|
Stot/tot hysterectomy after cesaren delivery 59525
|
$5,436.60 |
$5,436.60 |
$5,436.60 |
$2,607.60
|
|
Strapping of ankle and/or ft 29540
|
$160.20 |
$160.20 |
$160.20 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$171.60 |
$171.60 |
$171.60 |
$154.70
|
|
Strapping of hand or finger
|
$171.60 |
$171.60 |
$171.60 |
$174.82
|
|
Strapping of knee
|
$171.60 |
$171.60 |
$171.60 |
$205.20
|
|
Stress test pulmonary
|
$427.20 |
$427.20 |
$427.20 |
$322.85
|
|
Stress tte complete
|
$4,075.80 |
$4,075.80 |
$4,075.80 |
$1,870.50
|
|
Str markers spec anal addl
|
$495.00 |
$495.00 |
$495.00 |
$479.17
|
|
Str markers specimen anal
|
$1,112.40 |
$1,112.40 |
$1,112.40 |
$751.50
|
|
St treatment speech individual
|
$256.80 |
$256.80 |
$477.00 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$108.00 |
$108.00 |
$216.00 |
$240.31
|
|
Sugars single quant
|
$771.60 |
$771.60 |
$771.60 |
$64.28
|
|
Support clav 29.6-40.5in med
|
$169.20 |
$169.20 |
$169.20 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$75.60 |
$75.60 |
$117.60 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$112.80 |
$112.80 |
$336.60 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$153.00 |
$153.00 |
$430.20 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$206.40 |
$206.40 |
$526.80 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$424.20 |
$424.20 |
$652.80 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$667.80 |
$667.80 |
$1,428.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$114.60 |
$114.60 |
$114.60 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$30.00 |
$30.00 |
$51.00 |
$35.70
|
|
Susceptibility mic per plate
|
$83.40 |
$83.40 |
$83.40 |
$106.00
|
|
Svc venogram s&i
|
$1,522.20 |
$1,522.20 |
$2,799.60 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$183.60 |
$183.60 |
$183.60 |
$125.40
|
|
Synch audio-only est high 40
|
$160.20 |
$160.20 |
$160.20 |
$189.40
|
|
Synch audio-only est low 20
|
$73.20 |
$73.20 |
$73.20 |
$90.60
|
|
Synch audio-only est mod 30
|
$108.60 |
$108.60 |
$108.60 |
$136.64
|
|
Synch audio-only est sf 10
|
$40.20 |
$40.20 |
$40.20 |
$53.20
|
|
Synch audio-only new high 60
|
$196.20 |
$196.20 |
$196.20 |
$200.30
|
|
Synch audio-only new low 30
|
$94.80 |
$94.80 |
$94.80 |
$117.00
|
|
Synch audio-only new mod 45
|
$150.00 |
$150.00 |
$150.00 |
$163.38
|
|
Synch audio-only new sf 15
|
$54.60 |
$54.60 |
$54.60 |
$67.80
|
|
Synthetic sentence id test
|
$310.80 |
$310.80 |
$310.80 |
$99.32
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.20 |
$76.20 |
$76.20 |
$41.60
|
|
T3 (triiodothyronine) free
|
$340.80 |
$340.80 |
$340.80 |
$99.20
|
|
T3 (triiodothyronine) total
|
$273.00 |
$273.00 |
$273.00 |
$93.52
|
|
T4 (thyroxine) free
|
$137.40 |
$137.40 |
$137.40 |
$85.20
|
|
T4 (thyroxine) total
|
$185.40 |
$185.40 |
$185.40 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$47.40 |
$47.40 |
$192.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,849.20 |
$1,849.20 |
$5,106.60 |
$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
|
$3,120.60 |
$3,120.60 |
$3,120.60 |
$1,655.52
|
|
Tas congenital car anomal
|
$9,413.40 |
$9,413.40 |
$9,413.40 |
$6,003.27
|
|
Tavr perq femoral
|
$48,116.40 |
$48,116.40 |
$48,116.40 |
$15,454.40
|
|
Tbs techl calculation only
|
$111.00 |
$111.00 |
$111.00 |
$153.60
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$295.20 |
$295.20 |
$295.20 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$256.80 |
$256.80 |
$256.80 |
$176.40
|
|
T cells absolute cd 4 count
|
$282.60 |
$282.60 |
$282.60 |
$111.20
|
|
T cells total count
|
$214.20 |
$214.20 |
$214.20 |
$126.90
|
|
Tdh sdrl/ventr pnxr
|
$1,172.40 |
$1,172.40 |
$1,172.40 |
$1,087.20
|
|
Telehealth original site facility fee
|
$61.20 |
$61.20 |
