|
Strapping of toes 29550
|
$85.16 |
$85.16 |
$85.16 |
$185.36
|
|
Strep a ag ia
|
$36.61 |
$36.61 |
$36.61 |
$75.40
|
|
Streptomycin injection
|
$145.94 |
$145.94 |
$145.94 |
$138.30
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$17.25 |
$17.25 |
$17.25 |
$74.79
|
|
Surgical pathology level 1 gross examination only
|
$63.55 |
$63.55 |
$63.55 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$63.55 |
$63.55 |
$63.55 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$97.62 |
$97.62 |
$97.62 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$97.62 |
$97.62 |
$97.62 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$423.50 |
$423.50 |
$423.50 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$889.45 |
$889.45 |
$889.45 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$21.87 |
$21.87 |
$21.87 |
$40.30
|
|
Susceptibility mic per plate
|
$27.46 |
$27.46 |
$27.46 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$19.83 |
$19.83 |
$19.83 |
$48.30
|
|
Svc venogram s&i
|
$720.15 |
$720.15 |
$720.15 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$104.23 |
$104.23 |
$104.23 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$15.77 |
$15.77 |
$15.77 |
$44.85
|
|
System cardiomems hosp electronics
|
$21,352.80 |
$21,352.80 |
$21,352.80 |
$41,518.75
|
|
System pacing micra av
|
$11,439.00 |
$11,439.00 |
$11,439.00 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$7,946.46 |
$7,946.46 |
$7,946.46 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$90.50 |
$90.50 |
$90.50 |
$89.82
|
|
T3 (triiodothyronine) total
|
$50.08 |
$50.08 |
$50.08 |
$94.90
|
|
T4 (thyroxine) free
|
$37.63 |
$37.63 |
$37.63 |
$81.60
|
|
T4 (thyroxine) total
|
$34.58 |
$34.58 |
$34.58 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$30.00 |
$30.00 |
$30.00 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$466.75 |
$466.75 |
$466.75 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$46.27 |
$46.27 |
$46.27 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$26.70 |
$26.70 |
$26.70 |
$166.46
|
|
Tc-99m apcitide diag
|
$608.31 |
$608.31 |
$608.31 |
$1,765.30
|
|
Tc-99m arcitumomab
|
$834.54 |
$834.54 |
$834.54 |
$2,159.40
|
|
Tc-99m depreotide
|
$2,085.21 |
$2,085.21 |
$2,085.21 |
$1,937.35
|
|
Tc-99m exame autol wbc diag per dose
|
$615.93 |
$615.93 |
$615.93 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$611.86 |
$611.86 |
$611.86 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$78.55 |
$78.55 |
$78.55 |
$323.01
|
|
Tc-99m maa
|
$102.19 |
$102.19 |
$102.19 |
$312.06
|
|
Tc-99m mebrofenin
|
$51.61 |
$51.61 |
$51.61 |
$169.53
|
|
Tc-99m medronate
|
$91.77 |
$91.77 |
$91.77 |
$122.46
|
|
Tc-99m mertiatide
|
$216.84 |
$216.84 |
$216.84 |
$757.25
|
|
Tc-99m oxidronate
|
$91.77 |
$91.77 |
$91.77 |
$124.23
|
|
Tc-99m pentetate dtpa aerosol
|
$48.81 |
$48.81 |
$48.81 |
$244.02
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$48.81 |
$48.81 |
$48.81 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$168.03 |
$168.03 |
$168.03 |
$221.60
|
|
Tc-99m sulfur colloid
|
$104.48 |
$104.48 |
$104.48 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$166.51 |
$166.51 |
$166.51 |
$198.05
|
|
T cells absolute cd4/cd8 including ratio
|
$132.95 |
$132.95 |
$132.95 |
$186.00
|
|
T cells absolute cd 4 count
|
$111.85 |
$111.85 |
$111.85 |
$120.25
|
|
T cells total count
|
$124.56 |
$124.56 |
$124.56 |
$124.11
|
|
Tcranial magn stim tx plan
|
$153.54 |
$153.54 |
$153.54 |
$386.88
|
|
Tdh sdrl/ventr pnxr
|
$371.90 |
$371.90 |
$371.90 |
$1,087.20
|
|
Telethx isodose plan cplx
|
$155.58 |
$155.58 |
$155.58 |
$1,617.00
|
|
Telethx isodose plan simple
|
$68.13 |
$68.13 |
$68.13 |
$848.72
|
|
Temozolomide
