|
Sedimentation rate erythrocyte automated
|
$56.99 |
$56.99 |
$56.99 |
$42.25
|
|
Semen analysis presence/motility
|
$53.71 |
$53.71 |
$53.71 |
$74.75
|
|
Sevelamer carbonate 800 mg tablet
|
$2.21 |
$2.21 |
$2.21 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$4.48 |
$4.48 |
$4.48 |
$22.02
|
|
Shoulder MRI (with and without contrast)
|
$1,942.17 |
$1,942.17 |
$1,942.17 |
$2,739.30
|
|
Shoulder MRI (without contrast)
|
$998.76 |
$998.76 |
$998.76 |
$2,087.25
|
|
Shoulder X-ray
|
$95.94 |
$95.94 |
$95.94 |
$340.10
|
|
Sickling rbc
|
$56.99 |
$56.99 |
$56.99 |
$56.00
|
|
Sinus CT scan (with and without contrast)
|
$674.04 |
$674.04 |
$674.04 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$620.74 |
$620.74 |
$620.74 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$607.62 |
$607.62 |
$607.62 |
$1,290.19
|
|
Skel musc relaxant 3 or more
|
$152.11 |
$152.11 |
$152.11 |
$16.12
|
|
Skin Biopsy
|
$262.40 |
$262.40 |
$262.40 |
$360.34
|
|
Slitting of prepuce
|
$1,090.19 |
$1,090.19 |
$1,090.19 |
$3,616.86
|
|
Smear fluorescent and/or acid fast stain
|
$82.41 |
$82.41 |
$82.41 |
$64.00
|
|
Smear gram stain
|
$78.31 |
$78.31 |
$78.31 |
$53.64
|
|
Smear special stain inclusion bodies/parasites
|
$44.28 |
$44.28 |
$44.28 |
$71.20
|
|
Smear wet mount
|
$18.04 |
$18.04 |
$18.04 |
$66.30
|
|
Sodium 24 hour urine
|
$11.07 |
$11.07 |
$11.07 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$23.37 |
$23.37 |
$23.37 |
$45.50
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$304.42 |
$304.42 |
$304.42 |
$177.52
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$208.69 |
$208.69 |
$208.69 |
$543.26
|
|
Split blood or products
|
$85.28 |
$85.28 |
$85.28 |
$127.80
|
|
St analysis behavior qualitative voice/resonance
|
$83.64 |
$83.64 |
$83.64 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$71.75 |
$71.75 |
$71.75 |
$281.00
|
|
St evaluate speech sound production
|
$67.24 |
$67.24 |
$67.24 |
$289.20
|
|
St evaluate speech sound production comprehensive/expressive
|
$161.54 |
$161.54 |
$161.54 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$71.75 |
$71.75 |
$71.75 |
$370.20
|
|
St evaluation swallow function
|
$108.24 |
$108.24 |
$108.24 |
$309.60
|
|
Strapping of ankle and/or ft 29540
|
$80.77 |
$80.77 |
$80.77 |
$217.70
|
|
Strapping of chest
|
$93.89 |
$93.89 |
$93.89 |
$196.93
|
|
Strapping of elbow or wrist 29260
|
$80.77 |
$80.77 |
$80.77 |
$152.00
|
|
Strapping of hand or finger
|
$80.77 |
$80.77 |
$80.77 |
$171.00
|
|
Strapping of knee
|
$62.73 |
$62.73 |
$62.73 |
$206.50
|
|
Strapping of toes 29550
|
$62.73 |
$62.73 |
$62.73 |
$164.70
|
|
Strep a ag ia
|
$53.71 |
$53.71 |
$53.71 |
$75.40
|
|
Streptokinase antibody
|
$65.19 |
$65.19 |
$65.19 |
$25.60
|
|
Stress test pulmonary
|
$91.84 |
$91.84 |
$91.84 |
$322.85
|
|
St treatment speech individual
|
$94.71 |
$94.71 |
$94.71 |
$249.00
|
|
St treatment swallow dysfunction/oral
|
$83.64 |
$83.64 |
$83.64 |
$240.50
|
|
Surgical pathology level 1 gross examination only
|
$22.14 |
$22.14 |
$22.14 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$9.02 |
$9.02 |
$9.02 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$55.35 |
$55.35 |
$55.35 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$59.86 |
$59.86 |
$59.86 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$89.38 |
$89.38 |
$89.38 |
$480.00
|
|
Susceptibility agar dilution per agent
|
$6.56 |
$6.56 |
$6.56 |
$43.00
|
|
Susceptibility enzyme detection per enzyme
|
$56.58 |
$56.58 |
$56.58 |
$35.40
|
|
Susceptibility mic per plate
|
$38.13 |
$38.13 |
$38.13 |
$104.58
|
|
Suscept studies macrobroth dilution ea
|
$8.61 |
$8.61 |
$8.61 |
$59.28
|
|
Sweat collection by iontophoresis
|
$66.42 |
$66.42 |
$66.42 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$4.51 |
