|
Stereotactic radiation trmt
|
$458.19 |
$458.19 |
$458.19 |
$845.60
|
|
Sterile water/saline, 10 ml
|
$30.37 |
$30.37 |
$30.37 |
$13.32
|
|
Sternal debridement
|
$511.92 |
$511.92 |
$511.92 |
$1,318.40
|
|
St evaluate speech sound production
|
$182.79 |
$182.79 |
$182.79 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$225.99 |
$225.99 |
$225.99 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$216.81 |
$216.81 |
$216.81 |
$399.60
|
|
St evaluation swallow function
|
$156.33 |
$156.33 |
$156.33 |
$314.40
|
|
Stimulants synthetic
|
$40.50 |
$40.50 |
$40.50 |
$80.08
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$418.77 |
$418.77 |
$418.77 |
$2,607.60
|
|
Strapping of ankle and/or ft 29540
|
$27.00 |
$27.00 |
$27.00 |
$223.45
|
|
Strapping of chest
|
$30.24 |
$30.24 |
$30.24 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$27.81 |
$27.81 |
$27.81 |
$154.70
|
|
Strapping of hand or finger
|
$28.08 |
$28.08 |
$28.08 |
$174.82
|
|
Strapping of hip
|
$33.21 |
$33.21 |
$33.21 |
$164.70
|
|
Strapping of knee
|
$28.08 |
$28.08 |
$28.08 |
$205.20
|
|
Strapping of toes 29550
|
$18.90 |
$18.90 |
$18.90 |
$164.70
|
|
Strep b dna amp probe
|
$8.24 |
$8.24 |
$8.24 |
$120.90
|
|
Stress test pulmonary
|
$23.49 |
$23.49 |
$23.49 |
$322.85
|
|
Stress tte complete
|
$86.67 |
$86.67 |
$86.67 |
$1,870.50
|
|
Str markers specimen anal
|
$68.18 |
$68.18 |
$68.18 |
$751.50
|
|
St treatment speech individual
|
$139.59 |
$139.59 |
$139.59 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$135.00 |
$135.00 |
$135.00 |
$240.31
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$252.18 |
$252.18 |
$252.18 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$78.84 |
$78.84 |
$78.84 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$75.87 |
$75.87 |
$75.87 |
$216.00
|
|
Subtalar arthro w/fb rmvl
|
$608.31 |
$608.31 |
$608.31 |
$3,839.54
|
|
Subtalar arthro w/fusion
|
$826.74 |
$826.74 |
$826.74 |
$14,241.77
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$10.35 |
$10.35 |
$10.35 |
$52.31
|
|
Sugars single quant
|
$2.76 |
$2.76 |
$2.76 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$33.91 |
$33.91 |
$33.91 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$58.05 |
$58.05 |
$58.05 |
$114.88
|
|
Sup of prep of antigen # of vials 95144
|
$11.61 |
$11.61 |
$11.61 |
$54.60
|
|
Support clav 29.6-40.5in med
|
$58.86 |
$58.86 |
$58.86 |
$94.19
|
|
Suprv interfacilty transport
|
$38.61 |
$38.61 |
$38.61 |
$139.20
|
|
Suprv interfac trnsport addl
|
$33.75 |
$33.75 |
$33.75 |
$120.80
|
|
Surg dx exam anorectal
|
$97.20 |
$97.20 |
$97.20 |
$3,245.23
|
|
Surg ect salp-oophorectomy 59120
|
$731.43 |
$731.43 |
$731.43 |
$1,632.60
|
|
Surg ect without salp-oophorectomy 59121
|
$731.16 |
$731.16 |
$731.16 |
$1,634.40
|
|
Surgical opening of stomach 43500
|
$714.96 |
$714.96 |
$714.96 |
$1,477.80
|
|
Surgical pathology level 1 gross examination only
|
$7.83 |
$7.83 |
$7.83 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$11.61 |
$11.61 |
$11.61 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$15.93 |
$15.93 |
$15.93 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$27.00 |
$27.00 |
$27.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$106.92 |
$106.92 |
$106.92 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$227.88 |
$227.88 |
$227.88 |
$718.00
|
|
Surgical repair stomach bleedin ulcer 43501
|
$1,211.49 |
$1,211.49 |
$1,211.49 |
$2,536.20
|
|
Surgical repair stomach gastric lac 43502
|
$1,368.36 |
$1,368.36 |
$1,368.36 |
$2,864.40
|
|
Surgical revision intestine
|
$968.22 |
$968.22 |
$968.22 |
$2,607.20
|
|
Surg tx anal fistula 2nd stage 46285
|
$404.73 |
$404.73 |
$404.73 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$1.28 |
$1.28 |
