|
Screen cerv/vag thin layer
|
$418.00 |
$418.00 |
$418.00 |
$47.04
|
|
Screening prostate cancer PSA
|
$265.00 |
$265.00 |
$265.00 |
$81.31
|
|
Sc ther infusion reset pump
|
$656.00 |
$656.00 |
$656.00 |
$126.75
|
|
Sedimentation rate erythrocyte automated
|
$139.00 |
$139.00 |
$139.00 |
$44.20
|
|
Semen analysis presence/motility
|
$245.00 |
$245.00 |
$245.00 |
$70.85
|
|
Serpina1 gene
|
$320.00 |
$320.00 |
$320.00 |
$191.73
|
|
Sialidase enzyme assay
|
$31.00 |
$31.00 |
$31.00 |
$49.44
|
|
Sialography s&i
|
$1,587.00 |
$1,587.00 |
$1,587.00 |
$462.40
|
|
Sinus CT scan (with and without contrast)
|
$7,703.00 |
$7,703.00 |
$7,703.00 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$7,115.00 |
$7,115.00 |
$7,115.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$6,498.00 |
$6,498.00 |
$6,498.00 |
$1,279.50
|
|
Skyla, 13.5 mg
|
$3,884.00 |
$3,884.00 |
$3,884.00 |
$2,343.60
|
|
Sleep study attended
|
$5,916.00 |
$5,916.00 |
$5,916.00 |
$1,237.08
|
|
Sleep study unattended
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$595.50
|
|
Sm-153 lexidron ther
|
$20,875.00 |
$20,875.00 |
$20,875.00 |
$11,563.30
|
|
Smear nasal eosinophil
|
$156.00 |
$156.00 |
$156.00 |
$49.50
|
|
Smear wet mount
|
$139.00 |
$139.00 |
$139.00 |
$68.63
|
|
Sodium 24 hour urine
|
$139.00 |
$139.00 |
$139.00 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$306.00 |
$306.00 |
$306.00 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$306.00 |
$306.00 |
$306.00 |
$51.51
|
|
Sodium serum/plasma/whole blood
|
$43.00 |
$43.00 |
$43.00 |
$42.70
|
|
Special physics consult
|
$1,783.00 |
$1,783.00 |
$1,783.00 |
$700.74
|
|
Special teletx port plan
|
$1,661.00 |
$1,661.00 |
$1,661.00 |
$1,046.65
|
|
Specific gravity body fluid
|
$139.00 |
$139.00 |
$139.00 |
$23.63
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$2,925.00 |
$2,925.00 |
$2,925.00 |
$559.96
|
|
Sputum specimen collection
|
$90.00 |
$90.00 |
$90.00 |
$180.00
|
|
Srs linear based
|
$63,884.00 |
$63,884.00 |
$63,884.00 |
$14,124.25
|
|
Strep b assay w/optic
|
$402.00 |
$402.00 |
$402.00 |
$32.00
|
|
Stress test pulmonary
|
$697.00 |
$697.00 |
$697.00 |
$327.20
|
|
Str markers specimen anal
|
$339.00 |
$339.00 |
$339.00 |
$835.28
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$83.00 |
$83.00 |
$83.00 |
$49.13
|
|
Sugars single quant
|
$114.00 |
$114.00 |
$114.00 |
$52.47
|
|
Support clav 29.6-40.5in med
|
$423.00 |
$423.00 |
$423.00 |
$68.54
|
|
Surgical pathology level 1 gross examination only
|
$264.00 |
$264.00 |
$264.00 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$292.00 |
$292.00 |
$292.00 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$241.00 |
$241.00 |
$241.00 |
$192.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$662.00 |
$662.00 |
$662.00 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,520.00 |
$1,520.00 |
$1,520.00 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$72.00 |
$72.00 |
$72.00 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$79.00 |
$79.00 |
$79.00 |
$34.48
|
|
Suscept studies macrobroth dilution ea
|
$212.00 |
$212.00 |
$212.00 |
$48.30
|
|
Svc venogram s&i
|
$6,990.00 |
$6,990.00 |
$6,990.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$458.00 |
$458.00 |
$458.00 |
$105.21
|
|
T3 (triiodothyronine) free
|
$245.00 |
$245.00 |
$245.00 |
$89.82
|
|
T3 (triiodothyronine) total
|
$190.00 |
$190.00 |
$190.00 |
$94.90
|
|
T4 (thyroxine) total
|
$157.00 |
$157.00 |
$157.00 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$735.00 |
$735.00 |
$735.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$2,493.00 |
$2,493.00 |
$2,493.00 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$4,435.00 |
$4,435.00 |
$4,435.00 |
$3,385.00
|
|
Target gsa panel organ neop
|
$5,166.00 |
$5,166.00 |
$5,166.00 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$387.00 |
$387.00 |
