|
Screw cortex 2.0 x 10mm
|
$10,311.79 |
$10,311.79 |
$10,311.79 |
$28,563.75
|
|
Self-adher band w>=3" <5"/yd
|
$1.32 |
$1.32 |
$1.32 |
$11.40
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$63.17 |
$63.17 |
$63.17 |
$235.13
|
|
Sheath gldlight lasr 12fx50cm
|
$2,059.76 |
$2,059.76 |
$2,059.76 |
$6,108.01
|
|
Shoulder MRI (with and without contrast)
|
$1,246.76 |
$1,246.76 |
$1,246.76 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$1,194.80 |
$1,194.80 |
$1,194.80 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,038.93 |
$1,038.93 |
$1,038.93 |
$2,051.28
|
|
Shoulder X-ray
|
$116.66 |
$116.66 |
$116.66 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$272.02 |
$272.02 |
$272.02 |
$345.00
|
|
Sickling rbc
|
$17.83 |
$17.83 |
$17.83 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$899.10 |
$899.10 |
$899.10 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$830.58 |
$830.58 |
$830.58 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$761.81 |
$761.81 |
$761.81 |
$1,279.50
|
|
Sleep Study (Polysomnography)
|
$1,216.20 |
$1,216.20 |
$1,216.20 |
$3,936.80
|
|
Sleep study unattended
|
$152.57 |
$152.57 |
$152.57 |
$595.50
|
|
Sling suprapubic suburetheral
|
$5,494.39 |
$5,494.39 |
$5,494.39 |
$10,328.15
|
|
Smear fluorescent and/or acid fast stain
|
$23.95 |
$23.95 |
$23.95 |
$64.20
|
|
Smear gram stain
|
$13.25 |
$13.25 |
$13.25 |
$57.85
|
|
Smear nasal eosinophil
|
$9.94 |
$9.94 |
$9.94 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$12.23 |
$12.23 |
$12.23 |
$64.35
|
|
Smear wet mount
|
$10.45 |
$10.45 |
$10.45 |
$68.63
|
|
Sodium 24 hour urine
|
$38.46 |
$38.46 |
$38.46 |
$48.50
|
|
Sodium chloride 3 % ivpb
|
$52.35 |
$52.35 |
$52.35 |
$48.11
|
|
Sodium serum/plasma/whole blood
|
$24.46 |
$24.46 |
$24.46 |
$42.70
|
|
Specific gravity body fluid
|
$2.81 |
$2.81 |
$2.81 |
$23.63
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$462.03 |
$462.03 |
$462.03 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$157.92 |
$157.92 |
$157.92 |
$559.96
|
|
Sputum specimen collection
|
$28.79 |
$28.79 |
$28.79 |
$180.00
|
|
St cognitve performance testing healthcare professional each hour
|
$83.55 |
$83.55 |
$83.55 |
$313.96
|
|
Stent axios caut enh 15x10mm electrocaut
|
$14,365.08 |
$14,365.08 |
$14,365.08 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$303.61 |
$303.61 |
$303.61 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,390.67 |
$1,390.67 |
$1,390.67 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$133.80 |
$133.80 |
$133.80 |
$5,943.00
|
|
Strapping of ankle and/or ft 29540
|
$85.33 |
$85.33 |
$85.33 |
$248.05
|
|
Strapping of chest
|
$102.14 |
$102.14 |
$102.14 |
$201.60
|
|
Strapping of knee
|
$88.90 |
$88.90 |
$88.90 |
$224.80
|
|
Strep a ag ia
|
$33.63 |
$33.63 |
$33.63 |
$75.40
|
|
Strep b assay w/optic
|
$8.16 |
$8.16 |
$8.16 |
$32.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$37.41 |
$37.41 |
$37.41 |
$49.13
|
|
Sugars single quant
|
$23.44 |
$23.44 |
$23.44 |
$52.47
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$17.29 |
$17.29 |
$17.29 |
$74.79
|
|
Surgical pathology level 1 gross examination only
|
$12.74 |
$12.74 |
$12.74 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$25.47 |
$25.47 |
$25.47 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$25.47 |
$25.47 |
$25.47 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$34.13 |
$34.13 |
$34.13 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$80.74 |
$80.74 |
$80.74 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$110.54 |
$110.54 |
$110.54 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$26.24 |
$26.24 |
$26.24 |
$40.30
|
|
Susceptibility mic per plate
|
$16.31 |
$16.31 |
$16.31 |
$94.38
|
|
Sweat collection by iontophoresis
