|
Sulfonylurea screen qn-sendout
|
$109.65 |
$109.65 |
$109.65 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$30.80 |
$30.80 |
$30.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$48.66 |
$48.66 |
$48.66 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$66.53 |
$66.53 |
$66.53 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$66.53 |
$66.53 |
$66.53 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$442.29 |
$442.29 |
$442.29 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$994.22 |
$994.22 |
$994.22 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$170.34 |
$170.34 |
$170.34 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$37.41 |
$37.41 |
$37.41 |
$35.89
|
|
Susceptibility mic per plate
|
$176.20 |
$176.20 |
$176.20 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$38.74 |
$38.74 |
$38.74 |
$59.28
|
|
Swallowing Evaluation (Bedside)
|
$132.34 |
$132.34 |
$132.34 |
$316.80
|
|
Swallowing Therapy Session
|
$126.10 |
$126.10 |
$126.10 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$38.43 |
$38.43 |
$38.43 |
$42.24
|
|
System pacing micra av
|
$24,502.41 |
$24,502.41 |
$24,502.41 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$76,564.10 |
$76,564.10 |
$76,564.10 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$43.74 |
$43.74 |
$43.74 |
$100.32
|
|
T3 (triiodothyronine) total
|
$26.49 |
$26.49 |
$26.49 |
$93.52
|
|
T4 (thyroxine) free
|
$40.66 |
$40.66 |
$40.66 |
$89.60
|
|
T4 (thyroxine) total
|
$34.50 |
$34.50 |
$34.50 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$39.42 |
$39.42 |
$39.42 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$211.15 |
$211.15 |
$211.15 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$1,513.64 |
$1,513.64 |
$1,513.64 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$5,535.69 |
$5,535.69 |
$5,535.69 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$221.70 |
$221.70 |
$221.70 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$137.45 |
$137.45 |
$137.45 |
$179.95
|
|
Tc-99m labeled rbc
|
$82.15 |
$82.15 |
$82.15 |
$306.00
|
|
Tc-99m maa
|
$49.64 |
$49.64 |
$49.64 |
$312.06
|
|
Tc-99m mebrofenin
|
$72.10 |
$72.10 |
$72.10 |
$157.65
|
|
Tc-99m medronate
|
$209.39 |
$209.39 |
$209.39 |
$111.01
|
|
Tc-99m mertiatide
|
$219.85 |
$219.85 |
$219.85 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$72.10 |
$72.10 |
$72.10 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$337.46 |
$337.46 |
$337.46 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$4.14 |
$4.14 |
$4.14 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$164.24 |
$164.24 |
$164.24 |
$287.20
|
|
Tc-99m sulfur colloid
|
$82.15 |
$82.15 |
$82.15 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$104.20 |
$104.20 |
$104.20 |
$184.00
|
|
T cells absolute cd 4 count
|
$82.03 |
$82.03 |
$82.03 |
$111.20
|
|
T cells total count
|
$84.25 |
$84.25 |
$84.25 |
$130.20
|
|
Testicular imaging w/vasc flow
|
$533.60 |
$533.60 |
$533.60 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,028.53 |
$1,028.53 |
$1,028.53 |
$953.40
|
|
Theophylline therapeutic drug level
|
$26.49 |
$26.49 |
$26.49 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$66.02 |
$66.02 |
$66.02 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$88.26 |
$88.26 |
$88.26 |
$98.58
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$183.26 |
$183.26 |
$183.26 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,235.79 |
$1,235.79 |
$1,235.79 |
$1,724.25
|
|
Thoracotomy w/expl
|
$849.57 |
$849.57 |
$849.57 |
$2,045.17
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,608.34 |
$1,608.34 |
$1,608.34 |
$1,703.45
|
|
Thrombin time
|
$34.89 |
$34.89 |
