|
Stimulants synthetic
|
$20.00 |
$20.00 |
$20.00 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$154.80 |
$154.80 |
$154.80 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$130.40 |
$130.40 |
$130.40 |
$154.70
|
|
Strapping of hip
|
$172.80 |
$172.80 |
$172.80 |
$164.70
|
|
Strapping of knee
|
$160.00 |
$160.00 |
$160.00 |
$205.20
|
|
Strep a ag ia
|
$33.20 |
$33.20 |
$33.20 |
$75.40
|
|
Stress test pulmonary
|
$371.60 |
$371.60 |
$371.60 |
$322.85
|
|
Stress tte complete
|
$377.20 |
$377.20 |
$377.20 |
$1,870.50
|
|
Str markers specimen anal
|
$676.00 |
$676.00 |
$676.00 |
$751.50
|
|
St treatment speech individual
|
$143.20 |
$143.20 |
$143.20 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$154.00 |
$154.00 |
$154.00 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$80.00 |
$80.00 |
$80.00 |
$52.31
|
|
Sugars multiple quant
|
$29.60 |
$29.60 |
$29.60 |
$44.19
|
|
Sugars single quant
|
$29.60 |
$29.60 |
$29.60 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$9,786.12 |
$9,786.12 |
$9,786.12 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.25 |
$0.25 |
$0.25 |
$82.43
|
|
Sulfonylurea screen qn-sendout
|
$170.00 |
$170.00 |
$170.00 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$38.86 |
$38.86 |
$38.86 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$36.40 |
$36.40 |
$36.40 |
$94.19
|
|
Surg dx exam anorectal
|
$5,546.80 |
$5,546.80 |
$5,546.80 |
$3,245.23
|
|
Surgical pathology level 1 gross examination only
|
$78.00 |
$78.00 |
$78.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$84.00 |
$84.00 |
$84.00 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$158.00 |
$158.00 |
$158.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$167.60 |
$167.60 |
$167.60 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$394.40 |
$394.40 |
$394.40 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$518.00 |
$518.00 |
$518.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$12.40 |
$12.40 |
$12.40 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$12.00 |
$12.00 |
$12.00 |
$35.70
|
|
Susceptibility mic per plate
|
$22.00 |
$22.00 |
$22.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$17.60 |
$17.60 |
$17.60 |
$59.28
|
|
Suspension sleeve lower ext
|
$75.60 |
$75.60 |
$75.60 |
$251.38
|
|
Svc venogram s&i
|
$2,773.20 |
$2,773.20 |
$2,773.20 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$94.40 |
$94.40 |
$94.40 |
$125.40
|
|
Synvisc or synvisc-one
|
$12.40 |
$12.40 |
$12.40 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.20 |
$11.20 |
$11.20 |
$41.60
|
|
System cardiomems hosp electronics
|
$165,516.80 |
$165,516.80 |
$165,516.80 |
$39,037.95
|
|
System pacing micra av
|
$21,574.40 |
$21,574.40 |
$21,574.40 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,168.00 |
$8,168.00 |
$8,168.00 |
$12,003.00
|
|
System sealant biosentry tract
|
$991.60 |
$991.60 |
$991.60 |
$889.35
|
|
T3 (triiodothyronine) free
|
$22.40 |
$22.40 |
$22.40 |
$99.20
|
|
T3 (triiodothyronine) total
|
$35.20 |
$35.20 |
$35.20 |
$93.52
|
|
T4 (thyroxine) free
|
$22.00 |
$22.00 |
$22.00 |
$85.20
|
|
T4 (thyroxine) total
|
$17.20 |
$17.20 |
$17.20 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$9.80 |
$9.80 |
$9.80 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$34.00 |
$34.00 |
$34.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$928.00 |
$928.00 |
$928.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,518.00 |
$3,518.00 |
$3,518.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$823.20 |
$823.20 |
$823.20 |
$1,655.52
|
|
Tavr perq femoral
|
$16,124.80 |
$16,124.80 |
$16,124.80 |
$15,454.40
|
|
Tbp gene detc abnor alleles
|
$309.60 |
$309.60 |
$309.60 |
