|
Removal of scrotum lesion
|
$2,911.48 |
$2,911.48 |
$2,911.48 |
$2,507.31
|
|
Remove hip foreign body 27086
|
$3,856.32 |
$3,856.32 |
$3,856.32 |
$2,292.15
|
|
Remove shoulder fb deep
|
$3,856.32 |
$3,856.32 |
$3,856.32 |
$3,278.34
|
|
Remove shoulder foreign body subq 23330
|
$1,011.92 |
$1,011.92 |
$1,011.92 |
$1,788.80
|
|
Remove vaginal foreign body 57415
|
$4,267.12 |
$4,267.12 |
$4,267.12 |
$3,762.53
|
|
Renal function panel
|
$18.72 |
$18.72 |
$18.72 |
$114.37
|
|
Repair blood vessel direct hand finger
|
$2,114.32 |
$2,114.32 |
$2,114.32 |
$3,786.00
|
|
Repair blood vessel dir lower extr
|
$974.48 |
$974.48 |
$974.48 |
$1,694.40
|
|
Repair blood vessel dir upper extr
|
$4,585.88 |
$4,585.88 |
$4,585.88 |
$3,848.26
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$269.88 |
$269.88 |
$269.88 |
$1,025.95
|
|
Repair extns tendon finger without grft ea
|
$2,420.60 |
$2,420.60 |
$2,420.60 |
$2,269.00
|
|
Repair eyelid wound
|
$3,567.72 |
$3,567.72 |
$3,567.72 |
$2,760.73
|
|
Repair lip full thkns =<one-half vert height
|
$357.24 |
$357.24 |
$357.24 |
$1,308.00
|
|
Repair rpr lip full thickness vermilion only
|
$733.20 |
$733.20 |
$733.20 |
$1,224.63
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$138.32 |
$138.32 |
$138.32 |
$478.00
|
|
Replace duod/jej tube perc
|
$601.12 |
$601.12 |
$601.12 |
$1,354.54
|
|
Resp virus 6-11 targets
|
$223.60 |
$223.60 |
$223.60 |
$465.60
|
|
Resuscitation cardiopulmonary
|
$568.88 |
$568.88 |
$568.88 |
$751.00
|
|
Reticulocyte automated
|
$5.72 |
$5.72 |
$5.72 |
$52.80
|
|
Revision of cervix
|
$4,151.16 |
$4,151.16 |
$4,151.16 |
$3,760.68
|
|
Rheumatoid factor qualitative
|
$31.72 |
$31.72 |
$31.72 |
$57.20
|
|
Rheumatoid factor quantitative
|
$104.00 |
$104.00 |
$104.00 |
$56.58
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$3,317.77 |
$3,317.77 |
$3,317.77 |
$2,429.37
|
|
Rmvl fb upr arm/elbow deep
|
$3,856.32 |
$3,856.32 |
$3,856.32 |
$3,386.84
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$605.28 |
$605.28 |
$605.28 |
$1,822.05
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$4,545.95 |
$4,545.95 |
$4,545.95 |
$6,333.33
|
|
Rsv assay w/optic
|
$70.72 |
$70.72 |
$70.72 |
$82.68
|
|
Rubella antibody igg
|
$76.44 |
$76.44 |
$76.44 |
$76.86
|
|
Rubeola antibody igg
|
$37.96 |
$37.96 |
$37.96 |
$80.00
|
|
Rx metab gen seq alys pnl 6
|
$276.12 |
$276.12 |
$276.12 |
$917.08
|
|
Sarscov coronavirus ag ia
|
$96.72 |
$96.72 |
$96.72 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$260.52 |
$260.52 |
$260.52 |
$104.00
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$284.44 |
$284.44 |
$284.44 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$411.84 |
$411.84 |
$411.84 |
$662.40
|
|
Scan duplex extremity veins unilateral/limited study
|
$171.08 |
$171.08 |
$171.08 |
$721.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$462.28 |
$462.28 |
$462.28 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$273.00 |
$273.00 |
$273.00 |
$658.45
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$382.20 |
$382.20 |
$382.20 |
$583.20
|
|
Screening prostate cancer PSA
|
$49.92 |
$49.92 |
$49.92 |
$98.28
|
|
Sedimentation rate erythrocyte automated
|
$14.56 |
$14.56 |
$14.56 |
$42.48
|
|
Sevelamer carbonate 800 mg tablet
|
$2.80 |
$2.80 |
$2.80 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$5.69 |
$5.69 |
$5.69 |
$22.02
|
|
Shoulder MRI (with and without contrast)
|
$2,563.60 |
$2,563.60 |
$2,563.60 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$2,231.84 |
$2,231.84 |
$2,231.84 |
$2,456.30
|
|
Shoulder MRI (without contrast)
|
$992.68 |
$992.68 |
$992.68 |
$2,110.00
|
|
Shoulder X-ray
|
$123.76 |
$123.76 |
$123.76 |
$344.38
|
|
Sickling rbc
|
$13.00 |
$13.00 |
$13.00 |
$57.00
|
|
Sinus CT scan (with and without contrast)
|
$848.12 |
$848.12 |
$848.12 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$714.48 |
