|
Sinus CT scan (with contrast)
|
$1,683.50 |
$1,683.50 |
$1,683.50 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,464.50 |
$1,464.50 |
$1,464.50 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,613.50 |
$1,613.50 |
$1,613.50 |
$2,489.25
|
|
Sleep study attended
|
$1,937.50 |
$1,937.50 |
$1,937.50 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,850.50 |
$2,850.50 |
$2,850.50 |
$3,607.50
|
|
Sling suprapubic suburetheral
|
$26,970.50 |
$26,970.50 |
$26,970.50 |
$9,679.96
|
|
Slitting of prepuce
|
$3,146.50 |
$3,146.50 |
$3,146.50 |
$3,365.50
|
|
Smear fluorescent and/or acid fast stain
|
$103.00 |
$103.00 |
$103.00 |
$64.20
|
|
Smear gram stain
|
$77.50 |
$77.50 |
$77.50 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$36.00 |
$36.00 |
$36.00 |
$73.15
|
|
Smear wet mount
|
$147.50 |
$147.50 |
$147.50 |
$67.49
|
|
So airplane w/wo joint cf
|
$1,361.50 |
$1,361.50 |
$1,361.50 |
$1,276.80
|
|
Socket insert w lock mech
|
$881.50 |
$881.50 |
$881.50 |
$1,544.50
|
|
Sodium 24 hour urine
|
$63.00 |
$63.00 |
$63.00 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$63.00 |
$63.00 |
$63.00 |
$45.60
|
|
Soft interface below knee se
|
$132.00 |
$132.00 |
$132.00 |
$179.08
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$694.50 |
$694.50 |
$694.50 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$501.00 |
$501.00 |
$501.00 |
$543.26
|
|
Splint rstrc wrst/cmc right med
|
$18.50 |
$18.50 |
$18.50 |
$99.04
|
|
St analysis behavior qualitative voice/resonance
|
$270.50 |
$270.50 |
$270.50 |
$297.60
|
|
Staph a dna amp probe
|
$83.00 |
$83.00 |
$83.00 |
$125.00
|
|
Static or dynami afo pre ots
|
$228.50 |
$228.50 |
$228.50 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$150.00 |
$150.00 |
$150.00 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$28,392.00 |
$28,392.00 |
$28,392.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,754.50 |
$2,754.50 |
$2,754.50 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$66,903.50 |
$66,903.50 |
$66,903.50 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$3,820.50 |
$3,820.50 |
$3,820.50 |
$4,939.20
|
|
St evaluate speech sound production
|
$270.50 |
$270.50 |
$270.50 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$270.50 |
$270.50 |
$270.50 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$289.00 |
$289.00 |
$289.00 |
$399.60
|
|
St evaluation swallow function
|
$282.00 |
$282.00 |
$282.00 |
$314.40
|
|
Strapping of ankle and/or ft 29540
|
$181.50 |
$181.50 |
$181.50 |
$223.45
|
|
Strapping of knee
|
$189.00 |
$189.00 |
$189.00 |
$205.20
|
|
Stress test pulmonary
|
$232.50 |
$232.50 |
$232.50 |
$322.85
|
|
Stress tte complete
|
$1,026.50 |
$1,026.50 |
$1,026.50 |
$1,870.50
|
|
Str markers spec anal addl
|
$454.50 |
$454.50 |
$454.50 |
$479.17
|
|
Str markers specimen anal
|
$373.50 |
$373.50 |
$373.50 |
$751.50
|
|
St treatment speech individual
|
$202.50 |
$202.50 |
$202.50 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$193.50 |
$193.50 |
$193.50 |
$240.31
|
|
Sugars single quant
|
$88.00 |
$88.00 |
$88.00 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$264.00 |
$264.00 |
$264.00 |
$156.16
|
|
Support clav 29.6-40.5in med
|
$88.00 |
$88.00 |
$88.00 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$82.00 |
$82.00 |
$82.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$160.50 |
$160.50 |
$160.50 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$193.00 |
$193.00 |
$193.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$248.00 |
$248.00 |
$248.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$368.00 |
$368.00 |
$368.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$409.00 |
$409.00 |
$409.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$69.50 |
$69.50 |
$69.50 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$52.00 |
