|
Scan duplex extracranial arteries unilateral/limited study
|
$786.16 |
$786.16 |
$786.16 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$2,153.57 |
$2,153.57 |
$2,153.57 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,777.48 |
$1,777.48 |
$1,777.48 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,179.65 |
$1,179.65 |
$1,179.65 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$790.90 |
$790.90 |
$790.90 |
$601.70
|
|
Sclerotherapy fluid collection pq w/img
|
$5,725.56 |
$5,725.56 |
$5,725.56 |
$2,114.45
|
|
Screening Mammogram
|
$366.29 |
$366.29 |
$366.29 |
$303.55
|
|
Screening pap smear by phys
|
$36.81 |
$36.81 |
$36.81 |
$40.59
|
|
Sedimentation rate erythrocyte automated
|
$218.74 |
$218.74 |
$218.74 |
$44.20
|
|
Set radiation therapy field
|
$1,437.02 |
$1,437.02 |
$1,437.02 |
$731.50
|
|
Set radiation therapy field
|
$2,605.19 |
$2,605.19 |
$2,605.19 |
$1,636.36
|
|
Shoulder MRI (with and without contrast)
|
$5,066.69 |
$5,066.69 |
$5,066.69 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$4,932.03 |
$4,932.03 |
$4,932.03 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$4,668.43 |
$4,668.43 |
$4,668.43 |
$2,051.28
|
|
Shoulder X-ray
|
$380.30 |
$380.30 |
$380.30 |
$367.02
|
|
Sickling rbc
|
$177.10 |
$177.10 |
$177.10 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$3,291.94 |
$3,291.94 |
$3,291.94 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,027.57 |
$3,027.57 |
$3,027.57 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$2,763.30 |
$2,763.30 |
$2,763.30 |
$1,279.50
|
|
Sleep Study (Polysomnography)
|
$9,172.69 |
$9,172.69 |
$9,172.69 |
$3,936.80
|
|
Sleep study unattended
|
$4,112.99 |
$4,112.99 |
$4,112.99 |
$595.50
|
|
Smear fluorescent and/or acid fast stain
|
$200.56 |
$200.56 |
$200.56 |
$64.20
|
|
Smear gram stain
|
$145.24 |
$145.24 |
$145.24 |
$57.85
|
|
Smear special stain inclusion bodies/parasites
|
$299.86 |
$299.86 |
$299.86 |
$64.35
|
|
Smear wet mount
|
$132.02 |
$132.02 |
$132.02 |
$68.63
|
|
Sodium 24 hour urine
|
$151.51 |
$151.51 |
$151.51 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$57.84 |
$57.84 |
$57.84 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$278.66 |
$278.66 |
$278.66 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$1,001.49 |
$1,001.49 |
$1,001.49 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$2,652.02 |
$2,652.02 |
$2,652.02 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$77.93 |
$77.93 |
$77.93 |
$42.70
|
|
Special physics consult
|
$1,055.88 |
$1,055.88 |
$1,055.88 |
$700.74
|
|
Special radiation dosimetry
|
$731.34 |
$731.34 |
$731.34 |
$445.50
|
|
Special radiation treatment
|
$5,476.66 |
$5,476.66 |
$5,476.66 |
$1,934.03
|
|
Special teletx port plan
|
$1,667.45 |
$1,667.45 |
$1,667.45 |
$1,046.65
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,201.78 |
$2,201.78 |
$2,201.78 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$704.00 |
$704.00 |
$704.00 |
$559.96
|
|
Srs multisource
|
$100,225.33 |
$100,225.33 |
$100,225.33 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$729.29 |
$729.29 |
$729.29 |
$300.00
|
|
Staph a dna amp probe
|
$438.63 |
$438.63 |
$438.63 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$624.71 |
$624.71 |
$624.71 |
$313.96
|
|
Stent iliac/open or perc/uni/init 37221
|
$13,568.93 |
$13,568.93 |
$13,568.93 |
$17,281.80
|
|
St evaluate speech sound production
|
$703.16 |
$703.16 |
$703.16 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$703.16 |
$703.16 |
$703.16 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$452.31 |
$452.31 |
$452.31 |
$406.40
|
|
St evaluation swallow function
|
$520.16 |
$520.16 |
$520.16 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$973.41 |
$973.41 |
$973.41 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$415.89 |
$415.89 |
$415.89 |
$171.00
|
|
Strapping of knee
|
$737.51 |
$737.51 |
$737.51 |
$224.80
|
|
Strapping of toes 29550
|
