|
Sincalide 5 mcg solution for injection
|
$156.71 |
$156.71 |
$156.71 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$4,364.43 |
$4,364.43 |
$4,364.43 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,642.08 |
$3,642.08 |
$3,642.08 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$3,009.98 |
$3,009.98 |
$3,009.98 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$1,517.04 |
$1,517.04 |
$1,517.04 |
$2,489.25
|
|
Sirolimus, oral
|
$37.05 |
$37.05 |
$37.05 |
$42.11
|
|
Skin Biopsy
|
$322.82 |
$322.82 |
$322.82 |
$382.80
|
|
Sling arm deluxe w/pad xs
|
$103.20 |
$103.20 |
$103.20 |
$25.55
|
|
Sling pelv split sam med
|
$134.95 |
$134.95 |
$134.95 |
$115.20
|
|
Sling suprapubic suburetheral
|
$6,050.52 |
$6,050.52 |
$6,050.52 |
$10,328.15
|
|
Smear fluorescent and/or acid fast stain
|
$67.61 |
$67.61 |
$87.62 |
$64.20
|
|
Smear gram stain
|
$79.97 |
$79.97 |
$135.90 |
$57.85
|
|
Smear nasal eosinophil
|
$36.17 |
$36.17 |
$62.81 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$117.63 |
$117.63 |
$174.05 |
$64.35
|
|
Smear wet mount
|
$69.09 |
$69.09 |
$109.07 |
$68.63
|
|
Snrpn/ube3a gene
|
$98.49 |
$98.49 |
$191.29 |
$228.80
|
|
Sock fracture or equal each
|
$134.95 |
$134.95 |
$134.95 |
$77.87
|
|
Sodium 24 hour urine
|
$57.92 |
$57.92 |
$149.61 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$19.11 |
$19.11 |
$19.11 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$19.11 |
$19.11 |
$19.11 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$37.64 |
$37.64 |
$37.64 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$4.57 |
$4.57 |
$57.33 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$36.75 |
$36.75 |
$36.75 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$55.96 |
$55.96 |
$154.35 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$102.32 |
$102.32 |
$102.32 |
$195.48
|
|
Soft interface below knee se
|
$103.20 |
$103.20 |
$103.20 |
$196.00
|
|
Somatosensory testing
|
$1,221.28 |
$1,221.28 |
$1,221.28 |
$583.80
|
|
Special physics consult
|
$427.48 |
$427.48 |
$427.48 |
$700.74
|
|
Special pump services
|
$12,401.81 |
$12,401.81 |
$12,401.81 |
$928.00
|
|
Special radiation dosimetry
|
$419.54 |
$419.54 |
$419.54 |
$445.50
|
|
Special radiation treatment
|
$1,472.06 |
$1,472.06 |
$1,472.06 |
$1,934.03
|
|
Special teletx port plan
|
$1,452.95 |
$1,452.95 |
$1,452.95 |
$1,046.65
|
|
Specific gravity body fluid
|
$47.40 |
$47.40 |
$68.80 |
$23.63
|
|
Speech evaluation complex
|
$181.40 |
$181.40 |
$181.40 |
$527.06
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$697.67 |
$697.67 |
$697.67 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$441.59 |
$441.59 |
$746.87 |
$559.96
|
|
Splint extn xsm w sof-stretch rolyan
|
$35.87 |
$35.87 |
$35.87 |
$52.65
|
|
Splint finger frog med
|
$6.77 |
$6.77 |
$6.77 |
$27.95
|
|
Splint func pos polyflex ii med
|
$78.21 |
$78.21 |
$78.21 |
$52.22
|
|
Splint rstrc wrst/cmc right med
|
$26.46 |
$26.46 |
$26.46 |
$101.18
|
|
Split blood or products
|
$57.92 |
$57.92 |
$131.91 |
$148.98
|
|
Sr-89 stront chlor ther / mci
|
$2,882.09 |
$2,882.09 |
$2,882.09 |
$4,588.65
|
|
Srs linear based
|
$4,029.57 |
$4,029.57 |
$4,029.57 |
$14,124.25
|
|
Static or dynami afo pre ots
|
$264.60 |
$264.60 |
$264.60 |
$101.56
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$11,706.50 |
$11,706.50 |
$11,706.50 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$24,217.08 |
$24,217.08 |
$24,217.08 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$1,123.67 |
$1,123.67 |
$1,123.67 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$12,427.38 |
$12,427.38 |
$12,427.38 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$4,176.86 |
$4,176.86 |
$4,176.86 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$12,511.17 |
$12,511.17 |
