|
St evaluate speech sound production
|
$123.76 |
$123.76 |
$123.76 |
|
|
St evaluate speech sound production comprehensive/expressive
|
$131.30 |
$131.30 |
$131.30 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$215.02 |
$215.02 |
$215.02 |
|
|
St evaluation swallow function
|
$189.54 |
$189.54 |
$189.54 |
|
|
Stimulants synthetic
|
$16.12 |
$16.12 |
$16.12 |
|
|
Strapping of ankle and/or ft 29540
|
$222.82 |
$222.82 |
$222.82 |
|
|
Strapping of elbow or wrist 29260
|
$222.82 |
$222.82 |
$222.82 |
|
|
Stress test pulmonary
|
$171.60 |
$171.60 |
$171.60 |
|
|
Stress tte complete
|
$1,025.18 |
$1,025.18 |
$1,025.18 |
|
|
St treatment speech individual
|
$113.88 |
$113.88 |
$113.88 |
|
|
St treatment swallow dysfunction/oral
|
$88.66 |
$88.66 |
$88.66 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$69.11 |
$69.11 |
$69.11 |
|
|
Sugars single quant
|
$22.10 |
$22.10 |
$22.10 |
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$3,264.89 |
$3,264.89 |
$3,264.89 |
|
|
Sulfonylurea screen qn-sendout
|
$16.12 |
$16.12 |
$16.12 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$39.98 |
$39.98 |
$39.98 |
|
|
Surgical pathology level 1 gross examination only
|
$10.92 |
$10.92 |
$10.92 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$20.02 |
$20.02 |
$20.02 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$32.76 |
$32.76 |
$32.76 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$33.02 |
$33.02 |
$33.02 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$63.96 |
$63.96 |
$63.96 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$142.74 |
$142.74 |
$142.74 |
|
|
Susceptibility agar dilution per agent
|
$22.62 |
$22.62 |
$22.62 |
|
|
Susceptibility enzyme detection per enzyme
|
$64.48 |
$64.48 |
$64.48 |
|
|
Susceptibility mic per plate
|
$195.78 |
$195.78 |
$195.78 |
|
|
Suscept studies macrobroth dilution ea
|
$227.50 |
$227.50 |
$227.50 |
|
|
Svc venogram s&i
|
$1,165.58 |
$1,165.58 |
$1,165.58 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$77.48 |
$77.48 |
$77.48 |
|
|
T3 (triiodothyronine) free
|
$35.10 |
$35.10 |
$35.10 |
|
|
T3 (triiodothyronine) total
|
$52.78 |
$52.78 |
$52.78 |
|
|
T4 (thyroxine) free
|
$53.56 |
$53.56 |
$53.56 |
|
|
T4 (thyroxine) total
|
$17.42 |
$17.42 |
$17.42 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$48.57 |
$48.57 |
$48.57 |
|
|
Tacrolimus therapeutic drug level
|
$26.78 |
$26.78 |
$26.78 |
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$10.31 |
$10.31 |
$10.31 |
|
|
Tavr perq femoral
|
$2,291.12 |
$2,291.12 |
$2,291.12 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,105.41 |
$1,105.41 |
$1,105.41 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$170.56 |
$170.56 |
$170.56 |
|
|
Tc-99m exametazime diag
|
$1,025.96 |
$1,025.96 |
$1,025.96 |
|
|
Tc-99m labeled rbc
|
$167.44 |
$167.44 |
$167.44 |
|
|
Tc-99m maa
|
$384.66 |
$384.66 |
$384.66 |
|
|
Tc-99m mebrofenin
|
$164.84 |
$164.84 |
$164.84 |
|
|
Tc-99m medronate
|
$226.26 |
$226.26 |
$226.26 |
|
|
Tc-99m mertiatide
|
$905.32 |
$905.32 |
$905.32 |
|
|
Tc-99m non-heu per study dose
|
$5.98 |
$5.98 |
$5.98 |
|
|
Tc-99m pentetate dtpa
|
$167.44 |
$167.44 |
$167.44 |
|
|
Tc-99m pertechnetate per mci
|
$5.98 |
$5.98 |
$5.98 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$175.05 |
$175.05 |
$175.05 |
|
|
Tc-99m sestamibi p study dose
|
$593.06 |
$593.06 |
$593.06 |
|
|
Tc-99m sulfur colloid
|
$169.26 |
$169.26 |
$169.26 |
|
|
