|
Sperm antibody test
|
$48.76 |
$48.76 |
$48.76 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$476.10 |
$476.10 |
$476.10 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$107.41 |
$107.41 |
$107.41 |
$543.26
|
|
Split blood or products
|
$47.84 |
$47.84 |
$47.84 |
$127.48
|
|
Sputum specimen collection
|
$65.78 |
$65.78 |
$65.78 |
$180.00
|
|
Sr-89 stront chlor ther / mci
|
$909.42 |
$909.42 |
$909.42 |
$2,667.94
|
|
Srs linear based
|
$3,782.81 |
$3,782.81 |
$3,782.81 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$69.00 |
$69.00 |
$69.00 |
$297.60
|
|
Staph a dna amp probe
|
$36.34 |
$36.34 |
$36.34 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$81.88 |
$81.88 |
$81.88 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$17,684.93 |
$17,684.93 |
$17,684.93 |
$21,626.50
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,193.93 |
$1,193.93 |
$1,193.93 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$13,038.01 |
$13,038.01 |
$13,038.01 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$10,300.78 |
$10,300.78 |
$10,300.78 |
$9,008.54
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$13,038.01 |
$13,038.01 |
$13,038.01 |
$17,271.50
|
|
St evaluate speech sound production
|
$67.16 |
$67.16 |
$67.16 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$138.23 |
$138.23 |
$138.23 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$221.03 |
$221.03 |
$221.03 |
$399.60
|
|
St evaluation swallow function
|
$125.58 |
$125.58 |
$125.58 |
$314.40
|
|
Stimulants synthetic
|
$17.48 |
$17.48 |
$17.48 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$64.86 |
$64.86 |
$64.86 |
$223.45
|
|
Strapping of chest
|
$53.82 |
$53.82 |
$53.82 |
$195.33
|
|
Strapping of hand or finger
|
$33.81 |
$33.81 |
$33.81 |
$174.82
|
|
Strapping of hip
|
$38.18 |
$38.18 |
$38.18 |
$164.70
|
|
Strapping of knee
|
$39.33 |
$39.33 |
$39.33 |
$205.20
|
|
Strapping of toes 29550
|
$33.81 |
$33.81 |
$33.81 |
$164.70
|
|
Strep b dna amp probe
|
$30.13 |
$30.13 |
$30.13 |
$120.90
|
|
Streptomycin injection
|
$66.92 |
$66.92 |
$66.92 |
$138.30
|
|
Stress test pulmonary
|
$51.52 |
$51.52 |
$51.52 |
$322.85
|
|
Stress tte complete
|
$450.34 |
$450.34 |
$450.34 |
$1,870.50
|
|
St treatment speech individual
|
$181.01 |
$181.01 |
$181.01 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$181.01 |
$181.01 |
$181.01 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$48.13 |
$48.13 |
$48.13 |
$52.31
|
|
Sulfonylurea screen qn-sendout
|
$71.07 |
$71.07 |
$71.07 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$39.90 |
$39.90 |
$39.90 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$9.20 |
$9.20 |
$9.20 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$14.49 |
$14.49 |
$14.49 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$24.38 |
$24.38 |
$24.38 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$31.97 |
$31.97 |
$31.97 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$123.97 |
$123.97 |
$123.97 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$260.82 |
$260.82 |
$260.82 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$3.45 |
$3.45 |
$3.45 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$5.52 |
$5.52 |
$5.52 |
$35.70
|
|
Susceptibility mic per plate
|
$63.48 |
$63.48 |
$63.48 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$4.83 |
$4.83 |
$4.83 |
$59.28
|
|
Svc venogram s&i
|
$667.23 |
$667.23 |
$667.23 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$37.26 |
$37.26 |
$37.26 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$2.76 |
$2.76 |
$2.76 |
$41.60
|
|
T3 (triiodothyronine) free
|
$89.24 |
$89.24 |
$89.24 |
$99.20
|
|
T3 (triiodothyronine) total
|
$46.00 |
$46.00 |
