|
Strapping of ankle and/or ft 29540
|
$51.60 |
$51.60 |
$51.60 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$37.35 |
$37.35 |
$37.35 |
$154.70
|
|
Strapping of hand or finger
|
$56.70 |
$56.70 |
$56.70 |
$174.82
|
|
Strapping of knee
|
$56.85 |
$56.85 |
$56.85 |
$205.20
|
|
Strapping of toes 29550
|
$51.60 |
$51.60 |
$51.60 |
$164.70
|
|
Strep a ag ia
|
$20.10 |
$20.10 |
$20.10 |
$75.40
|
|
Strep b dna amp probe
|
$61.50 |
$61.50 |
$61.50 |
$120.90
|
|
Stress test pulmonary
|
$91.80 |
$91.80 |
$91.80 |
$322.85
|
|
Stress tte complete
|
$448.35 |
$448.35 |
$448.35 |
$1,870.50
|
|
Str markers specimen anal
|
$396.00 |
$396.00 |
$396.00 |
$751.50
|
|
St treatment speech individual
|
$77.40 |
$77.40 |
$77.40 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$84.00 |
$84.00 |
$84.00 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$47.37 |
$47.37 |
$47.37 |
$52.31
|
|
Sugars multiple quant
|
$12.30 |
$12.30 |
$12.30 |
$44.19
|
|
Sugars single quant
|
$20.10 |
$20.10 |
$20.10 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$18.75 |
$18.75 |
$18.75 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.65 |
$50.65 |
$50.65 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$19.20 |
$19.20 |
$19.20 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$39.60 |
$39.60 |
$39.60 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$45.15 |
$45.15 |
$45.15 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$75.45 |
$75.45 |
$75.45 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$235.20 |
$235.20 |
$235.20 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$333.45 |
$333.45 |
$333.45 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$8.40 |
$8.40 |
$8.40 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$3.75 |
$3.75 |
$3.75 |
$35.70
|
|
Susceptibility mic per plate
|
$15.30 |
$15.30 |
$15.30 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$7.20 |
$7.20 |
$7.20 |
$59.28
|
|
Svc venogram s&i
|
$429.15 |
$429.15 |
$429.15 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$23.40 |
$23.40 |
$23.40 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$7.65 |
$7.65 |
$7.65 |
$41.60
|
|
T3 (triiodothyronine) free
|
$29.55 |
$29.55 |
$29.55 |
$99.20
|
|
T3 (triiodothyronine) total
|
$24.90 |
$24.90 |
$24.90 |
$93.52
|
|
T4 (thyroxine) free
|
$15.75 |
$15.75 |
$15.75 |
$85.20
|
|
T4 (thyroxine) total
|
$12.15 |
$12.15 |
$12.15 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$832.20 |
$832.20 |
$832.20 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,746.70 |
$3,746.70 |
$3,746.70 |
$3,746.70
|
|
Target gsa panel organ neop
|
$373.65 |
$373.65 |
$373.65 |
$1,655.52
|
|
Tavr perq femoral
|
$2,262.75 |
$2,262.75 |
$2,262.75 |
$15,454.40
|
|
Tbp gene detc abnor alleles
|
$107.70 |
$107.70 |
$107.70 |
$225.42
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$108.45 |
$108.45 |
$108.45 |
$177.65
|
|
Tc-99m disofenin
|
$36.45 |
$36.45 |
$36.45 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$902.70 |
$902.70 |
$902.70 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$512.70 |
$512.70 |
$512.70 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$209.85 |
$209.85 |
$209.85 |
$302.40
|
|
Tc-99m maa
|
$34.50 |
$34.50 |
$34.50 |
$292.80
|
|
Tc-99m mebrofenin
|
$37.05 |
$37.05 |
$37.05 |
$157.65
|
|
Tc-99m medronate
|
$19.05 |
$19.05 |
$19.05 |
$111.01
|
|
Tc-99m mertiatide
|
$256.05 |
$256.05 |
$256.05 |
$756.00
|
|
Tc-99m oxidronate
|
$19.05 |
$19.05 |
$19.05 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$46.05 |
$46.05 |
$46.05 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$3.75 |
$3.75 |