$12,511.17 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,753.50 |
$3,753.50 |
$3,753.50 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$13,206.78 |
$13,206.78 |
$13,206.78 |
$19,765.20
|
|
Strep a ag ia
|
$90.85 |
$90.85 |
$90.85 |
$75.40
|
|
Strep b dna amp probe
|
$59.69 |
$59.69 |
$78.80 |
$139.20
|
|
Streptozocin injection
|
$400.43 |
$400.43 |
$400.43 |
$943.23
|
|
Stress test pulmonary
|
$161.70 |
$161.70 |
$161.70 |
$327.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$99.67 |
$99.67 |
$99.67 |
$49.13
|
|
Sugars single quant
|
$11.18 |
$11.18 |
$21.70 |
$52.47
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,006.55 |
$2,006.55 |
$2,006.55 |
$8,988.00
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$43.81 |
$43.81 |
$43.81 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$107.61 |
$107.61 |
$196.43 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$46.46 |
$46.46 |
$46.46 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$9.60 |
$9.60 |
$154.35 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$21.48 |
$21.48 |
$177.58 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$25.80 |
$25.80 |
$200.51 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$153.03 |
$153.03 |
$230.50 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$166.06 |
$166.06 |
$269.60 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$233.28 |
$233.28 |
$306.65 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$36.31 |
$36.31 |
$55.57 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$13.53 |
$13.53 |
$22.62 |
$34.48
|
|
Susceptibility mic per plate
|
$196.40 |
$196.40 |
$334.04 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$13.20 |
$13.20 |
$25.63 |
$48.30
|
|
Svc venogram s&i
|
$1,651.99 |
$1,651.99 |
$1,651.99 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$123.78 |
$123.78 |
$238.68 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$15.21 |
$15.21 |
$101.43 |
$44.85
|
|
System cardiomems hosp electronics
|
$20,014.35 |
$20,014.35 |
$20,014.35 |
$41,518.75
|
|
System pacing micra av
|
$12,427.38 |
$12,427.38 |
$12,427.38 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,050.52 |
$6,050.52 |
$6,050.52 |
$10,980.00
|
|
System recell skin grafting/harvesting
|
$6,050.52 |
$6,050.52 |
$6,050.52 |
$13,777.23
|
|
System sealant biosentry tract
|
$344.57 |
$344.57 |
$344.57 |
$900.00
|
|
T3 (triiodothyronine) free
|
$47.40 |
$47.40 |
$56.45 |
$89.82
|
|
T3 (triiodothyronine) total
|
$38.83 |
$38.83 |
$42.93 |
$94.90
|
|
T4 (thyroxine) free
|
$259.02 |
$259.02 |
$372.87 |
$81.60
|
|
T4 (thyroxine) total
|
$238.14 |
$238.14 |
$260.95 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.57 |
$4.57 |
$34.40 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$172.29 |
$172.29 |
$172.29 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$20.58 |
$20.58 |
$38.26 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$649.74 |
$649.74 |
$649.74 |
$1,928.40
|
|
Tavr perq femoral
|
$11,478.65 |
$11,478.65 |
$11,478.65 |
$16,357.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$10.29 |
$10.29 |
$19.99 |
$166.46
|
|
Tc-99m bicisate
|
$2.94 |
$2.94 |
$2.94 |
$1,969.45
|
|
Tc-99m depreotide
|
$1,202.76 |
$1,202.76 |
$1,202.76 |
$1,937.35
|
|
Tc-99m diag per dose
|
$208.45 |
$208.45 |
$208.45 |
$279.95
|
|
Tc-99m exame autol wbc diag per dose
|
$1,198.35 |
$1,198.35 |
$1,198.35 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$667.09 |
$667.09 |
$667.09 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$294.30 |
$294.30 |
$294.30 |
$323.01
|
|
Tc-99m maa
|
$226.68 |
$226.68 |
$226.68 |
$312.06
|
|
Tc-99m mebrofenin
|
$596.53 |
$596.53 |
$596.53 |
$169.53
|
|
Tc-99m medronate
|
$157.88 |
$157.88 |
$157.88 |
$122.46
|
|
Tc-99m mertiatide
|
$260.49 |
$260.49 |
$260.49 |
$757.25
|
