|
St evaluate speech sound production
|
$142.40 |
$142.40 |
$142.40 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$155.40 |
$155.40 |
$155.40 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$248.20 |
$248.20 |
$248.20 |
$399.60
|
|
St evaluation swallow function
|
$124.60 |
$124.60 |
$124.60 |
$314.40
|
|
Stimulants synthetic
|
$1.40 |
$1.40 |
$1.40 |
$80.08
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$310.20 |
$310.20 |
$310.20 |
$2,607.60
|
|
Strapping of ankle and/or ft 29540
|
$225.20 |
$225.20 |
$225.20 |
$223.45
|
|
Strapping of chest
|
$22.40 |
$22.40 |
$22.40 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$20.40 |
$20.40 |
$20.40 |
$154.70
|
|
Strapping of hand or finger
|
$20.80 |
$20.80 |
$20.80 |
$174.82
|
|
Strapping of hip
|
$24.60 |
$24.60 |
$24.60 |
$164.70
|
|
Strapping of knee
|
$261.20 |
$261.20 |
$261.20 |
$205.20
|
|
Strapping of toes 29550
|
$14.00 |
$14.00 |
$14.00 |
$164.70
|
|
Strep b dna amp probe
|
$117.40 |
$117.40 |
$117.40 |
$120.90
|
|
Stress test pulmonary
|
$122.40 |
$122.40 |
$122.40 |
$322.85
|
|
Stress tte complete
|
$722.00 |
$722.00 |
$722.00 |
$1,870.50
|
|
St treatment speech individual
|
$104.40 |
$104.40 |
$104.40 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$204.00 |
$204.00 |
$204.00 |
$240.31
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$186.80 |
$186.80 |
$186.80 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$58.40 |
$58.40 |
$58.40 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$56.20 |
$56.20 |
$56.20 |
$216.00
|
|
Subtalar arthro w/fb rmvl
|
$450.60 |
$450.60 |
$450.60 |
$3,839.54
|
|
Subtalar arthro w/fusion
|
$612.40 |
$612.40 |
$612.40 |
$14,241.77
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$2.41 |
$2.41 |
$2.41 |
$52.31
|
|
Sugars single quant
|
$23.38 |
$23.38 |
$23.38 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$25.60 |
$25.60 |
$25.60 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$97.00 |
$97.00 |
$97.00 |
$114.88
|
|
Sup of prep of antigen # of vials 95144
|
$8.60 |
$8.60 |
$8.60 |
$54.60
|
|
Support clav 29.6-40.5in med
|
$43.60 |
$43.60 |
$43.60 |
$94.19
|
|
Suprv interfacilty transport
|
$28.60 |
$28.60 |
$28.60 |
$139.20
|
|
Suprv interfac trnsport addl
|
$25.00 |
$25.00 |
$25.00 |
$120.80
|
|
Surg dx exam anorectal
|
$72.00 |
$72.00 |
$72.00 |
$3,245.23
|
|
Surg ect salp-oophorectomy 59120
|
$541.80 |
$541.80 |
$541.80 |
$1,632.60
|
|
Surg ect without salp-oophorectomy 59121
|
$541.60 |
$541.60 |
$541.60 |
$1,634.40
|
|
Surgical opening of stomach 43500
|
$529.60 |
$529.60 |
$529.60 |
$1,477.80
|
|
Surgical pathology level 1 gross examination only
|
$28.00 |
$28.00 |
$28.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$66.20 |
$66.20 |
$66.20 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$80.40 |
$80.40 |
$80.40 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$122.20 |
$122.20 |
$122.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$270.80 |
$270.80 |
$270.80 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$521.60 |
$521.60 |
$521.60 |
$718.00
|
|
Surgical repair stomach bleedin ulcer 43501
|
$897.40 |
$897.40 |
$897.40 |
$2,536.20
|
|
Surgical repair stomach gastric lac 43502
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
$2,864.40
|
|
Surgical revision intestine
|
$717.20 |
$717.20 |
$717.20 |
$2,607.20
|
|
Surg tx anal fistula 2nd stage 46285
|
$299.80 |
$299.80 |
$299.80 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$13.60 |
$13.60 |
$13.60 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$14.00 |
$14.00 |
$14.00 |
$35.70
|
|
Susceptibility mic per plate
|
$40.00 |
$40.00 |
$40.00 |
$106.00
|
|
Suspension of testis
|
$205.60 |
$205.60 |
$205.60 |
$4,061.71
|
|