$52.00 |
$52.00 |
$35.70
|
|
Susceptibility mic per plate
|
$99.00 |
$99.00 |
$99.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$72.50 |
$72.50 |
$72.50 |
$59.28
|
|
Svc venogram s&i
|
$4,409.50 |
$4,409.50 |
$4,409.50 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$77.50 |
$77.50 |
$77.50 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.00 |
$76.00 |
$76.00 |
$41.60
|
|
System cardiomems hosp electronics
|
$90,382.50 |
$90,382.50 |
$90,382.50 |
$39,037.95
|
|
System pacing micra av
|
$37,907.00 |
$37,907.00 |
$37,907.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$17,630.00 |
$17,630.00 |
$17,630.00 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$8,229.00 |
$8,229.00 |
$8,229.00 |
$11,183.00
|
|
T3 (triiodothyronine) free
|
$129.00 |
$129.00 |
$129.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$109.00 |
$109.00 |
$109.00 |
$93.52
|
|
T4 (thyroxine) free
|
$105.00 |
$105.00 |
$105.00 |
$85.20
|
|
T4 (thyroxine) total
|
$79.00 |
$79.00 |
$79.00 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$248.00 |
$248.00 |
$248.00 |
$122.40
|
|
Talymed
|
$227.50 |
$227.50 |
$227.50 |
$3,411.49
|
|
Target gsa panel hmtlmph neop
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$4,174.50 |
$4,174.50 |
$4,174.50 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$315.00 |
$315.00 |
$315.00 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$84.50 |
$84.50 |
$84.50 |
$177.65
|
|
T cells absolute cd4/cd8 including ratio
|
$188.50 |
$188.50 |
$188.50 |
$176.40
|
|
T cells total count
|
$635.00 |
$635.00 |
$635.00 |
$126.90
|
|
Telehealth original site facility fee
|
$39.00 |
$39.00 |
$39.00 |
$51.00
|
|
Test stress cardiovascular tracing only
|
$1,012.50 |
$1,012.50 |
$1,012.50 |
$949.70
|
|
Theophylline therapeutic drug level
|
$98.50 |
$98.50 |
$98.50 |
$108.00
|
|
Ther/proph/diag inj ia
|
$145.00 |
$145.00 |
$145.00 |
$240.35
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,241.50 |
$1,241.50 |
$1,241.50 |
$1,687.50
|
|
Thrombin time
|
$134.50 |
$134.50 |
$134.50 |
$53.76
|
|
Thyroglobulin antibody
|
$124.50 |
$124.50 |
$124.50 |
$82.00
|
|
Thyroid imaging
|
$614.50 |
$614.50 |
$614.50 |
$695.02
|
|
Thyroid mets imag whole body
|
$1,333.00 |
$1,333.00 |
$1,333.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$126.50 |
$126.50 |
$126.50 |
$111.00
|
|
Thyroid Ultrasound
|
$561.00 |
$561.00 |
$561.00 |
$588.50
|
|
Thyroid uptake measurement
|
$475.00 |
$475.00 |
$475.00 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$95.50 |
$95.50 |
$95.50 |
$64.35
|
|
Tilt table study
|
$1,173.00 |
$1,173.00 |
$1,173.00 |
$1,507.01
|
|
Tissue culture skin/biopsy
|
$616.50 |
$616.50 |
$616.50 |
$484.00
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$251.00 |
$251.00 |
$251.00 |
$1,134.00
|
|
Tissue matrix xcm thk 20x30cm -cost per sq cm
|
$73.00 |
$73.00 |
$73.00 |
$18,999.96
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$22.50 |
$22.50 |
$22.50 |
$1,403.42
|
|
Tissue transglutaminase iga
|
$240.50 |
$240.50 |
$240.50 |
$44.16
|
|
Tixagev and cilgav inj
|
$677.50 |
$677.50 |
$677.50 |
$224.55
|
|
Tlso rigid lined custom fab
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$2,831.21
|
|
Tomosynthesis breast screen bilateral
|
$358.50 |
$358.50 |
$358.50 |
$72.68
|
|
Toxoplasma antibody igg
|
$124.50 |
$124.50 |
$124.50 |
$89.40
|
|
Toxoplasma antibody igm
|
$157.00 |
$157.00 |
$157.00 |
$87.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,811.50 |
$1,811.50 |
$1,811.50 |
$1,420.44
|
|
Transcatheter bx s&i
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$1,915.00
|
|
Transferrin
|
$95.50 |
$95.50 |
$95.50 |
$82.00
|
|
Transfusion blood/blood component(s)
|
$1,769.00 |
$1,769.00 |
$1,769.00 |
$983.00
|
|
Transparent film >16<=48 in
|
$86.00 |
$86.00 |
$86.00 |
$12.95
|
