|
Special teletx port plan
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$1,095.05
|
|
Specimen fat stain
|
$40.00 |
$40.00 |
$40.00 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$300.00 |
$300.00 |
$300.00 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$185.00 |
$185.00 |
$185.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$615.00 |
$615.00 |
$615.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$137.50 |
$137.50 |
$137.50 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$365.00 |
$365.00 |
$365.00 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$52.50 |
$52.50 |
$52.50 |
$71.44
|
|
Splint finger frog med
|
$35.00 |
$35.00 |
$35.00 |
$38.08
|
|
Split blood or products
|
$202.50 |
$202.50 |
$202.50 |
$127.80
|
|
Srs linear based
|
$16,170.00 |
$16,170.00 |
$16,170.00 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$300.00 |
$300.00 |
$300.00 |
$297.60
|
|
Staph a dna amp probe
|
$157.50 |
$157.50 |
$157.50 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$330.00 |
$330.00 |
$330.00 |
$286.00
|
|
Stem cells total count
|
$212.50 |
$212.50 |
$212.50 |
$194.25
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$16,680.00 |
$16,680.00 |
$16,680.00 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$7,042.64 |
$7,042.64 |
$7,042.64 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$422.08 |
$422.08 |
$422.08 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$3,356.25 |
$3,356.25 |
$3,356.25 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$11,100.00 |
$11,100.00 |
$11,100.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$5,885.00 |
$5,885.00 |
$5,885.00 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$9,820.00 |
$9,820.00 |
$9,820.00 |
$16,098.16
|
|
St evaluate speech sound production
|
$300.00 |
$300.00 |
$300.00 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$307.50 |
$307.50 |
$307.50 |
$400.00
|
|
Stimulants synthetic
|
$122.50 |
$122.50 |
$122.50 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$1,345.40
|
|
Strep a ag ia
|
$20.00 |
$20.00 |
$20.00 |
$75.40
|
|
Strep b dna amp probe
|
$172.50 |
$172.50 |
$172.50 |
$124.15
|
|
Stress test pulmonary
|
$247.50 |
$247.50 |
$247.50 |
$324.00
|
|
Stress tte complete
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$1,900.96
|
|
Str markers specimen anal
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$756.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$14.86 |
$14.86 |
$14.86 |
$54.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$4,222.93 |
$4,222.93 |
$4,222.93 |
$7,487.55
|
|
Sulfonylurea screen qn-sendout
|
$230.00 |
$230.00 |
$230.00 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$117.50 |
$117.50 |
$117.50 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$137.50 |
$137.50 |
$137.50 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$187.50 |
$187.50 |
$187.50 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$237.50 |
$237.50 |
$237.50 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$300.00 |
$300.00 |
$300.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$430.00 |
$430.00 |
$430.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$25.00 |
$25.00 |
$25.00 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$27.50 |
$27.50 |
$27.50 |
$35.89
|
|
Susceptibility mic per plate
|
$60.00 |
$60.00 |
$60.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$75.00 |
$75.00 |
$75.00 |
$59.28
|
|
Svc venogram s&i
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$200.00 |
$200.00 |
$200.00 |
$316.80
|
|
Swallowing Therapy Session
|
$150.00 |
$150.00 |
$150.00 |
$232.56
|
|
Sweat collection by iontophoresis
|
$177.50 |
$177.50 |
$177.50 |
$123.78
|
|
Synvisc or synvisc-one
|
$28.75 |
$28.75 |
$28.75 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$37.50 |
$37.50 |
$37.50 |
$42.24
|
|
System cardiomems hosp electronics
|
$25,756.75 |
$25,756.75 |
$25,756.75 |
$38,234.70
|
|
System pacing micra av
|
$9,415.00 |
$9,415.00 |
$9,415.00 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$4,649.80 |
$4,649.80 |
$4,649.80 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$82.50 |
$82.50 |
$82.50 |
$100.32
|
|
T3 (triiodothyronine) total
|
$62.50 |
$62.50 |
$62.50 |
$93.52
|
|
T4 (thyroxine) free
|
$65.00 |
$65.00 |
$65.00 |
$89.60
|
|
T4 (thyroxine) total
|
$85.00 |
$85.00 |
$85.00 |
$70.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$35.96 |
$35.96 |
$35.96 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$122.50 |
$122.50 |
$122.50 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$237.50 |
$237.50 |
$237.50 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,320.00 |
$2,320.00 |
$2,320.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,385.00 |
$3,385.00 |
$3,385.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,270.00 |
$2,270.00 |
$2,270.00 |
$1,701.91
|
|
Tavr perq femoral
|
$14,800.00 |
$14,800.00 |
$14,800.00 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$290.00 |
$290.00 |
$290.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$247.50 |
$247.50 |
$247.50 |
$179.95
|
|
Tc-99m maa
|
$417.50 |
$417.50 |
$417.50 |
$312.06
|
|
Tc-99m mebrofenin
|
$195.00 |
$195.00 |
$195.00 |
$157.65
|
|
Tc-99m medronate
|
$65.00 |
$65.00 |
$65.00 |
$111.01
|
|
Tc-99m mertiatide
|
$352.50 |
$352.50 |
$352.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$5.00 |
$8.00
|
|
Tc-99m pentetate dtpa aerosol
|
$168.00 |
$168.00 |
$168.00 |
$191.50
|
|
Tc-99m sulfur colloid
|
$112.50 |
$112.50 |
$112.50 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$710.00 |
$710.00 |
$710.00 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$410.00 |
$410.00 |
$410.00 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$237.50 |
$237.50 |
$237.50 |
$184.00
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$95.00 |
$111.20
|
|
T cells total count
|
$187.50 |
$187.50 |
$187.50 |
$130.20
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$37.50 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,145.00 |
$1,145.00 |
$1,145.00 |
$880.61
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$311.61 |
$311.61 |
$311.61 |
$14,951.87
|
|
Tert gene targeted seq alys
|
$327.50 |
$327.50 |
$327.50 |
$335.00
|
|
Test for chlorohydrocarbons
|
$95.00 |
$95.00 |
$95.00 |
$65.00
|
|
Test pathogen(s) for platelets reference
|
$60.00 |
$60.00 |
$60.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$3,505.00 |
$3,505.00 |
$3,505.00 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$90.00 |
$90.00 |
$90.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$60.00 |
$60.00 |
$60.00 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$85.00 |
$85.00 |
$85.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$85.00 |
$85.00 |
$85.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$55.00 |
$55.00 |
$55.00 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$47.50 |
$47.50 |
$47.50 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$35.32 |
$35.32 |
$35.32 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$355.00 |
$355.00 |
$355.00 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$960.00 |
$960.00 |
$960.00 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,395.00 |
$1,395.00 |
$1,395.00 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$4,165.00 |
$4,165.00 |
$4,165.00 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,065.00 |
$5,065.00 |
$5,065.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$15,185.00 |
$15,185.00 |
$15,185.00 |
$14,277.20
|
