|
Slp ther svc non-spch gen
|
$89.99 |
$89.99 |
$89.99 |
$188.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$432.95 |
$432.95 |
$432.95 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$46.72 |
$46.72 |
$46.72 |
$64.35
|
|
Smear gram stain
|
$59.42 |
$59.42 |
$59.42 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$12.37 |
$12.37 |
$12.37 |
$73.50
|
|
Smear wet mount
|
$36.41 |
$36.41 |
$36.41 |
$67.55
|
|
Sodium 24 hour urine
|
$44.14 |
$44.14 |
$44.14 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$27.59 |
$27.59 |
$27.59 |
$46.26
|
|
Specific gravity body fluid
|
$6.13 |
$6.13 |
$6.13 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$339.60 |
$339.60 |
$339.60 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$163.86 |
$163.86 |
$163.86 |
$246.87
|
|
Spine X-ray (single view, one level)
|
$236.94 |
$236.94 |
$236.94 |
$251.00
|
|
Sputum specimen collection
|
$224.63 |
$224.63 |
$224.63 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$322.62 |
$322.62 |
$322.62 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$217.34 |
$217.34 |
$217.34 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$29,129.66 |
$29,129.66 |
$29,129.66 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$6,161.23 |
$6,161.23 |
$6,161.23 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$23,304.26 |
$23,304.26 |
$23,304.26 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$6,161.23 |
$6,161.23 |
$6,161.23 |
$4,631.82
|
|
St evaluate speech sound production
|
$236.87 |
$236.87 |
$236.87 |
$292.95
|
|
Stimulants synthetic
|
$98.08 |
$98.08 |
$98.08 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,370.42 |
$1,370.42 |
$1,370.42 |
$1,345.40
|
|
Strep b dna amp probe
|
$72.82 |
$72.82 |
$72.82 |
$124.15
|
|
Stress test pulmonary
|
$364.72 |
$364.72 |
$364.72 |
$324.00
|
|
Str markers specimen anal
|
$1,051.70 |
$1,051.70 |
$1,051.70 |
$756.60
|
|
Sulfonylurea screen qn-sendout
|
$109.11 |
$109.11 |
$109.11 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$31.35 |
$31.35 |
$31.35 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$49.53 |
$49.53 |
$49.53 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$67.72 |
$67.72 |
$67.72 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$67.72 |
$67.72 |
$67.72 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$450.19 |
$450.19 |
$450.19 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,011.98 |
$1,011.98 |
$1,011.98 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$175.18 |
$175.18 |
$175.18 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$38.47 |
$38.47 |
$38.47 |
$35.89
|
|
Susceptibility mic per plate
|
$130.60 |
$130.60 |
$130.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$39.85 |
$39.85 |
$39.85 |
$59.28
|
|
Swallowing Evaluation (Bedside)
|
$136.30 |
$136.30 |
$136.30 |
$316.80
|
|
Swallowing Therapy Session
|
$180.84 |
$180.84 |
$180.84 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$39.94 |
$39.94 |
$39.94 |
$42.24
|
|
System pacing micra av
|
$20,115.26 |
$20,115.26 |
$20,115.26 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$62,855.30 |
$62,855.30 |
$62,855.30 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$43.52 |
$43.52 |
$43.52 |
$100.32
|
|
T3 (triiodothyronine) total
|
$26.36 |
$26.36 |
$26.36 |
$93.52
|
|
T4 (thyroxine) free
|
$40.46 |
$40.46 |
$40.46 |
$89.60
|
|
T4 (thyroxine) total
|
$34.33 |
$34.33 |
$34.33 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$39.23 |
$39.23 |
$39.23 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$228.32 |
$228.32 |
$228.32 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$1,765.12 |
$1,765.12 |
$1,765.12 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$6,455.38 |
$6,455.38 |
