|
Rheumatoid factor qualitative
|
$40.05 |
$40.05 |
$40.05 |
$57.20
|
|
Rheumatoid factor quantitative
|
$40.05 |
$40.05 |
$40.05 |
$56.55
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$2,871.15 |
$2,871.15 |
$2,871.15 |
$2,429.37
|
|
Rmvl fb upr arm/elbow deep
|
$3,337.20 |
$3,337.20 |
$3,337.20 |
$3,386.84
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$503.55 |
$503.55 |
$503.55 |
$1,876.00
|
|
Rmvl subq card rhythm mntr
|
$881.55 |
$881.55 |
$881.55 |
$1,734.00
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$3,933.99 |
$3,933.99 |
$3,933.99 |
$6,333.33
|
|
Rsv assay w/optic
|
$39.60 |
$39.60 |
$39.60 |
$82.68
|
|
Rubella antibody igg
|
$96.75 |
$96.75 |
$96.75 |
$76.86
|
|
Rubeola antibody igg
|
$58.05 |
$58.05 |
$58.05 |
$80.00
|
|
Russell viper venom diluted
|
$50.40 |
$50.40 |
$50.40 |
$68.64
|
|
Rx metab gen seq alys pnl 6
|
$238.95 |
$238.95 |
$238.95 |
$917.08
|
|
Salmonella antibody
|
$19.80 |
$19.80 |
$19.80 |
$37.58
|
|
Sarscov coronavirus ag ia
|
$83.70 |
$83.70 |
$83.70 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$225.45 |
$225.45 |
$225.45 |
$105.00
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$306.00 |
$306.00 |
$306.00 |
$966.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$430.65 |
$430.65 |
$430.65 |
$653.40
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$319.05 |
$319.05 |
$319.05 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$319.95 |
$319.95 |
$319.95 |
$709.76
|
|
Scan duplex lower extremity arteries complete bilateral
|
$459.00 |
$459.00 |
$459.00 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$266.40 |
$266.40 |
$266.40 |
$645.21
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$266.40 |
$266.40 |
$266.40 |
$567.00
|
|
Scr c/v cyto,thinlayer,rescr
|
$50.85 |
$50.85 |
$50.85 |
$83.40
|
|
Screening Colonoscopy (average risk)
|
$1,163.70 |
$1,163.70 |
$1,163.70 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$775.35 |
$775.35 |
$775.35 |
$2,000.00
|
|
Screening hepatitis c antibody high risk
|
$150.75 |
$150.75 |
$150.75 |
$99.66
|
|
Screening Mammogram
|
$218.25 |
$218.25 |
$218.25 |
$310.20
|
|
Screening prostate cancer PSA
|
$119.25 |
$119.25 |
$119.25 |
$98.28
|
|
Sedimentation rate erythrocyte automated
|
$62.55 |
$62.55 |
$62.55 |
$44.20
|
|
Semen analysis presence/motility
|
$58.95 |
$58.95 |
$58.95 |
$75.40
|
|
Sevelamer carbonate 800 mg tablet
|
$2.43 |
$2.43 |
$2.43 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$4.92 |
$4.92 |
$4.92 |
$21.42
|
|
Shoulder MRI (with and without contrast)
|
$2,131.65 |
$2,131.65 |
$2,131.65 |
$2,743.02
|
|
Shoulder MRI (without contrast)
|
$1,096.20 |
$1,096.20 |
$1,096.20 |
$2,110.00
|
|
Shoulder X-ray
|
$105.30 |
$105.30 |
$105.30 |
$343.70
|
|
Sickling rbc
|
$62.55 |
$62.55 |
$62.55 |
$54.00
|
|
Sinus CT scan (with and without contrast)
|
$739.80 |
$739.80 |
$739.80 |
$1,800.90
|
|
Sinus CT scan (with contrast)
|
$681.30 |
$681.30 |
$681.30 |
$1,562.50
|
|
Sinus CT scan (without contrast)
|
$666.90 |
$666.90 |
$666.90 |
$1,281.80
|
|
Skel musc relaxant 3 or more
|
$166.95 |
$166.95 |
$166.95 |
$13.60
|
|
Skin Biopsy
|
$288.00 |
$288.00 |
$288.00 |
$357.00
|
|
Slitting of prepuce
|
$1,196.55 |
$1,196.55 |
$1,196.55 |
$3,281.10
|
|
Smear fluorescent and/or acid fast stain
|
$90.45 |
$90.45 |
$90.45 |
$64.35
|
|
Smear gram stain
|
$85.95 |
$85.95 |
$85.95 |
$55.35
|
|
Smear special stain inclusion bodies/parasites
|
$48.60 |
$48.60 |
$48.60 |
$68.85
|
|
Smear wet mount
|
$19.80 |
$19.80 |
$19.80 |
$66.30
|
|
Sodium 24 hour urine
|
$12.15 |
$12.15 |
$12.15 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$25.65 |
$25.65 |
$25.65 |
$45.00
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$334.12 |
$334.12 |
$334.12 |
$177.52
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$229.05 |
