|
Smear gram stain
|
$40.70 |
$40.70 |
$40.70 |
$57.85
|
|
Smear nasal eosinophil
|
$45.10 |
$45.10 |
$45.10 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$86.35 |
$86.35 |
$86.35 |
$64.35
|
|
Smear wet mount
|
$154.00 |
$154.00 |
$154.00 |
$68.63
|
|
Smpd1 gene common variants
|
$230.45 |
$230.45 |
$230.45 |
$140.00
|
|
Snrpn/ube3a gene
|
$339.90 |
$339.90 |
$339.90 |
$228.80
|
|
Sodium 24 hour urine
|
$31.35 |
$31.35 |
$31.35 |
$48.50
|
|
Sodium serum/plasma/whole blood
|
$33.55 |
$33.55 |
$33.55 |
$42.70
|
|
Somatosensory testing
|
$400.40 |
$400.40 |
$400.40 |
$583.80
|
|
Special physics consult
|
$1,077.45 |
$1,077.45 |
$1,077.45 |
$700.74
|
|
Special radiation dosimetry
|
$219.45 |
$219.45 |
$219.45 |
$445.50
|
|
Special radiation treatment
|
$1,829.30 |
$1,829.30 |
$1,829.30 |
$1,934.03
|
|
Special teletx port plan
|
$646.25 |
$646.25 |
$646.25 |
$1,046.65
|
|
Specific gravity body fluid
|
$24.75 |
$24.75 |
$24.75 |
$23.63
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,035.00 |
$2,035.00 |
$2,035.00 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$737.55 |
$737.55 |
$737.55 |
$559.96
|
|
Spleen imaging
|
$495.55 |
$495.55 |
$495.55 |
$539.70
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$3,461.15 |
$3,461.15 |
$3,461.15 |
$4,560.66
|
|
Split blood or products
|
$83.60 |
$83.60 |
$83.60 |
$148.98
|
|
Sr-89 stront chlor ther / mci
|
$4,588.65 |
$4,588.65 |
$4,588.65 |
$4,588.65
|
|
Srs linear based
|
$13,585.00 |
$13,585.00 |
$13,585.00 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$287.10 |
$287.10 |
$287.10 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$172.70 |
$172.70 |
$172.70 |
$313.96
|
|
Stem cells total count
|
$125.40 |
$125.40 |
$125.40 |
$130.90
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$26,234.45 |
$26,234.45 |
$26,234.45 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,854.36 |
$6,854.36 |
$6,854.36 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$1,728.82 |
$1,728.82 |
$1,728.82 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$6,034.30 |
$6,034.30 |
$6,034.30 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$5,561.29 |
$5,561.29 |
$5,561.29 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$8,746.10 |
$8,746.10 |
$8,746.10 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$7,164.30 |
$7,164.30 |
$7,164.30 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$15,188.25 |
$15,188.25 |
$15,188.25 |
$19,765.20
|
|
St evaluate speech sound production comprehensive/expressive
|
$609.95 |
$609.95 |
$609.95 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$193.60 |
$193.60 |
$193.60 |
$406.40
|
|
St evaluation swallow function
|
$336.60 |
$336.60 |
$336.60 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$341.55 |
$341.55 |
$341.55 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$344.85 |
$344.85 |
$344.85 |
$171.00
|
|
Strapping of hand or finger
|
$361.90 |
$361.90 |
$361.90 |
$194.40
|
|
Strapping of hip
|
$242.55 |
$242.55 |
$242.55 |
$170.08
|
|
Strapping of knee
|
$293.15 |
$293.15 |
$293.15 |
$224.80
|
|
Strapping of toes 29550
|
$302.50 |
$302.50 |
$302.50 |
$185.36
|
|
Strep a ag ia
|
$24.20 |
$24.20 |
$24.20 |
$75.40
|
|
Strep b assay w/optic
|
$108.90 |
$108.90 |
$108.90 |
$32.00
|
|
Stress test pulmonary
|
$322.85 |
$322.85 |
$322.85 |
$327.20
|
|
Str markers specimen anal
|
$1,176.45 |
$1,176.45 |
$1,176.45 |
$835.28
|
|
St treatment speech individual
|
$198.55 |
$198.55 |
$198.55 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$289.30 |
$289.30 |
$289.30 |
$261.60
|
|
Sugars multiple quant
|
$26.95 |
$26.95 |
$26.95 |
$26.95
|
|
Sugars single quant
|
$168.85 |
$168.85 |
$168.85 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$138.05 |
$138.05 |
$138.05 |
$184.60
|
|
