|
Sho arthrs srg prtl synvct
|
$939.73 |
$939.73 |
$939.73 |
$5,741.00
|
|
Sho arthrs srg rmvl loose/fb
|
$1,020.32 |
$1,020.32 |
$1,020.32 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$1,797.54 |
$1,797.54 |
$1,797.54 |
$5,419.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$1,092.91 |
$1,092.91 |
$1,092.91 |
$3,839.54
|
|
Shoe post-op mens m
|
$23.98 |
$23.98 |
$23.98 |
$42.87
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$1,866.80 |
$1,866.80 |
$1,866.80 |
$6,839.00
|
|
Sickling rbc
|
$15.46 |
$15.46 |
$15.46 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$151.19 |
$151.19 |
$151.19 |
$1,351.63
|
|
Sigmoidoscopy/submucosal injection 45335
|
$133.20 |
$133.20 |
$133.20 |
$1,374.60
|
|
Sigmoidoscopy w/ablation
|
$366.97 |
$366.97 |
$366.97 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$219.78 |
$219.78 |
$219.78 |
$1,395.28
|
|
Sigmoidoscopy w/tumr remove
|
$249.09 |
$249.09 |
$249.09 |
$1,395.28
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$217.79 |
$217.79 |
$217.79 |
$1,664.40
|
|
Sinus CT scan (with and without contrast)
|
$7,260.74 |
$7,260.74 |
$7,260.74 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$5,914.08 |
$5,914.08 |
$5,914.08 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$4,808.52 |
$4,808.52 |
$4,808.52 |
$1,279.50
|
|
Skin Biopsy
|
$74.60 |
$74.60 |
$74.60 |
$382.80
|
|
Skin full graft 20sq cm less 15200
|
$1,009.66 |
$1,009.66 |
$1,009.66 |
$2,190.24
|
|
Skin full graft add-on 15241
|
$279.72 |
$279.72 |
$279.72 |
$445.60
|
|
Skyla, 13.5 mg
|
$3,300.54 |
$3,300.54 |
$3,300.54 |
$1,801.20
|
|
Sling arm deluxe w/pad xs
|
$233.77 |
$233.77 |
$233.77 |
$25.55
|
|
Slp pure tone screening
|
$44.63 |
$44.63 |
$44.63 |
$67.60
|
|
Small bowel endoscopy
|
$311.69 |
$311.69 |
$311.69 |
$2,466.10
|
|
Small bowel endoscopy
|
$436.90 |
$436.90 |
$436.90 |
$2,244.82
|
|
Small bowel endoscopy
|
$512.82 |
$512.82 |
$512.82 |
$2,638.57
|
|
Small bowel endoscopy
|
$524.81 |
$524.81 |
$524.81 |
$2,244.82
|
|
Small bowel endoscopy
|
$721.95 |
$721.95 |
$721.95 |
$2,734.20
|
|
Small bowel endoscopy
|
$143.19 |
$143.19 |
$143.19 |
$1,294.80
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$408.93 |
$408.93 |
$408.93 |
$2,244.82
|
|
Small bowel endoscopy 44365
|
$391.61 |
$391.61 |
$391.61 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$342.99 |
$342.99 |
$342.99 |
$2,442.70
|
|
Small bowel endoscopy br/wa
|
$119.88 |
$119.88 |
$119.88 |
$1,261.31
|
|
Smear fluorescent and/or acid fast stain
|
$103.90 |
$103.90 |
$103.90 |
$64.20
|
|
Smear gram stain
|
$117.22 |
$117.22 |
$117.22 |
$57.85
|
|
Smear nasal eosinophil
|
$45.29 |
$45.29 |
$45.29 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$337.00 |
$337.00 |
$337.00 |
$64.35
|
|
Smear wet mount
|
$48.62 |
$48.62 |
$48.62 |
$68.63
|
|
Sodium 24 hour urine
|
$104.57 |
$104.57 |
$104.57 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$49.95 |
$49.95 |
$49.95 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$2.67 |
$2.67 |
$2.67 |
$48.11
|
|
Sodium serum/plasma/whole blood
|
$53.28 |
$53.28 |
$53.28 |
$42.70
|
|
Specific gravity body fluid
|
$25.98 |
$25.98 |
$25.98 |
$23.63
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,204.13 |
$1,204.13 |
$1,204.13 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$568.10 |
$568.10 |
$568.10 |
$559.96
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$4,560.66
|
|
Split blood or products
|
$100.57 |
$100.57 |
$100.57 |
$148.98
|
|
Sr-89 stront chlor ther / mci
|
$6,044.62 |
$6,044.62 |
$6,044.62 |
$4,588.65
|
|
Strep a ag ia
|
$134.54 |
$134.54 |
$134.54 |
$75.40
|
|
Strep b dna amp probe
|
$58.43 |
$58.43 |
$58.43 |
$139.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$63.22 |
$63.22 |
$63.22 |
$49.13
|
|
Sugars single quant
|
$25.31 |
$25.31 |
$25.31 |
