|
Sincalide 5 mcg solution for injection
|
$169.20 |
$169.20 |
$169.20 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$2,734.20 |
$2,734.20 |
$2,734.20 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$2,757.00 |
$2,757.00 |
$2,757.00 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,613.60 |
$2,613.60 |
$2,613.60 |
$1,292.04
|
|
Skin Biopsy
|
$311.40 |
$311.40 |
$311.40 |
$360.34
|
|
Sleep Study (Polysomnography)
|
$5,097.60 |
$5,097.60 |
$5,097.60 |
$3,607.50
|
|
Sleep study unattended
|
$777.60 |
$777.60 |
$777.60 |
$580.87
|
|
Sling pelv split sam med
|
$307.80 |
$307.80 |
$307.80 |
$150.00
|
|
Slp ther svc non-spch gen
|
$330.00 |
$330.00 |
$330.00 |
$188.50
|
|
Smear fluorescent and/or acid fast stain
|
$66.60 |
$66.60 |
$66.60 |
$64.20
|
|
Smear gram stain
|
$82.20 |
$82.20 |
$82.20 |
$55.25
|
|
Smear nasal eosinophil
|
$72.60 |
$72.60 |
$72.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$75.60 |
$75.60 |
$75.60 |
$73.15
|
|
Smear wet mount
|
$90.00 |
$90.00 |
$90.00 |
$67.49
|
|
Snrpn/ube3a gene
|
$1,055.40 |
$1,055.40 |
$1,055.40 |
$231.85
|
|
Sodium 24 hour urine
|
$54.60 |
$54.60 |
$54.60 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$52.80 |
$52.80 |
$52.80 |
$45.60
|
|
So neo gsap dna mcrstl ins
|
$8,194.80 |
$8,194.80 |
$8,194.80 |
$2,296.00
|
|
Special physics consult
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$725.00
|
|
Special radiation dosimetry
|
$239.40 |
$239.40 |
$239.40 |
$392.50
|
|
Special radiation treatment
|
$2,509.80 |
$2,509.80 |
$2,509.80 |
$1,986.00
|
|
Special teletx port plan
|
$1,285.80 |
$1,285.80 |
$1,285.80 |
$1,086.99
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,962.60 |
$1,962.60 |
$1,962.60 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$543.26
|
|
Splint extn xsm w sof-stretch rolyan
|
$85.20 |
$85.20 |
$85.20 |
$68.25
|
|
Splint func pos polyflex ii med
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$585.60 |
$585.60 |
$585.60 |
$99.04
|
|
Srs linear based
|
$17,185.80 |
$17,185.80 |
$17,185.80 |
$13,585.00
|
|
Srs multisource
|
$35,698.20 |
$35,698.20 |
$35,698.20 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$358.20 |
$358.20 |
$358.20 |
$297.60
|
|
Staph a dna amp probe
|
$173.40 |
$173.40 |
$173.40 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$280.20 |
$280.20 |
$280.20 |
$286.00
|
|
St evaluate speech sound production
|
$293.40 |
$293.40 |
$293.40 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$406.20 |
$406.20 |
$406.20 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$410.40 |
$410.40 |
$410.40 |
$399.60
|
|
St evaluation swallow function
|
$309.60 |
$309.60 |
$309.60 |
$314.40
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$4,589.40 |
$4,589.40 |
$4,589.40 |
$2,607.60
|
|
Stress test pulmonary
|
$349.20 |
$349.20 |
$349.20 |
$322.85
|
|
Stress tte complete
|
$2,067.60 |
$2,067.60 |
$2,067.60 |
$1,870.50
|
|
Str markers spec anal addl
|
$406.20 |
$406.20 |
$406.20 |
$479.17
|
|
Str markers specimen anal
|
$913.20 |
$913.20 |
$913.20 |
$751.50
|
|
St treatment speech individual
|
$256.80 |
$256.80 |
$256.80 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$216.00 |
$216.00 |
$216.00 |
$240.31
|
|
Sugars single quant
|
$271.20 |
$271.20 |
$271.20 |
$64.28
|
|
Support clav 29.6-40.5in med
|
$169.20 |
$169.20 |
$169.20 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$103.20 |
$103.20 |
$103.20 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$161.40 |
$161.40 |
$161.40 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$214.20 |
$214.20 |
$214.20 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$288.60 |
$288.60 |
$288.60 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$411.60 |
$411.60 |
$411.60 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$537.60 |
