|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$92.43
|
|
Pt application of modality >=1 area hot/cold packs
|
$31.53 |
$31.53 |
$31.53 |
$32.21
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$111.65
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$85.93
|
|
Pt application of modality traction mechanical
|
$66.00 |
$66.00 |
$66.00 |
$93.00
|
|
Pt evaluation high complexity patient/family
|
$307.97 |
$307.97 |
$307.97 |
$301.20
|
|
Pt evaluation low complexity patient/family
|
$299.90 |
$299.90 |
$299.90 |
$226.85
|
|
Pt evaluation moderate complexity patient/family
|
$304.30 |
$304.30 |
$304.30 |
$264.00
|
|
Pt re-evaluation patient/family
|
$123.19 |
$123.19 |
$123.19 |
$162.29
|
|
Pt repositioning canalith procedure(s) per day
|
$122.36 |
$122.36 |
$122.36 |
$139.20
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$239.40 |
$239.40 |
$239.40 |
$80.00
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$80.66 |
$80.66 |
$80.66 |
$86.80
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$74.80 |
$74.80 |
$74.80 |
$80.40
|
|
Pt wheelchair management each 15 minutes
|
$86.53 |
$86.53 |
$86.53 |
$85.00
|
|
Pulse ox continuous overnight monitoring
|
$305.55 |
$305.55 |
$305.55 |
$368.00
|
|
Pulse ox multiple
|
$94.50 |
$94.50 |
$94.50 |
$194.33
|
|
Puncture arterial withdrawal blood for diagnosis
|
$270.27 |
$270.27 |
$270.27 |
$126.00
|
|
Quest t3 uptake
|
$37.80 |
$37.80 |
$37.80 |
$58.95
|
|
Rbc count only automated
|
$34.02 |
$34.02 |
$34.02 |
$20.00
|
|
Rbc deglycerolized each unit
|
$509.12 |
$509.12 |
$509.12 |
$723.60
|
|
Rbc irradiated each unit
|
$313.36 |
$313.36 |
$313.36 |
$443.10
|
|
Red blood cells each unit
|
$350.70 |
$350.70 |
$350.70 |
$372.84
|
|
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit
|
$1,980.30 |
$1,980.30 |
$1,980.30 |
$543.28
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$671.30 |
$671.30 |
$671.30 |
$656.50
|
|
Red blood cells leukocytes reduced each unit
|
$441.00 |
$441.00 |
$441.00 |
$453.70
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$700.70 |
$700.70 |
$700.70 |
$607.38
|
|
Red blood cells washed each unit
|
$669.20 |
$669.20 |
$669.20 |
$553.30
|
|
Remdesivir 100 mg intravenous powder for solution
|
$70.66 |
$70.66 |
$70.66 |
$1,752.91
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$90.72 |
$90.72 |
$90.72 |
$236.60
|
|
Renal function panel
|
$223.65 |
$223.65 |
$223.65 |
$113.35
|
|
Reptilase test
|
$32.76 |
$32.76 |
$32.76 |
$65.72
|
|
Resuscitation cardiopulmonary
|
$2,656.08 |
$2,656.08 |
$2,656.08 |
$855.40
|
|
Reticulocyte automated
|
$60.48 |
$60.48 |
$60.48 |
$54.75
|
|
Reticulocyte direct measurement automated
|
$18.27 |
$18.27 |
$18.27 |
$33.57
|
|
Rheumatoid factor quantitative
|
$134.44 |
$134.44 |
$134.44 |
$57.00
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$70.66 |
$70.66 |
$70.66 |
$258.77
|
|
Russell viper venom diluted
|
$62.37 |
$62.37 |
$62.37 |
$73.03
|
|
Sarscov coronavirus ag ia
|
$98.28 |
$98.28 |
$98.28 |
$60.40
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,812.32 |
$2,812.32 |
$2,812.32 |
$1,000.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,032.57 |
$1,032.57 |
$1,032.57 |
$749.58
|
|
Scan duplex lower extremity arteries complete bilateral
|
$2,375.73 |
$2,375.73 |
$2,375.73 |
$985.80
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,430.10 |
$1,430.10 |
$1,430.10 |
$660.00
|
|
Sedimentation rate erythrocyte automated
|
$5.67 |
$5.67 |
$5.67 |
$44.20
|
|
Semen analysis presence/motility
|
$42.84 |
$42.84 |
$42.84 |
$79.92
|
|
Shoulder MRI (without contrast)
|
$1,404.90 |
$1,404.90 |
$1,404.90 |
$2,096.84
|
|
Shoulder X-ray
|
$194.67 |
$194.67 |
$194.67 |
$373.73
|
|
Sickling rbc
|
$42.84 |
$42.84 |
$42.84 |
$57.92
|
|
Sinus CT scan (with and without contrast)
|
$1,551.06 |
$1,551.06 |
$1,551.06 |
$1,822.80
|
|
Sinus CT scan (with contrast)
|
$1,178.10 |
$1,178.10 |
