|
Splint extn xsm w sof-stretch rolyan
|
$54.40 |
$54.40 |
$54.40 |
$71.44
|
|
Splint finger frog med
|
$32.00 |
$32.00 |
$32.00 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$54.40 |
$54.40 |
$54.40 |
$99.04
|
|
St analysis behavior qualitative voice/resonance
|
$477.60 |
$477.60 |
$477.60 |
$297.60
|
|
Staph a dna amp probe
|
$235.20 |
$235.20 |
$235.20 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$373.60 |
$373.60 |
$373.60 |
$286.00
|
|
St evaluate speech sound production
|
$391.20 |
$391.20 |
$391.20 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$547.20 |
$547.20 |
$547.20 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,224.80 |
$1,224.80 |
$1,224.80 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$199.20 |
$199.20 |
$199.20 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$192.80 |
$192.80 |
$192.80 |
$157.46
|
|
Strapping of hand or finger
|
$250.40 |
$250.40 |
$250.40 |
$177.45
|
|
Strapping of knee
|
$250.40 |
$250.40 |
$250.40 |
$205.20
|
|
Strep b dna amp probe
|
$310.40 |
$310.40 |
$310.40 |
$124.15
|
|
Stress test pulmonary
|
$985.60 |
$985.60 |
$985.60 |
$324.00
|
|
Stress tte complete
|
$2,748.80 |
$2,748.80 |
$2,748.80 |
$1,900.96
|
|
Str markers spec anal addl
|
$752.80 |
$752.80 |
$752.80 |
$479.17
|
|
Str markers specimen anal
|
$1,693.60 |
$1,693.60 |
$1,693.60 |
$756.60
|
|
Sugars single quant
|
$410.40 |
$410.40 |
$410.40 |
$64.28
|
|
Support clav 29.6-40.5in med
|
$58.40 |
$58.40 |
$58.40 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$147.20 |
$147.20 |
$147.20 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$339.20 |
$339.20 |
$339.20 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$414.40 |
$414.40 |
$414.40 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$529.60 |
$529.60 |
$529.60 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$654.40 |
$654.40 |
$654.40 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,423.20 |
$1,423.20 |
$1,423.20 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$85.60 |
$85.60 |
$85.60 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$53.60 |
$53.60 |
$53.60 |
$35.89
|
|
Susceptibility mic per plate
|
$80.80 |
$80.80 |
$80.80 |
$106.00
|
|
Svc venogram s&i
|
$5,157.60 |
$5,157.60 |
$5,157.60 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$412.80 |
$412.80 |
$412.80 |
$316.80
|
|
Swallowing Therapy Session
|
$288.00 |
$288.00 |
$288.00 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$104.00 |
$104.00 |
$104.00 |
$42.24
|
|
T3 (triiodothyronine) free
|
$247.20 |
$247.20 |
$247.20 |
$100.32
|
|
T3 (triiodothyronine) total
|
$195.20 |
$195.20 |
$195.20 |
$93.52
|
|
T4 (thyroxine) free
|
$132.80 |
$132.80 |
$132.80 |
$89.60
|
|
T4 (thyroxine) total
|
$132.80 |
$132.80 |
$132.80 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$452.00 |
$452.00 |
$452.00 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$448.80 |
$448.80 |
$448.80 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$8,216.80 |
$8,216.80 |
$8,216.80 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$3,746.70
|
|
Target gsa panel organ neop
|
$5,023.20 |
$5,023.20 |
$5,023.20 |
$1,701.91
|
|
Tas congenital car anomal
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
$6,003.27
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$411.20 |
$411.20 |
$411.20 |
$179.95
|
|
T cells absolute cd4/cd8 including ratio
|
$264.00 |
$264.00 |
$264.00 |
$184.00
|
|
T cells total count
|
$253.60 |
$253.60 |
$253.60 |
$130.20
|
|
Telehealth original site facility fee
|
$63.20 |
$63.20 |
$63.20 |
$51.00
|
|
Tert gene targeted seq alys
|
$3,048.80 |
$3,048.80 |
$3,048.80 |
$335.00
|
|
Testicular imaging w/vasc flow
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,663.20 |
