|
Stimulants synthetic
|
$10.50 |
$10.50 |
$10.50 |
$80.08
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$108.57 |
$108.57 |
$108.57 |
$2,607.60
|
|
Strapping of ankle and/or ft 29540
|
$18.55 |
$18.55 |
$18.55 |
$223.45
|
|
Strapping of chest
|
$7.84 |
$7.84 |
$7.84 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$18.55 |
$18.55 |
$18.55 |
$154.70
|
|
Strapping of hand or finger
|
$7.28 |
$7.28 |
$7.28 |
$174.82
|
|
Strapping of hip
|
$8.61 |
$8.61 |
$8.61 |
$164.70
|
|
Strapping of knee
|
$18.55 |
$18.55 |
$18.55 |
$205.20
|
|
Strapping of toes 29550
|
$4.90 |
$4.90 |
$4.90 |
$164.70
|
|
Strep a dna dir probe
|
$1.40 |
$1.40 |
$1.40 |
$96.72
|
|
Strep b assay w/optic
|
$0.89 |
$0.89 |
$0.89 |
$80.16
|
|
Strep b dna amp probe
|
$29.54 |
$29.54 |
$29.54 |
$120.90
|
|
Stress test pulmonary
|
$46.76 |
$46.76 |
$46.76 |
$322.85
|
|
Stress tte complete
|
$342.02 |
$342.02 |
$342.02 |
$1,870.50
|
|
Str markers specimen anal
|
$21.00 |
$21.00 |
$21.00 |
$751.50
|
|
St treatment speech individual
|
$89.53 |
$89.53 |
$89.53 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$89.53 |
$89.53 |
$89.53 |
$240.31
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$67.55 |
$67.55 |
$67.55 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$21.21 |
$21.21 |
$21.21 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$20.30 |
$20.30 |
$20.30 |
$216.00
|
|
Subtalar arthro w/fb rmvl
|
$157.71 |
$157.71 |
$157.71 |
$3,839.54
|
|
Subtalar arthro w/fusion
|
$214.34 |
$214.34 |
$214.34 |
$14,241.77
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
$52.31
|
|
Sugars single quant
|
$0.81 |
$0.81 |
$0.81 |
$64.28
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.14 |
$0.14 |
$0.14 |
$82.43
|
|
Sulfonylurea screen qn-sendout
|
$8.79 |
$8.79 |
$8.79 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$22.54 |
$22.54 |
$22.54 |
$114.88
|
|
Sup of prep of antigen # of vials 95144
|
$3.01 |
$3.01 |
$3.01 |
$54.60
|
|
Support clav 29.6-40.5in med
|
$15.26 |
$15.26 |
$15.26 |
$94.19
|
|
Suprv interfacilty transport
|
$10.01 |
$10.01 |
$10.01 |
$139.20
|
|
Suprv interfac trnsport addl
|
$8.75 |
$8.75 |
$8.75 |
$120.80
|
|
Surg dx exam anorectal
|
$25.20 |
$25.20 |
$25.20 |
$3,245.23
|
|
Surg ect salp-oophorectomy 59120
|
$189.63 |
$189.63 |
$189.63 |
$1,632.60
|
|
Surg ect without salp-oophorectomy 59121
|
$189.56 |
$189.56 |
$189.56 |
$1,634.40
|
|
Surgical opening of stomach 43500
|
$185.36 |
$185.36 |
$185.36 |
$1,477.80
|
|
Surgical pathology level 1 gross examination only
|
$3.50 |
$3.50 |
$3.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$5.25 |
$5.25 |
$5.25 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$10.85 |
$10.85 |
$10.85 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$11.20 |
$11.20 |
$11.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$17.50 |
$17.50 |
$17.50 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$21.00 |
$21.00 |
$21.00 |
$718.00
|
|
Surgical repair stomach bleedin ulcer 43501
|
$314.09 |
$314.09 |
$314.09 |
$2,536.20
|
|
Surgical repair stomach gastric lac 43502
|
$354.76 |
$354.76 |
$354.76 |
$2,864.40
|
|
Surgical revision intestine
|
$251.02 |
$251.02 |
$251.02 |
$2,607.20
|
|
Surg tx anal fistula 2nd stage 46285
|
$104.93 |
$104.93 |
$104.93 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$0.33 |
$0.33 |
$0.33 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$5.88 |
$5.88 |
$5.88 |
$35.70
|
|
Susceptibility mic per plate
|
$42.77 |
$42.77 |
$42.77 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$0.41 |
$0.41 |
$0.41 |
$59.28
|
|
Suspension of testis
|
$71.96 |
