|
Spine X-ray (single view, one level)
|
$90.50 |
$164.50 |
$1,497.00 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$111.00 |
$831.50 |
$2,607.32 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$53.50 |
$53.50 |
$337.96 |
|
|
Splint finger 4 prong foam sm
|
$1,539.50 |
$1,539.50 |
$1,539.50 |
|
|
Splint finger fold over sm
|
$114.50 |
$114.50 |
$496.96 |
|
|
Splint finger frog med
|
$35.50 |
$35.50 |
$505.74 |
|
|
Splint func pos polyflex ii med
|
$4,068.00 |
$4,068.00 |
$4,068.00 |
|
|
Splint rstrc wrst/cmc right med
|
$18.50 |
$153.50 |
$496.96 |
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$2,123.00 |
$2,882.50 |
$37,133.77 |
|
|
Split blood or products
|
$253.00 |
$281.00 |
$281.00 |
|
|
Sputum specimen collection
|
$90.00 |
$90.00 |
$122.40 |
|
|
Srs linear based
|
$7,861.00 |
$10,149.50 |
$63,884.00 |
|
|
Srs multisource
|
$29,123.00 |
$37,601.50 |
$37,601.50 |
|
|
St analysis behavior qualitative voice/resonance
|
$199.50 |
$252.50 |
$521.50 |
|
|
Staph a dna amp probe
|
$52.00 |
$71.50 |
$186.00 |
|
|
Static or dynami afo pre ots
|
$228.50 |
$374.50 |
$1,567.50 |
|
|
St cognitve performance testing healthcare professional each hour
|
$150.00 |
$214.00 |
$504.00 |
|
|
Stem cells total count
|
$198.50 |
$261.50 |
$303.50 |
|
|
Stenger test pure tone
|
$91.00 |
$91.00 |
$91.00 |
|
|
Stenger test speech
|
$303.00 |
$303.00 |
$303.00 |
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$19,932.50 |
$23,353.00 |
$41,200.00 |
|
|
Stent axios caut enh 15x10mm electrocaut
|
$28,392.00 |
$30,079.00 |
$113,102.65 |
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,289.00 |
$2,754.50 |
$90,915.00 |
|
|
Stent bili rx wallflx 10x80 uncvr
|
$41,616.00 |
$41,616.00 |
$98,752.50 |
|
|
Stent bronch dumon sil 10x40mm
|
$2,194.50 |
$5,613.00 |
$8,529.50 |
|
|
Stent iliac/open or perc/uni/init 37221
|
$5,421.50 |
$10,098.00 |
$55,917.31 |
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$5,421.50 |
$8,686.50 |
$18,541.50 |
|
|
Stent placemt retro carotid
|
$6,091.50 |
$7,520.50 |
$7,520.50 |
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$11,509.00 |
$14,636.50 |
$146,740.21 |
|
|
Sterile water/saline, 10 ml
|
$105.00 |
$105.00 |
$105.00 |
|
|
Sternal pad
|
$567.25 |
$567.25 |
$567.25 |
|
|
St evaluate speech sound production
|
$67.50 |
$238.50 |
$373.50 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$178.00 |
$367.00 |
$498.00 |
|
|
Stimulants synthetic
|
$313.80 |
$313.80 |
$313.80 |
|
|
Stocking sup grips 4 pre ots
|
$88.41 |
$88.41 |
$88.41 |
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$686.00 |
$1,420.00 |
$5,293.00 |
|
|
Straight knee joint heavy du
|
$277.50 |
$277.50 |
$830.71 |
|
|
Strapping of ankle and/or ft 29540
|
$119.50 |
$181.50 |
$364.20 |
|
|
Strapping of chest
|
$98.50 |
$119.00 |
$136.00 |
|
|
Strapping of elbow or wrist 29260
|
$143.40 |
$219.50 |
$492.50 |
|
|
Strapping of hand or finger
|
$119.00 |
$182.00 |
$607.00 |
|
|
Strapping of hip
|
$58.00 |
$80.00 |
$155.00 |
|
|
Strapping of knee
|
$65.50 |
$127.00 |
$290.40 |
|
|
Strapping of toes 29550
|
$54.00 |
$74.50 |
$113.50 |
|
|
Strep a ag ia
|
$102.00 |
$141.50 |
$906.00 |
|
|
Strep b assay w/optic
|
$209.40 |
$209.40 |
$402.00 |
|
|
Strep b dna amp probe
|
$50.70 |
$50.70 |
$151.80 |
|
|
Stress test pulmonary
|
$138.50 |
$232.50 |
$697.00 |
|
|
Stress tte complete
|
$1,026.50 |
$1,123.50 |
$1,730.30 |
|
|
Str markers spec anal addl
|
$335.00 |
$417.00 |
$534.00 |
|
|
Str markers specimen anal
|
$275.00 |
$342.00 |
$699.00 |
|
|
Subq njx filling matrl 1cc/<
|
