|
Rheumatoid factor quantitative
|
$85.60 |
$85.60 |
$85.60 |
$56.64
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$19,084.00 |
$19,084.00 |
$19,084.00 |
$24,844.79
|
|
Rmvl ndwellg tun pleural cath
|
$1,465.60 |
$1,465.60 |
$1,465.60 |
$1,087.03
|
|
Rmvl perm pm pulse gen
|
$6,752.00 |
$6,752.00 |
$6,752.00 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$15,445.60 |
$15,445.60 |
$15,445.60 |
$15,322.00
|
|
Rsv assay w/optic
|
$218.40 |
$218.40 |
$218.40 |
$82.68
|
|
Rtm 1st set-up&pt educaj eqp
|
$313.60 |
$313.60 |
$313.60 |
$162.12
|
|
Rtm dev sply mscskl 16-30 d
|
$90.40 |
$90.40 |
$90.40 |
$96.85
|
|
Rtm dev sply resp sys 16-30d
|
$90.40 |
$90.40 |
$90.40 |
$72.96
|
|
Rubella antibody igg
|
$30.40 |
$30.40 |
$30.40 |
$76.86
|
|
Rubeola antibody igg
|
$20.00 |
$20.00 |
$20.00 |
$80.00
|
|
Russell viper venom diluted
|
$136.80 |
$136.80 |
$136.80 |
$72.45
|
|
Rx metab gen seq alys pnl 6
|
$3,196.00 |
$3,196.00 |
$3,196.00 |
$917.08
|
|
Salivary glnd img serial img
|
$819.20 |
$819.20 |
$819.20 |
$747.90
|
|
Sarscov coronavirus ag ia
|
$72.00 |
$72.00 |
$72.00 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$364.80 |
$364.80 |
$364.80 |
$104.00
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$880.00 |
$880.00 |
$880.00 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$827.20 |
$827.20 |
$827.20 |
$664.80
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,190.40 |
$1,190.40 |
$1,190.40 |
$761.15
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,176.80 |
$1,176.80 |
$1,176.80 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$892.80 |
$892.80 |
$892.80 |
$721.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$875.20 |
$875.20 |
$875.20 |
$660.00
|
|
Scr c/v cyto,thinlayer,rescr
|
$146.40 |
$146.40 |
$146.40 |
$84.00
|
|
Screening Mammogram
|
$468.80 |
$468.80 |
$468.80 |
$313.35
|
|
Screening prostate cancer PSA
|
$196.80 |
$196.80 |
$196.80 |
$98.28
|
|
Sedimentation rate erythrocyte automated
|
$117.60 |
$117.60 |
$117.60 |
$43.07
|
|
Semen analysis presence/motility
|
$151.20 |
$151.20 |
$151.20 |
$75.40
|
|
Shoulder MRI (with and without contrast)
|
$5,537.60 |
$5,537.60 |
$5,537.60 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$4,901.60 |
$4,901.60 |
$4,901.60 |
$2,465.45
|
|
Shoulder MRI (without contrast)
|
$4,470.40 |
$4,470.40 |
$4,470.40 |
$2,110.00
|
|
Shoulder X-ray
|
$739.20 |
$739.20 |
$739.20 |
$344.38
|
|
Shuntogram nonvascular supervision & interpretation
|
$633.60 |
$633.60 |
$633.60 |
$359.20
|
|
Sickling rbc
|
$121.60 |
$121.60 |
$121.60 |
$57.00
|
|
Sinus CT scan (with and without contrast)
|
$2,596.00 |
$2,596.00 |
$2,596.00 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$2,405.60 |
$2,405.60 |
$2,405.60 |
$1,545.60
|
|
Sinus CT scan (without contrast)
|
$2,220.80 |
$2,220.80 |
$2,220.80 |
$1,296.85
|
|
Sinus/juglr venogram s&i
|
$2,644.00 |
$2,644.00 |
$2,644.00 |
$2,517.48
|
|
Skin Biopsy
|
$291.20 |
$291.20 |
$291.20 |
$360.34
|
|
Sleep Study (Polysomnography)
|
$4,248.80 |
$4,248.80 |
$4,248.80 |
$3,745.80
|
|
Sleep study unattended
|
$706.40 |
$706.40 |
$706.40 |
$594.00
|
|
Sleeve fing rolyan med
|
$165.60 |
$165.60 |
$165.60 |
$203.58
|
|
Slp stdy unatnd w/anal
|
$99.20 |
$99.20 |
$99.20 |
$296.34
|
|
Smear fluorescent and/or acid fast stain
|
$74.40 |
$74.40 |
$74.40 |
$64.48
|
|
Smear gram stain
|
$73.60 |
$73.60 |
$73.60 |
$54.75
|
|
Smear special stain inclusion bodies/parasites
|
$172.00 |
$172.00 |
$172.00 |
$71.82
|
|
Smear wet mount
|
$83.20 |
$83.20 |
$83.20 |
$67.49
|
|
Snrpn/ube3a gene
|
$980.80 |
$980.80 |
$980.80 |
$228.80
|
|
So cap design without jnts cf
|
$686.40 |
$686.40 |
$686.40 |
$856.10
|
|
Sodium 24 hour urine
|
$76.00 |
$76.00 |
$76.00 |
$48.68
|
|
Sodium serum/plasma/whole blood
|
$98.40 |
$98.40 |
$98.40 |
