|
Sodium 24 hour urine
|
$148.00 |
$148.00 |
$148.00 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$130.00 |
$130.00 |
$130.00 |
$45.60
|
|
So neo gsap dna mcrstl ins
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$2,296.00
|
|
Special physics consult
|
$4,074.00 |
$4,074.00 |
$4,074.00 |
$725.00
|
|
Special radiation dosimetry
|
$1,038.00 |
$1,038.00 |
$1,038.00 |
$392.50
|
|
Special radiation treatment
|
$4,819.00 |
$4,819.00 |
$4,819.00 |
$1,986.00
|
|
Special supplies phys/qhp
|
$85.50 |
$85.50 |
$85.50 |
$60.00
|
|
Special teletx port plan
|
$2,283.50 |
$2,283.50 |
$2,283.50 |
$1,086.99
|
|
Specific gravity body fluid
|
$42.00 |
$42.00 |
$42.00 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$843.50 |
$843.50 |
$843.50 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$760.00 |
$760.00 |
$760.00 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$134.00 |
$134.00 |
$134.00 |
$68.25
|
|
Splint finger frog med
|
$126.00 |
$126.00 |
$126.00 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$192.00 |
$192.00 |
$192.00 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$10,986.00 |
$10,986.00 |
$10,986.00 |
$4,619.65
|
|
Split blood or products
|
$276.00 |
$276.00 |
$276.00 |
$127.48
|
|
Srs linear based
|
$31,217.00 |
$31,217.00 |
$31,217.00 |
$13,585.00
|
|
Srs multisource
|
$69,805.00 |
$69,805.00 |
$69,805.00 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$392.50 |
$392.50 |
$392.50 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$308.00 |
$308.00 |
$308.00 |
$286.00
|
|
Stem cells total count
|
$491.50 |
$491.50 |
$491.50 |
$179.64
|
|
St evaluate speech sound production
|
$326.00 |
$326.00 |
$326.00 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$342.00 |
$342.00 |
$342.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$400.00 |
$400.00 |
$400.00 |
$399.60
|
|
St evaluation swallow function
|
$302.50 |
$302.50 |
$302.50 |
$314.40
|
|
Strapping of ankle and/or ft 29540
|
$286.00 |
$286.00 |
$286.00 |
$223.45
|
|
Strapping of hand or finger
|
$398.50 |
$398.50 |
$398.50 |
$174.82
|
|
Strapping of knee
|
$300.50 |
$300.50 |
$300.50 |
$205.20
|
|
Strapping of toes 29550
|
$323.00 |
$323.00 |
$323.00 |
$164.70
|
|
Strep b dna amp probe
|
$90.50 |
$90.50 |
$90.50 |
$120.90
|
|
Stress test pulmonary
|
$605.00 |
$605.00 |
$605.00 |
$322.85
|
|
Stress tte complete
|
$2,141.50 |
$2,141.50 |
$2,141.50 |
$1,870.50
|
|
Str markers specimen anal
|
$4,637.00 |
$4,637.00 |
$4,637.00 |
$751.50
|
|
St treatment speech individual
|
$229.00 |
$229.00 |
$229.00 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$115.50 |
$115.50 |
$115.50 |
$240.31
|
|
Sugars single quant
|
$38.00 |
$38.00 |
$38.00 |
$64.28
|
|
Surg dx exam anorectal
|
$3,480.50 |
$3,480.50 |
$3,480.50 |
$3,245.23
|
|
Surgical pathology level 1 gross examination only
|
$48.00 |
$48.00 |
$48.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$74.50 |
$74.50 |
$74.50 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$105.00 |
$105.00 |
$105.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$307.00 |
$307.00 |
$307.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$421.00 |
$421.00 |
$421.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$83.50 |
$83.50 |
$83.50 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$45.50 |
$45.50 |
$45.50 |
$35.70
|
|
Susceptibility mic per plate
|
$211.50 |
$211.50 |
$211.50 |
$106.00
|
|
Svc venogram s&i
|
$4,002.50 |
$4,002.50 |
$4,002.50 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$176.00 |
$176.00 |
$176.00 |
$41.60
|
|
System sealant biosentry tract
|
$1,174.50 |
$1,174.50 |
$1,174.50 |
$889.35
|
|
T3 (triiodothyronine) free
|
$471.50 |
$471.50 |
$471.50 |
$99.20
|
|
T3 (triiodothyronine) total