$61.20 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,135.80 |
$1,135.80 |
$1,135.80 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,068.00 |
$1,068.00 |
$1,068.00 |
$873.62
|
|
Tert gene targeted seq alys
|
$2,619.60 |
$2,619.60 |
$2,619.60 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$1,257.00 |
$1,257.00 |
$1,257.00 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$689.40 |
$689.40 |
$1,368.00 |
$949.70
|
|
Tgsap so/hl 51/< rna alys
|
$3,592.80 |
$3,592.80 |
$7,031.40 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$324.00 |
$324.00 |
$324.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$111.60 |
$111.60 |
$111.60 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$90.00 |
$90.00 |
$90.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$80.40 |
$80.40 |
$80.40 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$1,021.20 |
$1,021.20 |
$1,021.20 |
$529.08
|
|
Ther/proph/diag inj ia
|
$227.40 |
$227.40 |
$227.40 |
$240.35
|
|
Ther radiology tx plng cplx
|
$1,306.80 |
$1,306.80 |
$1,306.80 |
$332.00
|
|
Ther radiology tx plng intrm
|
$1,001.40 |
$1,001.40 |
$1,001.40 |
$224.00
|
|
Ther radiology tx plng smpl
|
$508.80 |
$508.80 |
$508.80 |
$148.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,012.80 |
$1,012.80 |
$7,215.00 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$1,466.40 |
$1,466.40 |
$1,466.40 |
$2,138.76
|
|
Throat x-ray & fluoroscopy
|
$172.20 |
$172.20 |
$348.00 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$7,323.00 |
$7,323.00 |
$7,323.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$21,088.80 |
$21,088.80 |
$21,088.80 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$29,874.00 |
$29,874.00 |
$29,874.00 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$33,287.40 |
$33,287.40 |
$33,287.40 |
$21,413.60
|
|
Thrombin time
|
$63.00 |
$63.00 |
$63.00 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$1,634.40 |
$1,634.40 |
$1,634.40 |
$3,980.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$185.40 |
$185.40 |
$185.40 |
$61.52
|
|
Thyroglobulin antibody
|
$130.20 |
$130.20 |
$130.20 |
$82.00
|
|
Thyroid imaging
|
$530.40 |
$530.40 |
$874.80 |
$695.02
|
|
Thyroid met imaging
|
$1,221.60 |
$1,221.60 |
$1,221.60 |
$838.25
|
|
Thyroid mets imag whole body
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,524.99
|
|
Thyroid met uptake
|
$254.40 |
$254.40 |
$254.40 |
$398.40
|
|
Thyroid (TSH) Test
|
$108.60 |
$108.60 |
$241.20 |
$111.00
|
|
Thyroid Ultrasound
|
$481.80 |
$481.80 |
$863.40 |
$588.50
|
|
Thyroid uptake measurement
|
$662.40 |
$662.40 |
$857.40 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$5,391.60 |
$5,391.60 |
$5,391.60 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$59.40 |
$59.40 |
$59.40 |
$64.35
|
|
Tilt table study
|
$1,245.00 |
$1,245.00 |
$2,302.80 |
$1,507.01
|
|
Tis cgen car anomal 1st shnt
|
$12,550.20 |
$12,550.20 |
$12,550.20 |
$8,068.54
|
|
Tis cgen car anomal ea addl
|
$3,138.60 |
$3,138.60 |
$3,138.60 |
$6,546.38
|
|
Tissue culture placenta
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$457.00
|
|
Tissue culture skin/biopsy
|
$1,754.40 |
$1,754.40 |
$1,754.40 |
$484.00
|
|
Tissue culture tumor
|
$3,619.20 |
$3,619.20 |
$3,619.20 |
$483.36
|
|
Tissue exam koh skin/hair/nails
|
$135.60 |
$135.60 |
$135.60 |
$47.20
|
|
Tixagev and cilgav inj
|
$92.40 |
$92.40 |
$101.40 |
$224.55
|
|
Tobramycin peak therapeutic drug level
|
$65.40 |
$65.40 |
$363.00 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$155.40 |
$155.40 |
$155.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$86.40 |
$86.40 |
$86.40 |
$72.68
|
|
Tone decay hearing test
|
$73.80 |
$73.80 |
$73.80 |
$90.37
|
|
Total tau
|
$333.00 |
$333.00 |
$339.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$127.20 |
$127.20 |
$127.20 |
$89.40
|
