|
Pr tube thoracostomy w/connection to drainage open
|
$11,850.51 |
$11,850.51 |
$11,850.51 |
$1,700.82
|
|
Pt application of modality traction mechanical
|
$342.61 |
$342.61 |
$342.61 |
$87.00
|
|
Pt evaluation high complexity patient/family
|
$902.33 |
$902.33 |
$902.33 |
$289.50
|
|
Pt evaluation low complexity patient/family
|
$345.81 |
$345.81 |
$345.81 |
$222.24
|
|
Pt evaluation moderate complexity patient/family
|
$681.98 |
$681.98 |
$681.98 |
$249.26
|
|
Pt repositioning canalith procedure(s) per day
|
$414.99 |
$414.99 |
$414.99 |
$115.35
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$231.62 |
$231.62 |
$231.62 |
$87.10
|
|
Pulmonary vent imaging
|
$7,274.39 |
$7,274.39 |
$7,274.39 |
$878.00
|
|
Pulse ox multiple
|
$825.75 |
$825.75 |
$825.75 |
$162.00
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$2,948.36 |
$2,948.36 |
$2,948.36 |
$496.00
|
|
Pyridoxine hcl 100 mg
|
$115.06 |
$115.06 |
$115.06 |
$48.70
|
|
Pyruvate
|
$572.71 |
$572.71 |
$572.71 |
$66.00
|
|
Quest t3 uptake
|
$435.54 |
$435.54 |
$435.54 |
$55.00
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$3,418.37 |
$3,418.37 |
$3,418.37 |
$3,770.01
|
|
Radphm lcl tmr plnr bdy two day img
|
$12,229.31 |
$12,229.31 |
$12,229.31 |
$2,658.60
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$8,227.32 |
$8,227.32 |
$8,227.32 |
$2,503.20
|
|
Radphm lcl tomogr sgl area sgl day
|
$7,422.85 |
$7,422.85 |
$7,422.85 |
$2,242.80
|
|
Radphm quant measure sgl area add-on
|
$2,988.52 |
$2,988.52 |
$2,988.52 |
$711.20
|
|
Rapid Strep Test
|
$608.73 |
$608.73 |
$608.73 |
$74.25
|
|
Rasburicase 1.5 mg intravenous solution
|
$6,648.49 |
$6,648.49 |
$6,648.49 |
$4,782.24
|
|
Rbc count only automated
|
$270.93 |
$270.93 |
$270.93 |
$20.00
|
|
Rbc osmotic fragility
|
$2,952.77 |
$2,952.77 |
$2,952.77 |
$75.04
|
|
Rbc serum pretx incubj drugs
|
$469.84 |
$469.84 |
$469.84 |
$234.00
|
|
Red blood cells leukocytes reduced each unit
|
$902.35 |
$902.35 |
$902.35 |
$422.84
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$1,475.32 |
$1,475.32 |
$1,475.32 |
$523.83
|
|
Red blood cells washed each unit
|
$741.10 |
$741.10 |
$741.10 |
$559.00
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$315.77 |
$315.77 |
$315.77 |
$378.22
|
|
Remdesivir 100 mg intravenous powder for solution
|
$3,342.73 |
$3,342.73 |
$3,342.73 |
$1,524.70
|
|
Renal venogram bil s&i
|
$4,456.79 |
$4,456.79 |
$4,456.79 |
$3,615.28
|
|
Reptilase test
|
$1,126.58 |
$1,126.58 |
$1,126.58 |
$72.80
|
|
Resuscitation delivery/birthing room
|
$3,450.19 |
$3,450.19 |
$3,450.19 |
$774.37
|
|
Rheumatoid factor qualitative
|
$397.81 |
$397.81 |
$397.81 |
$57.20
|
|
Rheumatoid factor quantitative
|
$768.20 |
$768.20 |
$768.20 |
$56.55
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$823.48 |
$823.48 |
$823.48 |
$247.55
|
|
Rho(d) immune globulin h, sd
|
$9,896.86 |
$9,896.86 |
$9,896.86 |
$3,856.80
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$883.73 |
$883.73 |
$883.73 |
$459.00
|
|
Ring barrier skin cx 1 9/16 adapt
|
$72.00 |
$72.00 |
$72.00 |
$2.60
|
|
Ring ostmy barr adapt 48mm
|
$42.00 |
$42.00 |
$42.00 |
$9.40
|
|
Rotavirus antibody
|
$1,954.79 |
$1,954.79 |
$1,954.79 |
$107.50
|
|
Rp loclzj tum 2+area 1+d img
|
$5,589.62 |
$5,589.62 |
$5,589.62 |
$1,340.00
|
|
Rp loclzj tum spect w/ct 1
|
$1,616.69 |
$1,616.69 |
$1,616.69 |
$2,531.25
|
|
Rp loclzj tum spect w/ct 2
|
$9,222.49 |
$9,222.49 |
$9,222.49 |
$3,136.90
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$9,275.24 |
$9,275.24 |
$9,275.24 |
$2,173.60
|
|
Rsv assay w/optic
|
$493.84 |
$493.84 |
$493.84 |
$82.68
|
|
Russell viper venom diluted
|
$982.55 |
$982.55 |
$982.55 |
$68.64
|
|
Salmonella antibody
|
$956.81 |
$956.81 |
$956.81 |
$37.58
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$4,146.50 |
$4,146.50 |
$4,146.50 |
$744.47
|
|
Scope uretscp lithovue dig disp
|
$49,905.00 |
$49,905.00 |
$49,905.00 |
$4,285.86
|
|
Screening Colonoscopy (average risk)
|
$3,658.14 |
$3,658.14 |
$3,658.14 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$7,112.47 |
