|
Shoulder MRI (with contrast)
|
$3,842.80 |
$3,842.80 |
$3,842.80 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$3,305.25 |
$3,305.25 |
$3,305.25 |
$2,096.84
|
|
Shoulder X-ray
|
$644.80 |
$644.80 |
$644.80 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$438.75 |
$438.75 |
$438.75 |
$263.25
|
|
Shunt glaucoma baerveldt 350mm
|
$9,790.95 |
$9,790.95 |
$9,790.95 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$497.90 |
$497.90 |
$497.90 |
$355.80
|
|
Sickling rbc
|
$92.95 |
$92.95 |
$92.95 |
$59.40
|
|
Sim ang w/prs cath rad emb
|
$31,254.60 |
$31,254.60 |
$31,254.60 |
$18,145.20
|
|
Sincalide 5 mcg solution for injection
|
$1,025.05 |
$1,025.05 |
$1,025.05 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$3,688.10 |
$3,688.10 |
$3,688.10 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$3,521.70 |
$3,521.70 |
$3,521.70 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,984.15 |
$2,984.15 |
$2,984.15 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$6,561.75 |
$6,561.75 |
$6,561.75 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$905.45 |
$905.45 |
$905.45 |
$346.45
|
|
Sinus X-ray (limited)
|
$372.45 |
$372.45 |
$372.45 |
$215.40
|
|
Sipuleucel-t - su
|
$173,460.30 |
$173,460.30 |
$173,460.30 |
$100,990.51
|
|
Sirolimus, oral
|
$98.15 |
$98.15 |
$98.15 |
$41.70
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$679.90 |
$679.90 |
$679.90 |
$14,361.10
|
|
Skel musc relaxant 3 or more
|
$7.15 |
$7.15 |
$7.15 |
$16.12
|
|
Skin Biopsy
|
$665.60 |
$665.60 |
$665.60 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$549.25 |
$549.25 |
$549.25 |
$294.45
|
|
Skull X-ray (complete)
|
$910.00 |
$910.00 |
$910.00 |
$417.50
|
|
Skyla, 13.5 mg
|
$2,802.15 |
$2,802.15 |
$2,802.15 |
$1,643.47
|
|
Sleep study attended
|
$3,988.40 |
$3,988.40 |
$3,988.40 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$4,228.25 |
$4,228.25 |
$4,228.25 |
$3,734.50
|
|
Sleep study unattended
|
$544.70 |
$544.70 |
$544.70 |
$594.00
|
|
Sling suprapubic suburetheral
|
$22,740.25 |
$22,740.25 |
$22,740.25 |
$9,679.96
|
|
Slp pure tone screening
|
$99.45 |
$99.45 |
$99.45 |
$64.50
|
|
Slp stdy unatnd w/anal
|
$560.95 |
$560.95 |
$560.95 |
$296.34
|
|
Sm-153 lexidron ther
|
$11,993.80 |
$11,993.80 |
$11,993.80 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$1,032.20 |
$1,032.20 |
$1,032.20 |
$557.70
|
|
Small bowel endoscopy/stent 44370
|
$4,575.35 |
$4,575.35 |
$4,575.35 |
$4,992.00
|
|
Smear fluorescent and/or acid fast stain
|
$360.10 |
$360.10 |
$360.10 |
$64.35
|
|
Smear gram stain
|
$160.55 |
$160.55 |
$160.55 |
$55.55
|
|
Smear nasal eosinophil
|
$119.60 |
$119.60 |
$119.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$191.75 |
$191.75 |
$191.75 |
$73.50
|
|
Smear wet mount
|
$176.80 |
$176.80 |
$176.80 |
$67.55
|
|
Sodium 24 hour urine
|
$122.85 |
$122.85 |
$122.85 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$215.80 |
$215.80 |
$215.80 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$185.25 |
$185.25 |
$185.25 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$150.15 |
$150.15 |
$150.15 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$185.25 |
$185.25 |
$185.25 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$53.30 |
$53.30 |
$53.30 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$54.60 |
$54.60 |
$54.60 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$693.55 |
$693.55 |
$693.55 |
$177.52
|
|
Solid skin barrier
|
$1.95 |
$1.95 |
$1.95 |
$2.84
|
|
Somatosensory testing
|
$827.45 |
$827.45 |
$827.45 |
$816.00
|
|
Specific gravity body fluid
|
$82.55 |
$82.55 |
$82.55 |
$22.00
|
|
Specimen fat stain
|
$77.35 |
$77.35 |
$77.35 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$586.95 |
$586.95 |
$586.95 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$408.85 |
$408.85 |
$408.85 |
$246.87
|
|
Sperm antibody test
|
$57.85 |
$57.85 |
