|
Skull X-ray (complete)
|
$297.17 |
$297.17 |
$297.17 |
$417.50
|
|
Sleep Study (Polysomnography)
|
$2,834.20 |
$2,834.20 |
$2,834.20 |
$3,734.50
|
|
Sleep study unattended
|
$601.92 |
$601.92 |
$601.92 |
$594.00
|
|
Sling suprapubic suburetheral
|
$10,902.93 |
$10,902.93 |
$10,902.93 |
$9,679.96
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$314.22 |
$314.22 |
$314.22 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$31.81 |
$31.81 |
$31.81 |
$64.35
|
|
Smear gram stain
|
$7.25 |
$7.25 |
$7.25 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$7.81 |
$7.81 |
$7.81 |
$73.50
|
|
Smear wet mount
|
$12.28 |
$12.28 |
$12.28 |
$67.55
|
|
Sodium 24 hour urine
|
$17.53 |
$17.53 |
$17.53 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$19.41 |
$19.41 |
$19.41 |
$46.26
|
|
Specific gravity body fluid
|
$6.26 |
$6.26 |
$6.26 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$601.34 |
$601.34 |
$601.34 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$265.68 |
$265.68 |
$265.68 |
$251.00
|
|
Sputum specimen collection
|
$252.58 |
$252.58 |
$252.58 |
$180.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$21,271.71 |
$21,271.71 |
$21,271.71 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$5,623.85 |
$5,623.85 |
$5,623.85 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$21,271.71 |
$21,271.71 |
$21,271.71 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$5,623.85 |
$5,623.85 |
$5,623.85 |
$4,631.82
|
|
Stimulants synthetic
|
$68.86 |
$68.86 |
$68.86 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,769.43 |
$1,769.43 |
$1,769.43 |
$1,345.40
|
|
Strep a ag ia
|
$28.46 |
$28.46 |
$28.46 |
$75.40
|
|
Sugars single quant
|
$6.89 |
$6.89 |
$6.89 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$80.13 |
$80.13 |
$80.13 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$3.80 |
$3.80 |
$3.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$5.91 |
$5.91 |
$5.91 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$12.66 |
$12.66 |
$12.66 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$12.66 |
$12.66 |
$12.66 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$19.41 |
$19.41 |
$19.41 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$19.41 |
$19.41 |
$19.41 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$8.93 |
$8.93 |
$8.93 |
$45.60
|
|
Susceptibility mic per plate
|
$103.80 |
$103.80 |
$103.80 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$35.67 |
$35.67 |
$35.67 |
$42.24
|
|
System pacing micra av
|
$24,429.87 |
$24,429.87 |
$24,429.87 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$76,337.43 |
$76,337.43 |
$76,337.43 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$13.15 |
$13.15 |
$13.15 |
$100.32
|
|
T3 (triiodothyronine) total
|
$26.92 |
$26.92 |
$26.92 |
$93.52
|
|
T4 (thyroxine) free
|
$17.53 |
$17.53 |
$17.53 |
$89.60
|
|
T4 (thyroxine) total
|
$3.76 |
$3.76 |
$3.76 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$8.76 |
$8.76 |
$8.76 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$223.04 |
$223.04 |
$223.04 |
$289.20
|
|
Tap block bilat cont infusion 64489
|
$198.33 |
$198.33 |
$198.33 |
$1,541.40
|
|
Tap block uni by cont infusion 64487
|
$162.88 |
$162.88 |
$162.88 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$1,315.55 |
$1,315.55 |
$1,315.55 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,823.25 |
$1,823.25 |
$1,823.25 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$28.03 |
$28.03 |
$28.03 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$19.11 |
$19.11 |
$19.11 |
$179.95
|
|
Tc-99m labeled rbc
|
$479.54 |
$479.54 |
$479.54 |
$306.00
|
|
Tc-99m maa
|
$204.92 |