|
$261.00 |
$261.00 |
$261.00 |
$93.52
|
|
T4 (thyroxine) free
|
$368.50 |
$368.50 |
$368.50 |
$85.20
|
|
T4 (thyroxine) total
|
$310.00 |
$310.00 |
$310.00 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$306.00 |
$306.00 |
$306.00 |
$122.40
|
|
Tap block bilat cont infusion 64489
|
$3,376.00 |
$3,376.00 |
$3,376.00 |
$1,407.60
|
|
Tap block uni by cont infusion 64487
|
$3,341.50 |
$3,341.50 |
$3,341.50 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$4,094.50 |
$4,094.50 |
$4,094.50 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,400.50 |
$2,400.50 |
$2,400.50 |
$1,655.52
|
|
Tavr perq femoral
|
$20,031.50 |
$20,031.50 |
$20,031.50 |
$15,454.40
|
|
Tbp gene detc abnor alleles
|
$413.00 |
$413.00 |
$413.00 |
$225.42
|
|
Tbs techl calculation only
|
$677.00 |
$677.00 |
$677.00 |
$153.60
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$77.50 |
$77.50 |
$77.50 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$319.50 |
$319.50 |
$319.50 |
$177.65
|
|
Tcd emboli detect w/inj
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$475.80
|
|
Tcd emboli detect without inj
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$678.50 |
$678.50 |
$678.50 |
$176.40
|
|
T cells absolute cd 4 count
|
$391.00 |
$391.00 |
$391.00 |
$111.20
|
|
T cells total count
|
$349.00 |
$349.00 |
$349.00 |
$126.90
|
|
Tee w or without fol w/cont,cong
|
$2,487.50 |
$2,487.50 |
$2,487.50 |
$2,101.65
|
|
Tee w or without fol w/cont, mon
|
$2,873.50 |
$2,873.50 |
$2,873.50 |
$1,431.95
|
|
Telehealth original site facility fee
|
$30.00 |
$30.00 |
$30.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$2,393.00 |
$2,393.00 |
$2,393.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$873.62
|
|
Tenolysis extensor tendon hand/finger each
|
$4,422.00 |
$4,422.00 |
$4,422.00 |
$2,811.20
|
|
Test stress cardiovascular tracing only
|
$3,940.50 |
$3,940.50 |
$3,940.50 |
$949.70
|
|
Theophylline therapeutic drug level
|
$262.00 |
$262.00 |
$262.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$191.00 |
$191.00 |
$191.00 |
$85.68
|
|
Ther/proph/diag inj ia
|
$480.50 |
$480.50 |
$480.50 |
$240.35
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,427.00 |
$2,427.00 |
$2,427.00 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$7,788.00 |
$7,788.00 |
$7,788.00 |
$2,138.76
|
|
Thrombectmy crnry perq mechanical
|
$10,175.00 |
$10,175.00 |
$10,175.00 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$13,621.00 |
$13,621.00 |
$13,621.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$12,945.50 |
$12,945.50 |
$12,945.50 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$14,326.50 |
$14,326.50 |
$14,326.50 |
$21,413.60
|
|
Thrombin time
|
$95.50 |
$95.50 |
$95.50 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$2,902.00 |
$2,902.00 |
$2,902.00 |
$3,980.60
|
|
Thromboendarterectomy including patch graft; iliac 35351
|
$4,585.00 |
$4,585.00 |
$4,585.00 |
$4,585.00
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$98.50 |
$98.50 |
$98.50 |
$61.52
|
|
Thyroglobulin antibody
|
$122.00 |
$122.00 |
$122.00 |
$82.00
|
|
Thyroid imaging
|
$1,330.50 |
$1,330.50 |
$1,330.50 |
$695.02
|
|
Thyroid mets imag whole body
|
$2,347.50 |
$2,347.50 |
$2,347.50 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$362.00 |
$362.00 |
$362.00 |
$111.00
|
|
Thyroid Ultrasound
|
$1,710.00 |
$1,710.00 |
$1,710.00 |
$588.50
|
|
Thyroid uptake measurement
|
$867.50 |
$867.50 |
$867.50 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$16.00 |
$16.00 |
$16.00 |
$64.35
|
|
Tilt table study
|
$6,999.00 |
$6,999.00 |
$6,999.00 |
$1,507.01
|
|
Tissue culture placenta
|
$124.00 |
$124.00 |
$124.00 |
$457.00
|
|
Tissue culture skin/biopsy
|
$147.50 |
$147.50 |
$147.50 |
$484.00
|