$57.85 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,356.25 |
$2,356.25 |
$2,356.25 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$484.90 |
$484.90 |
$484.90 |
$251.00
|
|
Spleen imaging
|
$1,203.80 |
$1,203.80 |
$1,203.80 |
$679.00
|
|
Splint rstrc wrst/cmc right med
|
$72.80 |
$72.80 |
$72.80 |
$99.04
|
|
Split blood or products
|
$94.90 |
$94.90 |
$94.90 |
$127.80
|
|
Sr-89 stront chlor ther / mci
|
$7,152.60 |
$7,152.60 |
$7,152.60 |
$2,515.15
|
|
St analysis behavior qualitative voice/resonance
|
$295.10 |
$295.10 |
$295.10 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$416.65 |
$416.65 |
$416.65 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$73,427.90 |
$73,427.90 |
$73,427.90 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$96,361.20 |
$96,361.20 |
$96,361.20 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$11,771.50 |
$11,771.50 |
$11,771.50 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$53,311.05 |
$53,311.05 |
$53,311.05 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$16,727.10 |
$16,727.10 |
$16,727.10 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$57,595.20 |
$57,595.20 |
$57,595.20 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$42,199.95 |
$42,199.95 |
$42,199.95 |
$8,925.76
|
|
Stent placemt retro carotid
|
$38,714.00 |
$38,714.00 |
$38,714.00 |
$5,328.00
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$61,822.80 |
$61,822.80 |
$61,822.80 |
$16,098.16
|
|
Sterile needle
|
$551.20 |
$551.20 |
$551.20 |
$190.13
|
|
St evaluate speech sound production
|
$375.05 |
$375.05 |
$375.05 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$750.10 |
$750.10 |
$750.10 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,968.20 |
$1,968.20 |
$1,968.20 |
$1,345.40
|
|
Strep a ag ia
|
$206.05 |
$206.05 |
$206.05 |
$75.40
|
|
Streptomycin injection
|
$638.95 |
$638.95 |
$638.95 |
$138.30
|
|
Streptozocin injection
|
$2,782.00 |
$2,782.00 |
$2,782.00 |
$785.95
|
|
Stress test pulmonary
|
$434.20 |
$434.20 |
$434.20 |
$324.00
|
|
Stress tte complete
|
$2,837.25 |
$2,837.25 |
$2,837.25 |
$1,900.96
|
|
Str markers specimen anal
|
$978.25 |
$978.25 |
$978.25 |
$756.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$167.05 |
$167.05 |
$167.05 |
$54.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$1,997,073.00 |
$1,997,073.00 |
$1,997,073.00 |
$7,487.55
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$3.25 |
$3.25 |
$3.25 |
$82.46
|
|
Sulfonylurea screen qn-sendout
|
$184.60 |
$184.60 |
$184.60 |
$158.75
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$171.60 |
$171.60 |
$171.60 |
$129.89
|
|
Supp non-insulin inf cath/wk
|
$8.45 |
$8.45 |
$8.45 |
$8.45
|
|
Surgical pathology level 1 gross examination only
|
$171.60 |
$171.60 |
$171.60 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$317.20 |
$317.20 |
$317.20 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$364.00 |
$364.00 |
$364.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$560.30 |
$560.30 |
$560.30 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$769.60 |
$769.60 |
$769.60 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,288.95 |
$1,288.95 |
$1,288.95 |
$720.75
|
|
Surgical trays
|
$843.05 |
$843.05 |
$843.05 |
$694.80
|
|
Susceptibility agar dilution per agent
|
$163.15 |
$163.15 |
$163.15 |
$45.60
|
|
Susceptibility mic per plate
|
$213.20 |
$213.20 |
$213.20 |
$106.00
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$13,034.45 |
$13,034.45 |
$13,034.45 |
$1,995.00
|
|
Svc venogram s&i
|
$1,781.65 |
$1,781.65 |
$1,781.65 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$585.00 |
$585.00 |
$585.00 |
$316.80
|
|
Swallowing Therapy Session
|
$370.50 |
$370.50 |
$370.50 |
$232.56
|
|
Synvisc or synvisc-one
|
$254.80 |
$254.80 |
$254.80 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$259.35 |
$259.35 |
$259.35 |
$42.24
|
