|
Special physics consult
|
$725.00 |
$725.00 |
$1,056.00 |
$725.00
|
|
Special pump services
|
$780.00 |
$780.00 |
$780.00 |
$901.60
|
|
Special radiation dosimetry
|
$392.50 |
$392.50 |
$422.40 |
$392.50
|
|
Special radiation treatment
|
$1,909.38 |
$1,909.38 |
$3,275.00 |
$1,986.00
|
|
Special teletx port plan
|
$1,358.28 |
$1,358.28 |
$1,900.00 |
$1,086.99
|
|
Specific gravity body fluid
|
$13.20 |
$13.20 |
$13.20 |
$22.00
|
|
Specimen fat stain
|
$31.68 |
$31.68 |
$47.50 |
$35.10
|
|
Speech evaluation complex
|
$551.76 |
$551.76 |
$551.76 |
$527.06
|
|
Sperm antibody test
|
$55.44 |
$55.44 |
$55.44 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,130.00 |
$1,130.00 |
$1,364.88 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$467.50 |
$467.50 |
$654.72 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$330.00 |
$330.00 |
$684.42 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$42.50 |
$42.50 |
$42.50 |
$68.25
|
|
Splint finger frog med
|
$42.50 |
$42.50 |
$48.84 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$62.50 |
$62.50 |
$62.50 |
$99.04
|
|
Split blood or products
|
$75.00 |
$75.00 |
$198.00 |
$127.48
|
|
Sputum specimen collection
|
$198.00 |
$198.00 |
$198.00 |
$180.00
|
|
Srs linear based
|
$24,095.00 |
$24,095.00 |
$24,095.00 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$184.14 |
$184.14 |
$227.50 |
$297.60
|
|
Staph a dna amp probe
|
$125.00 |
$125.00 |
$237.60 |
$125.00
|
|
Static or dynami afo pre ots
|
$85.80 |
$85.80 |
$85.80 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$230.00 |
$230.00 |
$230.00 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$15,719.88 |
$15,719.88 |
$17,760.00 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,408.72 |
$6,408.72 |
$6,408.72 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$335.66 |
$335.66 |
$335.66 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$2,632.00 |
$2,632.00 |
$2,632.00 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$131.20 |
$131.20 |
$131.20 |
$4,939.20
|
|
Stent iliac/open or perc/uni/init 37221
|
$12,760.00 |
$12,760.00 |
$13,098.36 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$5,539.38 |
$5,539.38 |
$12,760.00 |
$9,008.54
|
|
Stent placemt retro carotid
|
$4,540.14 |
$4,540.14 |
$4,540.14 |
$5,328.00
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$13,245.00 |
$13,245.00 |
$20,739.84 |
$17,271.50
|
|
St evaluate speech sound production
|
$181.50 |
$181.50 |
$227.50 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$340.00 |
$340.00 |
$345.18 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$282.48 |
$282.48 |
$337.50 |
$399.60
|
|
St evaluation swallow function
|
$273.24 |
$273.24 |
$337.50 |
$314.40
|
|
Strapping of ankle and/or ft 29540
|
$110.00 |
$110.00 |
$110.00 |
$223.45
|
|
Strapping of hand or finger
|
$97.50 |
$97.50 |
$97.50 |
$174.82
|
|
Strep a ag ia
|
$20.00 |
$20.00 |
$79.86 |
$75.40
|
|
Strep b assay w/optic
|
$116.82 |
$116.82 |
$116.82 |
$80.16
|
|
Strep b dna amp probe
|
$90.00 |
$90.00 |
$237.60 |
$120.90
|
|
Stress test pulmonary
|
$217.50 |
$217.50 |
$447.48 |
$322.85
|
|
Stress tte complete
|
$1,940.00 |
$1,940.00 |
$2,050.62 |
$1,870.50
|
|
Str markers specimen anal
|
$380.00 |
$380.00 |
$380.00 |
$751.50
|
|
St treatment speech individual
|
$224.40 |
$224.40 |
$255.00 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$224.40 |
$224.40 |
$270.00 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$14.72 |
$14.72 |
$14.72 |
$52.31
|
|
Sulfonylurea screen qn-sendout
|
$157.74 |
$157.74 |
$230.00 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$167.77 |
$167.77 |
$167.77 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$70.00 |
$70.00 |
$115.50 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$87.50 |
$87.50 |
