biopsy
|
$232.05 |
$232.05 |
$232.05 |
$362.40
|
|
Sleep Study (Polysomnography)
|
$3,063.45 |
$3,063.45 |
$3,063.45 |
$4,043.20
|
|
Smear fluorescent and/or acid fast stain
|
$52.65 |
$52.65 |
$52.65 |
$50.70
|
|
Smear gram stain
|
$82.55 |
$82.55 |
$82.55 |
$48.00
|
|
Smear nasal eosinophil
|
$27.30 |
$27.30 |
$27.30 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$68.25 |
$68.25 |
$68.25 |
$60.00
|
|
Smear wet mount
|
$76.70 |
$76.70 |
$76.70 |
$56.13
|
|
Snrpn/ube3a gene
|
$337.35 |
$337.35 |
$337.35 |
$228.80
|
|
Sodium 24 hour urine
|
$40.95 |
$40.95 |
$40.95 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$37.50 |
$37.50 |
$37.50 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$37.50 |
$37.50 |
$37.50 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$37.50 |
$37.50 |
$37.50 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$98.18 |
$98.18 |
$98.18 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$45.50 |
$45.50 |
$45.50 |
$42.43
|
|
Specific gravity body fluid
|
$9.10 |
$9.10 |
$9.10 |
$21.55
|
|
Specimen fat stain
|
$37.70 |
$37.70 |
$37.70 |
$40.00
|
|
Sperm antibody test
|
$89.05 |
$89.05 |
$89.05 |
$56.44
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$525.20 |
$525.20 |
$525.20 |
$526.80
|
|
Split blood or products
|
$102.70 |
$102.70 |
$102.70 |
$143.64
|
|
Sputum specimen collection
|
$101.40 |
$101.40 |
$101.40 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$416.00 |
$416.00 |
$416.00 |
$295.10
|
|
Staph a dna amp probe
|
$95.55 |
$95.55 |
$95.55 |
$116.39
|
|
St evaluate speech sound production
|
$416.00 |
$416.00 |
$416.00 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$425.75 |
$425.75 |
$425.75 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$822.90 |
$822.90 |
$822.90 |
$336.00
|
|
St evaluation swallow function
|
$366.60 |
$366.60 |
$366.60 |
$323.72
|
|
Strep a ag ia
|
$94.25 |
$94.25 |
$94.25 |
$75.40
|
|
Strep b dna amp probe
|
$120.90 |
$120.90 |
$120.90 |
$124.20
|
|
Str markers specimen anal
|
$703.30 |
$703.30 |
$703.30 |
$978.25
|
|
St treatment speech individual
|
$248.30 |
$248.30 |
$248.30 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$227.50 |
$227.50 |
$227.50 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$22.19
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$151.29 |
$151.29 |
$151.29 |
$52.49
|
|
Surgical pathology level 1 gross examination only
|
$77.35 |
$77.35 |
$77.35 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$150.80 |
$150.80 |
$150.80 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$6,103.97 |
$6,103.97 |
$6,103.97 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$4,504.82 |
$4,504.82 |
$4,504.82 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$357.50 |
$357.50 |
$357.50 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$443.30 |
$443.30 |
$443.30 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$33.15 |
$33.15 |
$33.15 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$35.10 |
$35.10 |
$35.10 |
$31.85
|
|
Susceptibility mic per plate
|
$55.25 |
$55.25 |
$55.25 |
$89.70
|
|
Sweat collection by iontophoresis
|
$61.10 |
$61.10 |
$61.10 |
$100.20
|
|
Synvisc or synvisc-one
|
$919.93 |
$919.93 |
$919.93 |
$1,053.54
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$60.45 |
$60.45 |
$60.45 |
$45.70
|
|
T3 (triiodothyronine) free
|
$63.70 |
$63.70 |
$63.70 |
$91.20
|
|
T3 (triiodothyronine) total
|
$73.45 |
$73.45 |
$73.45 |
$88.00
|
|
T4 (thyroxine) free
|
$51.35 |
$51.35 |
$51.35 |
$65.00
|
|
T4 (thyroxine) total
|
$52.65 |
$52.65 |
$52.65 |
$62.40
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Tacrolimus therapeutic drug level
|
$145.60 |
$145.60 |
$145.60 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$1,473.55 |
$1,473.55 |
$1,473.55 |
$1,928.40
|
|
Target gsa panel organ neop
|
$1,907.10 |
$1,907.10 |
$1,907.10 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$165.75 |
$165.75 |
$165.75 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$76.70 |
$76.70 |
$76.70 |
$178.40
|
|
T cells absolute cd4/cd8 including ratio
|
$114.40 |
$114.40 |
$114.40 |
$189.60
|
|
T cells absolute cd 4 count
|
$151.45 |
$151.45 |
$151.45 |
$120.25
|
|
T cells total count
|
$114.40 |
$114.40 |
$114.40 |
$126.90
|
|
Telehealth original site facility fee
|
$35.10 |
$35.10 |
$35.10 |
$55.65
|