$4.51 |
$4.51 |
$40.00
|
|
T3 (triiodothyronine) free
|
$84.87 |
$84.87 |
$84.87 |
$98.80
|
|
T3 (triiodothyronine) total
|
$66.83 |
$66.83 |
$66.83 |
$93.52
|
|
T4 (thyroxine) free
|
$41.00 |
$41.00 |
$41.00 |
$84.15
|
|
T4 (thyroxine) total
|
$31.16 |
$31.16 |
$31.16 |
$67.10
|
|
Tacrolimus therapeutic drug level
|
$92.25 |
$92.25 |
$92.25 |
$120.42
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,683.26 |
$1,683.26 |
$1,683.26 |
$2,762.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$51.66 |
$51.66 |
$51.66 |
$175.92
|
|
Tc-99m non-heu per study dose
|
$4.51 |
$4.51 |
$4.51 |
$6.50
|
|
T cells absolute cd4/cd8 including ratio
|
$25.01 |
$25.01 |
$25.01 |
$175.00
|
|
T cells absolute cd 4 count
|
$68.06 |
$68.06 |
$68.06 |
$110.72
|
|
T cells total count
|
$25.01 |
$25.01 |
$25.01 |
$123.00
|
|
Telehealth original site facility fee
|
$25.42 |
$25.42 |
$25.42 |
$51.85
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,630.81 |
$1,630.81 |
$1,630.81 |
$3,723.60
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$1,812.20 |
$1,812.20 |
$1,812.20 |
$2,139.67
|
|
Test for urine cystines
|
$244.36 |
$244.36 |
$244.36 |
$27.03
|
|
Test stress cardiovascular tracing only
|
$539.97 |
$539.97 |
$539.97 |
$949.92
|
|
Tgsap hl neo 5-50 rna alys
|
$1,010.65 |
$1,010.65 |
$1,010.65 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$3,883.93 |
$3,883.93 |
$3,883.93 |
$4,029.05
|
|
Tgsap so neo 5-50 rna alys
|
$795.81 |
$795.81 |
$795.81 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$66.83 |
$66.83 |
$66.83 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$19.68 |
$19.68 |
$19.68 |
$55.98
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$27.47 |
$27.47 |
$27.47 |
$50.00
|
|
Ther/proph/diag inj ia
|
$125.05 |
$125.05 |
$125.05 |
$246.00
|
|
Thiotepa injection
|
$2,674.01 |
$2,674.01 |
$2,674.01 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,252.96 |
$1,252.96 |
$1,252.96 |
$1,687.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$88.56 |
$88.56 |
$88.56 |
$61.20
|
|
Thyroglobulin antibody
|
$59.04 |
$59.04 |
$59.04 |
$81.90
|
|
Thyroid imaging
|
$350.55 |
$350.55 |
$350.55 |
$695.02
|
|
Thyroid (TSH) Test
|
$150.47 |
$150.47 |
$150.47 |
$111.75
|
|
Thyroid Ultrasound
|
$253.38 |
$253.38 |
$253.38 |
$588.50
|
|
Thyroid uptake measurement
|
$269.78 |
$269.78 |
$269.78 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$20.50 |
$20.50 |
$20.50 |
$64.35
|
|
Tirofiban 12.5 mg/50 ml
|
$258.30 |
$258.30 |
$258.30 |
$456.00
|
|
Tissue exam koh skin/hair/nails
|
$25.83 |
$25.83 |
$25.83 |
$47.50
|
|
Tissue transglutaminase iga
|
$15.58 |
$15.58 |
$15.58 |
$44.16
|
|
Tixagev and cilgav inj
|
$208.69 |
$208.69 |
$208.69 |
$209.97
|
|
Tobramycin peak therapeutic drug level
|
$70.11 |
$70.11 |
$70.11 |
$121.55
|
|
Tomosynthesis breast screen bilateral
|
$41.41 |
$41.41 |
$41.41 |
$68.43
|
|
Toxoplasma antibody igg
|
$28.70 |
$28.70 |
$28.70 |
$88.80
|
|
Toxoplasma antibody igm
|
$28.70 |
$28.70 |
$28.70 |
$87.00
|
|
Tp53 gene full gene sequence
|
$888.06 |
$888.06 |
$888.06 |
$706.04
|
|
Tp53 gene trgt sequence alys
|
$438.70 |
$438.70 |
$438.70 |
$823.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$501.02 |
$501.02 |
$501.02 |
$1,396.00
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$26.24 |
$26.24 |
$26.24 |
$101.25
|
|
Transferrin
|
$41.00 |
$41.00 |
$41.00 |
$81.60
|
|
Transfusion blood/blood component(s)
|
$136.53 |
$136.53 |
$136.53 |
$936.80
|
|
Trauma partial team response w/critical care services level 4
|
$1,279.20 |
$1,279.20 |
$1,279.20 |
$4,063.80
|
|
Trb@ gene rearrange dirprobe
|
$68.47 |
$68.47 |
$68.47 |
$73.46
|
|
Treat ankle dislocation
|
$1,786.37 |
$1,786.37 |
$1,786.37 |
$2,321.50
|