$7,112.47 |
$7,112.47 |
$2,000.00
|
|
Screening Mammogram
|
$789.09 |
$789.09 |
$789.09 |
$310.20
|
|
Screening prostate cancer PSA
|
$1,207.17 |
$1,207.17 |
$1,207.17 |
$98.28
|
|
Sevelamer carbonate 800 mg tablet
|
$23.77 |
$23.77 |
$23.77 |
$7.14
|
|
Shrinker prosth above knee
|
$672.00 |
$672.00 |
$672.00 |
$168.89
|
|
Sickling rbc
|
$548.71 |
$548.71 |
$548.71 |
$54.00
|
|
Sildenafil citrate, 25 mg
|
$32.34 |
$32.34 |
$32.34 |
$182.99
|
|
Sincalide 5 mcg solution for injection
|
$1,230.38 |
$1,230.38 |
$1,230.38 |
$309.14
|
|
Sinus/juglr venogram s&i
|
$7,650.32 |
$7,650.32 |
$7,650.32 |
$2,517.48
|
|
Smear nasal eosinophil
|
$469.84 |
$469.84 |
$469.84 |
$45.57
|
|
Socket insert without lock mech
|
$5,291.00 |
$5,291.00 |
$5,291.00 |
$1,286.05
|
|
Socket insert w lock mech
|
$4,037.00 |
$4,037.00 |
$4,037.00 |
$1,544.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$344.47 |
$344.47 |
$344.47 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$249.17 |
$249.17 |
$249.17 |
$44.34
|
|
Sodium chloride 3 % ivpb
|
$284.45 |
$284.45 |
$284.45 |
$42.25
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$336.46 |
$336.46 |
$336.46 |
$77.77
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$796.51 |
$796.51 |
$796.51 |
$177.52
|
|
Specific gravity body fluid
|
$173.20 |
$173.20 |
$173.20 |
$21.55
|
|
St cognitve performance testing healthcare professional each hour
|
$1,758.02 |
$1,758.02 |
$1,758.02 |
$284.65
|
|
Strep b assay w/optic
|
$651.60 |
$651.60 |
$651.60 |
$80.16
|
|
Streptokinase 1.5 m-units inj
|
$1,649.00 |
$1,649.00 |
$1,649.00 |
$917.47
|
|
Stress tte complete
|
$9,453.87 |
$9,453.87 |
$9,453.87 |
$1,784.25
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$26.60 |
$26.60 |
$26.60 |
$50.22
|
|
Sulfonylurea screen qn-sendout
|
$660.16 |
$660.16 |
$660.16 |
$152.64
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,503.50 |
$1,503.50 |
$1,503.50 |
$123.58
|
|
Surgical pathology level 1 gross examination only
|
$583.01 |
$583.01 |
$583.01 |
$80.60
|
|
Surgical pathology level 2 gross & microscopic examination
|
$1,073.43 |
$1,073.43 |
$1,073.43 |
$146.30
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,234.60 |
$1,234.60 |
$1,234.60 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,404.37 |
$1,404.37 |
$1,404.37 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,580.98 |
$1,580.98 |
$1,580.98 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,915.35 |
$1,915.35 |
$1,915.35 |
$730.20
|
|
Susceptibility enzyme detection per enzyme
|
$16.63 |
$16.63 |
$16.63 |
$35.10
|
|
Suscept studies macrobroth dilution ea
|
$202.34 |
$202.34 |
$202.34 |
$59.28
|
|
Svc venogram s&i
|
$3,165.46 |
$3,165.46 |
$3,165.46 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$1,891.43 |
$1,891.43 |
$1,891.43 |
$1,353.62
|
|
System recell skin grafting/harvesting
|
$176,963.00 |
$176,963.00 |
$176,963.00 |
$12,725.30
|
|
T3 (triiodothyronine) free
|
$675.60 |
$675.60 |
$675.60 |
$99.20
|
|
T3 (triiodothyronine) total
|
$1,303.20 |
$1,303.20 |
$1,303.20 |
$93.52
|
|
T4 (thyroxine) free
|
$615.58 |
$615.58 |
$615.58 |
$85.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$51.93 |
$51.93 |
$51.93 |
$10.03
|
|
Tacrolimus therapeutic drug level
|
$1,599.85 |
$1,599.85 |
$1,599.85 |
$120.60
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$58.19 |
$58.19 |
$58.19 |
$14.62
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$188.62 |
$188.62 |
$188.62 |
$194.35
|
|
Tc-99m exame autol wbc diag per dose
|
$8,843.40 |
$8,843.40 |
$8,843.40 |
$2,431.95
|
|
Tc-99m exametazime diag
|
$24,376.90 |
$24,376.90 |
$24,376.90 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$1,485.93 |
$1,485.93 |
$1,485.93 |
$302.40
|
|
Tc-99m maa
|
$2,087.93 |
$2,087.93 |
$2,087.93 |
$283.41
|
|
Tc-99m mebrofenin
|
$1,657.54 |
$1,657.54 |
$1,657.54 |
$160.58
|
|
Tc-99m medronate
|
$425.23 |
$425.23 |
$425.23 |
$109.50
|
|
Tc-99m mertiatide
|
$3,000.47 |
$3,000.47 |
$3,000.47 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$1,646.65 |
$1,646.65 |
$1,646.65 |
$222.60
|
