|
Slco1b1 gene com variants
|
$563.85 |
$563.85 |
$563.85 |
$241.24
|
|
Sling suprapubic suburetheral
|
$11,621.41 |
$11,621.41 |
$11,621.41 |
$9,679.96
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$424.51 |
$424.51 |
$424.51 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$36.48 |
$36.48 |
$36.48 |
$64.35
|
|
Smear gram stain
|
$8.18 |
$8.18 |
$8.18 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$180.52 |
$180.52 |
$180.52 |
$73.50
|
|
Smear wet mount
|
$33.34 |
$33.34 |
$33.34 |
$67.55
|
|
Sodium 24 hour urine
|
$44.28 |
$44.28 |
$44.28 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$19.07 |
$19.07 |
$19.07 |
$46.26
|
|
Specific gravity body fluid
|
$6.15 |
$6.15 |
$6.15 |
$22.00
|
|
Spine X-ray (single view, one level)
|
$232.32 |
$232.32 |
$232.32 |
$251.00
|
|
Sputum specimen collection
|
$264.19 |
$264.19 |
$264.19 |
$180.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$4,496.65 |
$4,496.65 |
$4,496.65 |
$32,403.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$8,990.07 |
$8,990.07 |
$8,990.07 |
$20,962.50
|
|
Stimulants synthetic
|
$98.40 |
$98.40 |
$98.40 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,363.98 |
$1,363.98 |
$1,363.98 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$250.97 |
$250.97 |
$250.97 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$310.02 |
$310.02 |
$310.02 |
$157.46
|
|
Strapping of hand or finger
|
$267.14 |
$267.14 |
$267.14 |
$177.45
|
|
Strapping of hip
|
$302.99 |
$302.99 |
$302.99 |
$164.70
|
|
Strapping of knee
|
$296.67 |
$296.67 |
$296.67 |
$205.20
|
|
Strep a ag ia
|
$32.08 |
$32.08 |
$32.08 |
$75.40
|
|
Strep b dna amp probe
|
$66.67 |
$66.67 |
$66.67 |
$124.15
|
|
Stress test pulmonary
|
$375.70 |
$375.70 |
$375.70 |
$324.00
|
|
Stress tte complete
|
$1,026.54 |
$1,026.54 |
$1,026.54 |
$1,900.96
|
|
Str markers specimen anal
|
$1,532.60 |
$1,532.60 |
$1,532.60 |
$756.60
|
|
Sulfonylurea screen qn-sendout
|
$109.47 |
$109.47 |
$109.47 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$34.50 |
$34.50 |
$34.50 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$54.51 |
$54.51 |
$54.51 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$74.52 |
$74.52 |
$74.52 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$74.52 |
$74.52 |
$74.52 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$495.42 |
$495.42 |
$495.42 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,113.66 |
$1,113.66 |
$1,113.66 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$160.40 |
$160.40 |
$160.40 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$35.22 |
$35.22 |
$35.22 |
$35.89
|
|
Susceptibility mic per plate
|
$153.60 |
$153.60 |
$153.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$36.48 |
$36.48 |
$36.48 |
$59.28
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$36.19 |
$36.19 |
$36.19 |
$42.24
|
|
T3 (triiodothyronine) free
|
$43.66 |
$43.66 |
$43.66 |
$100.32
|
|
T3 (triiodothyronine) total
|
$26.44 |
$26.44 |
$26.44 |
$93.52
|
|
T4 (thyroxine) free
|
$40.59 |
$40.59 |
$40.59 |
$89.60
|
|
T4 (thyroxine) total
|
$34.44 |
$34.44 |
$34.44 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$39.36 |
$39.36 |
$39.36 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$223.87 |
$223.87 |
$223.87 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,572.23 |
$2,572.23 |
$2,572.23 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$9,407.17 |
$9,407.17 |
$9,407.17 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$208.80 |
$208.80 |
$208.80 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$129.46 |
$129.46 |
$129.46 |
$179.95
|
|
Tc-99m labeled rbc
|
$494.86 |
$494.86 |
$494.86 |
$306.00
|
|
Tc-99m maa
|
$156.74 |