$6,455.38 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$230.40 |
$230.40 |
$230.40 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$142.85 |
$142.85 |
$142.85 |
$179.95
|
|
Tc-99m labeled rbc
|
$289.54 |
$289.54 |
$289.54 |
$306.00
|
|
Tc-99m maa
|
$149.42 |
$149.42 |
$149.42 |
$312.06
|
|
Tc-99m mebrofenin
|
$168.02 |
$168.02 |
$168.02 |
$157.65
|
|
Tc-99m medronate
|
$219.67 |
$219.67 |
$219.67 |
$111.01
|
|
Tc-99m pentetate dtpa
|
$350.30 |
$350.30 |
$350.30 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$6.82 |
$6.82 |
$6.82 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$136.40 |
$136.40 |
$136.40 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$172.30 |
$172.30 |
$172.30 |
$287.20
|
|
Tc-99m sulfur colloid
|
$150.04 |
$150.04 |
$150.04 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$108.29 |
$108.29 |
$108.29 |
$184.00
|
|
T cells total count
|
$87.55 |
$87.55 |
$87.55 |
$130.20
|
|
Telehealth original site facility fee
|
$21.56 |
$21.56 |
$21.56 |
$51.00
|
|
Testicular imaging w/vasc flow
|
$586.96 |
$586.96 |
$586.96 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,046.46 |
$1,046.46 |
$1,046.46 |
$953.40
|
|
Theophylline therapeutic drug level
|
$26.36 |
$26.36 |
$26.36 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$60.33 |
$60.33 |
$60.33 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$80.64 |
$80.64 |
$80.64 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$36.85 |
$36.85 |
$36.85 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.59 |
$34.59 |
$34.59 |
$50.40
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$198.17 |
$198.17 |
$198.17 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$189.51 |
$189.51 |
$189.51 |
$1,724.25
|
|
Thoracotomy w/expl
|
$917.13 |
$917.13 |
$917.13 |
$2,045.17
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,769.17 |
$1,769.17 |
$1,769.17 |
$1,703.45
|
|
Thrombin time
|
$33.71 |
$33.71 |
$33.71 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$62.01 |
$62.01 |
$62.01 |
$62.01
|
|
Thyroglobulin antibody
|
$73.73 |
$73.73 |
$73.73 |
$82.50
|
|
Thyroid imaging
|
$620.14 |
$620.14 |
$620.14 |
$695.60
|
|
Thyroid mets imag whole body
|
$1,419.55 |
$1,419.55 |
$1,419.55 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$68.04 |
$68.04 |
$68.04 |
$112.70
|
|
Thyroid Ultrasound
|
$788.56 |
$788.56 |
$788.56 |
$588.50
|
|
Thyroid uptake measurement
|
$386.63 |
$386.63 |
$386.63 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$27.59 |
$27.59 |
$27.59 |
$64.51
|
|
Tilt table study
|
$900.32 |
$900.32 |
$900.32 |
$1,561.82
|
|
Tissue culture skin/biopsy
|
$238.99 |
$238.99 |
$238.99 |
$488.74
|
|
Tissue exam koh skin/hair/nails
|
$147.71 |
$147.71 |
$147.71 |
$47.40
|
|
Tissue transglutaminase iga
|
$45.31 |
$45.31 |
$45.31 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$30.04 |
$30.04 |
$30.04 |
$120.60
|
|
Toe X-ray (both feet)
|
$184.53 |
$184.53 |
$184.53 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$43.79 |
$43.79 |
$43.79 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$38.47 |
$38.47 |
$38.47 |
$74.10
|
|
Tonsillectomy (age 12+)
|
$235.04 |
$235.04 |
$235.04 |
$4,558.89
|
|
Tonsillectomy (child under 12)
|
$245.44 |
$245.44 |
$245.44 |
$6,193.68
|
|
Total tau
|
$276.46 |
$276.46 |
$276.46 |
$312.50
|
|
Toxoplasma antibody igg
|
$48.38 |
$48.38 |
$48.38 |
$91.65
|
|
Toxoplasma antibody igm
|
$46.08 |
$46.08 |
$46.08 |
$87.75
|
|
Tpmt gene com vrnts
|
$386.92 |
$386.92 |
$386.92 |
$371.80
|
|
Tracheobrnchsc thru est trachs incisn
|
$107.12 |
$107.12 |
$107.12 |
$1,437.45
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$102.27 |
$102.27 |
$102.27 |
$102.27
|
|
Transferrin
|
$23.91 |
$23.91 |
$23.91 |
$82.00
|