$387.00 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$268.00 |
$268.00 |
$268.00 |
$186.00
|
|
T cells absolute cd 4 count
|
$571.00 |
$571.00 |
$571.00 |
$120.25
|
|
T cells total count
|
$28.00 |
$28.00 |
$28.00 |
$124.11
|
|
Telehealth original site facility fee
|
$92.00 |
$92.00 |
$92.00 |
$44.85
|
|
Telethx isodose plan cplx
|
$4,374.00 |
$4,374.00 |
$4,374.00 |
$1,617.00
|
|
Telethx isodose plan simple
|
$2,905.00 |
$2,905.00 |
$2,905.00 |
$848.72
|
|
Tetanus immune globulin inj
|
$1,746.00 |
$1,746.00 |
$1,746.00 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$458.00 |
$458.00 |
$458.00 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$157.00 |
$157.00 |
$157.00 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$116.00 |
$116.00 |
$116.00 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$2,897.00 |
$2,897.00 |
$2,897.00 |
$534.32
|
|
Thrombin time
|
$265.00 |
$265.00 |
$265.00 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$124.00 |
$124.00 |
$124.00 |
$56.93
|
|
Thyroid mets imag whole body
|
$4,666.00 |
$4,666.00 |
$4,666.00 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$350.00 |
$350.00 |
$350.00 |
$120.00
|
|
Thyroid Ultrasound
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$298.00 |
$298.00 |
$298.00 |
$63.60
|
|
Tissue culture skin/biopsy
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$187.00 |
$187.00 |
$187.00 |
$47.40
|
|
Toxoplasma antibody igg
|
$351.00 |
$351.00 |
$351.00 |
$84.35
|
|
Toxoplasma antibody igm
|
$284.00 |
$284.00 |
$284.00 |
$83.20
|
|
Tp53 gene trgt sequence alys
|
$880.00 |
$880.00 |
$880.00 |
$919.10
|
|
Tpmt gene com vrnts
|
$427.00 |
$427.00 |
$427.00 |
$381.55
|
|
Transcatheter bx s&i
|
$13,118.00 |
$13,118.00 |
$13,118.00 |
$1,875.96
|
|
Transferrin
|
$222.00 |
$222.00 |
$222.00 |
$87.30
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$524.00 |
$524.00 |
$524.00 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$524.00 |
$524.00 |
$524.00 |
$149.00
|
|
Treatment radiation delivery level 2
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$735.00
|
|
Trg gene rearrangement anal
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$455.70
|
|
Trichomonas assay w/optic
|
$34.00 |
$34.00 |
$34.00 |
$66.00
|
|
#tricyclicantidprssnt
|
$34.00 |
$34.00 |
$34.00 |
$57.08
|
|
Tx atrial fib pulm vein isol
|
$105,901.00 |
$105,901.00 |
$105,901.00 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$28,914.00 |
$28,914.00 |
$28,914.00 |
$7,717.80
|
|
Ultrasound chest
|
$2,081.00 |
$2,081.00 |
$2,081.00 |
$459.55
|
|
Ultrasound encephalogram
|
$2,614.00 |
$2,614.00 |
$2,614.00 |
$481.60
|
|
Ultrasound exam k transpl w/doppler
|
$1,904.00 |
$1,904.00 |
$1,904.00 |
$570.44
|
|
Ultrasound guidance for vascular access
|
$1,394.00 |
$1,394.00 |
$1,394.00 |
$340.22
|
|
Ultrasound guide intraoperative
|
$647.00 |
$647.00 |
$647.00 |
$632.90
|
|
Ultrasound joint complete left
|
$4,789.00 |
$4,789.00 |
$4,789.00 |
$556.14
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$2,848.00 |
$2,848.00 |
$2,848.00 |
$690.48
|
|
Ultrasound scrotum and contents
|
$2,312.00 |
$2,312.00 |
$2,312.00 |
$617.28
|
|
Ultrasound spinal canal and contents
|
$2,554.00 |
$2,554.00 |
$2,554.00 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$2,848.00 |
$2,848.00 |
$2,848.00 |
$425.10
|
|
Unlisted px med radj physics
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$376.03
|
|
Unlisted ultrasound procedure
|
$713.00 |
$713.00 |
$713.00 |
$321.20
|
|
Unsched dialysis esrd pt hos
|
$3,702.00 |
$3,702.00 |
$3,702.00 |
$1,505.29
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$11,724.00 |
$11,724.00 |
$11,724.00 |
$2,916.00
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$10,794.00 |
$10,794.00 |
$10,794.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$11,629.00 |
$11,629.00 |
$11,629.00 |
$2,013.08
|