$540.66 |
$540.66 |
$540.66 |
$185.36
|
|
St treatment speech individual
|
$787.53 |
$787.53 |
$787.53 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$481.92 |
$481.92 |
$481.92 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$365.41 |
$365.41 |
$365.41 |
$49.13
|
|
Sugars single quant
|
$122.78 |
$122.78 |
$122.78 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$280.90 |
$280.90 |
$280.90 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$213.38 |
$213.38 |
$213.38 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$377.38 |
$377.38 |
$377.38 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$708.51 |
$708.51 |
$708.51 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$993.38 |
$993.38 |
$993.38 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,306.68 |
$1,306.68 |
$1,306.68 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,680.53 |
$1,680.53 |
$1,680.53 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,862.12 |
$1,862.12 |
$1,862.12 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$78.46 |
$78.46 |
$78.46 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$78.46 |
$78.46 |
$78.46 |
$34.48
|
|
Susceptibility mic per plate
|
$183.31 |
$183.31 |
$183.31 |
$94.38
|
|
Synvisc or synvisc-one
|
$3,186.63 |
$3,186.63 |
$3,186.63 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$238.82 |
$238.82 |
$238.82 |
$44.85
|
|
T3 (triiodothyronine) free
|
$122.29 |
$122.29 |
$122.29 |
$89.82
|
|
T3 (triiodothyronine) total
|
$84.70 |
$84.70 |
$84.70 |
$94.90
|
|
T4 (thyroxine) free
|
$256.58 |
$256.58 |
$256.58 |
$81.60
|
|
T4 (thyroxine) total
|
$148.16 |
$148.16 |
$148.16 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$142.57 |
$142.57 |
$142.57 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$9,046.12 |
$9,046.12 |
$9,046.12 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$3,930.35 |
$3,930.35 |
$3,930.35 |
$3,385.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$5,907.60 |
$5,907.60 |
$5,907.60 |
$959.55
|
|
Tbs techl calculation only
|
$224.73 |
$224.73 |
$224.73 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$662.66 |
$662.66 |
$662.66 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$509.68 |
$509.68 |
$509.68 |
$186.00
|
|
T cells absolute cd 4 count
|
$509.68 |
$509.68 |
$509.68 |
$120.25
|
|
T cells total count
|
$304.90 |
$304.90 |
$304.90 |
$124.11
|
|
Telethx isodose plan cplx
|
$5,400.81 |
$5,400.81 |
$5,400.81 |
$1,617.00
|
|
Telethx isodose plan simple
|
$511.67 |
$511.67 |
$511.67 |
$848.72
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$48.70 |
$48.70 |
$48.70 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$483.87 |
$483.87 |
$483.87 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$3,596.19 |
$3,596.19 |
$3,596.19 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$66,758.57 |
$66,758.57 |
$66,758.57 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$293.27 |
$293.27 |
$293.27 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$305.18 |
$305.18 |
$305.18 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,214.29 |
$3,214.29 |
$3,214.29 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$6,886.81 |
$6,886.81 |
$6,886.81 |
$3,580.00
|
|
Thrombin time
|
$90.14 |
$90.14 |
$90.14 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$408.45 |
$408.45 |
$408.45 |
$56.93
|
|
Thyroglobulin antibody
|
$198.88 |
$198.88 |
$198.88 |
$84.00
|
|
Thyroid mets imag whole body
|
$3,964.65 |
$3,964.65 |
$3,964.65 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$319.14 |
$319.14 |
$319.14 |
$120.00
|
|
Thyroid Ultrasound
|
$648.35 |
$648.35 |
$648.35 |
$589.96
|
|
Thyroid uptake measurement
|
$3,056.83 |
$3,056.83 |
$3,056.83 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$91.35 |
$91.35 |
$91.35 |
$63.60
|
|
Tissue culture skin/biopsy
|
$1,641.94 |
$1,641.94 |
$1,641.94 |
$558.87
|
|
Tissue culture tumor
|
$1,364.81 |
$1,364.81 |
$1,364.81 |
$529.23
|