$714.48 |
$714.48 |
$1,530.90
|
|
Sinus CT scan (without contrast)
|
$640.12 |
$640.12 |
$640.12 |
$1,292.04
|
|
Skel musc relaxant 3 or more
|
$192.92 |
$192.92 |
$192.92 |
$16.12
|
|
Smear fluorescent and/or acid fast stain
|
$13.00 |
$13.00 |
$13.00 |
$64.35
|
|
Smear gram stain
|
$88.40 |
$88.40 |
$88.40 |
$54.75
|
|
Smear wet mount
|
$11.96 |
$11.96 |
$11.96 |
$66.95
|
|
Sodium 24 hour urine
|
$12.48 |
$12.48 |
$12.48 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$34.84 |
$34.84 |
$34.84 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$386.10 |
$386.10 |
$386.10 |
$177.52
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$252.72 |
$252.72 |
$252.72 |
$543.26
|
|
St analysis behavior qualitative voice/resonance
|
$156.00 |
$156.00 |
$156.00 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$185.12 |
$185.12 |
$185.12 |
$281.00
|
|
St evaluate speech sound production
|
$85.28 |
$85.28 |
$85.28 |
$288.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$204.88 |
$204.88 |
$204.88 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$110.76 |
$110.76 |
$110.76 |
$373.50
|
|
St evaluation swallow function
|
$171.08 |
$171.08 |
$171.08 |
$309.60
|
|
Stimulants synthetic
|
$39.52 |
$39.52 |
$39.52 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$93.60 |
$93.60 |
$93.60 |
$205.38
|
|
Strapping of hand or finger
|
$73.32 |
$73.32 |
$73.32 |
$174.82
|
|
Strapping of knee
|
$73.32 |
$73.32 |
$73.32 |
$206.50
|
|
Strapping of toes 29550
|
$73.32 |
$73.32 |
$73.32 |
$164.70
|
|
Stress test pulmonary
|
$116.48 |
$116.48 |
$116.48 |
$322.85
|
|
St treatment speech individual
|
$108.68 |
$108.68 |
$108.68 |
$250.50
|
|
St treatment swallow dysfunction/oral
|
$110.76 |
$110.76 |
$110.76 |
$243.99
|
|
Susceptibility mic per plate
|
$39.00 |
$39.00 |
$39.00 |
$105.93
|
|
Suscept studies macrobroth dilution ea
|
$10.92 |
$10.92 |
$10.92 |
$59.28
|
|
Sweat collection by iontophoresis
|
$84.24 |
$84.24 |
$84.24 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$53.04 |
$53.04 |
$53.04 |
$41.25
|
|
T3 (triiodothyronine) free
|
$53.04 |
$53.04 |
$53.04 |
$99.50
|
|
T3 (triiodothyronine) total
|
$36.40 |
$36.40 |
$36.40 |
$93.52
|
|
T4 (thyroxine) free
|
$34.84 |
$34.84 |
$34.84 |
$85.20
|
|
T4 (thyroxine) total
|
$26.00 |
$26.00 |
$26.00 |
$68.16
|
|
Tacrolimus therapeutic drug level
|
$103.48 |
$103.48 |
$103.48 |
$121.20
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$2,134.86 |
$2,134.86 |
$2,134.86 |
$2,762.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$342.16 |
$342.16 |
$342.16 |
$175.00
|
|
T cells absolute cd 4 count
|
$152.88 |
$152.88 |
$152.88 |
$110.72
|
|
Telehealth original site facility fee
|
$35.88 |
$35.88 |
$35.88 |
$51.85
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,068.34 |
$2,068.34 |
$2,068.34 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$2,252.64 |
$2,252.64 |
$2,252.64 |
$2,139.67
|
|
Test for chlorohydrocarbons
|
$12.48 |
$12.48 |
$12.48 |
$61.60
|
|
Tgsap hl neo 5-50 rna alys
|
$1,281.80 |
$1,281.80 |
$1,281.80 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$4,925.96 |
$4,925.96 |
$4,925.96 |
$4,029.05
|
|
Tgsap so neo 5-50 rna alys
|
$1,009.32 |
$1,009.32 |
$1,009.32 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$39.52 |
$39.52 |
$39.52 |
$108.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$39.00 |
$39.00 |
$39.00 |
$50.00
|
|
Ther/proph/diag inj ia
|
$100.88 |
$100.88 |
$100.88 |
$243.20
|
|
Thiotepa injection
|
$3,391.42 |
$3,391.42 |
$3,391.42 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,589.12 |
$1,589.12 |
$1,589.12 |
$1,687.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$13.52 |
$13.52 |
$13.52 |
$61.50
|
|
Thyroglobulin antibody
|
$34.84 |
$34.84 |
$34.84 |
$81.90
|
|
Thyroid (TSH) Test
|
$70.72 |
$70.72 |
$70.72 |
$112.70
|
|
Thyroid Ultrasound
|
$273.00 |
$273.00 |
$273.00 |
$589.96
|
