|
Scan duplex upper extremity arteries unilateral/limited study left
|
$962.64 |
$962.64 |
$962.64 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$109.44 |
$109.44 |
$109.44 |
$85.15
|
|
Screening Colonoscopy (high risk)
|
$2,499.12 |
$2,499.12 |
$2,499.12 |
$1,951.46
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$65.52 |
$65.52 |
$65.52 |
$57.60
|
|
Screening Mammogram
|
$327.60 |
$327.60 |
$327.60 |
$312.55
|
|
Screening prostate cancer PSA
|
$209.52 |
$209.52 |
$209.52 |
$100.63
|
|
Sedimentation rate erythrocyte automated
|
$76.32 |
$76.32 |
$76.32 |
$42.00
|
|
Semen analysis presence/motility
|
$70.56 |
$70.56 |
$70.56 |
$71.05
|
|
Serpina1 gene
|
$338.40 |
$338.40 |
$338.40 |
$197.00
|
|
Shoulder MRI (with and without contrast)
|
$3,960.72 |
$3,960.72 |
$3,960.72 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$3,857.04 |
$3,857.04 |
$3,857.04 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$2,881.44 |
$2,881.44 |
$2,881.44 |
$2,065.05
|
|
Shoulder X-ray
|
$412.56 |
$412.56 |
$412.56 |
$339.50
|
|
Sickling rbc
|
$52.56 |
$52.56 |
$52.56 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$236.16 |
$236.16 |
$236.16 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$2,024.64 |
$2,024.64 |
$2,024.64 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,565.28 |
$1,565.28 |
$1,565.28 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,177.20 |
$1,177.20 |
$1,177.20 |
$1,292.04
|
|
Sleep Study (Polysomnography)
|
$4,579.20 |
$4,579.20 |
$4,579.20 |
$3,607.50
|
|
Sleep study unattended
|
$337.68 |
$337.68 |
$337.68 |
$580.87
|
|
Smear fluorescent and/or acid fast stain
|
$92.16 |
$92.16 |
$92.16 |
$64.20
|
|
Smear gram stain
|
$80.64 |
$80.64 |
$80.64 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$72.00 |
$72.00 |
$72.00 |
$73.15
|
|
Smear wet mount
|
$74.16 |
$74.16 |
$74.16 |
$67.49
|
|
Sodium 24 hour urine
|
$36.00 |
$36.00 |
$36.00 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$39.60 |
$39.60 |
$39.60 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$39.60 |
$39.60 |
$39.60 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$39.60 |
$39.60 |
$39.60 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$39.60 |
$39.60 |
$39.60 |
$40.61
|
|
Sodium serum/plasma/whole blood
|
$63.36 |
$63.36 |
$63.36 |
$45.60
|
|
Specific gravity body fluid
|
$78.48 |
$78.48 |
$78.48 |
$22.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$672.48 |
$672.48 |
$672.48 |
$543.26
|
|
Sputum specimen collection
|
$370.08 |
$370.08 |
$370.08 |
$180.00
|
|
Staph a dna amp probe
|
$177.84 |
$177.84 |
$177.84 |
$125.00
|
|
St evaluate speech sound production
|
$227.52 |
$227.52 |
$227.52 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$469.44 |
$469.44 |
$469.44 |
$377.00
|
|
St evaluation swallow function
|
$144.72 |
$144.72 |
$144.72 |
$314.40
|
|
Strep a ag ia
|
$133.92 |
$133.92 |
$133.92 |
$75.40
|
|
Strep a dna quant
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
Strep b dna amp probe
|
$43.92 |
$43.92 |
$43.92 |
$120.90
|
|
Stress test pulmonary
|
$241.92 |
$241.92 |
$241.92 |
$322.85
|
|
St treatment speech individual
|
$296.64 |
$296.64 |
$296.64 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$296.64 |
$296.64 |
$296.64 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$25.20 |
$25.20 |
$25.20 |
$52.31
|
|
Sugars single quant
|
$145.44 |
$145.44 |
$145.44 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$25.20 |
$25.20 |
$25.20 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$76.32 |
$76.32 |
$76.32 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$116.64 |
$116.64 |
$116.64 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$131.76 |
$131.76 |