$225.42
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$186.00 |
$186.00 |
$186.00 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$113.60 |
$113.60 |
$113.60 |
$177.65
|
|
Tc-99m bicisate
|
$3,801.60 |
$3,801.60 |
$3,801.60 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$4,648.40 |
$4,648.40 |
$4,648.40 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$3,463.20 |
$3,463.20 |
$3,463.20 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$446.80 |
$446.80 |
$446.80 |
$302.40
|
|
Tc-99m maa
|
$417.60 |
$417.60 |
$417.60 |
$292.80
|
|
Tc-99m mebrofenin
|
$90.80 |
$90.80 |
$90.80 |
$157.65
|
|
Tc-99m medronate
|
$126.00 |
$126.00 |
$126.00 |
$111.01
|
|
Tc-99m mertiatide
|
$870.00 |
$870.00 |
$870.00 |
$756.00
|
|
Tc-99m oxidronate
|
$68.00 |
$68.00 |
$68.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$408.80 |
$408.80 |
$408.80 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$488.40 |
$488.40 |
$488.40 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$2.00 |
$2.00 |
$2.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$196.80 |
$196.80 |
$196.80 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$104.40 |
$104.40 |
$104.40 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$4,064.80 |
$4,064.80 |
$4,064.80 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$652.80 |
$652.80 |
$652.80 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$125.60 |
$125.60 |
$125.60 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$1,669.60 |
$1,669.60 |
$1,669.60 |
$955.60
|
|
Tcd emboli detect without inj
|
$322.00 |
$322.00 |
$322.00 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$109.20 |
$109.20 |
$109.20 |
$176.40
|
|
T cells absolute cd 4 count
|
$49.20 |
$49.20 |
$49.20 |
$111.20
|
|
T cells total count
|
$87.60 |
$87.60 |
$87.60 |
$126.90
|
|
Telehealth original site facility fee
|
$55.60 |
$55.60 |
$55.60 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$1,526.85
|
|
Telethx isodose plan simple
|
$963.20 |
$963.20 |
$963.20 |
$873.62
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$226.61 |
$226.61 |
$226.61 |
$15,245.38
|
|
Tension based scoliosis orth
|
$1,957.20 |
$1,957.20 |
$1,957.20 |
$3,528.00
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$30.60 |
$30.60 |
$30.60 |
$39.33
|
|
Term dev, passive hand mitt
|
$206.00 |
$206.00 |
$206.00 |
$406.00
|
|
Term dev, sport/rec/work att
|
$391.20 |
$391.20 |
$391.20 |
$879.20
|
|
Tert gene targeted seq alys
|
$325.60 |
$325.60 |
$325.60 |
$335.00
|
|
Test for chlorohydrocarbons
|
$16.00 |
$16.00 |
$16.00 |
$65.00
|
|
Test for urine cystines
|
$14.40 |
$14.40 |
$14.40 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$185.20 |
$185.20 |
$185.20 |
$70.00
|
|
Test socket below knee
|
$185.20 |
$185.20 |
$185.20 |
$535.15
|
|
Test socket symes
|
$194.80 |
$194.80 |
$194.80 |
$324.80
|
|
Test sock wrist disart/bel e
|
$148.40 |
$148.40 |
$148.40 |
$350.00
|
|
Test stress cardiovascular tracing only
|
$739.60 |
$739.60 |
$739.60 |
$949.70
|
|
Tgsap so neo 5-50 rna alys
|
$1,019.60 |
$1,019.60 |
$1,019.60 |
$1,019.60
|
|
Thaw preserved stem cells
|
$938.00 |
$938.00 |
$938.00 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$35.20 |
$35.20 |
$35.20 |
$108.00
|
|
Therapeutic procd strg endur
|
$77.60 |
$77.60 |
$77.60 |
$85.68
|
|
Therapy activity per session >= 45 minutes
|
$81.60 |
$81.60 |
$81.60 |
$191.50
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$54.00 |
$54.00 |
$54.00 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$47.20 |
$47.20 |
$47.20 |
$50.00
|
|
Ther nma rdctj intus/obstrcj
|
$591.20 |
$591.20 |
$591.20 |
$529.08
|
|
Ther/proph/diag inj ia
|
$527.60 |
$527.60 |
$527.60 |
$240.35
|
