|
Special teletx port plan
|
$3,399.84 |
$3,399.84 |
$3,399.84 |
$1,046.65
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,959.84 |
$1,959.84 |
$1,959.84 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$960.00 |
$960.00 |
$960.00 |
$559.96
|
|
Splint rstrc wrst/cmc right med
|
$74.57 |
$74.57 |
$74.57 |
$101.18
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$5,270.40 |
$5,270.40 |
$5,270.40 |
$4,560.66
|
|
Split blood or products
|
$131.04 |
$131.04 |
$131.04 |
$148.98
|
|
Srs linear based
|
$16,218.72 |
$16,218.72 |
$16,218.72 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$297.60 |
$297.60 |
$297.60 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$287.52 |
$287.52 |
$287.52 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$9,089.28 |
$9,089.28 |
$9,089.28 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$42,336.00 |
$42,336.00 |
$42,336.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$28,596.81 |
$28,596.81 |
$28,596.81 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$26,685.48 |
$26,685.48 |
$26,685.48 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$7,485.00 |
$7,485.00 |
$7,485.00 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$6,127.20 |
$6,127.20 |
$6,127.20 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$5,441.28 |
$5,441.28 |
$5,441.28 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$9,089.28 |
$9,089.28 |
$9,089.28 |
$19,765.20
|
|
St evaluate speech sound production
|
$297.60 |
$297.60 |
$297.60 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$297.60 |
$297.60 |
$297.60 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$389.28 |
$389.28 |
$389.28 |
$406.40
|
|
St evaluation swallow function
|
$183.36 |
$183.36 |
$183.36 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$334.08 |
$334.08 |
$334.08 |
$248.05
|
|
Strapping of chest
|
$290.40 |
$290.40 |
$290.40 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$214.56 |
$214.56 |
$214.56 |
$171.00
|
|
Strapping of hand or finger
|
$334.08 |
$334.08 |
$334.08 |
$194.40
|
|
Strapping of hip
|
$265.44 |
$265.44 |
$265.44 |
$170.08
|
|
Strapping of knee
|
$317.76 |
$317.76 |
$317.76 |
$224.80
|
|
Strapping of toes 29550
|
$317.76 |
$317.76 |
$317.76 |
$185.36
|
|
Stress test pulmonary
|
$775.68 |
$775.68 |
$775.68 |
$327.20
|
|
St treatment speech individual
|
$178.08 |
$178.08 |
$178.08 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$98.40 |
$98.40 |
$98.40 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$72.01 |
$72.01 |
$72.01 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$52.10 |
$52.10 |
$52.10 |
$74.79
|
|
Sulfonylurea screen qn-sendout
|
$5.24 |
$5.24 |
$5.24 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$44.76 |
$44.76 |
$44.76 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$51.61 |
$51.61 |
$51.61 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$101.76 |
$101.76 |
$101.76 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$152.16 |
$152.16 |
$152.16 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$203.52 |
$203.52 |
$203.52 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$286.56 |
$286.56 |
$286.56 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$492.48 |
$492.48 |
$492.48 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$517.44 |
$517.44 |
$517.44 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$78.72 |
$78.72 |
$78.72 |
$40.30
|
|
Susceptibility mic per plate
|
$248.64 |
$248.64 |
$248.64 |
$94.38
|
|
Svc venogram s&i
|
$3,416.64 |
$3,416.64 |
$3,416.64 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.40 |
$1.40 |
$1.40 |
$44.85
|
|
System cardiomems hosp electronics
|
$37,328.86 |
$37,328.86 |
$37,328.86 |
$41,639.82
|
|
System pacing micra av
|
$30,028.32 |
$30,028.32 |
$30,028.32 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$16,665.93 |
$16,665.93 |
$16,665.93 |
$10,980.00
|
|
