|
Sinus CT scan (with contrast)
|
$312.26 |
$312.26 |
$312.26 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$249.77 |
$249.77 |
$249.77 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$64.41 |
$64.41 |
$64.41 |
$346.45
|
|
Sinus X-ray (limited)
|
$54.15 |
$54.15 |
$54.15 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$29.26 |
$29.26 |
$29.26 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$64.22 |
$64.22 |
$64.22 |
$294.45
|
|
Skull X-ray (complete)
|
$81.70 |
$81.70 |
$81.70 |
$417.50
|
|
Slco1b1 gene com variants
|
$111.92 |
$111.92 |
$111.92 |
$241.24
|
|
Sling suprapubic suburetheral
|
$5,603.22 |
$5,603.22 |
$5,603.22 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$84.83 |
$84.83 |
$84.83 |
$285.09
|
|
Slp ther svc non-spch gen
|
$81.65 |
$81.65 |
$81.65 |
$188.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$104.31 |
$104.31 |
$104.31 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$12.51 |
$12.51 |
$12.51 |
$64.35
|
|
Smear gram stain
|
$23.37 |
$23.37 |
$23.37 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$13.25 |
$13.25 |
$13.25 |
$73.50
|
|
Smear wet mount
|
$9.75 |
$9.75 |
$9.75 |
$67.55
|
|
Sodium 24 hour urine
|
$13.68 |
$13.68 |
$13.68 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$19.38 |
$19.38 |
$19.38 |
$46.26
|
|
Specific gravity body fluid
|
$1.90 |
$1.90 |
$1.90 |
$22.00
|
|
Specimen fat stain
|
$3.31 |
$3.31 |
$3.31 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$122.58 |
$122.58 |
$122.58 |
$384.80
|
|
Speech evaluation complex
|
$141.93 |
$141.93 |
$141.93 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$83.35 |
$83.35 |
$83.35 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$348.08 |
$348.08 |
$348.08 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$46.17 |
$46.17 |
$46.17 |
$251.00
|
|
Split blood or products
|
$67.16 |
$67.16 |
$67.16 |
$127.80
|
|
Sputum specimen collection
|
$67.16 |
$67.16 |
$67.16 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$120.66 |
$120.66 |
$120.66 |
$297.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$11,205.59 |
$11,205.59 |
$11,205.59 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$1,975.11 |
$1,975.11 |
$1,975.11 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$7,470.68 |
$7,470.68 |
$7,470.68 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$1,975.11 |
$1,975.11 |
$1,975.11 |
$4,631.82
|
|
St evaluate speech sound production
|
$100.62 |
$100.62 |
$100.62 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$126.72 |
$126.72 |
$126.72 |
$400.00
|
|
Stimulants synthetic
|
$30.40 |
$30.40 |
$30.40 |
$80.08
|
|
Strep a ag ia
|
$9.38 |
$9.38 |
$9.38 |
$75.40
|
|
Strep b dna amp probe
|
$19.50 |
$19.50 |
$19.50 |
$124.15
|
|
Stress test pulmonary
|
$13.01 |
$13.01 |
$13.01 |
$324.00
|
|
Stress tte complete
|
$442.08 |
$442.08 |
$442.08 |
$1,900.96
|
|
Str markers specimen anal
|
$304.21 |
$304.21 |
$304.21 |
$756.60
|
|
Sulfonylurea screen qn-sendout
|
$33.82 |
$33.82 |
$33.82 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$11.94 |
$11.94 |
$11.94 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$27.50 |
$27.50 |
$27.50 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$70.99 |
$70.99 |
$70.99 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$108.30 |
$108.30 |
$108.30 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$242.17 |
$242.17 |
$242.17 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$364.96 |
$364.96 |
$364.96 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$12.14 |
$12.14 |
$12.14 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$10.30 |
$10.30 |
$10.30 |
$35.89
|
|
Susceptibility mic per plate