$229.05 |
$229.05 |
$536.34
|
|
Split blood or products
|
$93.60 |
$93.60 |
$93.60 |
$125.72
|
|
St analysis behavior qualitative voice/resonance
|
$91.80 |
$91.80 |
$91.80 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$78.75 |
$78.75 |
$78.75 |
$284.65
|
|
St evaluate speech sound production
|
$73.80 |
$73.80 |
$73.80 |
$288.75
|
|
St evaluate speech sound production comprehensive/expressive
|
$177.30 |
$177.30 |
$177.30 |
$376.84
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$78.75 |
$78.75 |
$78.75 |
$373.50
|
|
St evaluation swallow function
|
$118.80 |
$118.80 |
$118.80 |
$311.36
|
|
Strapping of ankle and/or ft 29540
|
$88.65 |
$88.65 |
$88.65 |
$205.38
|
|
Strapping of chest
|
$103.05 |
$103.05 |
$103.05 |
$196.93
|
|
Strapping of elbow or wrist 29260
|
$88.65 |
$88.65 |
$88.65 |
$157.46
|
|
Strapping of hand or finger
|
$88.65 |
$88.65 |
$88.65 |
$177.45
|
|
Strapping of knee
|
$68.85 |
$68.85 |
$68.85 |
$205.20
|
|
Strapping of toes 29550
|
$68.85 |
$68.85 |
$68.85 |
$164.70
|
|
Strep a ag ia
|
$58.95 |
$58.95 |
$58.95 |
$75.40
|
|
Streptokinase antibody
|
$71.55 |
$71.55 |
$71.55 |
$25.60
|
|
Stress test pulmonary
|
$100.80 |
$100.80 |
$100.80 |
$311.40
|
|
St treatment speech individual
|
$103.95 |
$103.95 |
$103.95 |
$253.80
|
|
St treatment swallow dysfunction/oral
|
$91.80 |
$91.80 |
$91.80 |
$245.50
|
|
Surgical pathology level 1 gross examination only
|
$24.30 |
$24.30 |
$24.30 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$9.90 |
$9.90 |
$9.90 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$60.75 |
$60.75 |
$60.75 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$65.70 |
$65.70 |
$65.70 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$98.10 |
$98.10 |
$98.10 |
$489.00
|
|
Susceptibility agar dilution per agent
|
$7.20 |
$7.20 |
$7.20 |
$42.70
|
|
Susceptibility enzyme detection per enzyme
|
$62.10 |
$62.10 |
$62.10 |
$35.10
|
|
Susceptibility mic per plate
|
$41.85 |
$41.85 |
$41.85 |
$104.00
|
|
Suscept studies macrobroth dilution ea
|
$9.45 |
$9.45 |
$9.45 |
$59.28
|
|
Sweat collection by iontophoresis
|
$72.90 |
$72.90 |
$72.90 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$4.95 |
$4.95 |
$4.95 |
$40.11
|
|
T3 (triiodothyronine) free
|
$93.15 |
$93.15 |
$93.15 |
$99.20
|
|
T3 (triiodothyronine) total
|
$73.35 |
$73.35 |
$73.35 |
$93.52
|
|
T4 (thyroxine) free
|
$45.00 |
$45.00 |
$45.00 |
$85.20
|
|
T4 (thyroxine) total
|
$34.20 |
$34.20 |
$34.20 |
$67.80
|
|
Tacrolimus therapeutic drug level
|
$101.25 |
$101.25 |
$101.25 |
$120.60
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,847.47 |
$1,847.47 |
$1,847.47 |
$2,675.52
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$56.70 |
$56.70 |
$56.70 |
$175.00
|
|
Tc-99m non-heu per study dose
|
$4.95 |
$4.95 |
$4.95 |
$6.50
|
|
T cells absolute cd4/cd8 including ratio
|
$27.45 |
$27.45 |
$27.45 |
$175.00
|
|
T cells absolute cd 4 count
|
$74.70 |
$74.70 |
$74.70 |
$110.00
|
|
T cells total count
|
$27.45 |
$27.45 |
$27.45 |
$123.00
|
|
Telehealth original site facility fee
|
$27.90 |
$27.90 |
$27.90 |
$49.80
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,789.91 |
$1,789.91 |
$1,789.91 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,989.00 |
$1,989.00 |
$1,989.00 |
$2,139.67
|
|
Test for urine cystines
|
$268.20 |
$268.20 |
$268.20 |
$27.03
|
|
Test stress cardiovascular tracing only
|
$592.65 |
$592.65 |
$592.65 |
$953.40
|
|
Tgsap hl neo 5-50 rna alys
|
$1,109.25 |
$1,109.25 |
$1,109.25 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$4,262.85 |
$4,262.85 |
$4,262.85 |
$3,505.00
|
|
Tgsap so neo 5-50 rna alys
|
$873.45 |
$873.45 |
$873.45 |
$918.72
|
|
Theophylline therapeutic drug level
|
$73.35 |
$73.35 |
$73.35 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$21.60 |
$21.60 |
$21.60 |
$57.50
|
