|
Sevelamer carbonate 800 mg tablet
|
$7.85 |
$7.85 |
$10.37 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$17.01 |
$17.01 |
$22.47 |
$21.42
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$142.36 |
$142.36 |
$188.07 |
$302.55
|
|
Sheath gldlight lasr 12fx50cm
|
$3,846.61 |
$3,846.61 |
$5,081.76 |
$7,076.25
|
|
Shoe post-op mens m
|
$125.35 |
$125.35 |
$165.60 |
$42.87
|
|
Shrinker prosth above knee
|
$95.92 |
$95.92 |
$126.72 |
$157.49
|
|
Shunt glaucoma baerveldt 350mm
|
$17,698.33 |
$17,698.33 |
$23,381.28 |
$4,709.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$156.75 |
$156.75 |
$207.08 |
$345.00
|
|
Sickling rbc
|
$36.63 |
$36.63 |
$48.39 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$143.01 |
$143.01 |
$188.93 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$1,547.59 |
$1,547.59 |
$2,044.52 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,547.59 |
$1,547.59 |
$2,044.52 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,031.80 |
$1,031.80 |
$1,363.11 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$1,614.51 |
$1,614.51 |
$2,132.93 |
$2,489.25
|
|
Sirolimus, oral
|
$30.74 |
$30.74 |
$40.61 |
$42.11
|
|
Skin Biopsy
|
$874.62 |
$874.62 |
$1,155.46 |
$382.80
|
|
Skyla, 13.5 mg
|
$1,034.41 |
$1,034.41 |
$1,366.56 |
$1,801.20
|
|
Sleep study unattended
|
$146.94 |
$146.94 |
$194.12 |
$595.50
|
|
Sleeve fing rolyan med
|
$86.77 |
$86.77 |
$114.63 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$95.92 |
$95.92 |
$126.72 |
$25.55
|
|
Sling suprapubic suburetheral
|
$8,452.95 |
$8,452.95 |
$11,167.20 |
$10,328.15
|
|
Sm-153 lexidron ther
|
$3,901.99 |
$3,901.99 |
$5,154.92 |
$11,563.30
|
|
Smallpox&monkeypox vac 0.5ml
|
$0.01 |
$0.01 |
$0.01 |
$318.64
|
|
Smear fluorescent and/or acid fast stain
|
$48.84 |
$48.84 |
$64.52 |
$64.20
|
|
Smear gram stain
|
$30.96 |
$30.96 |
$40.90 |
$57.85
|
|
Smear nasal eosinophil
|
$27.69 |
$27.69 |
$36.58 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$50.58 |
$50.58 |
$66.82 |
$64.35
|
|
Smear wet mount
|
$42.30 |
$42.30 |
$55.88 |
$68.63
|
|
Snrpn/ube3a gene
|
$73.03 |
$73.03 |
$96.48 |
$228.80
|
|
Sodium 24 hour urine
|
$36.85 |
$36.85 |
$48.68 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$17.01 |
$17.01 |
$22.47 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$17.01 |
$17.01 |
$22.47 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$34.45 |
$34.45 |
$45.51 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$52.11 |
$52.11 |
$68.84 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$33.36 |
$33.36 |
$44.07 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$30.96 |
$30.96 |
$40.90 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$93.31 |
$93.31 |
$123.27 |
$195.48
|
|
Special physics consult
|
$184.00 |
$184.00 |
$243.08 |
$700.74
|
|
Specific gravity body fluid
|
$1.97 |
$1.97 |
$2.60 |
$23.63
|
|
Speech evaluation complex
|
$531.05 |
$531.05 |
$701.57 |
$527.06
|
|
Sperm antibody test
|
$10.52 |
$10.52 |
$13.90 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$521.90 |
$521.90 |
$689.48 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$281.88 |
$281.88 |
$372.39 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$29.65 |
$29.65 |
$39.17 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$43.60 |
$43.60 |
$57.60 |
$52.65
|
|
Splint finger frog med
|
$39.68 |
$39.68 |
$52.42 |
$27.95
|
|
Splint func pos polyflex ii med
|
$3,846.61 |
$3,846.61 |
$5,081.76 |
$52.22
|
|
Splint rstrc wrst/cmc right med
|
$27.47 |
$27.47 |
$36.29 |
$101.18
|
|
Split blood or products
|
$25.29 |
$25.29 |
$33.41 |
$148.98
|
|
Staph a dna amp probe
|
$103.12 |
$103.12 |
$136.23 |
$116.39
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$8,305.80 |
$8,305.80 |
$10,972.80 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$41,729.56 |