|
$39.74 |
$39.74 |
$39.74 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$21.16 |
$21.16 |
$21.16 |
$59.28
|
|
Svc venogram s&i
|
$243.58 |
$243.58 |
$243.58 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$74.45 |
$74.45 |
$74.45 |
$316.80
|
|
Swallowing Therapy Session
|
$70.35 |
$70.35 |
$70.35 |
$232.56
|
|
Sweat collection by iontophoresis
|
$20.98 |
$20.98 |
$20.98 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$15.65 |
$15.65 |
$15.65 |
$42.24
|
|
System pacing micra av
|
$7,470.68 |
$7,470.68 |
$7,470.68 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$23,344.06 |
$23,344.06 |
$23,344.06 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$13.49 |
$13.49 |
$13.49 |
$100.32
|
|
T3 (triiodothyronine) total
|
$8.17 |
$8.17 |
$8.17 |
$93.52
|
|
T4 (thyroxine) free
|
$40.28 |
$40.28 |
$40.28 |
$89.60
|
|
T4 (thyroxine) total
|
$10.64 |
$10.64 |
$10.64 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$12.16 |
$12.16 |
$12.16 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$68.97 |
$68.97 |
$68.97 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$780.24 |
$780.24 |
$780.24 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$2,998.80 |
$2,998.80 |
$2,998.80 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$90.30 |
$90.30 |
$90.30 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$55.99 |
$55.99 |
$55.99 |
$179.95
|
|
T cells absolute cd4/cd8 including ratio
|
$42.44 |
$42.44 |
$42.44 |
$184.00
|
|
T cells absolute cd 4 count
|
$24.38 |
$24.38 |
$24.38 |
$111.20
|
|
T cells total count
|
$34.31 |
$34.31 |
$34.31 |
$130.20
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$17.95 |
$17.95 |
$17.95 |
$14,951.87
|
|
Test stress cardiovascular tracing only
|
$277.99 |
$277.99 |
$277.99 |
$953.40
|
|
Theophylline therapeutic drug level
|
$8.17 |
$8.17 |
$8.17 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$32.68 |
$32.68 |
$32.68 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$29.03 |
$29.03 |
$29.03 |
$98.58
|
|
Ther nma rdctj intus/obstrcj
|
$254.98 |
$254.98 |
$254.98 |
$538.88
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$70.30 |
$70.30 |
$70.30 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$642.77 |
$642.77 |
$642.77 |
$1,724.25
|
|
Throat x-ray & fluoroscopy
|
$100.32 |
$100.32 |
$100.32 |
$259.60
|
|
Thrombin time
|
$11.70 |
$11.70 |
$11.70 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$21.53 |
$21.53 |
$21.53 |
$62.01
|
|
Thyroglobulin antibody
|
$28.90 |
$28.90 |
$28.90 |
$82.50
|
|
Thyroid (TSH) Test
|
$62.32 |
$62.32 |
$62.32 |
$112.70
|
|
Thyroid Ultrasound
|
$105.20 |
$105.20 |
$105.20 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$8.55 |
$8.55 |
$8.55 |
$64.51
|
|
Tilt table study
|
$587.31 |
$587.31 |
$587.31 |
$1,561.82
|
|
Tissue culture placenta
|
$154.56 |
$154.56 |
$154.56 |
$453.00
|
|
Tissue culture skin/biopsy
|
$144.75 |
$144.75 |
$144.75 |
$488.74
|
|
Tissue culture tumor
|
$151.57 |
$151.57 |
$151.57 |
$486.50
|
|
Tissue exam koh skin/hair/nails
|
$39.56 |
$39.56 |
$39.56 |
$47.40
|
|
Tissue transglutaminase iga
|
$17.76 |
$17.76 |
$17.76 |
$44.80
|
|
Tobramycin peak therapeutic drug level
|
$9.31 |
$9.31 |
$9.31 |
$120.60
|
|
Toe X-ray (both feet)
|
$47.69 |
$47.69 |
$47.69 |
$258.65
|
|
Total tau
|
$85.69 |
$85.69 |
$85.69 |
$312.50
|
|
Toxoplasma antibody igg
|
$18.96 |
$18.96 |
$18.96 |
$91.65
|
|
Toxoplasma antibody igm
|
$18.06 |
$18.06 |
$18.06 |
$87.75
|
|
Tpmt gene com vrnts
|
$111.92 |
$111.92 |
$111.92 |
$371.80
|
|
Transferrin
|
$28.31 |
$28.31 |
$28.31 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$121.40 |
$121.40 |
$121.40 |
$561.60
|
