|
Rpl non-tun cvc wo sbq prt/pmp
|
$9,123.14 |
$9,123.14 |
$9,123.14 |
$2,331.08
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$6,100.31 |
$6,100.31 |
$6,100.31 |
$2,182.05
|
|
Rpl tun-cvad w subq port
|
$1,319.04 |
$1,319.04 |
$1,319.04 |
$4,738.00
|
|
Rpl tun cvc wo subq port
|
$1,567.11 |
$1,567.11 |
$1,567.11 |
$4,201.80
|
|
Rubella antibody igg
|
$344.67 |
$344.67 |
$344.67 |
$73.10
|
|
Rubeola antibody igg
|
$354.69 |
$354.69 |
$354.69 |
$79.68
|
|
Russell viper venom diluted
|
$539.72 |
$539.72 |
$539.72 |
$70.16
|
|
Salmonella antibody
|
$156.08 |
$156.08 |
$156.08 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,939.72 |
$2,939.72 |
$2,939.72 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,891.69 |
$1,891.69 |
$1,891.69 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,314.97 |
$1,314.97 |
$1,314.97 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,412.06 |
$1,412.06 |
$1,412.06 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,069.02 |
$1,069.02 |
$1,069.02 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,853.37 |
$1,853.37 |
$1,853.37 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$2,124.64 |
$2,124.64 |
$2,124.64 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,428.86 |
$1,428.86 |
$1,428.86 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,428.86 |
$1,428.86 |
$1,428.86 |
$601.70
|
|
Sclerotherapy fluid collection pq w/img
|
$2,442.41 |
$2,442.41 |
$2,442.41 |
$2,114.45
|
|
Screening Mammogram
|
$792.81 |
$792.81 |
$792.81 |
$303.55
|
|
Sec art mech thrmbc non-intracranial add-on
|
$7,555.35 |
$7,555.35 |
$7,555.35 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$144.47 |
$144.47 |
$144.47 |
$44.20
|
|
Semen analysis w/count
|
$118.27 |
$118.27 |
$118.27 |
$56.44
|
|
Serpina1 gene
|
$469.72 |
$469.72 |
$469.72 |
$191.73
|
|
Sertraline (zoloft) - sendout
|
$300.99 |
$300.99 |
$300.99 |
$173.16
|
|
Shoulder MRI (with and without contrast)
|
$5,923.72 |
$5,923.72 |
$5,923.72 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$4,842.53 |
$4,842.53 |
$4,842.53 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$4,455.61 |
$4,455.61 |
$4,455.61 |
$2,051.28
|
|
Shoulder X-ray
|
$692.77 |
$692.77 |
$692.77 |
$367.02
|
|
Sickling rbc
|
$171.18 |
$171.18 |
$171.18 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$3,486.14 |
$3,486.14 |
$3,486.14 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,250.16 |
$3,250.16 |
$3,250.16 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$3,020.14 |
$3,020.14 |
$3,020.14 |
$1,279.50
|
|
Skin Biopsy
|
$942.01 |
$942.01 |
$942.01 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$4,680.94 |
$4,680.94 |
$4,680.94 |
$3,936.80
|
|
Smear fluorescent and/or acid fast stain
|
$178.10 |
$178.10 |
$178.10 |
$64.20
|
|
Smear gram stain
|
$108.96 |
$108.96 |
$108.96 |
$57.85
|
|
Smear special stain inclusion bodies/parasites
|
$198.66 |
$198.66 |
$198.66 |
$64.35
|
|
Smear wet mount
|
$129.55 |
$129.55 |
$129.55 |
$68.63
|
|
Sodium 24 hour urine
|
$201.00 |
$201.00 |
$201.00 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$28.66 |
$28.66 |
$28.66 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$88.19 |
$88.19 |
$88.19 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$532.31 |
$532.31 |
$532.31 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,048.07 |
$1,048.07 |
$1,048.07 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$108.83 |
$108.83 |
$108.83 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,682.55 |
$1,682.55 |
$1,682.55 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,590.67 |
$1,590.67 |
$1,590.67 |
$559.96
|
|
St analysis behavior qualitative voice/resonance
|
$509.73 |
$509.73 |
$509.73 |
$300.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$32,265.56 |
$32,265.56 |
$32,265.56 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$7,262.69 |
$7,262.69 |
$7,262.69 |
$9,276.80
|
|
St evaluate speech sound production
|
$509.73 |
