|
Smear gram stain
|
$183.60 |
$183.60 |
$183.60 |
$55.25
|
|
Smear nasal eosinophil
|
$147.60 |
$147.60 |
$147.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$149.04 |
$149.04 |
$149.04 |
$73.15
|
|
Smear wet mount
|
$203.76 |
$203.76 |
$203.76 |
$67.49
|
|
Sodium 24 hour urine
|
$146.16 |
$146.16 |
$146.16 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$70.56 |
$70.56 |
$70.56 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$90.72 |
$90.72 |
$90.72 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$66.24 |
$66.24 |
$66.24 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$3.45 |
$3.45 |
$3.45 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$42.07 |
$42.07 |
$42.07 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$59.04 |
$59.04 |
$59.04 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$3.82 |
$3.82 |
$3.82 |
$177.52
|
|
So gsap dna cpy nmbr&mcrstl
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$1,046.35
|
|
Somatosensory testing
|
$1,433.52 |
$1,433.52 |
$1,433.52 |
$816.00
|
|
Special physics consult
|
$876.24 |
$876.24 |
$876.24 |
$725.00
|
|
Special radiation treatment
|
$2,427.84 |
$2,427.84 |
$2,427.84 |
$1,986.00
|
|
Specific gravity body fluid
|
$62.64 |
$62.64 |
$62.64 |
$22.00
|
|
Speech audiometry complete
|
$128.16 |
$128.16 |
$128.16 |
$109.20
|
|
Speech recep thresh
|
$128.16 |
$128.16 |
$128.16 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,749.60 |
$1,749.60 |
$1,749.60 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$745.92 |
$745.92 |
$745.92 |
$543.26
|
|
Srs linear based
|
$18,288.72 |
$18,288.72 |
$18,288.72 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$546.48 |
$546.48 |
$546.48 |
$297.60
|
|
Staph a dna amp probe
|
$177.84 |
$177.84 |
$177.84 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$264.24 |
$264.24 |
$264.24 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$38,786.40 |
$38,786.40 |
$38,786.40 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$25,020.00 |
$25,020.00 |
$25,020.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$432.00 |
$432.00 |
$432.00 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$7,920.00 |
$7,920.00 |
$7,920.00 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$21,614.40 |
$21,614.40 |
$21,614.40 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$9,614.88 |
$9,614.88 |
$9,614.88 |
$9,008.54
|
|
Stent placemt retro carotid
|
$8,285.76 |
$8,285.76 |
$8,285.76 |
$5,328.00
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$38,786.40 |
$38,786.40 |
$38,786.40 |
$17,271.50
|
|
St evaluate speech sound production
|
$546.48 |
$546.48 |
$546.48 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$546.48 |
$546.48 |
$546.48 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$493.20 |
$493.20 |
$493.20 |
$399.60
|
|
St evaluation swallow function
|
$472.32 |
$472.32 |
$472.32 |
$314.40
|
|
Stimulants synthetic
|
$70.56 |
$70.56 |
$70.56 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$340.56 |
$340.56 |
$340.56 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$810.72 |
$810.72 |
$810.72 |
$154.70
|
|
Strapping of hand or finger
|
$457.92 |
$457.92 |
$457.92 |
$174.82
|
|
Strapping of knee
|
$397.44 |
$397.44 |
$397.44 |
$205.20
|
|
Strapping of toes 29550
|
$423.00 |
$423.00 |
$423.00 |
$164.70
|
|
Strep a ag ia
|
$192.96 |
$192.96 |
$192.96 |
$75.40
|
|
Strep a dna quant
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
Strep b dna amp probe
|
$252.00 |
$252.00 |
$252.00 |
$120.90
|
|
Stress test pulmonary
|
$278.64 |
$278.64 |
$278.64 |
$322.85
|
|
Stress tte complete
|
$2,482.56 |
$2,482.56 |
$2,482.56 |
$1,870.50
|
|
St treatment speech individual
|
$382.32 |
$382.32 |
$382.32 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$232.56 |
$232.56 |
$232.56 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$12.93 |
