|
Specimen fat stain
|
$47.85 |
$47.85 |
$47.85 |
$32.76
|
|
Sperm antibody test
|
$79.20 |
$79.20 |
$79.20 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,057.55 |
$2,057.55 |
$2,057.55 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$277.20 |
$277.20 |
$277.20 |
$559.96
|
|
Split blood or products
|
$161.15 |
$161.15 |
$161.15 |
$148.98
|
|
Sputum specimen collection
|
$136.40 |
$136.40 |
$136.40 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$258.50 |
$258.50 |
$258.50 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$184.80 |
$184.80 |
$184.80 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$10,683.75 |
$10,683.75 |
$10,683.75 |
$23,387.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$341.74 |
$341.74 |
$341.74 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,819.87 |
$1,819.87 |
$1,819.87 |
$18,714.49
|
|
Stent iliac/open or perc/uni/init 37221
|
$6,421.25 |
$6,421.25 |
$6,421.25 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$4,614.50 |
$4,614.50 |
$4,614.50 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$7,723.10 |
$7,723.10 |
$7,723.10 |
$19,765.20
|
|
St evaluate speech sound production
|
$258.50 |
$258.50 |
$258.50 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$258.50 |
$258.50 |
$258.50 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$421.30 |
$421.30 |
$421.30 |
$406.40
|
|
St evaluation swallow function
|
$410.30 |
$410.30 |
$410.30 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$219.45 |
$219.45 |
$219.45 |
$248.05
|
|
Strapping of chest
|
$403.15 |
$403.15 |
$403.15 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$387.75 |
$387.75 |
$387.75 |
$171.00
|
|
Strapping of hand or finger
|
$346.50 |
$346.50 |
$346.50 |
$194.40
|
|
Strapping of knee
|
$283.80 |
$283.80 |
$283.80 |
$224.80
|
|
Strapping of toes 29550
|
$219.45 |
$219.45 |
$219.45 |
$185.36
|
|
Strep a ag ia
|
$196.90 |
$196.90 |
$196.90 |
$75.40
|
|
Strep b dna amp probe
|
$82.50 |
$82.50 |
$82.50 |
$139.20
|
|
Stress test pulmonary
|
$239.80 |
$239.80 |
$239.80 |
$327.20
|
|
St treatment speech individual
|
$130.90 |
$130.90 |
$130.90 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$158.40 |
$158.40 |
$158.40 |
$261.60
|
|
Sulfonylurea screen qn-sendout
|
$160.05 |
$160.05 |
$160.05 |
$184.60
|
|
Surgical pathology level 1 gross examination only
|
$69.85 |
$69.85 |
$69.85 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$132.55 |
$132.55 |
$132.55 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$313.50 |
$313.50 |
$313.50 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$970.75 |
$970.75 |
$970.75 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$402.60 |
$402.60 |
$402.60 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,010.35 |
$1,010.35 |
$1,010.35 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$198.00 |
$198.00 |
$198.00 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$44.00 |
$44.00 |
$44.00 |
$34.48
|
|
Susceptibility mic per plate
|
$525.25 |
$525.25 |
$525.25 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$197.45 |
$197.45 |
$197.45 |
$48.30
|
|
Svc venogram s&i
|
$2,913.35 |
$2,913.35 |
$2,913.35 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$56.10 |
$56.10 |
$56.10 |
$44.85
|
|
System sealant biosentry tract
|
$743.20 |
$743.20 |
$743.20 |
$900.00
|
|
T3 (triiodothyronine) free
|
$144.65 |
$144.65 |
$144.65 |
$89.82
|
|
T3 (triiodothyronine) total
|
$11.00 |
$11.00 |
$11.00 |
$94.90
|
|
T4 (thyroxine) free
|
$199.10 |
$199.10 |
$199.10 |
$81.60
|
|
T4 (thyroxine) total
|
$9.90 |
$9.90 |
$9.90 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$42.35 |
$42.35 |
$42.35 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$4,382.95 |
$4,382.95 |
$4,382.95 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$3,966.05 |