$52.47
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$296.45 |
$296.45 |
$296.45 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$23.98 |
$23.98 |
$23.98 |
$94.19
|
|
Surg dx exam anorectal
|
$191.15 |
$191.15 |
$191.15 |
$3,035.44
|
|
Surgical pathology level 1 gross examination only
|
$41.96 |
$41.96 |
$41.96 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$72.60 |
$72.60 |
$72.60 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$85.25 |
$85.25 |
$85.25 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$115.22 |
$115.22 |
$115.22 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$291.05 |
$291.05 |
$291.05 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$606.73 |
$606.73 |
$606.73 |
$790.00
|
|
Surgical repair stomach bleedin ulcer 43501
|
$2,362.97 |
$2,362.97 |
$2,362.97 |
$3,304.80
|
|
Susceptibility enzyme detection per enzyme
|
$43.96 |
$43.96 |
$43.96 |
$34.48
|
|
Susceptibility mic per plate
|
$109.23 |
$109.23 |
$109.23 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$21.98 |
$21.98 |
$21.98 |
$48.30
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$1,875.46 |
$1,875.46 |
$1,875.46 |
$2,600.80
|
|
Synvisc or synvisc-one
|
$4,469.62 |
$4,469.62 |
$4,469.62 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$66.60 |
$66.60 |
$66.60 |
$44.85
|
|
T3 (triiodothyronine) free
|
$96.57 |
$96.57 |
$96.57 |
$89.82
|
|
T3 (triiodothyronine) total
|
$75.26 |
$75.26 |
$75.26 |
$94.90
|
|
T4 (thyroxine) free
|
$128.54 |
$128.54 |
$128.54 |
$81.60
|
|
T4 (thyroxine) total
|
$11.45 |
$11.45 |
$11.45 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.08 |
$12.08 |
$12.08 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$135.87 |
$135.87 |
$135.87 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,731.60 |
$1,731.60 |
$1,731.60 |
$1,928.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$103.20 |
$103.20 |
$103.20 |
$166.46
|
|
Tc-99m bicisate
|
$952.38 |
$952.38 |
$952.38 |
$1,969.45
|
|
Tc-99m depreotide
|
$2,521.48 |
$2,521.48 |
$2,521.48 |
$1,937.35
|
|
Tc-99m diag per dose
|
$256.41 |
$256.41 |
$256.41 |
$279.95
|
|
Tc-99m labeled rbc
|
$323.01 |
$323.01 |
$323.01 |
$323.01
|
|
Tc-99m maa
|
$275.06 |
$275.06 |
$275.06 |
$312.06
|
|
Tc-99m mebrofenin
|
$937.07 |
$937.07 |
$937.07 |
$169.53
|
|
Tc-99m medronate
|
$275.06 |
$275.06 |
$275.06 |
$122.46
|
|
Tc-99m mertiatide
|
$546.12 |
$546.12 |
$546.12 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$399.60 |
$399.60 |
$399.60 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$4,540.13 |
$4,540.13 |
$4,540.13 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$263.74 |
$263.74 |
$263.74 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$286.38 |
$286.38 |
$286.38 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$674.66 |
$674.66 |
$674.66 |
$221.60
|
|
Tc-99m sulfur colloid
|
$513.49 |
$513.49 |
$513.49 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$140.53 |
$140.53 |
$140.53 |
$198.05
|
|
T cells absolute cd4/cd8 including ratio
|
$14.99 |
$14.99 |
$14.99 |
$186.00
|
|
T cells absolute cd 4 count
|
$19.98 |
$19.98 |
$19.98 |
$120.25
|
|
T cells total count
|
$19.46 |
$19.46 |
$19.46 |
$124.11
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$20,294.63 |
$20,294.63 |
$20,294.63 |
$16,531.64
|
|
Tenodesis biceps tdn at elbw
|
$1,114.22 |
$1,114.22 |
$1,114.22 |
$5,886.74
|
|
Tenolysis extensor tendon hand/finger each
|
$1,032.30 |
$1,032.30 |
$1,032.30 |
$3,594.44
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$432.90 |
$432.90 |
$432.90 |
$2,139.67
|
|
Test for chlorohydrocarbons
|
$66.60 |
$66.60 |
$66.60 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$3,361.97 |
$3,361.97 |
$3,361.97 |
$780.48
|
|
Test stress cardiovascular tracing only
|
$946.39 |
$946.39 |
$946.39 |
$1,001.55
|