$41,729.56 |
$55,128.96 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,846.61 |
$3,846.61 |
$5,081.76 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$19,468.49 |
$19,468.49 |
$25,719.84 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$5,000.92 |
$5,000.92 |
$6,606.72 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$6,631.78 |
$6,631.78 |
$8,761.25 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$4,957.76 |
$4,957.76 |
$6,549.70 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$6,443.43 |
$6,443.43 |
$8,512.42 |
$19,765.20
|
|
Strep b dna amp probe
|
$42.51 |
$42.51 |
$56.16 |
$139.20
|
|
Streptomycin injection
|
$19.62 |
$19.62 |
$25.92 |
$138.30
|
|
Streptozocin injection
|
$365.59 |
$365.59 |
$365.59 |
$943.23
|
|
Stress test pulmonary
|
$141.92 |
$141.92 |
$187.49 |
$327.20
|
|
Str markers specimen anal
|
$51.04 |
$51.04 |
$67.43 |
$835.28
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$52.32 |
$52.32 |
$69.12 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$39.90 |
$39.90 |
$52.71 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$98.32 |
$98.32 |
$129.89 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$95.92 |
$95.92 |
$126.72 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$104.86 |
$104.86 |
$138.53 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$134.95 |
$134.95 |
$178.28 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$184.21 |
$184.21 |
$243.36 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$214.08 |
$214.08 |
$282.82 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$574.00 |
$574.00 |
$758.31 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$854.35 |
$854.35 |
$1,128.68 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$5.67 |
$5.67 |
$7.49 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$19.62 |
$19.62 |
$25.92 |
$34.48
|
|
Susceptibility mic per plate
|
$50.14 |
$50.14 |
$66.24 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$9.79 |
$9.79 |
$12.93 |
$48.30
|
|
Svc venogram s&i
|
$445.38 |
$445.38 |
$588.39 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$55.81 |
$55.81 |
$73.73 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$8.25 |
$8.25 |
$10.89 |
$44.85
|
|
System cardiomems hosp electronics
|
$25,911.48 |
$25,911.48 |
$34,231.68 |
$41,639.82
|
|
System pacing micra av
|
$19,468.49 |
$19,468.49 |
$25,719.84 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$16,089.49 |
$16,089.49 |
$21,255.84 |
$10,980.00
|
|
System recell skin grafting/harvesting
|
$8,452.95 |
$8,452.95 |
$11,167.20 |
$13,777.23
|
|
System sealant biosentry tract
|
$360.79 |
$360.79 |
$476.64 |
$900.00
|
|
T3 (triiodothyronine) free
|
$49.71 |
$49.71 |
$65.67 |
$89.82
|
|
T3 (triiodothyronine) total
|
$174.62 |
$174.62 |
$230.69 |
$94.90
|
|
T4 (thyroxine) free
|
$167.65 |
$167.65 |
$221.48 |
$81.60
|
|
T4 (thyroxine) total
|
$106.61 |
$106.61 |
$140.84 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$31.40 |
$31.40 |
$41.48 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$157.18 |
$157.18 |
$207.65 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$2.62 |
$2.62 |
$3.46 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$566.80 |
$566.80 |
$748.80 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$643.10 |
$643.10 |
$849.60 |
$3,385.00
|
|
Target gsa panel organ neop
|
$316.10 |
$316.10 |
$417.60 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$16.35 |
$16.35 |
$21.60 |
$166.46
|
|
Tc-99m bicisate
|
$824.04 |
$824.04 |
$1,088.64 |
$1,969.45
|
|
Tc-99m disofenin
|
$74.34 |
$74.34 |
$98.21 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$2,274.83 |
$2,274.83 |
$3,005.28 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$1,230.83 |
$1,230.83 |
$1,626.05 |
$2,166.26
|