$3.75 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$121.65 |
$121.65 |
$121.65 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$46.95 |
$46.95 |
$46.95 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$157.35 |
$157.35 |
$157.35 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$45.75 |
$45.75 |
$45.75 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$154.35 |
$154.35 |
$154.35 |
$190.80
|
|
Tcd emboli detect w/inj
|
$300.45 |
$300.45 |
$300.45 |
$475.80
|
|
T cells absolute cd4/cd8 including ratio
|
$82.20 |
$82.20 |
$82.20 |
$176.40
|
|
T cells absolute cd 4 count
|
$46.80 |
$46.80 |
$46.80 |
$111.20
|
|
T cells total count
|
$66.00 |
$66.00 |
$66.00 |
$126.90
|
|
Telehealth original site facility fee
|
$22.95 |
$22.95 |
$22.95 |
$51.00
|
|
Telethx isodose plan cplx
|
$174.30 |
$174.30 |
$174.30 |
$1,526.85
|
|
Telethx isodose plan simple
|
$107.70 |
$107.70 |
$107.70 |
$873.62
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,446.87 |
$7,446.87 |
$7,446.87 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$43.99 |
$43.99 |
$43.99 |
$39.33
|
|
Test for chlorohydrocarbons
|
$6.45 |
$6.45 |
$6.45 |
$65.00
|
|
Test for porphobilinogen
|
$7.35 |
$7.35 |
$7.35 |
$33.57
|
|
Test for urine cystines
|
$8.85 |
$8.85 |
$8.85 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$452.25 |
$452.25 |
$452.25 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$223.95 |
$223.95 |
$223.95 |
$949.70
|
|
Test urine urobilinogen
|
$5.70 |
$5.70 |
$5.70 |
$9.75
|
|
Tetanus immune globulin inj
|
$677.46 |
$677.46 |
$677.46 |
$1,285.36
|
|
Tgsap so/hl 51/< rna alys
|
$965.85 |
$965.85 |
$965.85 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$24.90 |
$24.90 |
$24.90 |
$108.00
|
|
Therapeutic procd strg endur
|
$79.05 |
$79.05 |
$79.05 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$15.75 |
$15.75 |
$15.75 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$12.00 |
$12.00 |
$12.00 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$72.45 |
$72.45 |
$72.45 |
$529.08
|
|
Ther/proph/diag inj ia
|
$53.70 |
$53.70 |
$53.70 |
$240.35
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$6.08 |
$6.08 |
$6.08 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$383.85 |
$383.85 |
$383.85 |
$1,687.50
|
|
Thoracotomy with cardiac massage
|
$1,912.95 |
$1,912.95 |
$1,912.95 |
$2,138.76
|
|
Throat x-ray & fluoroscopy
|
$63.90 |
$63.90 |
$63.90 |
$259.60
|
|
Thrombectmy crnry perq mechanical
|
$1,468.65 |
$1,468.65 |
$1,468.65 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$2,648.25 |
$2,648.25 |
$2,648.25 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$5,352.15 |
$5,352.15 |
$5,352.15 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$8,112.60 |
$8,112.60 |
$8,112.60 |
$21,413.60
|
|
Thrombin time
|
$10.05 |
$10.05 |
$10.05 |
$53.76
|
|
Thromboendarterectomy common femoral
|
$1,069.65 |
$1,069.65 |
$1,069.65 |
$3,980.60
|
|
Thromboendarterectomy sfa
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$4,185.30
|
|
Thromboplastin inhibition
|
$16.80 |
$16.80 |
$16.80 |
$53.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$11.40 |
$11.40 |
$11.40 |
$61.52
|
|
Thyroglobulin antibody
|
$27.75 |
$27.75 |
$27.75 |
$82.00
|
|
Thyroid imaging
|
$452.25 |
$452.25 |
$452.25 |
$695.02
|
|
Thyroid mets imag whole body
|
$452.25 |
$452.25 |
$452.25 |
$1,524.99
|
|
Thyroid met uptake
|
$418.80 |
$418.80 |
$418.80 |
$398.40
|
|
Thyroid (TSH) Test
|
$29.40 |
$29.40 |
$29.40 |
$111.00
|
|
Thyroid Ultrasound
|
$101.55 |
$101.55 |
$101.55 |
$588.50
|
|
Thyroid uptake measurement
|
$452.25 |
$452.25 |
$452.25 |
$591.25
|