$97.02 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$147.50 |
$147.50 |
$198.66 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$190.00 |
$190.00 |
$248.16 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$297.66 |
$297.66 |
$307.50 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$480.00 |
$480.00 |
$974.16 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$680.00 |
$680.00 |
$1,391.94 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$20.00 |
$20.00 |
$68.64 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$20.00 |
$20.00 |
$49.50 |
$35.70
|
|
Susceptibility mic per plate
|
$40.00 |
$40.00 |
$356.40 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$100.00 |
$100.00 |
$143.88 |
$59.28
|
|
Svc venogram s&i
|
$2,095.00 |
$2,095.00 |
$2,383.26 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$155.76 |
$155.76 |
$155.76 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$17.50 |
$17.50 |
$42.24 |
$41.60
|
|
System pacing micra av
|
$3,806.53 |
$3,806.53 |
$3,806.53 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$4,341.60 |
$4,341.60 |
$4,341.60 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$11,137.50 |
$11,137.50 |
$11,137.50 |
$11,183.00
|
|
System sealant biosentry tract
|
$613.73 |
$613.73 |
$613.73 |
$889.35
|
|
T3 (triiodothyronine) free
|
$95.00 |
$95.00 |
$143.88 |
$99.20
|
|
T3 (triiodothyronine) total
|
$89.76 |
$89.76 |
$105.00 |
$93.52
|
|
T4 (thyroxine) free
|
$54.12 |
$54.12 |
$90.00 |
$85.20
|
|
T4 (thyroxine) total
|
$31.68 |
$31.68 |
$72.50 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$10.02 |
$10.02 |
$10.02 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$77.50 |
$77.50 |
$77.88 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,954.92 |
$1,954.92 |
$2,710.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,735.00 |
$1,735.00 |
$4,368.54 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,525.00 |
$1,525.00 |
$1,525.00 |
$1,655.52
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$997.66 |
$997.66 |
$997.66 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$212.50 |
$212.50 |
$295.02 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$175.00 |
$175.00 |
$415.14 |
$177.65
|
|
Tc-99m labeled rbc
|
$232.50 |
$232.50 |
$232.50 |
$302.40
|
|
Tc-99m maa
|
$265.00 |
$265.00 |
$265.00 |
$292.80
|
|
Tc-99m mebrofenin
|
$157.50 |
$157.50 |
$157.50 |
$157.65
|
|
Tc-99m medronate
|
$95.00 |
$95.00 |
$95.00 |
$111.01
|
|
Tc-99m mertiatide
|
$407.50 |
$407.50 |
$407.50 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$11.88 |
$6.60
|
|
Tc-99m pentetate dtpa
|
$175.00 |
$175.00 |
$175.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$115.00 |
$115.00 |
$115.00 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$4.00 |
$4.00 |
$4.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$110.00 |
$110.00 |
$110.00 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$310.00 |
$310.00 |
$310.00 |
$274.45
|
|
Tc-99m sulfur colloid
|
$250.00 |
$250.00 |
$250.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$357.50 |
$357.50 |
$357.50 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$800.00 |
$800.00 |
$800.00 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$175.00 |
$175.00 |
$316.80 |
$176.40
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$172.92 |
$111.20
|
|
T cells total count
|
$135.00 |
$135.00 |
$268.62 |
$126.90
|
|
Team conf w/pat by hc prof
|
$112.86 |
$112.86 |
$112.86 |
$107.10
|
|
Telehealth original site facility fee
|
$27.50 |
$27.50 |
$197.34 |
$51.00
|
|
Telethx isodose plan cplx
|
$2,457.84 |
$2,457.84 |
$3,980.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$580.80 |
$580.80 |
$1,780.00 |
$873.62
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$284.89 |
$284.89 |
$322.00 |
$15,245.38
|