$1,663.20 |
$1,663.20 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$9,375.20 |
$9,375.20 |
$9,375.20 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$201.60 |
$201.60 |
$201.60 |
$108.00
|
|
Therapeutic procd strg endur
|
$112.00 |
$112.00 |
$112.00 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$140.00 |
$140.00 |
$140.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$140.00 |
$140.00 |
$140.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$78.40 |
$78.40 |
$78.40 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$76.80 |
$76.80 |
$76.80 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$2,629.60 |
$2,629.60 |
$2,629.60 |
$538.88
|
|
Ther/proph/diag inj ia
|
$228.80 |
$228.80 |
$228.80 |
$247.33
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$883.20 |
$883.20 |
$883.20 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,814.40 |
$2,814.40 |
$2,814.40 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,314.40 |
$2,314.40 |
$2,314.40 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$9,803.20 |
$9,803.20 |
$9,803.20 |
$3,809.40
|
|
Thrombin time
|
$119.20 |
$119.20 |
$119.20 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$247.20 |
$247.20 |
$247.20 |
$62.01
|
|
Thyroglobulin antibody
|
$170.40 |
$170.40 |
$170.40 |
$82.50
|
|
Thyroid met imaging
|
$1,359.20 |
$1,359.20 |
$1,359.20 |
$838.25
|
|
Thyroid mets imag whole body
|
$2,395.20 |
$2,395.20 |
$2,395.20 |
$1,524.99
|
|
Thyroid met uptake
|
$355.20 |
$355.20 |
$355.20 |
$407.40
|
|
Thyroid (TSH) Test
|
$203.20 |
$203.20 |
$203.20 |
$112.70
|
|
Thyroid Ultrasound
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$588.50
|
|
Thyroid uptake measurement
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$75.20 |
$75.20 |
$75.20 |
$64.51
|
|
Tilt table study
|
$1,345.60 |
$1,345.60 |
$1,345.60 |
$1,561.82
|
|
Tissue culture placenta
|
$2,098.40 |
$2,098.40 |
$2,098.40 |
$453.00
|
|
Tissue culture skin/biopsy
|
$2,408.80 |
$2,408.80 |
$2,408.80 |
$488.74
|
|
Tissue culture tumor
|
$5,848.00 |
$5,848.00 |
$5,848.00 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$96.00 |
$96.00 |
$96.00 |
$47.40
|
|
Tixagev and cilgav inj
|
$128.80 |
$128.80 |
$128.80 |
$244.50
|
|
Tobramycin peak therapeutic drug level
|
$263.20 |
$263.20 |
$263.20 |
$120.60
|
|
Toe X-ray (both feet)
|
$412.80 |
$412.80 |
$412.80 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$234.40 |
$234.40 |
$234.40 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$133.60 |
$133.60 |
$133.60 |
$74.10
|
|
Total tau
|
$448.00 |
$448.00 |
$448.00 |
$312.50
|
|
Toxoplasma antibody igg
|
$175.20 |
$175.20 |
$175.20 |
$91.65
|
|
Toxoplasma antibody igm
|
$188.80 |
$188.80 |
$188.80 |
$87.75
|
|
Tp53 gene full gene sequence
|
$952.80 |
$952.80 |
$952.80 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$1,427.20 |
$1,427.20 |
$1,427.20 |
$804.00
|
|
Tpmt gene com vrnts
|
$1,780.00 |
$1,780.00 |
$1,780.00 |
$371.80
|
|
Tracheostoma revision; simple, without flap rotation
|
$6,022.40 |
$6,022.40 |
$6,022.40 |
$3,946.50
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$126.40 |
$126.40 |
$126.40 |
$102.27
|
|
Transcath biopsy
|
$4,531.20 |
$4,531.20 |
$4,531.20 |
$4,285.93
|
|
Transcath closure of asd
|
$82,828.80 |
$82,828.80 |
$82,828.80 |
$17,041.80
|
|
Transcath occlusion cns
|
$15,143.20 |
$15,143.20 |
$15,143.20 |
$7,337.20
|
|
Transcath occlusion non-cns
|
$17,658.40 |
$17,658.40 |
$17,658.40 |
$10,270.00
|
|
Transferrin
|
$167.20 |
$167.20 |
$167.20 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$1,111.20 |
$1,111.20 |
$1,111.20 |
$4,523.04
|
|
Treat elbow fracture
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$2,026.50
|
