|
Pt evaluation low complexity patient/family
|
$329.78 |
$329.78 |
$329.78 |
$222.24
|
|
Pt evaluation moderate complexity patient/family
|
$493.37 |
$493.37 |
$493.37 |
$249.26
|
|
Pt re-evaluation patient/family
|
$272.19 |
$272.19 |
$272.19 |
$152.40
|
|
Pt repositioning canalith procedure(s) per day
|
$326.78 |
$326.78 |
$326.78 |
$115.35
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$165.90 |
$165.90 |
$165.90 |
$79.20
|
|
Pulse ox multiple
|
$582.53 |
$582.53 |
$582.53 |
$162.00
|
|
Pulse ox single
|
$224.81 |
$224.81 |
$224.81 |
$85.60
|
|
Pyridoxine hcl 100 mg
|
$122.42 |
$122.42 |
$122.42 |
$48.70
|
|
Rabies ig ht&sol human im/sc
|
$3,381.38 |
$3,381.38 |
$3,381.38 |
$2,997.00
|
|
Radphm lcl tmr plnr bdy two day img
|
$5,778.15 |
$5,778.15 |
$5,778.15 |
$2,658.60
|
|
Radphm lcl tomogr sgl area sgl day
|
$4,561.33 |
$4,561.33 |
$4,561.33 |
$2,242.80
|
|
Radphm lcl tumor plr sgl day
|
$3,218.19 |
$3,218.19 |
$3,218.19 |
$1,102.80
|
|
Rapid Strep Test
|
$841.61 |
$841.61 |
$841.61 |
$74.25
|
|
Rbc count only automated
|
$354.18 |
$354.18 |
$354.18 |
$20.00
|
|
Rbc deglycerolized each unit
|
$930.41 |
$930.41 |
$930.41 |
$767.00
|
|
Red blood cells each unit
|
$860.92 |
$860.92 |
$860.92 |
$382.50
|
|
Red blood cells leukocytes reduced each unit
|
$930.41 |
$930.41 |
$930.41 |
$422.84
|
|
Red blood cells washed each unit
|
$958.06 |
$958.06 |
$958.06 |
$559.00
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$3,195.10 |
$3,195.10 |
$3,195.10 |
$378.22
|
|
Remdesivir 100 mg intravenous powder for solution
|
$2,498.96 |
$2,498.96 |
$2,498.96 |
$1,524.70
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$741.71 |
$741.71 |
$741.71 |
$236.64
|
|
Renal venogram bil s&i
|
$6,606.00 |
$6,606.00 |
$6,606.00 |
$3,615.28
|
|
Resuscitation delivery/birthing room
|
$2,148.35 |
$2,148.35 |
$2,148.35 |
$774.37
|
|
Reticulocyte direct measurement automated
|
$877.36 |
$877.36 |
$877.36 |
$35.84
|
|
Rheumatoid factor quantitative
|
$874.14 |
$874.14 |
$874.14 |
$56.55
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$673.60 |
$673.60 |
$673.60 |
$247.55
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$594.81 |
$594.81 |
$594.81 |
$459.00
|
|
Rubella antibody igg
|
$370.00 |
$370.00 |
$370.00 |
$76.86
|
|
Rubeola antibody igg
|
$831.86 |
$831.86 |
$831.86 |
$80.00
|
|
Russell viper venom diluted
|
$968.34 |
$968.34 |
$968.34 |
$68.64
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$2,027.13 |
$2,027.13 |
$2,027.13 |
$653.40
|
|
Screening Mammogram
|
$322.65 |
$322.65 |
$322.65 |
$310.20
|
|
Screening prostate cancer PSA
|
$1,238.06 |
$1,238.06 |
$1,238.06 |
$98.28
|
|
Sialidase enzyme assay
|
$12.22 |
$12.22 |
$12.22 |
$54.60
|
|
Sickling rbc
|
$877.36 |
$877.36 |
$877.36 |
$54.00
|
|
Sildenafil citrate, 25 mg
|
$295.99 |
$295.99 |
$295.99 |
$182.99
|
|
Sincalide 5 mcg solution for injection
|
$521.38 |
$521.38 |
$521.38 |
$309.14
|
|
Smear special stain inclusion bodies/parasites
|
$1,013.86 |
$1,013.86 |
$1,013.86 |
$68.85
|
|
Sock fracture or equal each
|
$580.00 |
$580.00 |
$580.00 |
$76.65
|
|
Sodium 24 hour urine
|
$386.68 |
$386.68 |
$386.68 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$103.46 |
$103.46 |
$103.46 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$23.22 |
$23.22 |
$23.22 |
$44.34
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$383.61 |
$383.61 |
$383.61 |
$77.77
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$374.41 |
$374.41 |
$374.41 |
$177.52
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,248.53 |
$1,248.53 |
$1,248.53 |
$536.34
|
|
Split blood or products
|
$27.56 |
$27.56 |
$27.56 |
$125.72
|
|
St analysis behavior qualitative voice/resonance
|
$910.38 |
$910.38 |
$910.38 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$439.56 |
$439.56 |
$439.56 |
$284.65
|
|
St evaluate speech sound production
|
$910.38 |
$910.38 |
$910.38 |
$288.75
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$848.71 |
