|
Shunt glaucoma baerveldt 350mm
|
$3,765.33 |
$3,765.33 |
$3,765.33 |
$4,709.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$561.00 |
$561.00 |
$561.00 |
$345.00
|
|
Sialolithotomy 42330
|
$6,441.81 |
$6,441.81 |
$6,441.81 |
$3,837.72
|
|
Sickling rbc
|
$12.04 |
$12.04 |
$12.04 |
$53.55
|
|
Sigmoidoscopy for bleeding
|
$1,652.40 |
$1,652.40 |
$1,652.40 |
$1,993.08
|
|
Sincalide 5 mcg solution for injection
|
$430.74 |
$430.74 |
$430.74 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$3,330.30 |
$3,330.30 |
$3,330.30 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,111.51 |
$3,111.51 |
$3,111.51 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$2,314.38 |
$2,314.38 |
$2,314.38 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$5,077.56 |
$5,077.56 |
$5,077.56 |
$2,489.25
|
|
Sipuleucel-t - su
|
$121,048.82 |
$121,048.82 |
$121,048.82 |
$95,750.46
|
|
Skin Biopsy
|
$409.53 |
$409.53 |
$409.53 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$2,883.03 |
$2,883.03 |
$2,883.03 |
$3,936.80
|
|
Sleep study unattended
|
$1,269.90 |
$1,269.90 |
$1,269.90 |
$595.50
|
|
Sling arm deluxe w/pad xs
|
$19.51 |
$19.51 |
$19.51 |
$25.55
|
|
Sling pelv split sam med
|
$130.05 |
$130.05 |
$130.05 |
$115.20
|
|
Sling suprapubic suburetheral
|
$8,764.02 |
$8,764.02 |
$8,764.02 |
$10,328.15
|
|
Slitting of prepuce
|
$4,200.87 |
$4,200.87 |
$4,200.87 |
$2,983.40
|
|
Smear fluorescent and/or acid fast stain
|
$143.82 |
$143.82 |
$143.82 |
$64.20
|
|
Smear gram stain
|
$160.14 |
$160.14 |
$160.14 |
$57.85
|
|
Smear nasal eosinophil
|
$121.89 |
$121.89 |
$121.89 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$57.63 |
$57.63 |
$57.63 |
$64.35
|
|
Smear wet mount
|
$104.55 |
$104.55 |
$104.55 |
$68.63
|
|
Sodium 24 hour urine
|
$71.40 |
$71.40 |
$71.40 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$65.33 |
$65.33 |
$65.33 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$65.33 |
$65.33 |
$65.33 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$65.33 |
$65.33 |
$65.33 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$157.05 |
$157.05 |
$157.05 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$70.89 |
$70.89 |
$70.89 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$84.15 |
$84.15 |
$84.15 |
$195.48
|
|
Special physics consult
|
$1,208.19 |
$1,208.19 |
$1,208.19 |
$700.74
|
|
Special radiation dosimetry
|
$359.55 |
$359.55 |
$359.55 |
$445.50
|
|
Special radiation treatment
|
$3,052.86 |
$3,052.86 |
$3,052.86 |
$1,934.03
|
|
Special teletx port plan
|
$1,446.36 |
$1,446.36 |
$1,446.36 |
$1,046.65
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$6,641.22 |
$6,641.22 |
$6,641.22 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$670.14 |
$670.14 |
$670.14 |
$559.96
|
|
Splint rstrc wrst/cmc right med
|
$84.19 |
$84.19 |
$84.19 |
$101.18
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$6,402.03 |
$6,402.03 |
$6,402.03 |
$4,560.66
|
|
Split blood or products
|
$161.67 |
$161.67 |
$161.67 |
$148.98
|
|
Srs linear based
|
$16,777.98 |
$16,777.98 |
$16,777.98 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$372.30 |
$372.30 |
$372.30 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$372.30 |
$372.30 |
$372.30 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$18,127.95 |
$18,127.95 |
$18,127.95 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$39,270.00 |
$39,270.00 |
$39,270.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$21,021.03 |
$21,021.03 |
$21,021.03 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$19,616.05 |
$19,616.05 |
$19,616.05 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$4,948.02 |
$4,948.02 |
$4,948.02 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$11,337.81 |
$11,337.81 |
$11,337.81 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$8,310.96 |
$8,310.96 |