$204.92 |
$204.92 |
$312.06
|
|
Tc-99m mebrofenin
|
$533.20 |
$533.20 |
$533.20 |
$157.65
|
|
Tc-99m medronate
|
$246.95 |
$246.95 |
$246.95 |
$111.01
|
|
Tc-99m mertiatide
|
$307.38 |
$307.38 |
$307.38 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$240.46 |
$240.46 |
$240.46 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$85.73 |
$85.73 |
$85.73 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$193.70 |
$193.70 |
$193.70 |
$287.20
|
|
Tc-99m sulfur colloid
|
$204.92 |
$204.92 |
$204.92 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$1,672.45 |
$1,672.45 |
$1,672.45 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$89.82 |
$89.82 |
$89.82 |
$184.00
|
|
T cells absolute cd 4 count
|
$38.86 |
$38.86 |
$38.86 |
$111.20
|
|
T cells total count
|
$72.62 |
$72.62 |
$72.62 |
$130.20
|
|
Team conf without pat by hc pro
|
$110.62 |
$110.62 |
$110.62 |
$112.86
|
|
Team conf without pat by phys
|
$143.61 |
$143.61 |
$143.61 |
$140.25
|
|
Team conf w/pat by hc prof
|
$125.08 |
$125.08 |
$125.08 |
$107.10
|
|
Test stress cardiovascular tracing only
|
$1,295.16 |
$1,295.16 |
$1,295.16 |
$953.40
|
|
Theophylline therapeutic drug level
|
$15.65 |
$15.65 |
$15.65 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$82.42 |
$82.42 |
$82.42 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$110.62 |
$110.62 |
$110.62 |
$98.58
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$251.90 |
$251.90 |
$251.90 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,090.98 |
$1,090.98 |
$1,090.98 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,282.74 |
$2,282.74 |
$2,282.74 |
$1,703.45
|
|
Thrombin time
|
$23.84 |
$23.84 |
$23.84 |
$54.18
|
|
Thromboxane urine
|
$73.87 |
$73.87 |
$73.87 |
$121.92
|
|
Thyroglobulin antibody
|
$7.01 |
$7.01 |
$7.01 |
$82.50
|
|
Thyroid imaging
|
$522.71 |
$522.71 |
$522.71 |
$695.60
|
|
Thyroid mets imag whole body
|
$879.01 |
$879.01 |
$879.01 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$92.02 |
$92.02 |
$92.02 |
$112.70
|
|
Thyroid Ultrasound
|
$826.60 |
$826.60 |
$826.60 |
$588.50
|
|
Thyroid uptake measurement
|
$330.13 |
$330.13 |
$330.13 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$18.15 |
$18.15 |
$18.15 |
$64.51
|
|
Tissue culture skin/biopsy
|
$221.82 |
$221.82 |
$221.82 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$92.07 |
$92.07 |
$92.07 |
$47.40
|
|
Tissue transglutaminase iga
|
$3.82 |
$3.82 |
$3.82 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$10.64 |
$10.64 |
$10.64 |
$120.60
|
|
Toe X-ray (both feet)
|
$183.02 |
$183.02 |
$183.02 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$47.91 |
$47.91 |
$47.91 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$41.01 |
$41.01 |
$41.01 |
$74.10
|
|
Total tau
|
$251.03 |
$251.03 |
$251.03 |
$312.50
|
|
Toxoplasma antibody igg
|
$11.47 |
$11.47 |
$11.47 |
$91.65
|
|
Toxoplasma antibody igm
|
$8.28 |
$8.28 |
$8.28 |
$87.75
|
|
Tp53 gene full gene sequence
|
$212.06 |
$212.06 |
$212.06 |
$706.04
|
|
Tpmt gene com vrnts
|
$24.12 |
$24.12 |
$24.12 |
$371.80
|
|
Transferrin
|
$24.41 |
$24.41 |
$24.41 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$788.14 |
$788.14 |
$788.14 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$663.32 |
$663.32 |
$663.32 |
$499.20
|
|
Treponema pallidum antibody
|
$33.76 |
$33.76 |
$33.76 |
$72.05
|
|
Trg gene rearrangement anal
|
$152.59 |
$152.59 |
$152.59 |
$455.70
|
|
Trichinella antibody
|
$12.10 |
$12.10 |
$12.10 |
$70.65
|
|
Triglycerides
|
$33.80 |
$33.80 |
$33.80 |
$58.50
|
|
Troponin quantitative
|
$86.39 |
$86.39 |
$86.39 |
$127.60
|
|
Ugt1a1 gene analy common variants
|
$87.52 |
$87.52 |
$87.52 |
$438.75
|