$34.89 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$64.17 |
$64.17 |
$64.17 |
$62.01
|
|
Thyroglobulin antibody
|
$70.94 |
$70.94 |
$70.94 |
$82.50
|
|
Thyroid imaging
|
$563.76 |
$563.76 |
$563.76 |
$695.60
|
|
Thyroid (TSH) Test
|
$68.38 |
$68.38 |
$68.38 |
$112.70
|
|
Thyroid Ultrasound
|
$725.25 |
$725.25 |
$725.25 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$27.72 |
$27.72 |
$27.72 |
$64.51
|
|
Tissue culture skin/biopsy
|
$275.80 |
$275.80 |
$275.80 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$143.62 |
$143.62 |
$143.62 |
$47.40
|
|
Tissue transglutaminase iga
|
$43.60 |
$43.60 |
$43.60 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$30.18 |
$30.18 |
$30.18 |
$120.60
|
|
Toe X-ray (both feet)
|
$170.65 |
$170.65 |
$170.65 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$43.74 |
$43.74 |
$43.74 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$39.98 |
$39.98 |
$39.98 |
$74.10
|
|
Total tau
|
$277.82 |
$277.82 |
$277.82 |
$312.50
|
|
Toxoplasma antibody igg
|
$46.56 |
$46.56 |
$46.56 |
$91.65
|
|
Toxoplasma antibody igm
|
$44.34 |
$44.34 |
$44.34 |
$87.75
|
|
Tpmt gene com vrnts
|
$331.80 |
$331.80 |
$331.80 |
$371.80
|
|
Transferrin
|
$24.02 |
$24.02 |
$24.02 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$636.44 |
$636.44 |
$636.44 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$536.73 |
$536.73 |
$536.73 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,772.29 |
$2,772.29 |
$2,772.29 |
$4,523.04
|
|
Treat elbow dislocation
|
$742.93 |
$742.93 |
$742.93 |
$2,272.50
|
|
Treat finger fracture each
|
$350.09 |
$350.09 |
$350.09 |
$1,592.00
|
|
Treat foot dislocation
|
$192.65 |
$192.65 |
$192.65 |
$445.80
|
|
Treat fracture of radius
|
$719.79 |
$719.79 |
$719.79 |
$1,790.00
|
|
Treat hip dislocation
|
$1,188.59 |
$1,188.59 |
$1,188.59 |
$2,211.05
|
|
Treat hip socket fracture
|
$1,532.14 |
$1,532.14 |
$1,532.14 |
$1,392.00
|
|
Treat humerus fracture
|
$890.31 |
$890.31 |
$890.31 |
$1,790.00
|
|
Treat knee dislocation
|
$987.89 |
$987.89 |
$987.89 |
$2,220.89
|
|
Treat knee fracture 27530
|
$444.15 |
$444.15 |
$444.15 |
$550.73
|
|
Treatment incomplete abortion completed surgically any trimester
|
$319.41 |
$319.41 |
$319.41 |
$3,928.20
|
|
Treatment of ankle fracture 27786
|
$449.68 |
$449.68 |
$449.68 |
$523.20
|
|
Treatment of fibula fracture 27780
|
$440.12 |
$440.12 |
$440.12 |
$501.20
|
|
Treatment of heel fracture 28400
|
$357.13 |
$357.13 |
$357.13 |
$473.00
|
|
Treatment of thigh fracture
|
$1,069.88 |
$1,069.88 |
$1,069.88 |
$1,790.00
|
|
Treat midfoot fracture each
|
$269.10 |
$269.10 |
$269.10 |
$1,884.74
|
|
Treat thigh fracture
|
$745.45 |
$745.45 |
$745.45 |
$661.00
|
|
Treat thigh fx growth plate
|
$753.49 |
$753.49 |
$753.49 |
$478.40
|
|
Treat ulnar fracture
|
$653.40 |
$653.40 |
$653.40 |
$1,677.20
|
|
Treponema pallidum antibody
|
$54.69 |
$54.69 |
$54.69 |
$72.05
|
|
Trg gene rearrangement anal
|
$382.36 |
$382.36 |
$382.36 |
$455.70
|
|
Trichinella antibody
|
$50.99 |
$50.99 |
$50.99 |
$70.65
|
|
Triglycerides
|
$33.26 |
$33.26 |
$33.26 |
$58.50
|
|
Troponin quantitative
|
$85.01 |
$85.01 |
$85.01 |
$127.60
|
|
Tte w or without fol w/cont, com
|
$841.43 |
$841.43 |
$841.43 |
$1,220.31
|
|
Tte w or without fol w/cont, f/u
|
$648.32 |
$648.32 |
$648.32 |
$1,178.00
|
|
Tx closed hip disl traumatic without anes
|
$290.73 |
$290.73 |
$290.73 |
$586.40
|
|
Tx closed tib shaft fx without manip
|
$499.98 |
$499.98 |
$499.98 |
$535.60
|
|
Tx tarsal bone fx without manip 28450
|
$198.68 |
$198.68 |
$198.68 |
$419.04
|
|
Ugt1a1 gene analy common variants
|
$443.66 |
$443.66 |
$443.66 |
$438.75
|
|
Ultrasound breast complete
|
$827.30 |
$827.30 |
$827.30 |
$532.00
|