|
Sinus/juglr venogram s&i
|
$1,049.34 |
$1,049.34 |
$1,049.34 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$86.78 |
$86.78 |
$86.78 |
$346.45
|
|
Sinus X-ray (limited)
|
$72.96 |
$72.96 |
$72.96 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$24.33 |
$24.33 |
$24.33 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$86.53 |
$86.53 |
$86.53 |
$294.45
|
|
Skull X-ray (complete)
|
$110.08 |
$110.08 |
$110.08 |
$417.50
|
|
Slco1b1 gene com variants
|
$113.92 |
$113.92 |
$113.92 |
$241.24
|
|
Sling suprapubic suburetheral
|
$8,064.63 |
$8,064.63 |
$8,064.63 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$106.52 |
$106.52 |
$106.52 |
$285.09
|
|
Slp ther svc non-spch gen
|
$72.00 |
$72.00 |
$72.00 |
$188.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$140.54 |
$140.54 |
$140.54 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$17.20 |
$17.20 |
$17.20 |
$64.35
|
|
Smear gram stain
|
$32.13 |
$32.13 |
$32.13 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$18.22 |
$18.22 |
$18.22 |
$73.50
|
|
Smear wet mount
|
$13.41 |
$13.41 |
$13.41 |
$67.55
|
|
Snrpn/ube3a gene
|
$63.36 |
$63.36 |
$63.36 |
$230.63
|
|
Sodium 24 hour urine
|
$11.38 |
$11.38 |
$11.38 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$15.17 |
$15.17 |
$15.17 |
$46.26
|
|
So neo gsap dna mcrstl ins
|
$1,053.75 |
$1,053.75 |
$1,053.75 |
$2,296.00
|
|
Special physics consult
|
$491.99 |
$491.99 |
$491.99 |
$725.00
|
|
Special radiation dosimetry
|
$250.80 |
$250.80 |
$250.80 |
$392.50
|
|
Special radiation treatment
|
$1,406.57 |
$1,406.57 |
$1,406.57 |
$2,052.00
|
|
Special teletx port plan
|
$770.79 |
$770.79 |
$770.79 |
$1,095.05
|
|
Specific gravity body fluid
|
$1.58 |
$1.58 |
$1.58 |
$22.00
|
|
Specimen fat stain
|
$3.76 |
$3.76 |
$3.76 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$108.10 |
$108.10 |
$108.10 |
$384.80
|
|
Speech evaluation complex
|
$191.23 |
$191.23 |
$191.23 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$73.51 |
$73.51 |
$73.51 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$564.26 |
$564.26 |
$564.26 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$62.21 |
$62.21 |
$62.21 |
$251.00
|
|
Spleen imaging
|
$249.66 |
$249.66 |
$249.66 |
$679.00
|
|
Split blood or products
|
$76.28 |
$76.28 |
$76.28 |
$127.80
|
|
Sputum specimen collection
|
$76.28 |
$76.28 |
$76.28 |
$180.00
|
|
Srs linear based
|
$7,260.66 |
$7,260.66 |
$7,260.66 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$106.41 |
$106.41 |
$106.41 |
$297.60
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$11,263.56 |
$11,263.56 |
$11,263.56 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$24,191.79 |
$24,191.79 |
$24,191.79 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,436.70 |
$2,436.70 |
$2,436.70 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$9,216.57 |
$9,216.57 |
$9,216.57 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$2,436.70 |
$2,436.70 |
$2,436.70 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$7,190.57 |
$7,190.57 |
$7,190.57 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,548.78 |
$3,548.78 |
$3,548.78 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$9,829.51 |
$9,829.51 |
$9,829.51 |
$16,098.16
|
|
St evaluate speech sound production
|
$88.74 |
$88.74 |
$88.74 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$159.12 |
$159.12 |
$159.12 |
$400.00
|
|
Stimulants synthetic
|
$25.28 |
$25.28 |
$25.28 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$457.66 |
$457.66 |
$457.66 |
$1,345.40
|
|
Strep a ag ia
|
$12.90 |
$12.90 |
$12.90 |
$75.40
|
|
Strep b dna amp probe
|
$26.82 |
$26.82 |
$26.82 |
$124.15
|
|
Stress test pulmonary
|
$18.97 |
$18.97 |
$18.97 |
$324.00