$46.00 |
$93.52
|
|
T4 (thyroxine) free
|
$36.34 |
$36.34 |
$36.34 |
$85.20
|
|
T4 (thyroxine) total
|
$36.34 |
$36.34 |
$36.34 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.00 |
$3.00 |
$3.00 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$179.86 |
$179.86 |
$179.86 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$944.26 |
$944.26 |
$944.26 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$442.06 |
$442.06 |
$442.06 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,699.47 |
$1,699.47 |
$1,699.47 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$156.86 |
$156.86 |
$156.86 |
$177.65
|
|
Tc-99m apcitide diag
|
$846.86 |
$846.86 |
$846.86 |
$1,181.70
|
|
Tc-99m disofenin
|
$103.14 |
$103.14 |
$103.14 |
$124.32
|
|
Tc-99m exametazime diag
|
$45.31 |
$45.31 |
$45.31 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$70.61 |
$70.61 |
$70.61 |
$302.40
|
|
Tc-99m maa
|
$55.89 |
$55.89 |
$55.89 |
$292.80
|
|
Tc-99m mebrofenin
|
$36.22 |
$36.22 |
$36.22 |
$157.65
|
|
Tc-99m medronate
|
$29.12 |
$29.12 |
$29.12 |
$111.01
|
|
Tc-99m mertiatide
|
$242.88 |
$242.88 |
$242.88 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$7.36 |
$7.36 |
$7.36 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$16.56 |
$16.56 |
$16.56 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$0.25 |
$0.25 |
$0.25 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$110.33 |
$110.33 |
$110.33 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$49.70 |
$49.70 |
$49.70 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$112.01 |
$112.01 |
$112.01 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$43.01 |
$43.01 |
$43.01 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$36.11 |
$36.11 |
$36.11 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$360.18 |
$360.18 |
$360.18 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$71.07 |
$71.07 |
$71.07 |
$176.40
|
|
T cells absolute cd 4 count
|
$54.05 |
$54.05 |
$54.05 |
$111.20
|
|
T cells total count
|
$57.73 |
$57.73 |
$57.73 |
$126.90
|
|
Telehealth original site facility fee
|
$15.87 |
$15.87 |
$15.87 |
$51.00
|
|
Telethx isodose plan cplx
|
$562.12 |
$562.12 |
$562.12 |
$1,526.85
|
|
Telethx isodose plan simple
|
$452.18 |
$452.18 |
$452.18 |
$873.62
|
|
Temozolomide
|
$134.35 |
$134.35 |
$134.35 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$914.84 |
$914.84 |
$914.84 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,031.32 |
$1,031.32 |
$1,031.32 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$8.62 |
$8.62 |
$8.62 |
$39.33
|
|
Test for urine cystines
|
$8.51 |
$8.51 |
$8.51 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$338.33 |
$338.33 |
$338.33 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$211.14 |
$211.14 |
$211.14 |
$949.70
|
|
Tgsap hl neo 5-50 rna alys
|
$566.95 |
$566.95 |
$566.95 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$2,178.79 |
$2,178.79 |
$2,178.79 |
$4,347.00
|
|
Tgsap so neo 5-50 rna alys
|
$446.43 |
$446.43 |
$446.43 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$46.23 |
$46.23 |
$46.23 |
$108.00
|
|
Therapeutic procd strg endur
|
$18.63 |
$18.63 |
$18.63 |
$85.68
|
|
Ther/proph/diag inj ia
|
$84.64 |
$84.64 |
$84.64 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$15.88 |
$15.88 |
$15.88 |
$25.54
|
|
Thiotepa injection
|
$1,500.05 |
$1,500.05 |
$1,500.05 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$738.30 |
$738.30 |
$738.30 |
$1,687.50
|
|
Thoracotomy w/expl
|
$668.38 |
$668.38 |
$668.38 |
$2,045.17
|
|
Thrombectmy crnry perq mechanical
|
$2,382.11 |
$2,382.11 |
$2,382.11 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,399.13 |
$2,399.13 |
$2,399.13 |
$8,084.00
|