|
Sialography s&i
|
$262.88 |
$262.88 |
$262.88 |
$499.20
|
|
Sickling rbc
|
$27.66 |
$27.66 |
$27.66 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$658.09 |
$658.09 |
$658.09 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$548.57 |
$548.57 |
$548.57 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$438.56 |
$438.56 |
$438.56 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$121.37 |
$121.37 |
$121.37 |
$346.45
|
|
Sinus X-ray (limited)
|
$98.58 |
$98.58 |
$98.58 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$72.38 |
$72.38 |
$72.38 |
$83.85
|
|
Skin Biopsy
|
$103.92 |
$103.92 |
$103.92 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$105.47 |
$105.47 |
$105.47 |
$294.45
|
|
Skull X-ray (complete)
|
$120.84 |
$120.84 |
$120.84 |
$417.50
|
|
Slco1b1 gene com variants
|
$235.20 |
$235.20 |
$235.20 |
$241.24
|
|
Sleep study attended
|
$1,448.21 |
$1,448.21 |
$1,448.21 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$3,267.55 |
$3,267.55 |
$3,267.55 |
$3,734.50
|
|
Sleep study unattended
|
$578.69 |
$578.69 |
$578.69 |
$594.00
|
|
Sling suprapubic suburetheral
|
$13,273.42 |
$13,273.42 |
$13,273.42 |
$9,679.96
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$144.69 |
$144.69 |
$144.69 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$32.16 |
$32.16 |
$32.16 |
$64.35
|
|
Smear gram stain
|
$41.68 |
$41.68 |
$41.68 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$30.27 |
$30.27 |
$30.27 |
$73.50
|
|
Smear wet mount
|
$25.07 |
$25.07 |
$25.07 |
$67.55
|
|
Snrpn/ube3a gene
|
$130.82 |
$130.82 |
$130.82 |
$230.63
|
|
Sodium 24 hour urine
|
$33.84 |
$33.84 |
$33.84 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$19.74 |
$19.74 |
$19.74 |
$46.26
|
|
Specific gravity body fluid
|
$4.70 |
$4.70 |
$4.70 |
$22.00
|
|
Specimen fat stain
|
$8.24 |
$8.24 |
$8.24 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$181.30 |
$181.30 |
$181.30 |
$384.80
|
|
Speech evaluation complex
|
$328.60 |
$328.60 |
$328.60 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$90.65 |
$90.65 |
$90.65 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$441.08 |
$441.08 |
$441.08 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$85.33 |
$85.33 |
$85.33 |
$251.00
|
|
Split blood or products
|
$167.17 |
$167.17 |
$167.17 |
$127.80
|
|
Sputum specimen collection
|
$167.17 |
$167.17 |
$167.17 |
$180.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$26,544.82 |
$26,544.82 |
$26,544.82 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$4,678.82 |
$4,678.82 |
$4,678.82 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$17,697.22 |
$17,697.22 |
$17,697.22 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$4,678.82 |
$4,678.82 |
$4,678.82 |
$4,631.82
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$190.86 |
$190.86 |
$190.86 |
$400.00
|
|
Stimulants synthetic
|
$75.20 |
$75.20 |
$75.20 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$548.59 |
$548.59 |
$548.59 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$56.39 |
$56.39 |
$56.39 |
$223.45
|
|
Strapping of chest
|
$12.73 |
$12.73 |
$12.73 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$17.50 |
$17.50 |
$17.50 |
$157.46
|
|
Strapping of hand or finger
|
$10.10 |
$10.10 |
$10.10 |
$177.45
|
|
Strapping of knee
|
$82.48 |
$82.48 |
$82.48 |
$205.20
|
|
Strapping of toes 29550
|
$91.10 |
$91.10 |
$91.10 |
$164.70
|
|
Strep a ag ia
|
$24.12 |
$24.12 |
$24.12 |
$75.40
|
|
Strep b dna amp probe
|
$50.14 |
$50.14 |
$50.14 |
$124.15
|
|
Stress test pulmonary
|
$134.68 |
$134.68 |
$134.68 |
$324.00
|
|
Str markers specimen anal
|
$639.30 |
$639.30 |
$639.30 |
$756.60
|
|
Sulfonylurea screen qn-sendout
|
$83.66 |
$83.66 |
