|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$356.40
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$84.85 |
$84.85 |
$84.85 |
$141.00
|
|
Pretreat rbc absorption reference
|
$212.15 |
$212.15 |
$212.15 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$223.45 |
$223.45 |
$223.45 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$84.85 |
$84.85 |
$84.85 |
$106.00
|
|
Prgr stim/pace a/iv drug
|
$9,494.35 |
$9,494.35 |
$9,494.35 |
$4,889.30
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$52.50 |
$52.50 |
$52.50 |
$46.50
|
|
Prochlorperazine maleate 5 mg tablet
|
$4.25 |
$4.25 |
$4.25 |
$4.25
|
|
Promethazine 25 mg tablet
|
$45.25 |
$45.25 |
$45.25 |
$7.01
|
|
Promethazine hcl injection
|
$82.25 |
$82.25 |
$82.25 |
$33.34
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$35.25 |
$35.25 |
$35.25 |
$39.59
|
|
Protein s total
|
$12.70 |
$12.70 |
$12.70 |
$78.87
|
|
Protein total serum plasma whole blood
|
$972.70 |
$972.70 |
$972.70 |
$42.81
|
|
Prothrombin time substitution plasma fractions each
|
$47.70 |
$47.70 |
$47.70 |
$37.05
|
|
Pt application of modality traction mechanical
|
$787.95 |
$787.95 |
$787.95 |
$88.20
|
|
Pt evaluation high complexity patient/family
|
$1,580.25 |
$1,580.25 |
$1,580.25 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$1,128.70 |
$1,128.70 |
$1,128.70 |
$226.00
|
|
Pt evaluation moderate complexity patient/family
|
$1,355.20 |
$1,355.20 |
$1,355.20 |
$263.90
|
|
Pt re-evaluation patient/family
|
$1,128.70 |
$1,128.70 |
$1,128.70 |
$157.30
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$760.85 |
$760.85 |
$760.85 |
$85.68
|
|
Pulmonary vent imaging
|
$10,293.85 |
$10,293.85 |
$10,293.85 |
$845.28
|
|
Pyridoxine hcl 100 mg
|
$166.25 |
$166.25 |
$166.25 |
$43.24
|
|
Pyruvate
|
$10.40 |
$10.40 |
$10.40 |
$65.00
|
|
Pyruvate kinase
|
$42.85 |
$42.85 |
$42.85 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$23,902.80 |
$23,902.80 |
$23,902.80 |
$1,524.16
|
|
Quant diff pulm perf w/imaging
|
$23,086.85 |
$23,086.85 |
$23,086.85 |
$1,209.44
|
|
Rabies ig heat-treated human im/subq 90376
|
$3,255.00 |
$3,255.00 |
$3,255.00 |
$1,059.01
|
|
Rabies ig ht&sol human im/sc
|
$1,854.35 |
$1,854.35 |
$1,854.35 |
$5,401.91
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$2,325.00 |
$2,325.00 |
$2,325.00 |
$3,213.80
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$18,813.60 |
$18,813.60 |
$18,813.60 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$44,522.10 |
$44,522.10 |
$44,522.10 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$10,420.00 |
$10,420.00 |
$10,420.00 |
$2,377.65
|
|
Radphm lcl tumor plr sgl day
|
$4,993.25 |
$4,993.25 |
$4,993.25 |
$1,139.40
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$1,389.25 |
$1,389.25 |
$1,389.25 |
$656.83
|
|
Remdesivir 100 mg intravenous powder for solution
|
$2,095.50 |
$2,095.50 |
$2,095.50 |
$1,864.71
|
|
Renal function panel
|
$1,983.15 |
$1,983.15 |
$1,983.15 |
$110.10
|
|
#resp virpnl dfa-adenovirus
|
$31.80 |
$31.80 |
$31.80 |
$48.00
|
|
Reticulocyte automated
|
$745.45 |
$745.45 |
$745.45 |
$54.60
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$640.25 |
$640.25 |
$640.25 |
$255.26
|
|
Rho(d) immune globulin h, sd
|
$640.25 |
$640.25 |
$640.25 |
$2,034.31
|
|
Rho d immune globulin inj
|
$812.25 |
$812.25 |
$812.25 |
$334.53
|
|
Right ventric recording
|
$10,068.95 |
$10,068.95 |
$10,068.95 |
$1,980.36
|
|
Romiplostim 125 mcg subcutaneous solution
|
$3,028.25 |
$3,028.25 |
$3,028.25 |
$8,779.01
|
|
Rp loclzj tum 2+area 1+d img
|
$12,933.85 |
$12,933.85 |
$12,933.85 |
$1,458.95
|
|
Sarscov coronavirus ag ia
|
$53.15 |
$53.15 |
$53.15 |
$60.40
|
|
Screening Mammogram
|
$1,515.25 |
$1,515.25 |
$1,515.25 |
$303.55
|
|
Screening prostate cancer PSA
|
$1,201.10 |
$1,201.10 |
$1,201.10 |
$81.31
|
|
Sc ther infusion reset pump
|
$255.00 |
$255.00 |
$255.00 |
$126.75
|
|
Signal avg ecg w or without ecg 93278
|
$2,354.70 |
$2,354.70 |
$2,354.70 |
$309.52
|
|
Sincalide 5 mcg solution for injection