|
|
Stress tte complete
|
$500.37 |
$500.37 |
$500.37 |
$1,900.96
|
|
Str markers specimen anal
|
$309.66 |
$309.66 |
$309.66 |
$756.60
|
|
Sugars multiple quant
|
$46.77 |
$46.77 |
$46.77 |
$44.19
|
|
Sulfonylurea screen qn-sendout
|
$28.12 |
$28.12 |
$28.12 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$13.72 |
$13.72 |
$13.72 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$31.60 |
$31.60 |
$31.60 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$81.58 |
$81.58 |
$81.58 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$124.46 |
$124.46 |
$124.46 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$278.32 |
$278.32 |
$278.32 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$419.44 |
$419.44 |
$419.44 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$16.70 |
$16.70 |
$16.70 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$14.17 |
$14.17 |
$14.17 |
$35.89
|
|
Susceptibility mic per plate
|
$54.65 |
$54.65 |
$54.65 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$29.09 |
$29.09 |
$29.09 |
$59.28
|
|
Svc venogram s&i
|
$328.19 |
$328.19 |
$328.19 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$93.48 |
$93.48 |
$93.48 |
$316.80
|
|
Swallowing Therapy Session
|
$62.04 |
$62.04 |
$62.04 |
$232.56
|
|
Sweat collection by iontophoresis
|
$23.83 |
$23.83 |
$23.83 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.17 |
$11.17 |
$11.17 |
$42.24
|
|
System cardiomems hosp electronics
|
$28,799.55 |
$28,799.55 |
$28,799.55 |
$38,234.70
|
|
System pacing micra av
|
$16,864.10 |
$16,864.10 |
$16,864.10 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$30,113.60 |
$30,113.60 |
$30,113.60 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$11.22 |
$11.22 |
$11.22 |
$100.32
|
|
T3 (triiodothyronine) total
|
$6.79 |
$6.79 |
$6.79 |
$93.52
|
|
T4 (thyroxine) free
|
$33.50 |
$33.50 |
$33.50 |
$89.60
|
|
T4 (thyroxine) total
|
$8.85 |
$8.85 |
$8.85 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$10.11 |
$10.11 |
$10.11 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$92.93 |
$92.93 |
$92.93 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$794.22 |
$794.22 |
$794.22 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,052.54 |
$3,052.54 |
$3,052.54 |
$3,746.70
|
|
Target gsa panel organ neop
|
$625.18 |
$625.18 |
$625.18 |
$1,701.91
|
|
Tas congenital car anomal
|
$3,283.90 |
$3,283.90 |
$3,283.90 |
$6,003.27
|
|
Tavr perq femoral
|
$3,647.34 |
$3,647.34 |
$3,647.34 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$44.70 |
$44.70 |
$44.70 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$27.71 |
$27.71 |
$27.71 |
$179.95
|
|
Tc-99m arcitumomab
|
$1,617.78 |
$1,617.78 |
$1,617.78 |
$2,085.68
|
|
Tc-99m bicisate
|
$568.29 |
$568.29 |
$568.29 |
$2,070.00
|
|
Tc-99m exame autol wbc diag per dose
|
$1,725.40 |
$1,725.40 |
$1,725.40 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$402.62 |
$402.62 |
$402.62 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$154.11 |
$154.11 |
$154.11 |
$306.00
|
|
Tc-99m maa
|
$42.01 |
$42.01 |
$42.01 |
$312.06
|
|
Tc-99m mebrofenin
|
$53.34 |
$53.34 |
$53.34 |
$157.65
|
|
Tc-99m medronate
|
$83.61 |
$83.61 |
$83.61 |
$111.01
|
|
Tc-99m mertiatide
|
$281.31 |
$281.31 |
$281.31 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$84.02 |
$84.02 |
$84.02 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$58.76 |
$58.76 |
$58.76 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$51.92 |
$51.92 |
$51.92 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$65.58 |
$65.58 |
$65.58 |
$287.20
|
|
Tc-99m sulfur colloid
|
$51.92 |
$51.92 |
$51.92 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$106.67 |
$106.67 |
$106.67 |
$193.28
|
