|
Sp bone algrft morsel add-on
|
$147.60 |
$147.60 |
$147.60 |
$498.55
|
|
Special physics consult
|
$1,071.60 |
$1,071.60 |
$1,071.60 |
$725.00
|
|
Special pump services
|
$838.80 |
$838.80 |
$838.80 |
$901.60
|
|
Special pump services
|
$587.40 |
$587.40 |
$587.40 |
$548.80
|
|
Special pump services
|
$336.60 |
$336.60 |
$336.60 |
$392.00
|
|
Special radiation dosimetry
|
$473.40 |
$473.40 |
$473.40 |
$392.50
|
|
Special radiation treatment
|
$2,753.40 |
$2,753.40 |
$2,753.40 |
$1,986.00
|
|
Special teletx port plan
|
$3,606.60 |
$3,606.60 |
$3,606.60 |
$1,086.99
|
|
Specific gravity body fluid
|
$91.80 |
$91.80 |
$91.80 |
$22.00
|
|
Speech evaluation complex
|
$898.20 |
$898.20 |
$898.20 |
$527.06
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$691.80 |
$691.80 |
$691.80 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$291.60 |
$291.60 |
$291.60 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$85.20 |
$85.20 |
$85.20 |
$68.25
|
|
Splint finger frog med
|
$24.00 |
$24.00 |
$24.00 |
$38.08
|
|
Splint func pos polyflex ii med
|
$307.80 |
$307.80 |
$307.80 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$585.60 |
$585.60 |
$585.60 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$4,533.60 |
$4,533.60 |
$4,533.60 |
$4,619.65
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$4,533.60 |
$4,533.60 |
$4,533.60 |
$1,612.78
|
|
Srs linear based
|
$19,326.00 |
$19,326.00 |
$19,326.00 |
$13,585.00
|
|
Srs multisource
|
$40,143.60 |
$40,143.60 |
$40,143.60 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$358.20 |
$358.20 |
$358.20 |
$297.60
|
|
Staph a dna amp probe
|
$236.40 |
$236.40 |
$236.40 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$280.20 |
$280.20 |
$280.20 |
$286.00
|
|
Stereotactic radiation trmt
|
$1,478.40 |
$1,478.40 |
$1,478.40 |
$845.60
|
|
St evaluate speech sound production
|
$293.40 |
$293.40 |
$293.40 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$406.20 |
$406.20 |
$406.20 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$410.40 |
$410.40 |
$410.40 |
$399.60
|
|
St evaluation swallow function
|
$309.60 |
$309.60 |
$309.60 |
$314.40
|
|
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
|
$303.00 |
$303.00 |
$303.00 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$303.00 |
$303.00 |
$303.00 |
$154.70
|
|
Strapping of hand or finger
|
$303.00 |
$303.00 |
$303.00 |
$174.82
|
|
Strapping of knee
|
$364.20 |
$364.20 |
$364.20 |
$205.20
|
|
Stress test pulmonary
|
$470.40 |
$470.40 |
$470.40 |
$322.85
|
|
Stress tte complete
|
$3,249.00 |
$3,249.00 |
$3,249.00 |
$1,870.50
|
|
Str markers spec anal addl
|
$465.00 |
$465.00 |
$465.00 |
$479.17
|
|
Str markers specimen anal
|
$1,044.60 |
$1,044.60 |
$1,044.60 |
$751.50
|
|
St treatment speech individual
|
$256.80 |
$256.80 |
$256.80 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$216.00 |
$216.00 |
$216.00 |
$240.31
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$679.80 |
$679.80 |
$679.80 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$213.00 |
$213.00 |
$213.00 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$204.60 |
$204.60 |
$204.60 |
$216.00
|
|
Sugars single quant
|
$306.60 |
$306.60 |
$306.60 |
$64.28
|
|
Support clav 29.6-40.5in med
|
$169.20 |
$169.20 |
$169.20 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$137.40 |
$137.40 |
$137.40 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$313.80 |
$313.80 |
$313.80 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$400.80 |