$71.96 |
$71.96 |
$4,061.71
|
|
Suspension of uterus 58400
|
$15.19 |
$15.19 |
$15.19 |
$1,136.00
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$245.35 |
$245.35 |
$245.35 |
$1,995.00
|
|
Suture bile duct injury 47900
|
$322.07 |
$322.07 |
$322.07 |
$3,036.66
|
|
Svc venogram s&i
|
$621.53 |
$621.53 |
$621.53 |
$1,934.62
|
|
Sympathectomy digital artery
|
$187.53 |
$187.53 |
$187.53 |
$2,310.83
|
|
Sympathectomy supfc palmar
|
$193.62 |
$193.62 |
$193.62 |
$3,880.00
|
|
Synvisc or synvisc-one
|
$77.21 |
$77.21 |
$77.21 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$17.36 |
$17.36 |
$17.36 |
$41.60
|
|
System pacing micra av
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$2,209.34 |
$2,209.34 |
$2,209.34 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$26.81 |
$26.81 |
$26.81 |
$99.20
|
|
T3 (triiodothyronine) total
|
$16.17 |
$16.17 |
$16.17 |
$93.52
|
|
T4 (thyroxine) free
|
$45.43 |
$45.43 |
$45.43 |
$85.20
|
|
T4 (thyroxine) total
|
$32.69 |
$32.69 |
$32.69 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.53 |
$4.53 |
$4.53 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$14.91 |
$14.91 |
$14.91 |
$122.40
|
|
Tah w/mmk 58152
|
$293.02 |
$293.02 |
$293.02 |
$2,428.80
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$1.75 |
$1.75 |
$1.75 |
$14.62
|
|
Tap block uni by cont infusion 64487
|
$14.00 |
$14.00 |
$14.00 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$171.50 |
$171.50 |
$171.50 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$172.55 |
$172.55 |
$172.55 |
$3,746.70
|
|
Tbs dxa cal w/i&r fx risk
|
$11.62 |
$11.62 |
$11.62 |
$127.12
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$66.36 |
$66.36 |
$66.36 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$4.34 |
$4.34 |
$4.34 |
$177.65
|
|
Tc-99m bicisate
|
$206.43 |
$206.43 |
$206.43 |
$1,969.45
|
|
Tc-99m labeled rbc
|
$118.51 |
$118.51 |
$118.51 |
$302.40
|
|
Tc-99m maa
|
$43.19 |
$43.19 |
$43.19 |
$292.80
|
|
Tc-99m mebrofenin
|
$104.86 |
$104.86 |
$104.86 |
$157.65
|
|
Tc-99m medronate
|
$41.86 |
$41.86 |
$41.86 |
$111.01
|
|
Tc-99m mertiatide
|
$416.29 |
$416.29 |
$416.29 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$4.90 |
$4.90 |
$4.90 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$2.38 |
$2.38 |
$2.38 |
$22.10
|
|
Tc-99m sestamibi p study dose
|
$164.36 |
$164.36 |
$164.36 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$206.43 |
$206.43 |
$206.43 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$11.06 |
$11.06 |
$11.06 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$32.90 |
$32.90 |
$32.90 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$98.21 |
$98.21 |
$98.21 |
$955.60
|
|
Tca peel dermal 15789
|
$133.91 |
$133.91 |
$133.91 |
$1,324.80
|
|
T cells absolute cd4/cd8 including ratio
|
$3.29 |
$3.29 |
$3.29 |
$176.40
|
|
T cells absolute cd 4 count
|
$1.87 |
$1.87 |
$1.87 |
$111.20
|
|
T cells total count
|
$2.64 |
$2.64 |
$2.64 |
$126.90
|
|
Tcranial magn stim tx deli
|
$40.32 |
$40.32 |
$40.32 |
$389.22
|
|
Tcranial magn stim tx plan
|
$56.84 |
$56.84 |
$56.84 |
$437.22
|
|
Tcran magn stim redetemine
|
$46.41 |
$46.41 |
$46.41 |
$457.60
|
|
Teaec w/wo patch graft iliofemoral
|
$228.06 |
$228.06 |
$228.06 |
$5,163.60
|
|
Team conf without pat by phys
|
$6.30 |
$6.30 |
$6.30 |
$140.25
|
|
Telehealth original site facility fee
|
$4.69 |
$4.69 |
$4.69 |
$51.00
|
|
Telethx isodose plan cplx
|
$43.05 |
$43.05 |
$43.05 |
$1,526.85
|
|
Telethx isodose plan simple
|
$20.72 |
$20.72 |
$20.72 |
$873.62
|
|
Tendon lngth upr a/e ea tdn
|
$144.27 |
$144.27 |
$144.27 |
$3,545.97
|
