|
Stent iliac/open or perc/uni/init 37221
|
$26,824.20 |
$26,824.20 |
$26,824.20 |
$19,385.83
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$26,824.20 |
$26,824.20 |
$26,824.20 |
$10,086.20
|
|
Stent placemt retro carotid
|
$11,623.20 |
$11,623.20 |
$11,623.20 |
$5,623.15
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$27,333.00 |
$27,333.00 |
$27,333.00 |
$24,161.40
|
|
St evaluate speech sound production
|
$128.40 |
$128.40 |
$128.40 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$264.00 |
$264.00 |
$264.00 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$336.00 |
$336.00 |
$336.00 |
$336.00
|
|
St evaluation swallow function
|
$240.00 |
$240.00 |
$240.00 |
$323.05
|
|
Strapping of ankle and/or ft 29540
|
$93.60 |
$93.60 |
$93.60 |
$185.36
|
|
Strapping of chest
|
$141.60 |
$141.60 |
$141.60 |
$196.93
|
|
Strapping of elbow or wrist 29260
|
$61.20 |
$61.20 |
$61.20 |
$176.31
|
|
Strapping of knee
|
$107.40 |
$107.40 |
$107.40 |
$216.34
|
|
Strep a ag ia
|
$148.20 |
$148.20 |
$148.20 |
$75.40
|
|
Strep b dna amp probe
|
$250.80 |
$250.80 |
$250.80 |
$124.20
|
|
Streptokinase 1.5 m-units inj
|
$635.54 |
$635.54 |
$635.54 |
$635.54
|
|
Streptomycin injection
|
$41.56 |
$41.56 |
$41.56 |
$26.21
|
|
Streptozocin injection
|
$397.01 |
$397.01 |
$397.01 |
$459.11
|
|
Stress test pulmonary
|
$482.40 |
$482.40 |
$482.40 |
$330.63
|
|
Stress tte complete
|
$2,572.80 |
$2,572.80 |
$2,572.80 |
$1,989.60
|
|
Str markers spec anal addl
|
$264.00 |
$264.00 |
$264.00 |
$479.17
|
|
Str markers specimen anal
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$978.25
|
|
St treatment speech individual
|
$190.20 |
$253.80 |
$253.80 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$211.20 |
$211.20 |
$211.20 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$49.13 |
$49.13 |
$49.13 |
$22.19
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.71 |
$50.71 |
$50.71 |
$50.71
|
|
Support clav 29.6-40.5in med
|
$57.00 |
$57.00 |
$57.00 |
$105.75
|
|
Supprelin la implant
|
$75,272.43 |
$75,272.43 |
$75,272.43 |
$45,560.39
|
|
Surgical pathology level 1 gross examination only
|
$184.80 |
$184.80 |
$184.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$275.40 |
$275.40 |
$275.40 |
$137.50
|
|
Surgical pathology level 3 gross & microscopic examination
|
$363.60 |
$363.60 |
$363.60 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$487.20 |
$487.20 |
$487.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$794.40 |
$794.40 |
$794.40 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$910.80 |
$910.80 |
$910.80 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$184.80 |
$184.80 |
$184.80 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$128.40 |
$128.40 |
$128.40 |
$32.50
|
|
Susceptibility mic per plate
|
$163.80 |
$163.80 |
$163.80 |
$89.70
|
|
Svc venogram s&i
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$92.40 |
$92.40 |
$165.60 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$97.20 |
$97.20 |
$97.20 |
$45.70
|
|
T3 (triiodothyronine) free
|
$517.20 |
$517.20 |
$517.20 |
$90.40
|
|
T3 (triiodothyronine) total
|
$363.60 |
$363.60 |
$363.60 |
$83.40
|
|
T4 (thyroxine) free
|
$304.80 |
$304.80 |
$304.80 |
$65.00
|
|
T4 (thyroxine) total
|
$172.20 |
$172.20 |
$172.20 |
$59.80
|
|
Tacrol astagraf ex rel oral
|
$10.20 |
$39.65 |
$39.65 |
$16.80
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$98.02 |
$98.02 |
$98.02 |
$4.87
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$612.11 |
$612.11 |
$612.11 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$487.80 |
$487.80 |
$487.80 |
$137.15
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$1,036.35 |
$1,036.35 |
$1,036.35 |
$133.80
|
|
Target gsa panel hmtlmph neop
|
$1,928.40 |
$1,928.40 |