$848.71 |
$848.71 |
$373.50
|
|
St evaluation swallow function
|
$831.08 |
$831.08 |
$831.08 |
$311.36
|
|
Strep b dna amp probe
|
$147.66 |
$147.66 |
$147.66 |
$122.43
|
|
St treatment speech individual
|
$709.21 |
$709.21 |
$709.21 |
$253.80
|
|
St treatment swallow dysfunction/oral
|
$709.21 |
$709.21 |
$709.21 |
$245.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$209.46 |
$209.46 |
$209.46 |
$50.22
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$209.25 |
$209.25 |
$209.25 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$526.87 |
$526.87 |
$526.87 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$334.69 |
$334.69 |
$334.69 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$334.69 |
$334.69 |
$334.69 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$422.42 |
$422.42 |
$422.42 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$422.42 |
$422.42 |
$422.42 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$714.86 |
$714.86 |
$714.86 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$714.86 |
$714.86 |
$714.86 |
$730.20
|
|
Susceptibility enzyme detection per enzyme
|
$13.19 |
$13.19 |
$13.19 |
$35.10
|
|
Suscept studies macrobroth dilution ea
|
$1,741.72 |
$1,741.72 |
$1,741.72 |
$59.28
|
|
Svc venogram s&i
|
$6,562.00 |
$6,562.00 |
$6,562.00 |
$1,934.62
|
|
T3 (triiodothyronine) free
|
$721.37 |
$721.37 |
$721.37 |
$99.20
|
|
T3 (triiodothyronine) total
|
$575.12 |
$575.12 |
$575.12 |
$93.52
|
|
T4 (thyroxine) free
|
$783.00 |
$783.00 |
$783.00 |
$85.20
|
|
T4 (thyroxine) total
|
$137.00 |
$137.00 |
$137.00 |
$67.80
|
|
Tacrolimus therapeutic drug level
|
$793.00 |
$793.00 |
$793.00 |
$120.60
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$50.08 |
$50.08 |
$50.08 |
$14.62
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$354.00 |
$354.00 |
$354.00 |
$175.00
|
|
Tc-99m exametazime diag
|
$2,913.64 |
$2,913.64 |
$2,913.64 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$635.77 |
$635.77 |
$635.77 |
$302.40
|
|
Tc-99m maa
|
$635.77 |
$635.77 |
$635.77 |
$283.41
|
|
Tc-99m mebrofenin
|
$1,305.23 |
$1,305.23 |
$1,305.23 |
$160.58
|
|
Tc-99m medronate
|
$614.71 |
$614.71 |
$614.71 |
$109.50
|
|
Tc-99m mertiatide
|
$1,044.18 |
$1,044.18 |
$1,044.18 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$635.77 |
$635.77 |
$635.77 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$730.00 |
$730.00 |
$730.00 |
$181.37
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$503.83 |
$503.83 |
$503.83 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$1,633.65 |
$1,633.65 |
$1,633.65 |
$293.73
|
|
Tc-99m sulfur colloid
|
$495.42 |
$495.42 |
$495.42 |
$239.40
|
|
Tc-99m tetrofosmin p study dose
|
$1,226.63 |
$1,226.63 |
$1,226.63 |
$188.50
|
|
Tc-99m tilmanocept diag
|
$1,754.35 |
$1,754.35 |
$1,754.35 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$2,411.16 |
$2,411.16 |
$2,411.16 |
$175.00
|
|
T cells absolute cd 4 count
|
$66.95 |
$66.95 |
$66.95 |
$110.00
|
|
T cells total count
|
$94.33 |
$94.33 |
$94.33 |
$123.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$36,130.54 |
$36,130.54 |
$36,130.54 |
$15,600.75
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$29.71 |
$29.71 |
$29.71 |
$39.18
|
|
Test pathogen(s) for platelets reference
|
$2,260.12 |
$2,260.12 |
$2,260.12 |
$66.00
|
|
Test stress cardiovascular tracing only
|
$4,012.67 |
$4,012.67 |
$4,012.67 |
$953.40
|
|
Tetanus immune globulin inj
|
$1,474.90 |
$1,474.90 |
$1,474.90 |
$1,228.80
|
|
Theophylline therapeutic drug level
|
$633.65 |
$633.65 |
$633.65 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$136.93 |
$136.93 |
$136.93 |
$25.54
|
|
Thrombin time
|
$1,069.10 |
$1,069.10 |
$1,069.10 |
$53.60
|
|
Thyroglobulin antibody
|
$880.61 |
$880.61 |
$880.61 |
$81.90
|
|
Thyroid mets imag whole body
|
$6,199.21 |
$6,199.21 |
$6,199.21 |
$1,544.00
|
|
Tigecycline injection
|
$1,191.64 |
$1,191.64 |
$1,191.64 |
$234.00
|
