|
Stent iliac/open or perc/uni/init 37221
|
$6,778.17 |
$12,666.80 |
$13,730.40 |
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,192.84 |
$8,302.20 |
$10,966.50 |
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$6,778.17 |
$10,182.20 |
$13,130.25 |
|
|
St evaluate speech sound production
|
$34.44 |
$70.08 |
$97.20 |
|
|
St evaluate speech sound production comprehensive/expressive
|
$110.66 |
$148.48 |
$204.88 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$36.75 |
$164.60 |
$277.25 |
|
|
St evaluation swallow function
|
$53.90 |
$118.80 |
$277.25 |
|
|
Stimulants synthetic
|
$15.80 |
$18.24 |
$39.52 |
|
|
Strapping of ankle and/or ft 29540
|
$37.40 |
$80.77 |
$225.28 |
|
|
Strapping of chest
|
$36.52 |
$56.25 |
$225.28 |
|
|
Strapping of elbow or wrist 29260
|
$30.20 |
$80.77 |
$145.28 |
|
|
Strapping of hand or finger
|
$20.16 |
$36.75 |
$89.60 |
|
|
Strapping of hip
|
$30.20 |
$36.52 |
$66.40 |
|
|
Strapping of knee
|
$33.20 |
$62.73 |
$178.56 |
|
|
Strapping of toes 29550
|
$30.20 |
$39.06 |
$184.96 |
|
|
Strep a ag ia
|
$19.36 |
$35.20 |
$58.95 |
|
|
Strep b dna amp probe
|
$20.58 |
$32.75 |
$65.60 |
|
|
Streptokinase antibody
|
$17.01 |
$65.19 |
$71.55 |
|
|
Streptomycin injection
|
$58.19 |
$69.83 |
$232.75 |
|
|
Stress test pulmonary
|
$44.80 |
$56.00 |
$176.00 |
|
|
Stress tte complete
|
$391.60 |
$391.60 |
$450.34 |
|
|
St treatment speech individual
|
$49.72 |
$107.17 |
$271.25 |
|
|
St treatment swallow dysfunction/oral
|
$53.68 |
$110.76 |
$277.25 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$41.85 |
$50.22 |
$167.40 |
|
|
Sulfonylurea screen qn-sendout
|
$54.81 |
$71.07 |
$128.80 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$34.70 |
$41.64 |
$138.79 |
|
|
Surgical pathology level 1 gross examination only
|
$7.60 |
$9.50 |
$24.30 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$9.02 |
$15.12 |
$55.04 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$24.38 |
$33.36 |
$60.75 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$30.66 |
$33.44 |
$77.44 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$51.48 |
$109.80 |
$194.04 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$231.20 |
$260.82 |
$608.80 |
|
|
Susceptibility agar dilution per agent
|
$2.50 |
$6.80 |
$37.68 |
|
|
Susceptibility enzyme detection per enzyme
|
$5.50 |
$12.98 |
$62.10 |
|
|
Susceptibility mic per plate
|
$26.40 |
$44.73 |
$124.20 |
|
|
Suscept studies macrobroth dilution ea
|
$4.20 |
$5.04 |
$10.92 |
|
|
Svc venogram s&i
|
$499.84 |
$667.23 |
$1,061.75 |
|
|
Sweat collection by iontophoresis
|
$32.40 |
$38.88 |
$84.24 |
|
|
Synvisc or synvisc-one
|
$4,922.75 |
$4,922.75 |
$4,922.75 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$2.40 |
$18.48 |
$53.04 |
|
|
T3 (triiodothyronine) free
|
$23.98 |
$84.87 |
$161.25 |
|
|
T3 (triiodothyronine) total
|
$14.74 |
$46.80 |
$134.25 |
|
|
T4 (thyroxine) free
|
$7.70 |
$39.25 |
$58.32 |
|
|
T4 (thyroxine) total
|
$22.66 |
$36.34 |
$57.60 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.61 |
$3.13 |
$12.54 |
|
|
Tacrolimus therapeutic drug level
|
$28.60 |
$101.25 |
$216.00 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$821.10 |
$1,026.38 |
$3,284.40 |
|
|
Tap block bilat cont infusion 64489
|
$203.20 |
$203.20 |
$203.20 |
|
|
Tap block uni by cont infusion 64487