$400.80 |
$400.80 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$491.40 |
$491.40 |
$491.40 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$605.40 |
$605.40 |
$605.40 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,317.00 |
$1,317.00 |
$1,317.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$114.00 |
$114.00 |
$114.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$57.00 |
$57.00 |
$57.00 |
$35.70
|
|
Susceptibility mic per plate
|
$83.40 |
$83.40 |
$83.40 |
$106.00
|
|
Svc venogram s&i
|
$2,676.60 |
$2,676.60 |
$2,676.60 |
$1,934.62
|
|
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
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.80 |
$76.80 |
$76.80 |
$41.60
|
|
T3 (triiodothyronine) free
|
$235.80 |
$235.80 |
$235.80 |
$99.20
|
|
T3 (triiodothyronine) total
|
$208.80 |
$208.80 |
$208.80 |
$93.52
|
|
T4 (thyroxine) free
|
$137.40 |
$137.40 |
$137.40 |
$85.20
|
|
T4 (thyroxine) total
|
$123.60 |
$123.60 |
$123.60 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$509.40 |
$509.40 |
$509.40 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$5,075.40 |
$5,075.40 |
$5,075.40 |
$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
|
$3,100.80 |
$3,100.80 |
$3,100.80 |
$1,655.52
|
|
Tas congenital car anomal
|
$6,990.00 |
$6,990.00 |
$6,990.00 |
$6,003.27
|
|
Tavr perq femoral
|
$38,387.40 |
$38,387.40 |
$38,387.40 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$294.60 |
$294.60 |
$294.60 |
$177.65
|
|
Tcd emboli detect w/inj
|
$611.40 |
$611.40 |
$611.40 |
$475.80
|
|
Tcd emboli detect without inj
|
$568.80 |
$568.80 |
$568.80 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$337.80 |
$337.80 |
$337.80 |
$176.40
|
|
T cells total count
|
$202.80 |
$202.80 |
$202.80 |
$126.90
|
|
Telehealth original site facility fee
|
$58.80 |
$58.80 |
$58.80 |
$51.00
|
|
Telethx isodose plan cplx
|
$3,606.60 |
$3,606.60 |
$3,606.60 |
$1,526.85
|
|
Telethx isodose plan simple
|
$3,606.60 |
$3,606.60 |
$3,606.60 |
$873.62
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$3,886.80 |
$3,886.80 |
$3,886.80 |
$2,139.67
|
|
Tert gene targeted seq alys
|
$2,344.80 |
$2,344.80 |
$2,344.80 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$908.40 |
$908.40 |
$908.40 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$951.60 |
$951.60 |
$951.60 |
$949.70
|
|
Tgsap so/hl 51/< rna alys
|
$7,031.40 |
$7,031.40 |
$7,031.40 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$184.80 |
$184.80 |
$184.80 |
$108.00
|
|
Therapeutic procd strg endur
|
$101.40 |
$101.40 |
$101.40 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$100.80 |
$100.80 |
$100.80 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$100.80 |
$100.80 |
$100.80 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$891.00 |
$891.00 |
$891.00 |
$529.08
|
|
Ther/proph/diag inj ia
|
$161.40 |
$161.40 |
$161.40 |
$240.35
|
|
Ther radiology tx plng cplx
|
$1,613.40 |
$1,613.40 |
$1,613.40 |
$332.00
|
|
Ther radiology tx plng intrm
|
$1,249.80 |
$1,249.80 |
$1,249.80 |
$224.00
|
|
Ther radiology tx plng smpl
|
$883.20 |
$883.20 |
$883.20 |
$148.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$5,652.60 |
$5,652.60 |
$5,652.60 |
$1,687.50
|
|
Thoracic aortic graft 33875
|
$3,898.20 |
$3,898.20 |
$3,898.20 |
$6,691.20
|
|
Thoracic lymphadenect/thoracotomy 38746
|
$441.00 |
$441.00 |
$441.00 |
$499.80
|
|
Thoracoabdominal graft 33877
|
$5,187.60 |
$5,187.60 |
$5,187.60 |
$8,824.00
|
