|
Scope uretscp lithovue dig disp
|
$2,797.95 |
$2,797.95 |
$2,797.95 |
$4,079.62
|
|
Screening Mammogram
|
$205.86 |
$205.86 |
$205.86 |
$303.55
|
|
Screw cortex 2.0 x 10mm
|
$25,246.76 |
$25,246.76 |
$25,246.76 |
$28,563.75
|
|
Sec art mech thrmbc non-intracranial add-on
|
$4,336.20 |
$4,336.20 |
$4,336.20 |
$4,565.60
|
|
Set radiation therapy field
|
$655.25 |
$655.25 |
$655.25 |
$731.50
|
|
Set radiation therapy field
|
$1,034.12 |
$1,034.12 |
$1,034.12 |
$1,102.40
|
|
Set radiation therapy field
|
$1,456.35 |
$1,456.35 |
$1,456.35 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$6.57 |
$6.57 |
$6.57 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$28.47 |
$28.47 |
$28.47 |
$21.42
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$282.20 |
$282.20 |
$282.20 |
$302.55
|
|
Shoe post-op mens m
|
$67.89 |
$67.89 |
$67.89 |
$42.87
|
|
Shoulder MRI (with and without contrast)
|
$2,042.40 |
$2,042.40 |
$2,042.40 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$1,726.16 |
$1,726.16 |
$1,726.16 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$2,431.34 |
$2,431.34 |
$2,431.34 |
$2,051.28
|
|
Shoulder X-ray
|
$337.26 |
$337.26 |
$337.26 |
$367.02
|
|
Shrinker prosth above knee
|
$200.17 |
$200.17 |
$200.17 |
$157.49
|
|
Shrinker prosth below knee
|
$200.17 |
$200.17 |
$200.17 |
$153.13
|
|
Shunt glaucoma baerveldt 350mm
|
$6,152.59 |
$6,152.59 |
$6,152.59 |
$4,709.25
|
|
Sialography s&i
|
$380.19 |
$380.19 |
$380.19 |
$462.40
|
|
Sickling rbc
|
$10.17 |
$10.17 |
$10.17 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$131.84 |
$131.84 |
$131.84 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$1,505.85 |
$1,505.85 |
$1,505.85 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,223.78 |
$1,223.78 |
$1,223.78 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,568.92 |
$1,568.92 |
$1,568.92 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$2,316.15 |
$2,316.15 |
$2,316.15 |
$2,489.25
|
|
Sipuleucel-t - su
|
$86,629.40 |
$86,629.40 |
$86,629.40 |
$95,750.46
|
|
Skin Biopsy
|
$1,126.73 |
$1,126.73 |
$1,126.73 |
$382.80
|
|
Sling pelv split sam med
|
$200.17 |
$200.17 |
$200.17 |
$115.20
|
|
Sling suprapubic suburetheral
|
$3,638.47 |
$3,638.47 |
$3,638.47 |
$10,328.15
|
|
Smear fluorescent and/or acid fast stain
|
$166.01 |
$166.01 |
$166.01 |
$64.20
|
|
Smear gram stain
|
$90.67 |
$90.67 |
$90.67 |
$57.85
|
|
Smear nasal eosinophil
|
$42.05 |
$42.05 |
$42.05 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$67.02 |
$67.02 |
$67.02 |
$64.35
|
|
Smear wet mount
|
$70.52 |
$70.52 |
$70.52 |
$68.63
|
|
Sodium 24 hour urine
|
$67.89 |
$67.89 |
$67.89 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$57.38 |
$57.38 |
$57.38 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$57.38 |
$57.38 |
$57.38 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$57.38 |
$57.38 |
$57.38 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$57.38 |
$57.38 |
$57.38 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$50.37 |
$50.37 |
$50.37 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$92.42 |
$92.42 |
$92.42 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$133.22 |
$133.22 |
$133.22 |
$195.48
|
|
Somatosensory testing
|
$241.78 |
$241.78 |
$241.78 |
$583.80
|
|
Special physics consult
|
$724.46 |
$724.46 |
$724.46 |
$700.74
|
|
Special radiation dosimetry
|
$692.04 |
$692.04 |
$692.04 |
$445.50
|
|
Special radiation treatment
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$1,934.03
|
|
Special teletx port plan
|
$357.85 |
$357.85 |
$357.85 |
$1,046.65
|
|
Specific gravity body fluid
|
$17.09 |
$17.09 |
$17.09 |
$23.63
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$790.59 |
$790.59 |
$790.59 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$736.28 |
$736.28 |
$736.28 |
$559.96
|
|
Splint extn xsm w sof-stretch rolyan
|
$88.92 |
$88.92 |
$88.92 |
$52.65
|
|
Splint finger frog med
|