$1,928.40 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$3,567.96
|
|
Tas congenital car anomal
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
$6,003.27
|
|
Tavr perq femoral
|
$19,833.60 |
$19,833.60 |
$19,833.60 |
$15,614.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$649.43 |
$649.43 |
$649.43 |
$760.95
|
|
Tbs techl calculation only
|
$153.60 |
$153.60 |
$153.60 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$222.00 |
$222.00 |
$222.00 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$332.40 |
$332.40 |
$332.40 |
$178.40
|
|
Tc-99m bicisate
|
$2,398.20 |
$2,398.20 |
$2,398.20 |
$2,398.20
|
|
Tc-99m depreotide
|
$1,181.40 |
$1,181.40 |
$1,181.40 |
$1,937.35
|
|
Tc-99m exame autol wbc diag per dose
|
$2,393.40 |
$2,393.40 |
$2,393.40 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$2,236.65
|
|
Tc-99m labeled rbc
|
$302.40 |
$302.40 |
$302.40 |
$312.70
|
|
Tc-99m maa
|
$258.60 |
$258.60 |
$1,019.40 |
$306.60
|
|
Tc-99m mebrofenin
|
$58.80 |
$58.80 |
$58.80 |
$169.53
|
|
Tc-99m medronate
|
$69.00 |
$69.00 |
$69.00 |
$120.35
|
|
Tc-99m mertiatide
|
$465.60 |
$465.60 |
$465.60 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.60 |
$10.00
|
|
Tc-99m oxidronate
|
$63.60 |
$63.60 |
$63.60 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$222.60 |
$222.60 |
$222.60 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$190.80 |
$190.80 |
$190.80 |
$231.60
|
|
Tc-99m pertechnetate per mci
|
$17.40 |
$17.40 |
$17.40 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$94.20 |
$94.20 |
$94.20 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$55.80 |
$55.80 |
$59.40 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$2,315.40 |
$2,315.40 |
$2,315.40 |
$1,749.60
|
|
Tc-99m sulfur colloid
|
$239.40 |
$239.40 |
$912.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$68.40 |
$68.40 |
$72.60 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$225.60 |
$477.60 |
$477.60 |
$189.60
|
|
T cells absolute cd 4 count
|
$334.80 |
$334.80 |
$334.80 |
$120.25
|
|
T cells total count
|
$181.20 |
$300.60 |
$300.60 |
$126.90
|
|
Telethx isodose plan cplx
|
$1,786.80 |
$1,786.80 |
$1,786.80 |
$1,526.85
|
|
Telethx isodose plan simple
|
$684.00 |
$684.00 |
$684.00 |
$848.72
|
|
Temozolomide
|
$849.67 |
$849.67 |
$849.67 |
$632.98
|
|
Temperature gradient studies
|
$295.20 |
$295.20 |
$295.20 |
$173.18
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$151.94 |
$151.94 |
$151.94 |
$116.48
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$240.21 |
$240.21 |
$240.21 |
$16,233.59
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,110.80 |
$2,110.80 |
$2,110.80 |
$1,985.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$131.66 |
$131.66 |
$131.66 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$999.00 |
$999.00 |
$999.00 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,073.02 |
$1,073.02 |
$1,073.02 |
$1,073.02
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$6,935.61 |
$6,935.61 |
$6,935.61 |
$6,935.61
|
|
Theophylline therapeutic drug level
|
$227.40 |
$227.40 |
$227.40 |
$101.40
|
|
Therapeutic procd strg endur
|
$100.80 |
$100.80 |
$100.80 |
$68.93
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$33.60 |
$33.60 |
$33.60 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$33.60 |
$33.60 |
$33.60 |
$47.50
|
|
Ther nma rdctj intus/obstrcj
|
$258.00 |
$258.00 |
$258.00 |
$524.80
|
|
Ther/proph/diag inj ia
|
$321.00 |
$321.00 |
$321.00 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$41.86 |
$41.86 |
$42.98 |
$23.67
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,980.00 |
$1,980.00 |
$1,980.00 |
$1,635.00
|
|
Thoracotomy with cardiac massage
|
$3,107.40 |
$3,107.40 |
$3,107.40 |
$2,313.88
|
|
Thrombectmy crnry perq mechanical
|
$2,898.60 |
$2,898.60 |
$2,898.60 |
$3,580.00
|
