|
Pretreat rbc density gradient separation reference
|
$20.00 |
$20.00 |
$20.00 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$20.00 |
$20.00 |
$20.00 |
$106.00
|
|
Procalcitonin
|
$316.25 |
$316.25 |
$316.25 |
$142.50
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$56.75 |
$56.75 |
$56.75 |
$46.61
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$118.25 |
$118.25 |
$118.25 |
$39.59
|
|
Prostate biopsy, any mthd
|
$1,357.22 |
$1,357.22 |
$1,357.22 |
$585.39
|
|
Protein c concentrate
|
$97.88 |
$97.88 |
$97.88 |
$15.05
|
|
Protein s total
|
$30.00 |
$30.00 |
$30.00 |
$78.87
|
|
Protein total serum plasma whole blood
|
$878.46 |
$878.46 |
$878.46 |
$42.81
|
|
Prothrombin time substitution plasma fractions each
|
$8.79 |
$8.79 |
$8.79 |
$38.40
|
|
PSA (Prostate) Test
|
$45.39 |
$45.39 |
$45.39 |
$108.27
|
|
Pulmonary vent imaging
|
$6,753.27 |
$6,753.27 |
$6,753.27 |
$841.26
|
|
Pyridoxine hcl 100 mg
|
$172.00 |
$172.00 |
$172.00 |
$43.24
|
|
Pyruvate
|
$11.19 |
$11.19 |
$11.19 |
$65.00
|
|
Pyruvate kinase
|
$55.16 |
$55.16 |
$55.16 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$8,038.39 |
$8,038.39 |
$8,038.39 |
$1,522.89
|
|
Quant diff pulm perf w/imaging
|
$8,038.39 |
$8,038.39 |
$8,038.39 |
$1,209.44
|
|
Rabies ig heat-treated human im/subq 90376
|
$2,991.50 |
$2,991.50 |
$2,991.50 |
$1,059.01
|
|
Rabies ig ht&sol human im/sc
|
$1,972.60 |
$1,972.60 |
$1,972.60 |
$5,401.91
|
|
Radiation physics consult
|
$487.00 |
$487.00 |
$487.00 |
$587.65
|
|
Radiation therapy dose plan
|
$572.00 |
$572.00 |
$572.00 |
$530.53
|
|
Radiation treatment aid(s)
|
$759.00 |
$759.00 |
$759.00 |
$544.83
|
|
Radiation treatment aid(s)
|
$535.00 |
$535.00 |
$535.00 |
$1,100.38
|
|
Radiology port images(s)
|
$374.00 |
$374.00 |
$374.00 |
$262.50
|
|
Radiotherapy dose plan imrt
|
$1,434.00 |
$1,434.00 |
$1,434.00 |
$5,996.21
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$9,868.30 |
$9,868.30 |
$9,868.30 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$19,748.09 |
$19,748.09 |
$19,748.09 |
$2,728.42
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$19,748.09 |
$19,748.09 |
$19,748.09 |
$2,566.53
|
|
Radphm lcl tomogr sgl area sgl day
|
$8,193.64 |
$8,193.64 |
$8,193.64 |
$2,379.29
|
|
Radphm lcl tumor plr sgl day
|
$4,732.19 |
$4,732.19 |
$4,732.19 |
$1,126.32
|
|
Rapid Strep Test
|
$814.04 |
$814.04 |
$814.04 |
$74.10
|
|
Refill maint impl spine pump
|
$783.30 |
$783.30 |
$783.30 |
$366.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$2,804.00 |
$2,804.00 |
$2,804.00 |
$674.98
|
|
Remdesivir 100 mg intravenous powder for solution
|
$2,542.80 |
$2,542.80 |
$2,542.80 |
$1,864.71
|
|
Renal cyst study s&i
|
$4,095.09 |
$4,095.09 |
$4,095.09 |
$648.84
|
|
Renal function panel
|
$2,089.27 |
$2,089.27 |
$2,089.27 |
$112.00
|
|
Renal venogram bil s&i
|
$10,371.68 |
$10,371.68 |
$10,371.68 |
$3,615.28
|
|
Reteplase injection
|
$23,502.00 |
$23,502.00 |
$23,502.00 |
$3,155.69
|
|
Rheumatoid factor qualitative
|
$46.85 |
$46.85 |
$46.85 |
$54.60
|
|
Rheumatoid factor quantitative
|
$2.50 |
$2.50 |
$2.50 |
$58.50
|
|
Rho d immune globulin inj
|
$1,456.75 |
$1,456.75 |
$1,456.75 |
$334.53
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$459.00 |
$459.00 |
$459.00 |
$550.10
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$460.00 |
$460.00 |
$460.00 |
$5,707.80
|
|
Sarscov coronavirus ag ia
|
$61.03 |
$61.03 |
$61.03 |
$60.40
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$5,791.98 |
$5,791.98 |
$5,791.98 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$5,791.98 |
$5,791.98 |
$5,791.98 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$5,373.25 |
$5,373.25 |
$5,373.25 |
$815.66
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$2,745.19 |
$2,745.19 |
$2,745.19 |
$586.30
|
|
Scan duplex lower extremity arteries complete bilateral
|
$8,102.33 |
$8,102.33 |
$8,102.33 |
$995.47
|
|
Screening Mammogram
|
$390.92 |
$390.92 |
$390.92 |
$299.01
|
|
Set radiation therapy field
|
$571.00 |
$571.00 |
$571.00 |
$731.50
|
|
Set radiation therapy field