$12.93 |
$12.93 |
$52.31
|
|
Sugars single quant
|
$361.44 |
$361.44 |
$361.44 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$217.01 |
$217.01 |
$217.01 |
$7,345.98
|
|
Sulfonylurea screen qn-sendout
|
$166.32 |
$166.32 |
$166.32 |
$156.16
|
|
Surgical pathology level 1 gross examination only
|
$178.56 |
$178.56 |
$178.56 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$226.80 |
$226.80 |
$226.80 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$398.88 |
$398.88 |
$398.88 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,763.28 |
$1,763.28 |
$1,763.28 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$749.52 |
$749.52 |
$749.52 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,020.96 |
$1,020.96 |
$1,020.96 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$78.48 |
$78.48 |
$78.48 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$117.36 |
$117.36 |
$117.36 |
$35.70
|
|
Susceptibility mic per plate
|
$170.64 |
$170.64 |
$170.64 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$131.04 |
$131.04 |
$131.04 |
$59.28
|
|
Svc venogram s&i
|
$3,355.20 |
$3,355.20 |
$3,355.20 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$68.17 |
$68.17 |
$68.17 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$68.40 |
$68.40 |
$68.40 |
$41.60
|
|
System pacing micra av
|
$24,120.00 |
$24,120.00 |
$24,120.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$12,852.00 |
$12,852.00 |
$12,852.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$277.92 |
$277.92 |
$277.92 |
$99.20
|
|
T3 (triiodothyronine) total
|
$180.72 |
$180.72 |
$180.72 |
$93.52
|
|
T4 (thyroxine) free
|
$167.76 |
$167.76 |
$167.76 |
$85.20
|
|
T4 (thyroxine) total
|
$68.40 |
$68.40 |
$68.40 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$19.30 |
$19.30 |
$19.30 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$318.96 |
$318.96 |
$318.96 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$3,732.48 |
$3,732.48 |
$3,732.48 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$7,750.80 |
$7,750.80 |
$7,750.80 |
$3,746.70
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,072.51 |
$1,072.51 |
$1,072.51 |
$937.50
|
|
Tbp gene detc abnor alleles
|
$287.28 |
$287.28 |
$287.28 |
$225.42
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$270.72 |
$270.72 |
$270.72 |
$177.65
|
|
Tc-99m non-heu per study dose
|
$21.60 |
$21.60 |
$21.60 |
$6.60
|
|
T cells absolute cd4/cd8 including ratio
|
$176.40 |
$176.40 |
$176.40 |
$176.40
|
|
T cells total count
|
$105.12 |
$105.12 |
$105.12 |
$126.90
|
|
Teaec w/wo patch graft iliofemoral
|
$4,793.76 |
$4,793.76 |
$4,793.76 |
$5,163.60
|
|
Telehealth original site facility fee
|
$84.24 |
$84.24 |
$84.24 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,846.08 |
$1,846.08 |
$1,846.08 |
$1,526.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$286.75 |
$286.75 |
$286.75 |
$15,245.38
|
|
Tert gene targeted seq alys
|
$1,583.28 |
$1,583.28 |
$1,583.28 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$948.24 |
$948.24 |
$948.24 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,339.20 |
$1,339.20 |
$1,339.20 |
$949.70
|
|
Tetanus immune globulin inj
|
$1,578.42 |
$1,578.42 |
$1,578.42 |
$1,285.36
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$285.84 |
$285.84 |
$285.84 |
$108.00
|
|
Therapeutic procd strg endur
|
$52.56 |
$52.56 |
$52.56 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.24 |
$66.24 |
$66.24 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$61.92 |
$61.92 |
$61.92 |
$50.00
|
|
Ther/proph/diag inj ia
|
$455.04 |
$455.04 |
$455.04 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$66.10 |
$66.10 |
$66.10 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,473.20 |
$2,473.20 |
$2,473.20 |
$1,687.50
|
|
Thrombectmy crnry perq mechanical
|
$6,696.00 |
$6,696.00 |
$6,696.00 |
$3,580.00
|