$83.66 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$26.55 |
$26.55 |
$26.55 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$42.08 |
$42.08 |
$42.08 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$57.11 |
$57.11 |
$57.11 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$57.11 |
$57.11 |
$57.11 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$381.76 |
$381.76 |
$381.76 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$857.71 |
$857.71 |
$857.71 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$31.22 |
$31.22 |
$31.22 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$26.49 |
$26.49 |
$26.49 |
$35.89
|
|
Susceptibility mic per plate
|
$91.60 |
$91.60 |
$91.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$54.39 |
$54.39 |
$54.39 |
$59.28
|
|
Svc venogram s&i
|
$1,278.36 |
$1,278.36 |
$1,278.36 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$162.40 |
$162.40 |
$162.40 |
$316.80
|
|
Swallowing Therapy Session
|
$100.45 |
$100.45 |
$100.45 |
$232.56
|
|
Sweat collection by iontophoresis
|
$52.21 |
$52.21 |
$52.21 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$19.03 |
$19.03 |
$19.03 |
$42.24
|
|
System pacing micra av
|
$16,926.25 |
$16,926.25 |
$16,926.25 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$52,890.43 |
$52,890.43 |
$52,890.43 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$33.37 |
$33.37 |
$33.37 |
$100.32
|
|
T3 (triiodothyronine) total
|
$20.21 |
$20.21 |
$20.21 |
$93.52
|
|
T4 (thyroxine) free
|
$31.02 |
$31.02 |
$31.02 |
$89.60
|
|
T4 (thyroxine) total
|
$26.32 |
$26.32 |
$26.32 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$30.08 |
$30.08 |
$30.08 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$104.94 |
$104.94 |
$104.94 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$1,072.96 |
$1,072.96 |
$1,072.96 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,924.03 |
$3,924.03 |
$3,924.03 |
$3,746.70
|
|
Target gsa panel organ neop
|
$803.71 |
$803.71 |
$803.71 |
$1,701.91
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$109.80 |
$109.80 |
$109.80 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$68.08 |
$68.08 |
$68.08 |
$179.95
|
|
Tc-99m labeled rbc
|
$238.26 |
$238.26 |
$238.26 |
$306.00
|
|
Tc-99m maa
|
$235.16 |
$235.16 |
$235.16 |
$312.06
|
|
Tc-99m mebrofenin
|
$1,773.97 |
$1,773.97 |
$1,773.97 |
$157.65
|
|
Tc-99m medronate
|
$180.34 |
$180.34 |
$180.34 |
$111.01
|
|
Tc-99m mertiatide
|
$458.35 |
$458.35 |
$458.35 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$143.33 |
$143.33 |
$143.33 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$93.71 |
$93.71 |
$93.71 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$250.22 |
$250.22 |
$250.22 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$141.45 |
$141.45 |
$141.45 |
$287.20
|
|
Tc-99m sulfur colloid
|
$221.92 |
$221.92 |
$221.92 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$465.99 |
$465.99 |
$465.99 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$1,221.35 |
$1,221.35 |
$1,221.35 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$51.61 |
$51.61 |
$51.61 |
$184.00
|
|
T cells absolute cd 4 count
|
$29.65 |
$29.65 |
$29.65 |
$111.20
|
|
T cells total count
|
$41.72 |
$41.72 |
$41.72 |
$130.20
|
|
Team conf w/pat by hc prof
|
$40.31 |
$40.31 |
$40.31 |
$107.10
|
|
Telehealth original site facility fee
|
$23.76 |
$23.76 |
$23.76 |
$51.00
|
|
Test stress cardiovascular tracing only
|
$466.36 |
$466.36 |
$466.36 |
$953.40
|
|
Theophylline therapeutic drug level
|
$20.21 |
$20.21 |
$20.21 |
$108.00
|
|
Therapeutic procd strg endur
|
$32.05 |
$32.05 |
$32.05 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$15.61 |
$15.61 |
$15.61 |
$101.38
|