System sealant biosentry tract
|
$1,314.18 |
$1,314.18 |
$1,314.18 |
$900.00
|
|
T3 (triiodothyronine) free
|
$76.32 |
$76.32 |
$76.32 |
$89.82
|
|
T3 (triiodothyronine) total
|
$74.88 |
$74.88 |
$74.88 |
$94.90
|
|
T4 (thyroxine) free
|
$54.72 |
$54.72 |
$54.72 |
$81.60
|
|
T4 (thyroxine) total
|
$55.68 |
$55.68 |
$55.68 |
$73.64
|
|
Tacrol envarsus ex rel oral
|
$8.91 |
$8.91 |
$8.91 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$29.03 |
$29.03 |
$29.03 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$785.68 |
$785.68 |
$785.68 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$78.72 |
$78.72 |
$78.72 |
$122.40
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$874.51 |
$874.51 |
$874.51 |
$21,795.67
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$12,360.00 |
$12,360.00 |
$12,360.00 |
$31,080.00
|
|
Target gsa panel hmtlmph neop
|
$960.00 |
$960.00 |
$960.00 |
$1,928.40
|
|
Tas congenital car anomal
|
$2,429.76 |
$2,429.76 |
$2,429.76 |
$6,003.27
|
|
Tavr perq femoral
|
$12,472.32 |
$12,472.32 |
$12,472.32 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$423.36 |
$423.36 |
$423.36 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$115.20 |
$115.20 |
$115.20 |
$166.46
|
|
Tcd emboli detect w/inj
|
$1,110.72 |
$1,110.72 |
$1,110.72 |
$404.68
|
|
T cells absolute cd4/cd8 including ratio
|
$150.55 |
$150.55 |
$150.55 |
$186.00
|
|
T cells absolute cd 4 count
|
$61.27 |
$61.27 |
$61.27 |
$120.25
|
|
T cells total count
|
$45.08 |
$45.08 |
$45.08 |
$124.11
|
|
Tcranial magn stim tx deli
|
$456.00 |
$456.00 |
$456.00 |
$368.50
|
|
Tcranial magn stim tx plan
|
$456.00 |
$456.00 |
$456.00 |
$386.88
|
|
Tcran magn stim redetemine
|
$456.00 |
$456.00 |
$456.00 |
$417.06
|
|
Teaec w/wo patch graft iliofemoral
|
$7,365.12 |
$7,365.12 |
$7,365.12 |
$5,030.40
|
|
Tee w or without fol w/cont,cong
|
$1,232.16 |
$1,232.16 |
$1,232.16 |
$1,995.40
|
|
Telethx isodose plan cplx
|
$5,576.16 |
$5,576.16 |
$5,576.16 |
$1,617.00
|
|
Telethx isodose plan simple
|
$3,374.88 |
$3,374.88 |
$3,374.88 |
$848.72
|
|
Temozolomide
|
$37.28 |
$37.28 |
$37.28 |
$374.66
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,583.75 |
$2,583.75 |
$2,583.75 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$14,606.90 |
$14,606.90 |
$14,606.90 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$3,839.54
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$44.76 |
$44.76 |
$44.76 |
$46.10
|
|
Testicular imaging w/vasc flow
|
$497.28 |
$497.28 |
$497.28 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$626.88 |
$626.88 |
$626.88 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,504.92 |
$1,504.92 |
$1,504.92 |
$1,204.50
|
|
Therapeutic procd strg endur
|
$129.60 |
$129.60 |
$129.60 |
$85.80
|
|
Therapy activity per session >= 45 minutes
|
$73.92 |
$73.92 |
$73.92 |
$158.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$107.52 |
$107.52 |
$107.52 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$101.76 |
$101.76 |
$101.76 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$1,047.84 |
$1,047.84 |
$1,047.84 |
$534.32
|
|
Ther/proph/diag inj ia
|
$305.28 |
$305.28 |
$305.28 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,684.80 |
$1,684.80 |
$1,684.80 |
$1,804.00
|
|
Thoracotomy w/expl
|
$5,571.84 |
$5,571.84 |
$5,571.84 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$7,463.04 |
$7,463.04 |
$7,463.04 |
$2,926.56
|
|
Thrombectmy crnry perq mechanical
|
$3,393.60 |
$3,393.60 |
$3,393.60 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,283.84 |
$5,283.84 |
$5,283.84 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$10,178.40 |
$10,178.40 |
$10,178.40 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$15,425.28 |
$15,425.28 |
$15,425.28 |
$24,605.30
|
|
Thrombin time
|
$40.80 |
$40.80 |
$40.80 |
$48.75
|
|
Thromboendarterectomy common femoral
|
$1,114.56 |
$1,114.56 |
$1,114.56 |
$7,431.06
|