$131.76 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$156.96 |
$156.96 |
$156.96 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$453.60 |
$453.60 |
$453.60 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$69.84 |
$69.84 |
$69.84 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$29.52 |
$29.52 |
$29.52 |
$35.70
|
|
Susceptibility mic per plate
|
$134.64 |
$134.64 |
$134.64 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$142.56 |
$142.56 |
$142.56 |
$59.28
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$44.64 |
$44.64 |
$44.64 |
$41.60
|
|
T3 (triiodothyronine) free
|
$135.36 |
$135.36 |
$135.36 |
$99.20
|
|
T3 (triiodothyronine) total
|
$231.84 |
$231.84 |
$231.84 |
$93.52
|
|
T4 (thyroxine) free
|
$82.08 |
$82.08 |
$82.08 |
$85.20
|
|
T4 (thyroxine) total
|
$86.40 |
$86.40 |
$86.40 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$5.04 |
$5.04 |
$5.04 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$189.36 |
$189.36 |
$189.36 |
$122.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$165.60 |
$165.60 |
$165.60 |
$177.65
|
|
Tc-99m non-heu per study dose
|
$18.72 |
$18.72 |
$18.72 |
$6.60
|
|
T cells absolute cd4/cd8 including ratio
|
$59.04 |
$59.04 |
$59.04 |
$176.40
|
|
T cells absolute cd 4 count
|
$121.68 |
$121.68 |
$121.68 |
$111.20
|
|
T cells total count
|
$185.04 |
$185.04 |
$185.04 |
$126.90
|
|
Telehealth original site facility fee
|
$66.96 |
$66.96 |
$66.96 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$439.60 |
$439.60 |
$439.60 |
$15,245.38
|
|
Test stress cardiovascular tracing only
|
$1,351.44 |
$1,351.44 |
$1,351.44 |
$949.70
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$727.20 |
$727.20 |
$727.20 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$90.00 |
$90.00 |
$90.00 |
$57.31
|
|
Ther/proph/diag inj ia
|
$455.04 |
$455.04 |
$455.04 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$25.20 |
$25.20 |
$25.20 |
$25.54
|
|
Thrombin time
|
$146.88 |
$146.88 |
$146.88 |
$53.76
|
|
Thromboplastin inhibition
|
$434.16 |
$434.16 |
$434.16 |
$53.30
|
|
Thyroglobulin antibody
|
$82.08 |
$82.08 |
$82.08 |
$82.00
|
|
Thyroid imaging
|
$867.60 |
$867.60 |
$867.60 |
$695.02
|
|
Thyroid (TSH) Test
|
$187.20 |
$187.20 |
$187.20 |
$111.00
|
|
Thyroid Ultrasound
|
$668.88 |
$668.88 |
$668.88 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$85.68 |
$85.68 |
$85.68 |
$64.35
|
|
Tissue exam koh skin/hair/nails
|
$69.84 |
$69.84 |
$69.84 |
$47.20
|
|
Tissue transglutaminase iga
|
$95.76 |
$95.76 |
$95.76 |
$44.16
|
|
Tixagev and cilgav inj
|
$325.44 |
$325.44 |
$325.44 |
$224.55
|
|
Tobramycin peak therapeutic drug level
|
$1,384.56 |
$1,384.56 |
$1,384.56 |
$120.60
|
|
Tomosynthesis breast diagnostic left
|
$122.40 |
$122.40 |
$122.40 |
$73.00
|
|
Tomosynthesis breast screen bilateral
|
$109.44 |
$109.44 |
$109.44 |
$72.68
|
|
Toxoplasma antibody igg
|
$131.76 |
$131.76 |
$131.76 |
$89.40
|
|
Toxoplasma antibody igm
|
$128.16 |
$128.16 |
$128.16 |
$87.00
|
|
Tp53 gene full gene sequence
|
$1,384.56 |
$1,384.56 |
$1,384.56 |
$709.80
|
|
Transferrin
|
$180.00 |
$180.00 |
$180.00 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,300.32 |
$1,300.32 |
$1,300.32 |
$983.00
|
|
Treat finger fracture each
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,536.00
|
|
Treat fracture of radius
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,849.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$278.64 |
$278.64 |
$278.64 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$97.92 |
$97.92 |
$97.92 |
$145.51
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$169.20 |
$169.20 |
$169.20 |
$203.35
|
|
Treponema pallidum antibody
|
$200.16 |
$200.16 |
$200.16 |
$70.40
|