$537.60 |
$537.60 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$63.00 |
$63.00 |
$63.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$70.20 |
$70.20 |
$70.20 |
$35.70
|
|
Susceptibility mic per plate
|
$70.80 |
$70.80 |
$70.80 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$71.40 |
$71.40 |
$71.40 |
$41.60
|
|
T3 (triiodothyronine) free
|
$165.00 |
$165.00 |
$165.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$162.60 |
$162.60 |
$162.60 |
$93.52
|
|
T4 (thyroxine) free
|
$117.00 |
$117.00 |
$117.00 |
$85.20
|
|
T4 (thyroxine) total
|
$94.20 |
$94.20 |
$94.20 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$202.80 |
$202.80 |
$202.80 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$4,873.20 |
$4,873.20 |
$4,873.20 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,592.80 |
$3,592.80 |
$3,592.80 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,790.00 |
$2,790.00 |
$2,790.00 |
$1,655.52
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$314.40 |
$314.40 |
$314.40 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$465.60 |
$465.60 |
$465.60 |
$176.40
|
|
T cells absolute cd 4 count
|
$120.00 |
$120.00 |
$120.00 |
$111.20
|
|
T cells total count
|
$486.00 |
$486.00 |
$486.00 |
$126.90
|
|
Telehealth original site facility fee
|
$49.80 |
$49.80 |
$49.80 |
$51.00
|
|
Telethx isodose plan cplx
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,689.00 |
$1,689.00 |
$1,689.00 |
$873.62
|
|
Tert gene targeted seq alys
|
$2,452.80 |
$2,452.80 |
$2,452.80 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$602.40 |
$602.40 |
$602.40 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$2,060.40 |
$2,060.40 |
$2,060.40 |
$949.70
|
|
Tgsap so/hl 51/< rna alys
|
$7,031.40 |
$7,031.40 |
$7,031.40 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$189.60 |
$189.60 |
$189.60 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.60 |
$66.60 |
$66.60 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$66.60 |
$66.60 |
$66.60 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$803.40 |
$803.40 |
$803.40 |
$529.08
|
|
Ther/proph/diag inj ia
|
$190.20 |
$190.20 |
$190.20 |
$240.35
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,823.60 |
$2,823.60 |
$2,823.60 |
$1,687.50
|
|
Thrombectmy crnry perq mechanical
|
$4,772.40 |
$4,772.40 |
$4,772.40 |
$3,580.00
|
|
Thrombin time
|
$102.60 |
$102.60 |
$102.60 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$168.60 |
$168.60 |
$168.60 |
$61.52
|
|
Thyroglobulin antibody
|
$173.40 |
$173.40 |
$173.40 |
$82.00
|
|
Thyroid imaging
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$695.02
|
|
Thyroid mets imag whole body
|
$2,402.40 |
$2,402.40 |
$2,402.40 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$165.00 |
$165.00 |
$165.00 |
$111.00
|
|
Thyroid Ultrasound
|
$720.00 |
$720.00 |
$720.00 |
$588.50
|
|
Thyroid uptake measurement
|
$424.80 |
$424.80 |
$424.80 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$124.20 |
$124.20 |
$124.20 |
$64.35
|
|
Tissue culture placenta
|
$1,295.40 |
$1,295.40 |
$1,295.40 |
$457.00
|
|
Tissue culture skin/biopsy
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$484.00
|
|
Tissue culture tumor
|
$3,722.40 |
$3,722.40 |
$3,722.40 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$47.40 |
$47.40 |
$47.40 |
$47.20
|
|
Tixagev and cilgav inj
|
$96.00 |
$96.00 |
$96.00 |
$224.55
|
|
Tobramycin peak therapeutic drug level
|
$147.60 |
$147.60 |
$147.60 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$27.60 |
$27.60 |
$27.60 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$37.20 |
$37.20 |
$37.20 |
$72.68
|
|
Total tau
|
$333.00 |
$333.00 |
$333.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$140.40 |
$140.40 |
$140.40 |
$89.40
|