$156.74 |
$156.74 |
$312.06
|
|
Tc-99m mebrofenin
|
$172.54 |
$172.54 |
$172.54 |
$157.65
|
|
Tc-99m medronate
|
$223.92 |
$223.92 |
$223.92 |
$111.01
|
|
Tc-99m mertiatide
|
$238.90 |
$238.90 |
$238.90 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$210.46 |
$210.46 |
$210.46 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$16.43 |
$16.43 |
$16.43 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$175.63 |
$175.63 |
$175.63 |
$287.20
|
|
Tc-99m sulfur colloid
|
$207.93 |
$207.93 |
$207.93 |
$245.70
|
|
Tcd emboli detect without inj
|
$400.73 |
$400.73 |
$400.73 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$98.14 |
$98.14 |
$98.14 |
$184.00
|
|
T cells total count
|
$79.34 |
$79.34 |
$79.34 |
$130.20
|
|
Team conf without pat by hc pro
|
$91.39 |
$91.39 |
$91.39 |
$112.86
|
|
Team conf without pat by phys
|
$142.36 |
$142.36 |
$142.36 |
$140.25
|
|
Team conf w/pat by hc prof
|
$121.62 |
$121.62 |
$121.62 |
$107.10
|
|
Telehealth original site facility fee
|
$63.15 |
$63.15 |
$63.15 |
$51.00
|
|
Testicular imaging w/vasc flow
|
$584.20 |
$584.20 |
$584.20 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,069.28 |
$1,069.28 |
$1,069.28 |
$953.40
|
|
Theophylline therapeutic drug level
|
$26.44 |
$26.44 |
$26.44 |
$108.00
|
|
Therapeutic procd strg endur
|
$72.90 |
$72.90 |
$72.90 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$66.78 |
$66.78 |
$66.78 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$89.28 |
$89.28 |
$89.28 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$44.69 |
$44.69 |
$44.69 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$41.95 |
$41.95 |
$41.95 |
$50.40
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$194.30 |
$194.30 |
$194.30 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,176.53 |
$1,176.53 |
$1,176.53 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,760.86 |
$1,760.86 |
$1,760.86 |
$1,703.45
|
|
Thrombin time
|
$35.62 |
$35.62 |
$35.62 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$65.51 |
$65.51 |
$65.51 |
$62.01
|
|
Thyroglobulin antibody
|
$66.82 |
$66.82 |
$66.82 |
$82.50
|
|
Thyroid imaging
|
$617.22 |
$617.22 |
$617.22 |
$695.60
|
|
Thyroid (TSH) Test
|
$68.26 |
$68.26 |
$68.26 |
$112.70
|
|
Thyroid Ultrasound
|
$779.25 |
$779.25 |
$779.25 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$27.68 |
$27.68 |
$27.68 |
$64.51
|
|
Tissue exam koh skin/hair/nails
|
$135.24 |
$135.24 |
$135.24 |
$47.40
|
|
Tissue transglutaminase iga
|
$41.06 |
$41.06 |
$41.06 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$30.13 |
$30.13 |
$30.13 |
$120.60
|
|
Toe X-ray (both feet)
|
$180.93 |
$180.93 |
$180.93 |
$258.65
|
|
Tomosynthesis breast diagnostic left
|
$41.78 |
$41.78 |
$41.78 |
$74.10
|
|
Tomosynthesis breast screen bilateral
|
$40.82 |
$40.82 |
$40.82 |
$74.10
|
|
Total tau
|
$277.36 |
$277.36 |
$277.36 |
$312.50
|
|
Toxoplasma antibody igg
|
$43.85 |
$43.85 |
$43.85 |
$91.65
|
|
Toxoplasma antibody igm
|
$41.76 |
$41.76 |
$41.76 |
$87.75
|
|
Tpmt gene com vrnts
|
$563.85 |
$563.85 |
$563.85 |
$371.80
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$124.03 |
$124.03 |
$124.03 |
$102.27
|
|
Transferrin
|
$23.98 |
$23.98 |
$23.98 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$683.83 |
$683.83 |
$683.83 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$576.69 |
$576.69 |
$576.69 |
$499.20
|
|
Trauma partial team response w/critical care services level 4
|
$2,164.89 |
$2,164.89 |
$2,164.89 |
$4,523.04
|
|
Treat ankle dislocation
|
$824.37 |
$824.37 |
$824.37 |
$2,360.00
|
|
Treat elbow dislocation
|
$791.67 |
$791.67 |
$791.67 |
$2,272.50
|
|
Treat fracture of radius
|
$767.02 |
$767.02 |
$767.02 |
$1,790.00
|