$509.73 |
$509.73 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$509.73 |
$509.73 |
$509.73 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$582.84 |
$582.84 |
$582.84 |
$406.40
|
|
St evaluation swallow function
|
$439.28 |
$439.28 |
$439.28 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$955.13 |
$955.13 |
$955.13 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$408.08 |
$408.08 |
$408.08 |
$171.00
|
|
Strapping of hand or finger
|
$501.54 |
$501.54 |
$501.54 |
$194.40
|
|
Strapping of knee
|
$723.66 |
$723.66 |
$723.66 |
$224.80
|
|
Strapping of toes 29550
|
$530.51 |
$530.51 |
$530.51 |
$185.36
|
|
Strep b dna amp probe
|
$209.28 |
$209.28 |
$209.28 |
$139.20
|
|
St treatment speech individual
|
$386.60 |
$386.60 |
$386.60 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$332.43 |
$332.43 |
$332.43 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$128.35 |
$128.35 |
$128.35 |
$49.13
|
|
Sugars single quant
|
$120.47 |
$120.47 |
$120.47 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$275.63 |
$275.63 |
$275.63 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$72.22 |
$72.22 |
$72.22 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$369.31 |
$369.31 |
$369.31 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$511.99 |
$511.99 |
$511.99 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$659.75 |
$659.75 |
$659.75 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,149.92 |
$1,149.92 |
$1,149.92 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,114.69 |
$1,114.69 |
$1,114.69 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,589.78 |
$1,589.78 |
$1,589.78 |
$790.00
|
|
Susceptibility enzyme detection per enzyme
|
$51.72 |
$51.72 |
$51.72 |
$34.48
|
|
Susceptibility mic per plate
|
$232.63 |
$232.63 |
$232.63 |
$94.38
|
|
Synvisc or synvisc-one
|
$1,257.54 |
$1,257.54 |
$1,257.54 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$115.73 |
$115.73 |
$115.73 |
$44.85
|
|
T3 (triiodothyronine) free
|
$404.79 |
$404.79 |
$404.79 |
$89.82
|
|
T3 (triiodothyronine) total
|
$236.76 |
$236.76 |
$236.76 |
$94.90
|
|
T4 (thyroxine) free
|
$267.31 |
$267.31 |
$267.31 |
$81.60
|
|
T4 (thyroxine) total
|
$227.20 |
$227.20 |
$227.20 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$526.09 |
$526.09 |
$526.09 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,323.66 |
$2,323.66 |
$2,323.66 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$355.06 |
$355.06 |
$355.06 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$850.28 |
$850.28 |
$850.28 |
$186.00
|
|
T cells absolute cd 4 count
|
$218.89 |
$218.89 |
$218.89 |
$120.25
|
|
T cells total count
|
$322.01 |
$322.01 |
$322.01 |
$124.11
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$25.74 |
$25.74 |
$25.74 |
$44.49
|
|
Test for chlorohydrocarbons
|
$137.29 |
$137.29 |
$137.29 |
$71.04
|
|
Test pathogen(s) for platelets reference
|
$474.78 |
$474.78 |
$474.78 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$2,010.11 |
$2,010.11 |
$2,010.11 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$26,166.10 |
$26,166.10 |
$26,166.10 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$268.11 |
$268.11 |
$268.11 |
$108.00
|
|
Therapy activity per session >= 45 minutes
|
$961.83 |
$961.83 |
$961.83 |
$210.44
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$125.67 |
$125.67 |
$125.67 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$5,692.94 |
$5,692.94 |
$5,692.94 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$15,242.10 |
$15,242.10 |
$15,242.10 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$21,917.13 |
$21,917.13 |
$21,917.13 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$27,648.88 |
$27,648.88 |
$27,648.88 |
$24,605.30
|
|
Thrombin time
|
$158.19 |
$158.19 |
$158.19 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$350.44 |
$350.44 |
$350.44 |
$56.93
|
|
Thyroglobulin antibody
|
$353.76 |
$353.76 |
$353.76 |
$84.00
|