T cells absolute cd4/cd8 including ratio
|
$96.46 |
$96.46 |
$96.46 |
|
|
T cells absolute cd 4 count
|
$111.54 |
$111.54 |
$111.54 |
|
|
T cells total count
|
$96.46 |
$96.46 |
$96.46 |
|
|
Telehealth original site facility fee
|
$126.62 |
$126.62 |
$126.62 |
|
|
Telethx isodose plan cplx
|
$743.60 |
$743.60 |
$743.60 |
|
|
Telethx isodose plan simple
|
$207.48 |
$207.48 |
$207.48 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$15,137.94 |
$15,137.94 |
$15,137.94 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$14.54 |
$14.54 |
$14.54 |
|
|
Testicular imaging w/vasc flow
|
$358.54 |
$358.54 |
$358.54 |
|
|
Test stress cardiovascular tracing only
|
$264.68 |
$264.68 |
$264.68 |
|
|
Theophylline therapeutic drug level
|
$44.72 |
$44.72 |
$44.72 |
|
|
Therapeutic procd strg endur
|
$103.22 |
$103.22 |
$103.22 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$62.40 |
$62.40 |
$62.40 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$54.08 |
$54.08 |
$54.08 |
|
|
Ther/proph/diag inj ia
|
$49.40 |
$49.40 |
$49.40 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$90.42 |
$90.42 |
$90.42 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,340.56 |
$1,340.56 |
$1,340.56 |
|
|
Thrombectmy crnry perq mechanical
|
$3,952.26 |
$3,952.26 |
$3,952.26 |
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,688.40 |
$2,688.40 |
$2,688.40 |
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$2,688.40 |
$2,688.40 |
$2,688.40 |
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$4,065.62 |
$4,065.62 |
$4,065.62 |
|
|
Thrombin time
|
$60.06 |
$60.06 |
$60.06 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$9.88 |
$9.88 |
$9.88 |
|
|
Thyroglobulin antibody
|
$30.16 |
$30.16 |
$30.16 |
|
|
Thyroid imaging
|
$389.48 |
$389.48 |
$389.48 |
|
|
Thyroid mets imag whole body
|
$397.54 |
$397.54 |
$397.54 |
|
|
Thyroid (TSH) Test
|
$43.42 |
$43.42 |
$43.42 |
|
|
Thyroid Ultrasound
|
$432.90 |
$432.90 |
$432.90 |
|
|
Thyroid uptake measurement
|
$389.48 |
$389.48 |
$389.48 |
|
|
Thyroxine binding globulin (tbg)
|
$15.34 |
$15.34 |
$15.34 |
|
|
Tib/per revasc stent & ather 37231
|
$13,558.48 |
$13,558.48 |
$13,558.48 |
|
|
Tib/per revasc stnt & ather
|
$12,945.14 |
$12,945.14 |
$12,945.14 |
|
|
Tib/per revasc w/ather add-on 37233
|
$4,260.88 |
$4,260.88 |
$4,260.88 |
|
|
Tigecycline injection
|
$552.86 |
$552.86 |
$552.86 |
|
|
Tirofiban 12.5 mg/50 ml
|
$805.88 |
$805.88 |
$805.88 |
|
|
Tissue transglutaminase iga
|
$31.98 |
$31.98 |
$31.98 |
|
|
Tl-201 thallium diag per mci
|
$450.06 |
$450.06 |
$450.06 |
|
|
Tobramycin peak therapeutic drug level
|
$31.72 |
$31.72 |
$31.72 |
|
|
Tomosynthesis breast screen bilateral
|
$47.58 |
$47.58 |
$47.58 |
|
|
Toxoplasma antibody igg
|
$52.78 |
$52.78 |
$52.78 |
|
|
Toxoplasma antibody igm
|
$153.14 |
$153.14 |
$153.14 |
|
|
Tracheobrnchsc thru est trachs incisn
|
$584.22 |
$584.22 |
$584.22 |
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$253.50 |
$253.50 |
$253.50 |
|
|
Transcath closure of asd
|
$8,200.66 |
$8,200.66 |
$8,200.66 |
|
|
Transcath rmvl perm ldss pmkr rv
|
$1,858.22 |
$1,858.22 |
$1,858.22 |
|
|
Transferrin
|
$57.20 |
$57.20 |
$57.20 |
|
|
Transfusion blood/blood component(s)
|
$764.40 |
$764.40 |
$764.40 |
|
|
Trastuzumab-qyyp 150 mg intravenous solution
|
$8,258.53 |
$8,258.53 |
$8,258.53 |
|
|
Treat clavicle dislocation 23545
|
$530.40 |
$530.40 |
$530.40 |
|
|
Treat elbow dislocation
|
$1,300.52 |
$1,300.52 |
$1,300.52 |
|