|
Somatosensory testing
|
$418.50 |
$418.50 |
$418.50 |
$816.00
|
|
Special physics consult
|
$336.00 |
$336.00 |
$336.00 |
$725.00
|
|
Special radiation dosimetry
|
$414.00 |
$414.00 |
$414.00 |
$392.50
|
|
Special radiation treatment
|
$1,688.50 |
$1,688.50 |
$1,688.50 |
$1,986.00
|
|
Special teletx port plan
|
$978.50 |
$978.50 |
$978.50 |
$1,086.99
|
|
Specific gravity body fluid
|
$17.50 |
$17.50 |
$17.50 |
$22.00
|
|
Specimen fat stain
|
$30.00 |
$30.00 |
$30.00 |
$35.10
|
|
Speech audiometry complete
|
$44.50 |
$44.50 |
$44.50 |
$109.20
|
|
Speech recep thresh
|
$32.50 |
$32.50 |
$32.50 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,073.50 |
$1,073.50 |
$1,073.50 |
$1,439.40
|
|
Spirmtry w/brnchdil inf-2 yr
|
$298.50 |
$298.50 |
$298.50 |
$368.50
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$430.00 |
$430.00 |
$430.00 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$470.00 |
$470.00 |
$470.00 |
$392.09
|
|
Split flat caliper stirr & p
|
$159.00 |
$159.00 |
$159.00 |
$109.20
|
|
Sprchoroidal spc njx rx agt
|
$478.00 |
$478.00 |
$478.00 |
$454.19
|
|
Sputum specimen collection
|
$65.50 |
$65.50 |
$65.50 |
$180.00
|
|
Sr-89 stront chlor ther / mci
|
$1,699.50 |
$1,699.50 |
$1,699.50 |
$2,667.94
|
|
Srs linear based
|
$7,175.50 |
$7,175.50 |
$7,175.50 |
$13,585.00
|
|
Srs multisource
|
$8,973.50 |
$8,973.50 |
$8,973.50 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$233.50 |
$233.50 |
$233.50 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$219.00 |
$219.00 |
$219.00 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$12,833.00 |
$12,833.00 |
$12,833.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$5,024.50 |
$5,024.50 |
$5,024.50 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$8,227.50 |
$8,227.50 |
$8,227.50 |
$20,962.50
|
|
Sterile needle
|
$281.50 |
$281.50 |
$281.50 |
$190.13
|
|
St evaluate speech sound production
|
$185.00 |
$185.00 |
$185.00 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$185.00 |
$185.00 |
$185.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$208.50 |
$208.50 |
$208.50 |
$399.60
|
|
St evaluation swallow function
|
$198.00 |
$198.00 |
$198.00 |
$314.40
|
|
Stimulants synthetic
|
$85.00 |
$85.00 |
$85.00 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$184.00 |
$184.00 |
$184.00 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$133.00 |
$133.00 |
$133.00 |
$154.70
|
|
Strapping of hand or finger
|
$123.00 |
$123.00 |
$123.00 |
$174.82
|
|
Strep a ag ia
|
$33.50 |
$33.50 |
$33.50 |
$75.40
|
|
Strep b dna amp probe
|
$85.00 |
$85.00 |
$85.00 |
$120.90
|
|
Stress test pulmonary
|
$241.50 |
$241.50 |
$241.50 |
$322.85
|
|
Str markers specimen anal
|
$751.50 |
$751.50 |
$751.50 |
$751.50
|
|
St treatment speech individual
|
$162.50 |
$162.50 |
$162.50 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$196.00 |
$196.00 |
$196.00 |
$240.31
|
|
Subq njx filling matrl 1cc/<
|
$231.00 |
$231.00 |
$231.00 |
$235.13
|
|
Sugars single quant
|
$520.00 |
$520.00 |
$520.00 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$354.50 |
$354.50 |
$354.50 |
$7,345.98
|
|
Sulfonylurea screen qn-sendout
|
$110.00 |
$110.00 |
$110.00 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$12.50 |
$12.50 |
$12.50 |
$114.88
|
|
Supprelin la implant
|
$75,271.50 |
$75,271.50 |
$75,271.50 |
$80,935.72
|
|
Surgical pathology level 1 gross examination only
|
$79.50 |
$79.50 |
$79.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$93.50 |
$93.50 |
$93.50 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$136.50 |
$136.50 |
$136.50 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$151.50 |
$151.50 |
$151.50 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$692.00 |
$692.00 |