$3,966.05 |
$3,966.05 |
$3,385.00
|
|
Target gsa panel organ neop
|
$6,824.40 |
$6,824.40 |
$6,824.40 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$294.25 |
$294.25 |
$294.25 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$266.75 |
$266.75 |
$266.75 |
$166.46
|
|
Tc-99m bicisate
|
$1,696.75 |
$1,696.75 |
$1,696.75 |
$1,969.45
|
|
Tc-99m labeled rbc
|
$267.30 |
$267.30 |
$267.30 |
$323.01
|
|
Tc-99m maa
|
$230.45 |
$230.45 |
$230.45 |
$312.06
|
|
Tc-99m mebrofenin
|
$225.50 |
$225.50 |
$225.50 |
$169.53
|
|
Tc-99m medronate
|
$209.55 |
$209.55 |
$209.55 |
$122.46
|
|
Tc-99m mertiatide
|
$799.15 |
$799.15 |
$799.15 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$12.65 |
$12.65 |
$12.65 |
$8.00
|
|
Tc-99m pentetate dtpa
|
$1.91 |
$1.91 |
$1.91 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$175.45 |
$175.45 |
$175.45 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$209.55 |
$209.55 |
$209.55 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$209.55 |
$209.55 |
$209.55 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$375.65 |
$375.65 |
$375.65 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$371.25 |
$371.25 |
$371.25 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$76.45 |
$76.45 |
$76.45 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$545.60 |
$545.60 |
$545.60 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$66.00 |
$66.00 |
$66.00 |
$186.00
|
|
T cells total count
|
$66.00 |
$66.00 |
$66.00 |
$124.11
|
|
Telehealth original site facility fee
|
$52.25 |
$52.25 |
$52.25 |
$60.80
|
|
Telethx isodose plan cplx
|
$585.75 |
$585.75 |
$585.75 |
$1,617.00
|
|
Telethx isodose plan simple
|
$319.55 |
$319.55 |
$319.55 |
$848.72
|
|
Test stress cardiovascular tracing only
|
$805.75 |
$805.75 |
$805.75 |
$1,001.55
|
|
Theophylline therapeutic drug level
|
$190.85 |
$190.85 |
$190.85 |
$108.00
|
|
Ther nma rdctj intus/obstrcj
|
$1,331.00 |
$1,331.00 |
$1,331.00 |
$534.32
|
|
Ther/proph/diag inj ia
|
$215.60 |
$215.60 |
$215.60 |
$247.33
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,995.30 |
$2,995.30 |
$2,995.30 |
$1,804.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$3,251.60 |
$3,251.60 |
$3,251.60 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$6,477.35 |
$6,477.35 |
$6,477.35 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$7,375.50 |
$7,375.50 |
$7,375.50 |
$24,605.30
|
|
Thrombin time
|
$43.45 |
$43.45 |
$43.45 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$93.50 |
$93.50 |
$93.50 |
$56.93
|
|
Thyroglobulin antibody
|
$49.50 |
$49.50 |
$49.50 |
$84.00
|
|
Thyroid (TSH) Test
|
$152.90 |
$152.90 |
$152.90 |
$120.00
|
|
Thyroid Ultrasound
|
$1,120.90 |
$1,120.90 |
$1,120.90 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$29.15 |
$29.15 |
$29.15 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$10,868.00 |
$10,868.00 |
$10,868.00 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$6,777.65 |
$6,777.65 |
$6,777.65 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$5,648.50 |
$5,648.50 |
$5,648.50 |
$10,406.14
|
|
Tilt table study
|
$1,196.80 |
$1,196.80 |
$1,196.80 |
$1,495.00
|
|
Tissue culture placenta
|
$590.15 |
$590.15 |
$590.15 |
$520.91
|
|
Tissue culture skin/biopsy
|
$532.40 |
$532.40 |
$532.40 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$225.50 |
$225.50 |
$225.50 |
$47.40
|
|
Tissue transglutaminase iga
|
$62.70 |
$62.70 |
$62.70 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$57.20 |
$57.20 |
$57.20 |
$77.22
|
|
Tobramycin peak therapeutic drug level
|
$158.95 |
$158.95 |
$158.95 |
$121.55
|
|
Total tau
|
$275.00 |
$275.00 |
$275.00 |
$293.00
|
|
Toxoplasma antibody igg
|
$16.50 |
$16.50 |
$16.50 |
$84.35
|
|
Toxoplasma antibody igm
|
$16.50 |
$16.50 |
$16.50 |
$83.20
|
