|
Stent/tib/peroneal/unilat/initial 37230
|
$39,248.00 |
$39,248.00 |
$39,248.00 |
$16,098.16
|
|
St evaluate speech sound production
|
$353.00 |
$353.00 |
$353.00 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$465.00 |
$465.00 |
$465.00 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$1,345.40
|
|
Strep b dna amp probe
|
$262.00 |
$262.00 |
$262.00 |
$124.15
|
|
Stress test pulmonary
|
$160.00 |
$160.00 |
$160.00 |
$324.00
|
|
Surgical pathology level 1 gross examination only
|
$85.00 |
$85.00 |
$85.00 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$160.00 |
$160.00 |
$160.00 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$191.00 |
$191.00 |
$191.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$306.00 |
$306.00 |
$306.00 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$514.00 |
$514.00 |
$514.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$859.00 |
$859.00 |
$859.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$21.00 |
$21.00 |
$21.00 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$42.00 |
$42.00 |
$42.00 |
$35.89
|
|
Susceptibility mic per plate
|
$92.00 |
$92.00 |
$92.00 |
$106.00
|
|
Svc venogram s&i
|
$2,054.00 |
$2,054.00 |
$2,054.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$353.00 |
$353.00 |
$353.00 |
$316.80
|
|
Swallowing Therapy Session
|
$268.00 |
$268.00 |
$268.00 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$40.00 |
$40.00 |
$40.00 |
$42.24
|
|
T3 (triiodothyronine) free
|
$157.00 |
$157.00 |
$157.00 |
$100.32
|
|
T3 (triiodothyronine) total
|
$141.00 |
$141.00 |
$141.00 |
$93.52
|
|
T4 (thyroxine) free
|
$97.00 |
$97.00 |
$97.00 |
$89.60
|
|
T4 (thyroxine) total
|
$74.00 |
$74.00 |
$74.00 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$53.00 |
$53.00 |
$53.00 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$439.00 |
$439.00 |
$439.00 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$2,246.30
|
|
Target gsa panel organ neop
|
$3,578.00 |
$3,578.00 |
$3,578.00 |
$1,701.91
|
|
Tavr perq femoral
|
$23,773.00 |
$23,773.00 |
$23,773.00 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$206.00 |
$206.00 |
$206.00 |
$179.95
|
|
T cells absolute cd4/cd8 including ratio
|
$262.00 |
$262.00 |
$262.00 |
$184.00
|
|
T cells absolute cd 4 count
|
$140.00 |
$140.00 |
$140.00 |
$111.20
|
|
T cells total count
|
$244.00 |
$244.00 |
$244.00 |
$130.20
|
|
Telehealth original site facility fee
|
$68.00 |
$68.00 |
$68.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,355.00 |
$1,355.00 |
$1,355.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$742.00 |
$742.00 |
$742.00 |
$880.61
|
|
Test stress cardiovascular tracing only
|
$1,029.00 |
$1,029.00 |
$1,029.00 |
$953.40
|
|
Theophylline therapeutic drug level
|
$80.00 |
$80.00 |
$80.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$65.00 |
$65.00 |
$65.00 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$127.00 |
$127.00 |
$127.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$149.00 |
$149.00 |
$149.00 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$40.00 |
$40.00 |
$40.00 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$36.00 |
$36.00 |
$36.00 |
$50.40
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$407.00 |
$407.00 |
$407.00 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$1,703.45
|
|
Thrombectmy crnry perq mechanical
|
$898.00 |
$898.00 |
$898.00 |
$3,809.40
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$35,891.00 |
$35,891.00 |
$35,891.00 |
$21,413.60
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$27.00 |
$27.00 |
$27.00 |
$62.01
|
|
Thyroglobulin antibody
|
$75.00 |
$75.00 |
$75.00 |
$82.50
|
|
Thyroid mets imag whole body
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$1,524.99
|
|
Thyroid met uptake
|
$129.00 |
$129.00 |
$129.00 |
$407.40
|
|
