|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$1,342.00
|
|
Strapping of ankle and/or ft 29540
|
$142.50 |
$142.50 |
$142.50 |
$223.45
|
|
Strapping of hand or finger
|
$142.50 |
$142.50 |
$142.50 |
$174.82
|
|
Strapping of hip
|
$142.50 |
$142.50 |
$142.50 |
$164.70
|
|
Strapping of knee
|
$142.50 |
$142.50 |
$142.50 |
$205.20
|
|
Strep a ag ia
|
$20.00 |
$20.00 |
$20.00 |
$75.40
|
|
Strep b dna amp probe
|
$172.50 |
$172.50 |
$172.50 |
$122.43
|
|
Stress test pulmonary
|
$247.50 |
$247.50 |
$247.50 |
$324.00
|
|
Stress tte complete
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$1,894.20
|
|
Str markers specimen anal
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$751.50
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$4,302.28 |
$4,302.28 |
$4,302.28 |
$7,345.98
|
|
Sulfonylurea screen qn-sendout
|
$230.00 |
$230.00 |
$230.00 |
$160.05
|
|
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 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$187.50 |
$187.50 |
$187.50 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$237.50 |
$237.50 |
$237.50 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$630.00 |
$630.00 |
$630.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$920.00 |
$920.00 |
$920.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$25.00 |
$25.00 |
$25.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$27.50 |
$27.50 |
$27.50 |
$35.75
|
|
Susceptibility mic per plate
|
$60.00 |
$60.00 |
$60.00 |
$105.75
|
|
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 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$200.00 |
$200.00 |
$200.00 |
$316.55
|
|
Swallowing Therapy Session
|
$250.00 |
$250.00 |
$250.00 |
$240.31
|
|
Sweat collection by iontophoresis
|
$177.50 |
$177.50 |
$177.50 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$37.50 |
$37.50 |
$37.50 |
$41.60
|
|
System cardiomems hosp electronics
|
$38,108.50 |
$38,108.50 |
$38,108.50 |
$38,234.70
|
|
System pacing micra av
|
$25,671.00 |
$25,671.00 |
$25,671.00 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,855.80 |
$5,855.80 |
$5,855.80 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$9,678.75 |
$9,678.75 |
$9,678.75 |
$11,183.00
|
|
System sealant biosentry tract
|
$1,159.47 |
$1,159.47 |
$1,159.47 |
$889.35
|
|
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 |
$88.44
|
|
T4 (thyroxine) total
|
$85.00 |
$85.00 |
$85.00 |
$69.58
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$47.33 |
$47.33 |
$47.33 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$284.62 |
$284.62 |
$284.62 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$122.50 |
$122.50 |
$122.50 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$33.53 |
$33.53 |
$33.53 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$237.50 |
$237.50 |
$237.50 |
$289.90
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$128.65 |
$128.65 |
$128.65 |
$21,745.13
|
|
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 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$24,217.20
|
|
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 |
$180.80
|
|
Tc-99m mebrofenin
|
$107.50 |
$107.50 |
$107.50 |
$157.65
|
|
Tc-99m medronate
|
$125.77 |
$125.77 |
$125.77 |
$111.01
|
|
Tc-99m mertiatide
|
$650.50 |
$650.50 |
$650.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$5.00 |
$6.50
|
|
Tc-99m sestamibi p study dose
|
$285.00 |
$285.00 |
$285.00 |
$287.20
|
|
Tc-99m tilmanocept diag
|
$630.00 |
$630.00 |
$630.00 |
$985.60
|
|
Tcd emboli detect w/inj
|
$895.00 |
$895.00 |
$895.00 |
$475.80
|
|
T cells absolute cd4/cd8 including ratio
|
$237.50 |
$237.50 |
$237.50 |
$185.28
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$95.00 |
$111.20
|
|
T cells total count
|
$187.50 |
$187.50 |
$187.50 |
$130.35
|
|
Team conf without pat by hc pro
|
$130.00 |
$130.00 |
$130.00 |
$110.62
|
|
Team conf without pat by phys
|
$145.00 |
$145.00 |
$145.00 |
$139.10
|
|
Team conf w/pat by hc prof
|
$130.00 |
$130.00 |
$130.00 |
$104.59
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$501.78 |
$501.78 |
$501.78 |
$40,114.80
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$37.50 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,550.00 |
$1,550.00 |
$1,550.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$915.00 |
$915.00 |
$915.00 |
$877.09
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$312.33 |
$312.33 |
$312.33 |
$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 |
$61.60
|
|
Testicular imaging w/vasc flow
|
$1,180.00 |
$1,180.00 |
$1,180.00 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$60.00 |
$60.00 |
$60.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$515.00 |
$515.00 |
$515.00 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$3,505.00 |
$3,505.00 |
$3,505.00 |
$4,563.00
|
|
Thaw preserved stem cells
|
$790.00 |
$790.00 |
$790.00 |
$1,136.85
|
|
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 activation ipnss
|
$195.00 |
$195.00 |
$195.00 |
$226.24
|
|
Therapy activity per session >= 45 minutes
|
$77.50 |
$77.50 |
$77.50 |
$191.50
|
|
Therapy Activity Training (each 15 minutes)
|
$85.00 |
$85.00 |
$85.00 |
$101.85
|
|
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
|
|
Ther nma rdctj intus/obstrcj
|
$500.00 |
$500.00 |
$500.00 |
$538.88
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$41.55 |
$41.55 |
$41.55 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$405.00 |
$405.00 |
$405.00 |
$314.50
|
|
Thiotepa injection
|
$984.24 |
$984.24 |
$984.24 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$1,733.65
|
|
Thoracotomy with cardiac massage
|
$1,130.00 |
$1,130.00 |
$1,130.00 |
$2,138.76
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,635.00 |
$1,635.00 |
$1,635.00 |
$1,684.80
|
|
Throat x-ray & fluoroscopy
|
$400.00 |
$400.00 |
$400.00 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$3,836.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,185.00 |
$6,185.00 |
$6,185.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$15,255.00 |
$15,255.00 |
$15,255.00 |
$14,465.94
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$21,600.00 |
$21,600.00 |
$21,600.00 |
$21,413.60
|
|
Thrombin time
|
$40.00 |
$40.00 |
$40.00 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$47.50 |
$47.50 |
$47.50 |
$61.52
|
|
Thyroglobulin antibody
|
$72.50 |
$72.50 |
$72.50 |
$82.73
|
|
Thyroid imaging
|
$795.00 |
$795.00 |
$795.00 |
$696.75
|
|
Thyroid mets imag whole body
|
$1,320.00 |
$1,320.00 |
$1,320.00 |
$1,524.99
|
|
Thyroid met uptake
|
$380.00 |
$380.00 |
$380.00 |
$407.40
|