$8,310.96 |
$9,276.80
|
|
Stent placemt retro carotid
|
$18,082.56 |
$18,082.56 |
$18,082.56 |
$9,313.36
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$18,127.95 |
$18,127.95 |
$18,127.95 |
$19,765.20
|
|
St evaluate speech sound production
|
$372.30 |
$372.30 |
$372.30 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$372.30 |
$372.30 |
$372.30 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$285.60 |
$285.60 |
$285.60 |
$406.40
|
|
St evaluation swallow function
|
$244.29 |
$244.29 |
$244.29 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$459.00 |
$459.00 |
$459.00 |
$248.05
|
|
Strapping of chest
|
$329.97 |
$329.97 |
$329.97 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$130.05 |
$130.05 |
$130.05 |
$171.00
|
|
Strapping of hand or finger
|
$133.11 |
$133.11 |
$133.11 |
$194.40
|
|
Strapping of hip
|
$263.67 |
$263.67 |
$263.67 |
$170.08
|
|
Strapping of knee
|
$248.37 |
$248.37 |
$248.37 |
$224.80
|
|
Strapping of toes 29550
|
$345.78 |
$345.78 |
$345.78 |
$185.36
|
|
Stress test pulmonary
|
$349.86 |
$349.86 |
$349.86 |
$327.20
|
|
Stress tte complete
|
$879.24 |
$879.24 |
$879.24 |
$1,964.95
|
|
St treatment speech individual
|
$223.89 |
$223.89 |
$223.89 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$165.75 |
$165.75 |
$165.75 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$145.10 |
$145.10 |
$145.10 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$92.29 |
$92.29 |
$92.29 |
$74.79
|
|
Sulfonylurea screen qn-sendout
|
$5.56 |
$5.56 |
$5.56 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$84.15 |
$84.15 |
$84.15 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$58.26 |
$58.26 |
$58.26 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$109.65 |
$109.65 |
$109.65 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$153.51 |
$153.51 |
$153.51 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$207.57 |
$207.57 |
$207.57 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$275.91 |
$275.91 |
$275.91 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$409.53 |
$409.53 |
$409.53 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$797.64 |
$797.64 |
$797.64 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$66.30 |
$66.30 |
$66.30 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$80.58 |
$80.58 |
$80.58 |
$34.48
|
|
Susceptibility mic per plate
|
$274.38 |
$274.38 |
$274.38 |
$94.38
|
|
Svc venogram s&i
|
$4,839.39 |
$4,839.39 |
$4,839.39 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.49 |
$1.49 |
$1.49 |
$44.85
|
|
System cardiomems hosp electronics
|
$27,439.81 |
$27,439.81 |
$27,439.81 |
$41,639.82
|
|
System pacing micra av
|
$16,932.51 |
$16,932.51 |
$16,932.51 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,252.27 |
$6,252.27 |
$6,252.27 |
$10,980.00
|
|
System sealant biosentry tract
|
$1,311.98 |
$1,311.98 |
$1,311.98 |
$900.00
|
|
T3 (triiodothyronine) free
|
$311.61 |
$311.61 |
$311.61 |
$89.82
|
|
T3 (triiodothyronine) total
|
$63.50 |
$63.50 |
$63.50 |
$94.90
|
|
T4 (thyroxine) free
|
$140.76 |
$140.76 |
$140.76 |
$81.60
|
|
T4 (thyroxine) total
|
$65.28 |
$65.28 |
$65.28 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$24.17 |
$24.17 |
$24.17 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$158.10 |
$158.10 |
$158.10 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$684.42 |
$684.42 |
$684.42 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$929.22 |
$929.22 |
$929.22 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$159.96 |
$159.96 |
$159.96 |
$186.00
|
|
T cells absolute cd 4 count
|
$65.10 |
$65.10 |
$65.10 |
$120.25
|
|
T cells total count
|
$47.89 |
$47.89 |
$47.89 |
$124.11
|
|
Teaec w/wo patch graft iliofemoral
|
$8,951.52 |
$8,951.52 |
$8,951.52 |
$5,030.40
|
|
Telehealth original site facility fee
|
$120.36 |
$120.36 |
$120.36 |
$60.80
|