|
$195.60 |
$195.60 |
$195.60 |
|
|
Target gsa panel hmtlmph neop
|
$419.79 |
$443.52 |
$964.80 |
|
|
Target gsa panel organ/hmtlmph neop
|
$1,149.40 |
$1,699.47 |
$2,124.80 |
|
|
Target gsa panel organ neop
|
$274.56 |
$441.00 |
$499.20 |
|
|
Tbs techl calculation only
|
$98.12 |
$98.12 |
$178.40 |
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$37.80 |
$37.80 |
$39.69 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$34.10 |
$62.00 |
$342.16 |
|
|
Tc-99m apcitide diag
|
$846.86 |
$846.86 |
$846.86 |
|
|
Tc-99m depreotide
|
$43.60 |
$43.60 |
$43.60 |
|
|
Tc-99m disofenin
|
$89.68 |
$103.14 |
$179.37 |
|
|
Tc-99m exametazime diag
|
$45.31 |
$516.80 |
$804.75 |
|
|
Tc-99m labeled rbc
|
$61.40 |
$70.61 |
$93.45 |
|
|
Tc-99m maa
|
$22.89 |
$48.60 |
$60.75 |
|
|
Tc-99m mebrofenin
|
$31.50 |
$37.80 |
$63.00 |
|
|
Tc-99m medronate
|
$25.32 |
$29.12 |
$50.64 |
|
|
Tc-99m mertiatide
|
$211.20 |
$242.88 |
$422.40 |
|
|
Tc-99m non-heu per study dose
|
$2.10 |
$4.51 |
$4.95 |
|
|
Tc-99m oxidronate
|
$15.00 |
$15.00 |
$15.00 |
|
|
Tc-99m pentetate dtpa
|
$6.40 |
$7.36 |
$10.50 |
|
|
Tc-99m pentetate dtpa aerosol
|
$16.56 |
$16.56 |
$35.60 |
|
|
Tc-99m pertechnetate per mci
|
$0.22 |
$0.25 |
$9.39 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$95.93 |
$110.33 |
$191.87 |
|
|
Tc-99m sestamibi p study dose
|
$43.22 |
$51.86 |
$98.49 |
|
|
Tc-99m succimer (dmsa)
|
$97.40 |
$97.40 |
$112.01 |
|
|
Tc-99m sulfur colloid
|
$37.40 |
$43.01 |
$56.91 |
|
|
Tc-99m tetrofosmin p study dose
|
$31.40 |
$36.11 |
$39.25 |
|
|
Tc-99m tilmanocept diag
|
$313.20 |
$360.18 |
$626.40 |
|
|
Tcd emboli detect w/inj
|
$76.44 |
$76.44 |
$76.44 |
|
|
Tcd emboli detect without inj
|
$74.13 |
$74.13 |
$74.13 |
|
|
Tcd vasoreactivity study
|
$153.51 |
$153.51 |
$153.51 |
|
|
T cells absolute cd4/cd8 including ratio
|
$17.38 |
$31.60 |
$258.40 |
|
|
T cells absolute cd 4 count
|
$34.86 |
$54.05 |
$152.88 |
|
|
T cells total count
|
$12.81 |
$31.60 |
$207.40 |
|
|
Telehealth original site facility fee
|
$13.02 |
$16.56 |
$35.88 |
|
|
Telethx isodose plan cplx
|
$197.12 |
$505.20 |
$562.12 |
|
|
Telethx isodose plan simple
|
$212.74 |
$406.20 |
$456.00 |
|
|
Temozolomide
|
$116.83 |
$140.20 |
$560.78 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$795.52 |
$994.40 |
$3,182.06 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$20,709.96 |
$20,709.96 |
$20,709.96 |
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$910.40 |
$1,039.68 |
$2,252.64 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$7.50 |
$9.00 |
$40.00 |
|
|
Test for chlorohydrocarbons
|
$12.48 |
$12.48 |
$92.25 |
|
|
Test for urine cystines
|
$7.98 |
$9.12 |
$268.20 |
|
|
Testicular imaging w/vasc flow
|
$313.53 |
$338.33 |
$398.72 |
|
|
Test pathogen(s) for platelets reference
|
$23.31 |
$23.31 |
$23.31 |
|
|
Test stress cardiovascular tracing only
|
$211.14 |
$293.40 |
$592.65 |
|
|
Tetanus immune globulin inj
|
$1,657.98 |
$1,657.98 |
$1,657.98 |
|
|
Tgsap hl neo 5-50 rna alys
|
$493.00 |
$591.60 |
$1,281.80 |
|
|
Tgsap so/hl 51/< rna alys
|
$1,894.60 |
$2,273.52 |
$4,925.96 |
|
|
Tgsap so neo 5-50 rna alys
|
$388.20 |
$465.84 |
$1,009.32 |
|
|
Theophylline therapeutic drug level
|
$32.56 |
$59.20 |
$134.25 |
|
|
Therapeutic procd strg endur
|
$16.20 |
$19.44 |
$92.90 |
|