$692.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,078.00 |
$1,078.00 |
$1,078.00 |
$718.00
|
|
Surgical trays
|
$1,397.50 |
$1,397.50 |
$1,397.50 |
$694.80
|
|
Susceptibility agar dilution per agent
|
$50.50 |
$50.50 |
$50.50 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$9.00 |
$9.00 |
$9.00 |
$35.70
|
|
Susceptibility mic per plate
|
$462.00 |
$462.00 |
$462.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$177.50 |
$177.50 |
$177.50 |
$59.28
|
|
Svc venogram s&i
|
$3,492.00 |
$3,492.00 |
$3,492.00 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$125.50 |
$125.50 |
$125.50 |
$125.40
|
|
Synvisc or synvisc-one
|
$30.00 |
$30.00 |
$30.00 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$50.00 |
$50.00 |
$50.00 |
$41.60
|
|
System pacing micra av
|
$4,475.00 |
$4,475.00 |
$4,475.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,372.00 |
$5,372.00 |
$5,372.00 |
$12,003.00
|
|
System sealant biosentry tract
|
$724.00 |
$724.00 |
$724.00 |
$889.35
|
|
T3 (triiodothyronine) free
|
$72.00 |
$72.00 |
$72.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$98.00 |
$98.00 |
$98.00 |
$93.52
|
|
T4 (thyroxine) free
|
$32.00 |
$32.00 |
$32.00 |
$85.20
|
|
T4 (thyroxine) total
|
$49.00 |
$49.00 |
$49.00 |
$69.00
|
|
Tacrol envarsus ex rel oral
|
$3.50 |
$3.50 |
$3.50 |
$15.60
|
|
Tacrolimus therapeutic drug level
|
$75.50 |
$75.50 |
$75.50 |
$122.40
|
|
Tap block bilat cont infusion 64489
|
$3,941.50 |
$3,941.50 |
$3,941.50 |
$1,407.60
|
|
Tap block uni by cont infusion 64487
|
$1,437.50 |
$1,437.50 |
$1,437.50 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$2,600.00 |
$2,600.00 |
$2,600.00 |
$2,246.30
|
|
Target gsa panel organ neop
|
$1,550.00 |
$1,550.00 |
$1,550.00 |
$1,655.52
|
|
Tattooing/intraderm 6.1-20.0 sq cm 11921
|
$849.50 |
$849.50 |
$849.50 |
$953.29
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$139.00 |
$139.00 |
$139.00 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$220.50 |
$220.50 |
$220.50 |
$177.65
|
|
Tc-99m diag per dose
|
$1,816.50 |
$1,816.50 |
$1,816.50 |
$470.40
|
|
Tc-99m disofenin
|
$121.50 |
$121.50 |
$121.50 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$2,386.50 |
$2,386.50 |
$2,386.50 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,837.50 |
$1,837.50 |
$1,837.50 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$31.00 |
$31.00 |
$31.00 |
$302.40
|
|
Tc-99m maa
|
$34.00 |
$34.00 |
$34.00 |
$292.80
|
|
Tc-99m mebrofenin
|
$125.00 |
$125.00 |
$125.00 |
$157.65
|
|
Tc-99m medronate
|
$34.00 |
$34.00 |
$34.00 |
$111.01
|
|
Tc-99m mertiatide
|
$855.50 |
$855.50 |
$855.50 |
$756.00
|
|
Tc-99m oxidronate
|
$33.00 |
$33.00 |
$33.00 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$67.00 |
$67.00 |
$67.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$226.50 |
$226.50 |
$226.50 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$2.50 |
$2.50 |
$2.50 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$64.00 |
$64.00 |
$64.00 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$495.50 |
$495.50 |
$495.50 |
$274.45
|
|
Tc-99m sulfur colloid
|
$144.50 |
$144.50 |
$144.50 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$226.50 |
$226.50 |
$226.50 |
$190.80
|
|
T cells absolute cd4/cd8 including ratio
|
$154.00 |
$154.00 |
$154.00 |
$176.40
|
|
T cells absolute cd 4 count
|
$32.00 |
$32.00 |
$32.00 |
$111.20
|
|
T cells total count
|
$123.00 |
$123.00 |
$123.00 |
$126.90
|
|
Tcranial magn stim tx deli
|
$248.50 |
$248.50 |
$248.50 |
$389.22
|
|
Telehealth original site facility fee
|
$56.00 |
$56.00 |
$56.00 |
$51.00
|
|
Telethx isodose plan cplx
|
$973.50 |
$973.50 |
$973.50 |
$1,526.85
|
|
Telethx isodose plan simple
|
$484.00 |
$484.00 |
$484.00 |
$873.62
|