|
$983.20 |
$983.20 |
$983.20 |
$374.66
|
|
Testicular imaging w/vasc flow
|
$346.48 |
$346.48 |
$346.48 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$125.07 |
$125.07 |
$125.07 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$257.26 |
$257.26 |
$257.26 |
$1,001.55
|
|
Test urine for porphyrins
|
$28.48 |
$28.48 |
$28.48 |
$27.30
|
|
Theophylline therapeutic drug level
|
$46.78 |
$46.78 |
$46.78 |
$108.00
|
|
Ther nma rdctj intus/obstrcj
|
$221.16 |
$221.16 |
$221.16 |
$534.32
|
|
Ther/proph/diag inj ia
|
$49.32 |
$49.32 |
$49.32 |
$247.33
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$371.14 |
$371.14 |
$371.14 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$442.06 |
$442.06 |
$442.06 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$1,840.41 |
$1,840.41 |
$1,840.41 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$415.62 |
$415.62 |
$415.62 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$5,639.69 |
$5,639.69 |
$5,639.69 |
$24,605.30
|
|
Thrombin time
|
$30.25 |
$30.25 |
$30.25 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$25.93 |
$25.93 |
$25.93 |
$56.93
|
|
Thyroglobulin antibody
|
$63.30 |
$63.30 |
$63.30 |
$84.00
|
|
Thyroid imaging
|
$219.89 |
$219.89 |
$219.89 |
$670.80
|
|
Thyroid mets imag whole body
|
$610.85 |
$610.85 |
$610.85 |
$1,524.99
|
|
Thyroid met uptake
|
$275.05 |
$275.05 |
$275.05 |
$380.00
|
|
Thyroid (TSH) Test
|
$71.69 |
$71.69 |
$71.69 |
$120.00
|
|
Thyroid Ultrasound
|
$152.78 |
$152.78 |
$152.78 |
$589.96
|
|
Thyroid uptake measurement
|
$118.97 |
$118.97 |
$118.97 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$49.07 |
$49.07 |
$49.07 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$14,405.01 |
$14,405.01 |
$14,405.01 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$4,115.76 |
$4,115.76 |
$4,115.76 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$5,307.19 |
$5,307.19 |
$5,307.19 |
$10,406.14
|
|
Tilt table study
|
$414.86 |
$414.86 |
$414.86 |
$1,495.00
|
|
Tissue culture placenta
|
$210.74 |
$210.74 |
$210.74 |
$520.91
|
|
Tissue culture tumor
|
$210.74 |
$210.74 |
$210.74 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$11.44 |
$11.44 |
$11.44 |
$47.40
|
|
Tissue transglutaminase iga
|
$9.16 |
$9.16 |
$9.16 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$38.13 |
$38.13 |
$38.13 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$8.45 |
$8.45 |
$8.45 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$61.78 |
$61.78 |
$61.78 |
$121.55
|
|
Toxoplasma antibody igg
|
$47.54 |
$47.54 |
$47.54 |
$84.35
|
|
Toxoplasma antibody igm
|
$47.54 |
$47.54 |
$47.54 |
$83.20
|
|
Transcath biopsy
|
$654.57 |
$654.57 |
$654.57 |
$4,298.05
|
|
Transcath closure of asd
|
$6,214.43 |
$6,214.43 |
$6,214.43 |
$18,772.00
|
|
Transcatheter bx s&i
|
$1,488.09 |
$1,488.09 |
$1,488.09 |
$1,875.96
|
|
Transcath rmvl perm ldss pmkr rv
|
$2,032.08 |
$2,032.08 |
$2,032.08 |
$4,627.00
|
|
Transferrin
|
$40.17 |
$40.17 |
$40.17 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$720.41 |
$720.41 |
$720.41 |
$988.24
|
|
Trauma partial team response w/critical care services level 4
|
$674.14 |
$674.14 |
$674.14 |
$5,104.55
|
|
Treat big toe fracture
|
$2,686.14 |
$2,686.14 |
$2,686.14 |
$3,981.06
|
|
Treat clavicle dislocation 23545
|
$205.14 |
$205.14 |
$205.14 |
$734.00
|
|
Treat elbow dislocation
|
$1,186.36 |
$1,186.36 |
$1,186.36 |
$2,326.40
|
|
Treat elbow fracture
|
$938.26 |
$938.26 |
$938.26 |
$2,125.60
|
|
Treat finger fracture each
|
$712.02 |
$712.02 |
$712.02 |
$1,815.75
|
|
Treat foot dislocation
|
$1,186.36 |
$1,186.36 |
$1,186.36 |
$3,935.24
|
|
Treat foot dislocation
|
$159.13 |
$159.13 |
$159.13 |
$527.28
|