Surgical pathology level 1 gross examination only
|
$74.25 |
$74.25 |
$74.25 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$146.30 |
$146.30 |
$146.30 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$154.00 |
$154.00 |
$154.00 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$201.85 |
$201.85 |
$201.85 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$372.90 |
$372.90 |
$372.90 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$558.25 |
$558.25 |
$558.25 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$63.80 |
$63.80 |
$63.80 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$25.30 |
$25.30 |
$25.30 |
$34.48
|
|
Susceptibility mic per plate
|
$147.95 |
$147.95 |
$147.95 |
$94.38
|
|
Svc venogram s&i
|
$1,317.25 |
$1,317.25 |
$1,317.25 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$55.00 |
$55.00 |
$55.00 |
$44.85
|
|
System cardiomems hosp electronics
|
$26,408.18 |
$26,408.18 |
$26,408.18 |
$41,639.82
|
|
System pacing micra av
|
$11,781.99 |
$11,781.99 |
$11,781.99 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$2,805.16 |
$2,805.16 |
$2,805.16 |
$10,980.00
|
|
System sealant biosentry tract
|
$3,569.67 |
$3,569.67 |
$3,569.67 |
$900.00
|
|
T3 (triiodothyronine) free
|
$57.75 |
$57.75 |
$57.75 |
$89.82
|
|
T3 (triiodothyronine) total
|
$52.25 |
$52.25 |
$52.25 |
$94.90
|
|
T4 (thyroxine) free
|
$59.40 |
$59.40 |
$59.40 |
$81.60
|
|
T4 (thyroxine) total
|
$33.00 |
$33.00 |
$33.00 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$118.80 |
$118.80 |
$118.80 |
$122.40
|
|
Tavr perq femoral
|
$11,046.20 |
$11,046.20 |
$11,046.20 |
$16,357.00
|
|
Tbs techl calculation only
|
$110.55 |
$110.55 |
$110.55 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$99.55 |
$99.55 |
$99.55 |
$166.46
|
|
Tc-99m bicisate
|
$793.10 |
$793.10 |
$793.10 |
$1,969.45
|
|
Tc-99m diag per dose
|
$279.95 |
$279.95 |
$279.95 |
$279.95
|
|
Tc-99m exame autol wbc diag per dose
|
$1,419.55 |
$1,419.55 |
$1,419.55 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$525.80 |
$525.80 |
$525.80 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$148.50 |
$148.50 |
$148.50 |
$323.01
|
|
Tc-99m maa
|
$288.75 |
$288.75 |
$288.75 |
$312.06
|
|
Tc-99m mebrofenin
|
$51.15 |
$51.15 |
$51.15 |
$169.53
|
|
Tc-99m medronate
|
$34.10 |
$34.10 |
$34.10 |
$122.46
|
|
Tc-99m mertiatide
|
$550.00 |
$550.00 |
$550.00 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$20.35 |
$20.35 |
$20.35 |
$8.00
|
|
Tc-99m oxidronate
|
$37.40 |
$37.40 |
$37.40 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$160.60 |
$160.60 |
$160.60 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$160.60 |
$160.60 |
$160.60 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$5.50 |
$5.50 |
$5.50 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$99.00 |
$99.00 |
$99.00 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$141.90 |
$141.90 |
$141.90 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$470.80 |
$470.80 |
$470.80 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$178.20 |
$178.20 |
$178.20 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$124.85 |
$124.85 |
$124.85 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$684.75 |
$684.75 |
$684.75 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$79.75 |
$79.75 |
$79.75 |
$186.00
|
|
T cells absolute cd 4 count
|
$135.85 |
$135.85 |
$135.85 |
$120.25
|
|
T cells total count
|
$79.75 |
$79.75 |
$79.75 |
$124.11
|
|
Tee w or without fol w/cont,cong
|
$1,995.40 |
$1,995.40 |
$1,995.40 |
$1,995.40
|
|
Telehealth original site facility fee
|
$57.75 |
$57.75 |
$57.75 |
$60.80
|
|
Telethx isodose plan cplx
|
$2,083.40 |
$2,083.40 |
$2,083.40 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,463.00 |
$1,463.00 |
$1,463.00 |
$848.72
|