$3,638.47 |
$3,638.47 |
$3,638.47 |
$27.95
|
|
St analysis behavior qualitative voice/resonance
|
$229.52 |
$229.52 |
$229.52 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$178.27 |
$178.27 |
$178.27 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$21,131.75 |
$21,131.75 |
$21,131.75 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$72,028.23 |
$72,028.23 |
$72,028.23 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$977.62 |
$977.62 |
$977.62 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$27,771.39 |
$27,771.39 |
$27,771.39 |
$18,714.49
|
|
Stent iliac/open or perc/uni/init 37221
|
$7,828.82 |
$7,828.82 |
$7,828.82 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$12,420.37 |
$12,420.37 |
$12,420.37 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$11,858.85 |
$11,858.85 |
$11,858.85 |
$19,765.20
|
|
St evaluate speech sound production
|
$233.46 |
$233.46 |
$233.46 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$500.20 |
$500.20 |
$500.20 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$202.36 |
$202.36 |
$202.36 |
$406.40
|
|
St evaluation swallow function
|
$187.91 |
$187.91 |
$187.91 |
$336.60
|
|
Stress tte complete
|
$2,227.67 |
$2,227.67 |
$2,227.67 |
$1,964.95
|
|
St treatment speech individual
|
$168.63 |
$168.63 |
$168.63 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$187.91 |
$187.91 |
$187.91 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$29.35 |
$29.35 |
$29.35 |
$49.13
|
|
Sugars single quant
|
$16.65 |
$16.65 |
$16.65 |
$52.47
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$36.80 |
$36.80 |
$36.80 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$111.69 |
$111.69 |
$111.69 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$22.78 |
$22.78 |
$22.78 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$127.46 |
$127.46 |
$127.46 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$146.30 |
$146.30 |
$146.30 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$165.57 |
$165.57 |
$165.57 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$190.10 |
$190.10 |
$190.10 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$222.51 |
$222.51 |
$222.51 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$391.58 |
$391.58 |
$391.58 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$0.67 |
$0.67 |
$0.67 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$35.92 |
$35.92 |
$35.92 |
$34.48
|
|
Susceptibility mic per plate
|
$294.78 |
$294.78 |
$294.78 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$121.77 |
$121.77 |
$121.77 |
$48.30
|
|
Svc venogram s&i
|
$2,070.87 |
$2,070.87 |
$2,070.87 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.66 |
$11.66 |
$11.66 |
$44.85
|
|
System pacing micra av
|
$27,771.39 |
$27,771.39 |
$27,771.39 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$19,710.00 |
$19,710.00 |
$19,710.00 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$70.52 |
$70.52 |
$70.52 |
$89.82
|
|
T3 (triiodothyronine) total
|
$117.83 |
$117.83 |
$117.83 |
$94.90
|
|
T4 (thyroxine) free
|
$135.35 |
$135.35 |
$135.35 |
$81.60
|
|
T4 (thyroxine) total
|
$58.70 |
$58.70 |
$58.70 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$34.61 |
$34.61 |
$34.61 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$236.96 |
$236.96 |
$236.96 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$48.62 |
$48.62 |
$48.62 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$20.11 |
$20.11 |
$20.11 |
$3,817.00
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$77.55 |
$77.55 |
$77.55 |
$21,795.67
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$428.98 |
$428.98 |
$428.98 |
$31,080.00
|
|
Target gsa panel hmtlmph neop
|
$1,423.50 |
$1,423.50 |
$1,423.50 |
$1,928.40
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$2,509.61 |
$2,509.61 |
$2,509.61 |
$27,030.00
|
|
Tavr perq femoral
|
$46,330.33 |
$46,330.33 |
$46,330.33 |
$16,357.00
|