$1.28 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$4.05 |
$4.05 |
$4.05 |
$35.70
|
|
Susceptibility mic per plate
|
$81.81 |
$81.81 |
$81.81 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$6.05 |
$6.05 |
$6.05 |
$59.28
|
|
Suspension of testis
|
$277.56 |
$277.56 |
$277.56 |
$4,061.71
|
|
Suspension of uterus 58400
|
$58.59 |
$58.59 |
$58.59 |
$1,136.00
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$946.35 |
$946.35 |
$946.35 |
$1,995.00
|
|
Suture bile duct injury 47900
|
$1,242.27 |
$1,242.27 |
$1,242.27 |
$3,036.66
|
|
Svc venogram s&i
|
$54.81 |
$54.81 |
$54.81 |
$1,934.62
|
|
Sympathectomy digital artery
|
$723.33 |
$723.33 |
$723.33 |
$2,310.83
|
|
Sympathectomy supfc palmar
|
$746.82 |
$746.82 |
$746.82 |
$3,880.00
|
|
Synvisc or synvisc-one
|
$297.81 |
$297.81 |
$297.81 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$5.13 |
$5.13 |
$5.13 |
$41.60
|
|
T3 (triiodothyronine) free
|
$63.72 |
$63.72 |
$63.72 |
$99.20
|
|
T3 (triiodothyronine) total
|
$23.76 |
$23.76 |
$23.76 |
$93.52
|
|
T4 (thyroxine) free
|
$70.74 |
$70.74 |
$70.74 |
$85.20
|
|
T4 (thyroxine) total
|
$59.94 |
$59.94 |
$59.94 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$3.30 |
$3.30 |
$3.30 |
$122.40
|
|
Tah w/mmk 58152
|
$1,130.22 |
$1,130.22 |
$1,130.22 |
$2,428.80
|
|
Tap block uni by cont infusion 64487
|
$54.00 |
$54.00 |
$54.00 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$661.50 |
$661.50 |
$661.50 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$788.29 |
$788.29 |
$788.29 |
$3,746.70
|
|
Target gsa panel organ neop
|
$631.80 |
$631.80 |
$631.80 |
$1,655.52
|
|
Tbs dxa cal w/i&r fx risk
|
$44.82 |
$44.82 |
$44.82 |
$127.12
|
|
Tbs techl prep&transmis data
|
$71.55 |
$71.55 |
$71.55 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$96.39 |
$96.39 |
$96.39 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$22.41 |
$22.41 |
$22.41 |
$177.65
|
|
Tca peel dermal 15789
|
$516.51 |
$516.51 |
$516.51 |
$1,324.80
|
|
T cells absolute cd4/cd8 including ratio
|
$11.22 |
$11.22 |
$11.22 |
$176.40
|
|
T cells absolute cd 4 count
|
$6.43 |
$6.43 |
$6.43 |
$111.20
|
|
T cells total count
|
$9.11 |
$9.11 |
$9.11 |
$126.90
|
|
Tcranial magn stim tx deli
|
$155.52 |
$155.52 |
$155.52 |
$389.22
|
|
Tcranial magn stim tx plan
|
$219.24 |
$219.24 |
$219.24 |
$437.22
|
|
Tcran magn stim redetemine
|
$179.01 |
$179.01 |
$179.01 |
$457.60
|
|
Teaec w/wo patch graft iliofemoral
|
$879.66 |
$879.66 |
$879.66 |
$5,163.60
|
|
Telehealth original site facility fee
|
$21.06 |
$21.06 |
$21.06 |
$51.00
|
|
Telethx isodose plan cplx
|
$166.05 |
$166.05 |
$166.05 |
$1,526.85
|
|
Telethx isodose plan simple
|
$79.92 |
$79.92 |
$79.92 |
$873.62
|
|
Tendon lngth upr a/e ea tdn
|
$556.47 |
$556.47 |
$556.47 |
$3,545.97
|
|
Tendon transfer with graft
|
$883.17 |
$883.17 |
$883.17 |
$3,786.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$11,694.16 |
$11,694.16 |
$11,694.16 |
$15,245.38
|
|
Tenodesis biceps tdn at elbw
|
$578.61 |
$578.61 |
$578.61 |
$5,886.74
|
|
Tenolysis extensor tendon hand/finger each
|
$585.90 |
$585.90 |
$585.90 |
$2,811.20
|
|
Tenosynovectomy radic 26145
|
$498.96 |
$498.96 |
$498.96 |
$1,893.86
|
|
Tenotomy hip flexor open
|
$682.83 |
$682.83 |
$682.83 |
$2,618.20
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$361.53 |
$361.53 |
$361.53 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$15.81 |
$15.81 |
$15.81 |
$39.33
|
|
Test for chlorohydrocarbons
|
$31.59 |
$31.59 |
$31.59 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$35.91 |
$35.91 |
$35.91 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$434.70 |
$434.70 |
$434.70 |
$949.70
|
|
Theophylline therapeutic drug level
|
$44.01 |
$44.01 |
$44.01 |
$108.00
|