Thyroid (TSH) Test
|
$125.00 |
$125.00 |
$125.00 |
$112.70
|
|
Thyroid Ultrasound
|
$814.00 |
$814.00 |
$814.00 |
$588.50
|
|
Tilt table study
|
$1,595.00 |
$1,595.00 |
$1,595.00 |
$1,561.82
|
|
Tissue culture skin/biopsy
|
$484.00 |
$484.00 |
$484.00 |
$488.74
|
|
Tissue transglutaminase iga
|
$87.00 |
$87.00 |
$87.00 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$80.00 |
$80.00 |
$80.00 |
$120.60
|
|
Toe X-ray (both feet)
|
$210.00 |
$210.00 |
$210.00 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$115.00 |
$115.00 |
$115.00 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$115.00 |
$115.00 |
$115.00 |
$74.10
|
|
Toxoplasma antibody igg
|
$117.00 |
$117.00 |
$117.00 |
$91.65
|
|
Toxoplasma antibody igm
|
$117.00 |
$117.00 |
$117.00 |
$87.75
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$183.00 |
$183.00 |
$183.00 |
$102.27
|
|
Transcutaneous carboxyhb
|
$20.00 |
$20.00 |
$20.00 |
$33.57
|
|
Transferrin
|
$126.00 |
$126.00 |
$126.00 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$731.00 |
$731.00 |
$731.00 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$607.00 |
$607.00 |
$607.00 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$5,431.00 |
$5,431.00 |
$5,431.00 |
$4,523.04
|
|
Treat elbow dislocation
|
$2,444.00 |
$2,444.00 |
$2,444.00 |
$2,272.50
|
|
Treat elbow fracture
|
$2,392.00 |
$2,392.00 |
$2,392.00 |
$2,026.50
|
|
Treat finger fracture each
|
$1,208.00 |
$1,208.00 |
$1,208.00 |
$1,592.00
|
|
Treat fracture of radius
|
$2,322.00 |
$2,322.00 |
$2,322.00 |
$1,790.00
|
|
Treat fracture of ulna
|
$404.00 |
$404.00 |
$404.00 |
$731.04
|
|
Treat hip socket fracture
|
$844.00 |
$844.00 |
$844.00 |
$1,392.00
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$336.00 |
$336.00 |
$336.00 |
$227.70
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$172.00 |
$172.00 |
$172.00 |
$147.48
|
|
Treponema pallidum antibody
|
$94.00 |
$94.00 |
$94.00 |
$72.05
|
|
Trichomonas assay w/optic
|
$62.00 |
$62.00 |
$62.00 |
$57.40
|
|
Triglycerides
|
$62.00 |
$62.00 |
$62.00 |
$58.50
|
|
Trim nondyst nails
|
$110.00 |
$110.00 |
$110.00 |
$113.88
|
|
Trnscath plc stent crv crtd without prtct
|
$4,119.00 |
$4,119.00 |
$4,119.00 |
$7,795.71
|
|
Trnscath plc stent crv crtd w/prtct
|
$3,640.00 |
$3,640.00 |
$3,640.00 |
$9,767.25
|
|
Trnscath plc vas stent w/s&i ini vein
|
$20,001.00 |
$20,001.00 |
$20,001.00 |
$14,461.50
|
|
Trnscath retrv pq vasc fb w/guide
|
$7,093.00 |
$7,093.00 |
$7,093.00 |
$4,766.40
|
|
Trnscath tx thromblytc artery non-intracrn ini day
|
$5,283.00 |
$5,283.00 |
$5,283.00 |
$5,139.20
|
|
Trnscath tx thromblytc cath rmv sbsq day
|
$5,238.00 |
$5,238.00 |
$5,238.00 |
$4,354.35
|
|
Troponin quantitative
|
$106.00 |
$106.00 |
$106.00 |
$127.60
|
|
Tte w or without fol w/con,stres
|
$1,628.00 |
$1,628.00 |
$1,628.00 |
$1,632.80
|
|
Tx atrial fib pulm vein isol
|
$37,856.00 |
$37,856.00 |
$37,856.00 |
$29,030.54
|
|
Tx closed hip disl traumatic without anes
|
$282.00 |
$282.00 |
$282.00 |
$586.40
|
|
Tx l/r atrial fib addl
|
$14,432.00 |
$14,432.00 |
$14,432.00 |
$6,986.85
|
|
Ultrasound breast complete
|
$599.00 |
$599.00 |
$599.00 |
$532.00
|
|
Ultrasound breast unilateral limited (both sides)
|
$536.00 |
$536.00 |
$536.00 |
$452.40
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$586.00 |
$586.00 |
$586.00 |
$338.00
|
|
Ultrasound dx ophth b-scan
|
$309.00 |
$309.00 |
$309.00 |
$296.80
|
|
Ultrasound elastography parenchyma
|
$370.00 |
$370.00 |
$370.00 |
$313.95
|
|
Ultrasound encephalogram
|
$1,024.00 |
$1,024.00 |
$1,024.00 |
$494.92
|
|
Ultrasound exam k transpl w/doppler
|
$733.00 |
$733.00 |
$733.00 |
$578.40
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$861.00 |
$861.00 |
$861.00 |
$476.94
|
|
Ultrasound Guidance for a Needle Procedure
|
$1,087.00 |
$1,087.00 |
$1,087.00 |
$720.15
|