$1,178.10 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$959.49 |
$959.49 |
$959.49 |
$1,284.40
|
|
Sirolimus, oral
|
$27.72 |
$27.72 |
$27.72 |
$34.13
|
|
Sleep Study (Polysomnography)
|
$3,572.10 |
$3,572.10 |
$3,572.10 |
$3,960.55
|
|
Sleep study unattended
|
$340.90 |
$340.90 |
$340.90 |
$604.98
|
|
Smear fluorescent and/or acid fast stain
|
$101.43 |
$101.43 |
$101.43 |
$61.75
|
|
Smear gram stain
|
$127.89 |
$127.89 |
$127.89 |
$56.00
|
|
Smear nasal eosinophil
|
$68.04 |
$68.04 |
$68.04 |
$50.00
|
|
Smear wet mount
|
$114.66 |
$114.66 |
$114.66 |
$68.63
|
|
Sodium 24 hour urine
|
$50.40 |
$50.40 |
$50.40 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$109.12 |
$109.12 |
$109.12 |
$44.34
|
|
Sodium chloride 0.9 % IV bolus
|
$104.34 |
$104.34 |
$104.34 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$105.71 |
$105.71 |
$105.71 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$7.81 |
$7.81 |
$7.81 |
$53.79
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$324.49 |
$324.49 |
$324.49 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$41.58 |
$41.58 |
$41.58 |
$43.00
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$70.66 |
$70.66 |
$70.66 |
$345.74
|
|
Specific gravity body fluid
|
$25.83 |
$25.83 |
$25.83 |
$22.40
|
|
Specimen fat stain
|
$169.47 |
$169.47 |
$169.47 |
$35.10
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$642.60 |
$642.60 |
$642.60 |
$426.22
|
|
Splint rstrc wrst/cmc right med
|
$148.40 |
$148.40 |
$148.40 |
$73.06
|
|
Split blood or products
|
$556.92 |
$556.92 |
$556.92 |
$139.86
|
|
St analysis behavior qualitative voice/resonance
|
$110.88 |
$110.88 |
$110.88 |
$310.20
|
|
Staph a dna amp probe
|
$164.43 |
$164.43 |
$164.43 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$299.88 |
$299.88 |
$299.88 |
$313.96
|
|
St evaluate speech sound production
|
$242.55 |
$242.55 |
$242.55 |
$323.34
|
|
St evaluate speech sound production comprehensive/expressive
|
$503.37 |
$503.37 |
$503.37 |
$423.40
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$286.65 |
$286.65 |
$286.65 |
$408.60
|
|
St evaluation swallow function
|
$217.98 |
$217.98 |
$217.98 |
$340.13
|
|
St treatment speech individual
|
$210.42 |
$210.42 |
$210.42 |
$261.00
|
|
St treatment swallow dysfunction/oral
|
$228.69 |
$228.69 |
$228.69 |
$263.99
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$70.66 |
$70.66 |
$70.66 |
$123.58
|
|
Susceptibility agar dilution per agent
|
$189.63 |
$189.63 |
$189.63 |
$40.30
|
|
Susceptibility mic per plate
|
$79.38 |
$79.38 |
$79.38 |
$94.38
|
|
Sweat collection by iontophoresis
|
$105.21 |
$105.21 |
$105.21 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$121.56 |
$121.56 |
$121.56 |
$45.70
|
|
T3 (triiodothyronine) total
|
$85.05 |
$85.05 |
$85.05 |
$93.60
|
|
T4 (thyroxine) free
|
$108.36 |
$108.36 |
$108.36 |
$87.75
|
|
T4 (thyroxine) total
|
$37.80 |
$37.80 |
$37.80 |
$76.05
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.95 |
$12.95 |
$12.95 |
$10.30
|
|
Tacrolimus therapeutic drug level
|
$42.21 |
$42.21 |
$42.21 |
$122.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$503.93 |
$503.93 |
$503.93 |
$165.10
|
|
T cells absolute cd4/cd8 including ratio
|
$138.46 |
$138.46 |
$138.46 |
$185.28
|
|
T cells total count
|
$229.43 |
$229.43 |
$229.43 |
$124.52
|
|
Theophylline therapeutic drug level
|
$78.12 |
$78.12 |
$78.12 |
$108.00
|
|
Therapeutic procd strg endur
|
$47.88 |
$47.88 |
$47.88 |
$85.80
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$70.66 |
$70.66 |
$70.66 |
$32.34
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,683.99 |
$1,683.99 |
$1,683.99 |
$1,755.68
|
|
Thrombin time
|
$109.62 |
$109.62 |
$109.62 |
$49.50
|
|
Thrombin time titer
|
$22.05 |
$22.05 |
$22.05 |
$9.13
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$97.65 |
$97.65 |
$97.65 |
$57.50
|
|
Thyroid (TSH) Test
|
$146.79 |
$146.79 |
$146.79 |
$112.67
|