|
$915.00 |
$915.00 |
$915.00 |
$1,102.40
|
|
Set radiation therapy field
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$1,636.36
|
|
Shrinker prosth below knee
|
$410.97 |
$410.97 |
$410.97 |
$153.13
|
|
Shuntogram nonvascular supervision & interpretation
|
$3,245.91 |
$3,245.91 |
$3,245.91 |
$345.00
|
|
Sialidase enzyme assay
|
$73.93 |
$73.93 |
$73.93 |
$48.88
|
|
Sialography s&i
|
$2,585.61 |
$2,585.61 |
$2,585.61 |
$458.15
|
|
Signal avg ecg w or without ecg 93278
|
$1,058.03 |
$1,058.03 |
$1,058.03 |
$310.05
|
|
Sincalide 5 mcg solution for injection
|
$1,157.75 |
$1,157.75 |
$1,157.75 |
$412.96
|
|
Sinus CT scan (with and without contrast)
|
$16,256.75 |
$16,256.75 |
$16,256.75 |
$1,822.80
|
|
Sinus CT scan (with contrast)
|
$16,620.38 |
$16,620.38 |
$16,620.38 |
$1,520.35
|
|
Sinus CT scan (without contrast)
|
$15,114.25 |
$15,114.25 |
$15,114.25 |
$1,281.80
|
|
Sleep study attended
|
$1,218.13 |
$1,218.13 |
$1,218.13 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$6,362.98 |
$6,362.98 |
$6,362.98 |
$3,920.95
|
|
Sm-153 lexidron ther
|
$29,255.60 |
$29,255.60 |
$29,255.60 |
$11,563.30
|
|
Sodium 24 hour urine
|
$509.51 |
$509.51 |
$509.51 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$102.00 |
$102.00 |
$102.00 |
$46.85
|
|
Sodium chloride 0.9 % IV bolus
|
$102.00 |
$102.00 |
$102.00 |
$51.51
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$190.80 |
$190.80 |
$190.80 |
$104.98
|
|
Sodium serum/plasma/whole blood
|
$721.80 |
$721.80 |
$721.80 |
$43.00
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$582.00 |
$582.00 |
$582.00 |
$228.31
|
|
Special physics consult
|
$1,714.00 |
$1,714.00 |
$1,714.00 |
$703.62
|
|
Special radiation dosimetry
|
$1,241.00 |
$1,241.00 |
$1,241.00 |
$445.25
|
|
Specific gravity body fluid
|
$433.38 |
$433.38 |
$433.38 |
$23.63
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$2,961.42 |
$2,961.42 |
$2,961.42 |
$559.30
|
|
Split blood or products
|
$556.95 |
$556.95 |
$556.95 |
$148.92
|
|
Sr-89 stront chlor ther / mci
|
$6,603.78 |
$6,603.78 |
$6,603.78 |
$4,588.65
|
|
St analysis behavior qualitative voice/resonance
|
$1,213.74 |
$1,213.74 |
$1,213.74 |
$302.00
|
|
St evaluate speech sound production
|
$1,213.74 |
$1,213.74 |
$1,213.74 |
$302.40
|
|
St evaluate speech sound production comprehensive/expressive
|
$1,213.74 |
$1,213.74 |
$1,213.74 |
$389.64
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$2,377.69 |
$2,377.69 |
$2,377.69 |
$406.52
|
|
St evaluation swallow function
|
$1,570.98 |
$1,570.98 |
$1,570.98 |
$336.60
|
|
Strep b assay w/optic
|
$437.77 |
$437.77 |
$437.77 |
$32.00
|
|
Streptomycin injection
|
$232.50 |
$232.50 |
$232.50 |
$100.00
|
|
Stress test pulmonary
|
$426.44 |
$426.44 |
$426.44 |
$325.60
|
|
St treatment speech individual
|
$931.17 |
$931.17 |
$931.17 |
$256.55
|
|
St treatment swallow dysfunction/oral
|
$1,010.23 |
$1,010.23 |
$1,010.23 |
$260.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$8.00 |
$8.00 |
$8.00 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$218.94 |
$218.94 |
$218.94 |
$66.80
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$66.00 |
$66.00 |
$66.00 |
$109.26
|
|
Surgical pathology level 1 gross examination only
|
$894.56 |
$894.56 |
$894.56 |
$92.95
|
|
Surgical pathology level 2 gross & microscopic examination
|
$1,061.48 |
$1,061.48 |
$1,061.48 |
$150.40
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,221.06 |
$1,221.06 |
$1,221.06 |
$195.06
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,431.89 |
$1,431.89 |
$1,431.89 |
$494.40
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,527.05 |
$1,527.05 |
$1,527.05 |
$791.85
|
|
Susceptibility agar dilution per agent
|
$854.00 |
$854.00 |
$854.00 |
$40.68
|
|
Suscept studies macrobroth dilution ea
|
$305.70 |
$305.70 |
$305.70 |
$51.50
|
|
T4 (thyroxine) free
|
$789.15 |
$789.15 |
$789.15 |
$83.65
|
|
Tacrol envarsus ex rel oral
|
$210.92 |
$210.92 |
$210.92 |
$3.20
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,802.25 |
$1,802.25 |
$1,802.25 |
$612.11
|