|
$431.00 |
$431.00 |
$431.00 |
$409.96
|
|
Sirolimus, oral
|
$69.25 |
$69.25 |
$69.25 |
$31.60
|
|
Smear nasal eosinophil
|
$827.95 |
$827.95 |
$827.95 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$1,076.20 |
$1,076.20 |
$1,076.20 |
$64.35
|
|
Sodium 24 hour urine
|
$677.50 |
$677.50 |
$677.50 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$15.50 |
$15.50 |
$15.50 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$102.00 |
$102.00 |
$102.00 |
$51.51
|
|
Sodium serum/plasma/whole blood
|
$677.50 |
$677.50 |
$677.50 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$660.00 |
$660.00 |
$660.00 |
$223.86
|
|
Specific gravity body fluid
|
$321.55 |
$321.55 |
$321.55 |
$23.63
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$3,967.55 |
$3,967.55 |
$3,967.55 |
$559.96
|
|
St analysis behavior qualitative voice/resonance
|
$806.85 |
$806.85 |
$806.85 |
$300.00
|
|
St evaluate speech sound production
|
$806.85 |
$806.85 |
$806.85 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$806.85 |
$806.85 |
$806.85 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$2,113.50 |
$2,113.50 |
$2,113.50 |
$406.40
|
|
St evaluation swallow function
|
$806.85 |
$806.85 |
$806.85 |
$336.60
|
|
Strep b assay w/optic
|
$753.85 |
$753.85 |
$753.85 |
$32.00
|
|
Streptomycin injection
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Stress tte complete
|
$1,914.20 |
$1,914.20 |
$1,914.20 |
$1,964.95
|
|
St treatment speech individual
|
$657.95 |
$657.95 |
$657.95 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$1,358.05 |
$1,358.05 |
$1,358.05 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$71.00 |
$71.00 |
$71.00 |
$49.13
|
|
Sugars single quant
|
$31.65 |
$31.65 |
$31.65 |
$52.47
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$320.75 |
$320.75 |
$320.75 |
$91.67
|
|
Support clav 29.6-40.5in med
|
$49.95 |
$49.95 |
$49.95 |
$68.54
|
|
Surgical pathology level 1 gross examination only
|
$900.15 |
$900.15 |
$900.15 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$1,408.05 |
$1,408.05 |
$1,408.05 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,603.95 |
$1,603.95 |
$1,603.95 |
$192.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,167.60 |
$2,167.60 |
$2,167.60 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$758.10 |
$758.10 |
$758.10 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$962.75 |
$962.75 |
$962.75 |
$34.48
|
|
Suscept studies macrobroth dilution ea
|
$496.45 |
$496.45 |
$496.45 |
$48.30
|
|
Sweat collection by iontophoresis
|
$993.70 |
$993.70 |
$993.70 |
$105.21
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$110.00 |
$110.00 |
$110.00 |
$612.11
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$58.35 |
$58.35 |
$58.35 |
$166.46
|
|
Tc-99m apcitide diag
|
$9,223.60 |
$9,223.60 |
$9,223.60 |
$1,765.30
|
|
Tc-99m disofenin
|
$1,033.30 |
$1,033.30 |
$1,033.30 |
$151.32
|
|
Tc-99m exametazime diag
|
$4,588.00 |
$4,588.00 |
$4,588.00 |
$2,166.26
|
|
Tc-99m maa
|
$936.05 |
$936.05 |
$936.05 |
$312.06
|
|
Tc-99m mebrofenin
|
$1,033.30 |
$1,033.30 |
$1,033.30 |
$169.53
|
|
Tc-99m medronate
|
$696.25 |
$696.25 |
$696.25 |
$122.46
|
|
Tc-99m mertiatide
|
$2,066.55 |
$2,066.55 |
$2,066.55 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$1,153.35 |
$1,153.35 |
$1,153.35 |
$245.85
|
|
Tc-99m pertechnetate per mci
|
$24.10 |
$24.10 |
$24.10 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$660.50 |
$660.50 |
$660.50 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$3,697.60 |
$3,697.60 |
$3,697.60 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$2,407.75 |
$2,407.75 |
$2,407.75 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$1,033.30 |
$1,033.30 |
$1,033.30 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$3,658.70 |
$3,658.70 |
$3,658.70 |
$198.05
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$15,600.75 |
$15,600.75 |
$15,600.75 |
$17,652.73
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$54.75 |
$54.75 |
$54.75 |
$44.49
|