$225.00 |
$311.50 |
$311.50 |
|
|
Subq njx fil matrl 5.1-10cc
|
$550.50 |
$550.50 |
$550.50 |
|
|
Subtalar arthro w/deb
|
$16,430.12 |
$16,430.12 |
$16,430.12 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$45.00 |
$45.00 |
$83.00 |
|
|
Suction lipectomy trunk
|
$2,357.00 |
$3,259.00 |
$43,788.59 |
|
|
Suction lipectomy upr extrem
|
$32,681.65 |
$32,681.65 |
$32,681.65 |
|
|
Sugars single quant
|
$69.50 |
$96.00 |
$125.50 |
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$68.12 |
$312.62 |
$349.87 |
|
|
Sulfonylurea screen qn-sendout
|
$171.60 |
$240.00 |
$264.00 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,942.00 |
$1,942.00 |
$1,942.00 |
|
|
Support clav 29.6-40.5in med
|
$88.00 |
$137.00 |
$1,431.38 |
|
|
Surg dx exam anorectal
|
$2,317.50 |
$2,832.50 |
$3,204.50 |
|
|
Surgical pathology level 1 gross examination only
|
$52.00 |
$82.00 |
$264.00 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$63.00 |
$159.50 |
$292.00 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$124.00 |
$193.00 |
$289.20 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$195.50 |
$275.00 |
$378.50 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$246.50 |
$368.00 |
$662.00 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$380.00 |
$524.00 |
$1,520.00 |
|
|
Susceptibility agar dilution per agent
|
$41.40 |
$73.00 |
$108.00 |
|
|
Susceptibility enzyme detection per enzyme
|
$32.50 |
$44.50 |
$90.00 |
|
|
Susceptibility mic per plate
|
$99.00 |
$346.50 |
$1,251.60 |
|
|
Suscept studies macrobroth dilution ea
|
$50.40 |
$139.00 |
$212.00 |
|
|
Suspension sleeve lower ext
|
$600.61 |
$600.61 |
$600.61 |
|
|
Svc venogram s&i
|
$831.50 |
$2,170.80 |
$6,990.00 |
|
|
Swallowing Evaluation (Bedside)
|
$199.50 |
$252.50 |
$490.00 |
|
|
Swallowing Therapy Session
|
$153.50 |
$194.50 |
$533.00 |
|
|
Sweat collection by iontophoresis
|
$77.50 |
$158.50 |
$458.00 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$57.50 |
$86.50 |
$188.00 |
|
|
System cardiomems hosp electronics
|
$90,382.50 |
$111,240.00 |
$144,844.00 |
|
|
System pacing micra av
|
$21,995.50 |
$22,599.50 |
$104,709.00 |
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$11,419.50 |
$25,946.50 |
$82,056.00 |
|
|
System recell skin grafting/harvesting
|
$8,229.00 |
$11,183.00 |
$43,106.25 |
|
|
T3 (triiodothyronine) free
|
$65.50 |
$230.50 |
$624.00 |
|
|
T3 (triiodothyronine) total
|
$63.00 |
$109.00 |
$455.00 |
|
|
T4 (thyroxine) free
|
$59.50 |
$101.40 |
$407.00 |
|
|
T4 (thyroxine) total
|
$38.00 |
$157.00 |
$477.50 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$64.49 |
$72.18 |
$108.74 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$2,026.00 |
$2,026.00 |
$2,371.76 |
|
|
Tacrolimus therapeutic drug level
|
$79.00 |
$178.00 |
$735.00 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$6,951.44 |
$6,951.44 |
$7,956.46 |
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$148.50 |
$347.50 |
$1,118.00 |
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$34,789.24 |
$34,789.24 |
$39,819.01 |
|
|
Talymed
|
$199.00 |
$199.00 |
$8,151.00 |
|
|
Tap block bilat cont infusion 64489
|
$765.50 |
$1,058.50 |
$2,443.80 |
|
|
Tap block uni by cont infusion 64487
|
$383.50 |
$530.50 |
$1,222.20 |
|
|
Target gsa panel hmtlmph neop
|
$1,597.50 |
$2,392.20 |
$4,356.50 |
|
|
Target gsa panel organ/hmtlmph neop
|
$3,153.00 |
$4,435.00 |
$8,758.80 |
|
|
Target gsa panel organ neop
|
$1,597.50 |
$3,420.00 |
$5,166.00 |
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$385.00 |
$532.00 |
$532.00 |
|