Suspension of uterus 58400
|
$43.40 |
$43.40 |
$43.40 |
$1,136.00
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$701.00 |
$701.00 |
$701.00 |
$1,995.00
|
|
Suture bile duct injury 47900
|
$920.20 |
$920.20 |
$920.20 |
$3,036.66
|
|
Svc venogram s&i
|
$40.60 |
$40.60 |
$40.60 |
$1,934.62
|
|
Sympathectomy digital artery
|
$535.80 |
$535.80 |
$535.80 |
$2,310.83
|
|
Sympathectomy supfc palmar
|
$553.20 |
$553.20 |
$553.20 |
$3,880.00
|
|
Synvisc or synvisc-one
|
$406.80 |
$406.80 |
$406.80 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.96 |
$1.96 |
$1.96 |
$41.60
|
|
System pacing micra av
|
$2,613.60 |
$2,613.60 |
$2,613.60 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,472.80 |
$6,472.80 |
$6,472.80 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$42.80 |
$42.80 |
$42.80 |
$99.20
|
|
T3 (triiodothyronine) total
|
$36.40 |
$36.40 |
$36.40 |
$93.52
|
|
T4 (thyroxine) free
|
$45.80 |
$45.80 |
$45.80 |
$85.20
|
|
T4 (thyroxine) total
|
$25.60 |
$25.60 |
$25.60 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.36 |
$4.36 |
$4.36 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$2.44 |
$2.44 |
$2.44 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,720.95 |
$1,720.95 |
$1,720.95 |
$2,762.00
|
|
Tah w/mmk 58152
|
$837.20 |
$837.20 |
$837.20 |
$2,428.80
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$5,029.77 |
$5,029.77 |
$5,029.77 |
$2,369.70
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$4.00 |
$4.00 |
$4.00 |
$14.62
|
|
Tap block uni by cont infusion 64487
|
$40.00 |
$40.00 |
$40.00 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$490.00 |
$490.00 |
$490.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$493.00 |
$493.00 |
$493.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$620.00 |
$620.00 |
$620.00 |
$1,655.52
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$297.11 |
$297.11 |
$297.11 |
$937.50
|
|
Tbs dxa cal w/i&r fx risk
|
$33.20 |
$33.20 |
$33.20 |
$127.12
|
|
Tbs techl calculation only
|
$64.60 |
$64.60 |
$64.60 |
$153.60
|
|
Tbs techl prep&transmis data
|
$64.60 |
$64.60 |
$64.60 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$187.40 |
$187.40 |
$187.40 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$102.20 |
$102.20 |
$102.20 |
$177.65
|
|
Tc-99m depreotide
|
$654.80 |
$654.80 |
$654.80 |
$1,486.80
|
|
Tc-99m diag per dose
|
$617.80 |
$617.80 |
$617.80 |
$470.40
|
|
Tc-99m disofenin
|
$636.20 |
$636.20 |
$636.20 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$763.40 |
$763.40 |
$763.40 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$636.20 |
$636.20 |
$636.20 |
$2,033.20
|
|
Tc-99m gluceptate
|
$636.20 |
$636.20 |
$636.20 |
$31.35
|
|
Tc-99m labeled rbc
|
$645.60 |
$645.60 |
$645.60 |
$302.40
|
|
Tc-99m maa
|
$877.40 |
$877.40 |
$877.40 |
$292.80
|
|
Tc-99m mebrofenin
|
$93.80 |
$93.80 |
$93.80 |
$157.65
|
|
Tc-99m medronate
|
$636.20 |
$636.20 |
$636.20 |
$111.01
|
|
Tc-99m mertiatide
|
$842.00 |
$842.00 |
$842.00 |
$756.00
|
|
Tc-99m oxidronate
|
$93.80 |
$93.80 |
$93.80 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$842.00 |
$842.00 |
$842.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$804.00 |
$804.00 |
$804.00 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$71.00 |
$71.00 |
$71.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$701.60 |
$701.60 |
$701.60 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$112.40 |
$112.40 |
$112.40 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$636.20 |
$636.20 |
$636.20 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$783.00 |
$783.00 |
$783.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$154.20 |
$154.20 |
$154.20 |
$190.80
|
|
Tca peel dermal 15789
|
$382.60 |
$382.60 |
$382.60 |
$1,324.80
|