$46.00
|
|
So neo gsap dna mcrstl ins
|
$10,926.40 |
$10,926.40 |
$10,926.40 |
$2,296.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$560.00 |
$560.00 |
$560.00 |
$543.75
|
|
Spleen imaging
|
$828.80 |
$828.80 |
$828.80 |
$732.60
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$388.80 |
$388.80 |
$388.80 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$54.40 |
$54.40 |
$54.40 |
$67.76
|
|
Splint finger frog med
|
$32.00 |
$32.00 |
$32.00 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$54.40 |
$54.40 |
$54.40 |
$100.00
|
|
St analysis behavior qualitative voice/resonance
|
$477.60 |
$477.60 |
$477.60 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$373.60 |
$373.60 |
$373.60 |
$285.60
|
|
St evaluate speech sound production
|
$391.20 |
$391.20 |
$391.20 |
$289.20
|
|
St evaluate speech sound production comprehensive/expressive
|
$541.60 |
$541.60 |
$541.60 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$547.20 |
$547.20 |
$547.20 |
$373.80
|
|
St evaluation swallow function
|
$412.80 |
$412.80 |
$412.80 |
$309.60
|
|
Stress test pulmonary
|
$370.40 |
$370.40 |
$370.40 |
$322.85
|
|
St treatment speech individual
|
$342.40 |
$342.40 |
$342.40 |
$252.54
|
|
St treatment swallow dysfunction/oral
|
$288.00 |
$288.00 |
$288.00 |
$244.00
|
|
Support clav 29.6-40.5in med
|
$58.40 |
$58.40 |
$58.40 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$89.60 |
$89.60 |
$89.60 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$152.80 |
$152.80 |
$152.80 |
$144.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$216.80 |
$216.80 |
$216.80 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$287.20 |
$287.20 |
$287.20 |
$252.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$410.40 |
$410.40 |
$410.40 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$700.80 |
$700.80 |
$700.80 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$75.20 |
$75.20 |
$75.20 |
$43.50
|
|
Susceptibility enzyme detection per enzyme
|
$81.60 |
$81.60 |
$81.60 |
$35.70
|
|
Susceptibility mic per plate
|
$80.80 |
$80.80 |
$80.80 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$85.60 |
$85.60 |
$85.60 |
$41.40
|
|
T3 (triiodothyronine) free
|
$240.80 |
$240.80 |
$240.80 |
$99.82
|
|
T3 (triiodothyronine) total
|
$166.40 |
$166.40 |
$166.40 |
$93.52
|
|
T4 (thyroxine) free
|
$132.80 |
$132.80 |
$132.80 |
$85.20
|
|
T4 (thyroxine) total
|
$162.40 |
$162.40 |
$162.40 |
$68.40
|
|
Tacrolimus therapeutic drug level
|
$219.20 |
$219.20 |
$219.20 |
$121.39
|
|
Target gsa panel hmtlmph neop
|
$1,835.20 |
$1,835.20 |
$1,835.20 |
$2,160.00
|
|
Target gsa panel organ/hmtlmph neop
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$178.40 |
$178.40 |
$178.40 |
$175.00
|
|
T cells absolute cd4/cd8 including ratio
|
$142.40 |
$142.40 |
$142.40 |
$175.20
|
|
T cells total count
|
$122.40 |
$122.40 |
$122.40 |
$123.00
|
|
Telehealth original site facility fee
|
$55.20 |
$55.20 |
$55.20 |
$51.00
|
|
Tert gene targeted seq alys
|
$3,085.60 |
$3,085.60 |
$3,085.60 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$1,001.60 |
$1,001.60 |
$1,001.60 |
$879.80
|
|
Test stress cardiovascular tracing only
|
$928.00 |
$928.00 |
$928.00 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$4,029.05
|
|
Theophylline therapeutic drug level
|
$25.60 |
$25.60 |
$25.60 |
$108.00
|
|
Therapeutic procd strg endur
|
$61.60 |
$61.60 |
$61.60 |
$83.16
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$90.40 |
$90.40 |
$90.40 |
$55.98
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$77.60 |
$77.60 |
$77.60 |
$50.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,308.80 |
$1,308.80 |
$1,308.80 |
$1,687.50
|
|
Thrombin time
|
$112.80 |
$112.80 |
$112.80 |
$53.76
|
|
Thyroglobulin antibody
|
$118.40 |
$118.40 |
$118.40 |
$82.00
|