|
$1.28 |
$1.28 |
$1.28 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$15.80 |
$15.80 |
$15.80 |
$44.85
|
|
System pacing micra av
|
$3,102.25 |
$3,102.25 |
$3,102.25 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$4,065.02 |
$4,065.02 |
$4,065.02 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$90.68 |
$90.68 |
$90.68 |
$89.82
|
|
T3 (triiodothyronine) total
|
$29.80 |
$29.80 |
$29.80 |
$94.90
|
|
T4 (thyroxine) free
|
$23.69 |
$23.69 |
$23.69 |
$81.60
|
|
T4 (thyroxine) total
|
$21.15 |
$21.15 |
$21.15 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$12.99 |
$12.99 |
$12.99 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$748.47 |
$748.47 |
$748.47 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$46.36 |
$46.36 |
$46.36 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$26.75 |
$26.75 |
$26.75 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$82.27 |
$82.27 |
$82.27 |
$186.00
|
|
T cells absolute cd 4 count
|
$77.43 |
$77.43 |
$77.43 |
$120.25
|
|
T cells total count
|
$76.16 |
$76.16 |
$76.16 |
$124.11
|
|
Tcranial magn stim tx plan
|
$153.84 |
$153.84 |
$153.84 |
$386.88
|
|
Telehealth original site facility fee
|
$17.32 |
$17.32 |
$17.32 |
$60.80
|
|
Teriparatide injection
|
$8,029.24 |
$8,029.24 |
$8,029.24 |
$7,403.20
|
|
Test pathogen(s) for platelets reference
|
$54.00 |
$54.00 |
$54.00 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$402.43 |
$402.43 |
$402.43 |
$1,001.55
|
|
Theophylline therapeutic drug level
|
$28.53 |
$28.53 |
$28.53 |
$108.00
|
|
Therapeutic procd strg endur
|
$33.88 |
$33.88 |
$33.88 |
$85.80
|
|
Therapy activity per session >= 45 minutes
|
$106.98 |
$106.98 |
$106.98 |
$158.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$15.80 |
$15.80 |
$15.80 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$4.08 |
$4.08 |
$4.08 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$221.59 |
$221.59 |
$221.59 |
$534.32
|
|
Ther/proph/diag inj ia
|
$49.42 |
$49.42 |
$49.42 |
$247.33
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$453.37 |
$453.37 |
$453.37 |
$1,804.00
|
|
Thoracotomy with cardiac massage
|
$511.95 |
$511.95 |
$511.95 |
$2,926.56
|
|
Thrombin time
|
$14.52 |
$14.52 |
$14.52 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$16.82 |
$16.82 |
$16.82 |
$56.93
|
|
Thyroglobulin antibody
|
$38.97 |
$38.97 |
$38.97 |
$84.00
|
|
Thyroid (TSH) Test
|
$43.81 |
$43.81 |
$43.81 |
$120.00
|
|
Thyroid Ultrasound
|
$153.08 |
$153.08 |
$153.08 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$10.96 |
$10.96 |
$10.96 |
$63.60
|
|
Tigecycline injection
|
$292.92 |
$292.92 |
$292.92 |
$277.31
|
|
Tilt table study
|
$407.52 |
$407.52 |
$407.52 |
$1,495.00
|
|
Tissue culture tumor
|
$116.91 |
$116.91 |
$116.91 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$7.14 |
$7.14 |
$7.14 |
$47.40
|
|
Tissue transglutaminase iga
|
$9.17 |
$9.17 |
$9.17 |
$48.57
|
|
Tobramycin peak therapeutic drug level
|
$37.70 |
$37.70 |
$37.70 |
$121.55
|
|
Tomosynthesis breast screen bilateral
|
$28.53 |
$28.53 |
$28.53 |
$73.45
|
|
Toxoplasma antibody igg
|
$7.65 |
$7.65 |
$7.65 |
$84.35
|
|
Toxoplasma antibody igm
|
$7.65 |
$7.65 |
$7.65 |
$83.20
|
|
Tracheostoma revision; simple, without flap rotation
|
$598.80 |
$598.80 |
$598.80 |
$3,837.72
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$58.08 |
$58.08 |
$58.08 |
$104.50
|
|
Transferrin
|
$11.21 |
$11.21 |
$11.21 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$331.88 |
$331.88 |
$331.88 |
$988.24
|
|
Trauma partial team response w/critical care services level 4
|
$675.47 |
$675.47 |
$675.47 |
$5,104.55
|
|
Treat elbow dislocation
|
$1,188.69 |
$1,188.69 |
$1,188.69 |
$2,326.40
|
|
Treat elbow fracture
|
$940.10 |
$940.10 |
$940.10 |
$2,125.60
|