|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$357.98 |
$357.98 |
$357.98 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$755.17 |
$755.17 |
$755.17 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$691.07 |
$691.07 |
$691.07 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$856.00 |
$856.00 |
$856.00 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$527.25 |
$527.25 |
$527.25 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$530.12 |
$530.12 |
$530.12 |
$601.70
|
|
Screening Mammogram
|
$287.12 |
$287.12 |
$287.12 |
$303.55
|
|
Sedimentation rate erythrocyte automated
|
$42.00 |
$42.00 |
$42.00 |
$44.20
|
|
Semen analysis presence/motility
|
$30.34 |
$30.34 |
$30.34 |
$70.85
|
|
Serpina1 gene
|
$101.75 |
$101.75 |
$101.75 |
$191.73
|
|
Shoulder MRI (with and without contrast)
|
$934.81 |
$934.81 |
$934.81 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$888.93 |
$888.93 |
$888.93 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,136.27 |
$1,136.27 |
$1,136.27 |
$2,051.28
|
|
Shoulder X-ray
|
$263.63 |
$263.63 |
$263.63 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$199.25 |
$199.25 |
$199.25 |
$345.00
|
|
Sickling rbc
|
$29.97 |
$29.97 |
$29.97 |
$53.55
|
|
Signal avg ecg w or without ecg 93278
|
$91.58 |
$91.58 |
$91.58 |
$309.52
|
|
Sinus CT scan (with and without contrast)
|
$693.10 |
$693.10 |
$693.10 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$647.32 |
$647.32 |
$647.32 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$601.44 |
$601.44 |
$601.44 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$4,867.81 |
$4,867.81 |
$4,867.81 |
$2,489.25
|
|
Sirolimus, oral
|
$9.81 |
$9.81 |
$9.81 |
$31.60
|
|
Smear fluorescent and/or acid fast stain
|
$27.47 |
$27.47 |
$27.47 |
$64.20
|
|
Smear gram stain
|
$22.11 |
$22.11 |
$22.11 |
$57.85
|
|
Smear nasal eosinophil
|
$23.68 |
$23.68 |
$23.68 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$26.92 |
$26.92 |
$26.92 |
$64.35
|
|
Smear wet mount
|
$9.07 |
$9.07 |
$9.07 |
$68.63
|
|
Sodium 24 hour urine
|
$30.34 |
$30.34 |
$30.34 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$81.18 |
$81.18 |
$81.18 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$34.86 |
$34.86 |
$34.86 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$81.18 |
$81.18 |
$81.18 |
$46.35
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$9.62 |
$9.62 |
$9.62 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$6.85 |
$6.85 |
$6.85 |
$42.70
|
|
Somatosensory testing
|
$971.44 |
$971.44 |
$971.44 |
$583.80
|
|
Specific gravity body fluid
|
$8.97 |
$8.97 |
$8.97 |
$23.63
|
|
Specimen fat stain
|
$18.69 |
$18.69 |
$18.69 |
$32.76
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$506.90 |
$506.90 |
$506.90 |
$559.96
|
|
Split blood or products
|
$240.87 |
$240.87 |
$240.87 |
$148.98
|
|
St analysis behavior qualitative voice/resonance
|
$116.00 |
$116.00 |
$116.00 |
$300.00
|
|
Staph a dna amp probe
|
$92.96 |
$92.96 |
$92.96 |
$116.39
|
|
St evaluate speech sound production
|
$116.64 |
$116.64 |
$116.64 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$147.72 |
$147.72 |
$147.72 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$115.07 |
$115.07 |
$115.07 |
$406.40
|
|
St evaluation swallow function
|
$114.79 |
$114.79 |
$114.79 |
$336.60
|
|
Strep a ag ia
|
$54.39 |
$54.39 |
$54.39 |
$75.40
|
|
Strep b dna amp probe
|
$68.82 |
$68.82 |
$68.82 |
$139.20
|
|
Stress test pulmonary
|
$358.90 |
$358.90 |
$358.90 |
$327.20
|
|
Stress tte complete
|
$3,220.20 |
$3,220.20 |
$3,220.20 |
$1,964.95
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$6.87 |
$6.87 |
$6.87 |
$49.13
|
|
Sugars single quant
|
$9.99 |
$9.99 |
$9.99 |
$52.47
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.51 |
$0.51 |
$0.51 |
$71.09
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$48.14 |
$48.14 |
$48.14 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$12.86 |
$12.86 |
$12.86 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$22.11 |
$22.11 |
$22.11 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$25.25 |
$25.25 |
$25.25 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$43.11 |
$43.11 |
$43.11 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$74.74 |
$74.74 |
$74.74 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$187.59 |
$187.59 |
$187.59 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$19.98 |
$19.98 |
$19.98 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$13.23 |
$13.23 |
$13.23 |
$34.48
|
|
Susceptibility mic per plate
|
$39.78 |
$39.78 |
$39.78 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$62.72 |
$62.72 |
$62.72 |
$48.30
|
|
Svc venogram s&i
|
$1,312.11 |
$1,312.11 |
$1,312.11 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$11.19 |
$11.19 |
$11.19 |
$44.85
|
|
T3 (triiodothyronine) free
|
$16.28 |
$16.28 |
$16.28 |
$89.82
|
|
T3 (triiodothyronine) total
|
$145.69 |
$145.69 |
$145.69 |
$94.90
|
|
T4 (thyroxine) free
|
$128.95 |
$128.95 |
$128.95 |
$81.60
|
|
T4 (thyroxine) total
|
$137.18 |
$137.18 |
$137.18 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.44 |
$2.44 |
$2.44 |
$9.99
|
|
Tacrolimus therapeutic drug level
|
$61.42 |
$61.42 |
$61.42 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$888.00 |
$888.00 |
$888.00 |
$1,928.40
|
|
Target gsa panel organ neop
|
$518.00 |
$518.00 |
$518.00 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$0.32 |
$0.32 |
$0.32 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$110.08 |
$110.08 |
$110.08 |
$166.46
|
|
Tc-99m exame autol wbc diag per dose
|
$5,342.71 |
$5,342.71 |
$5,342.71 |
$2,393.40
|
|
Tc-99m labeled rbc
|
$174.64 |
$174.64 |
$174.64 |
$323.01
|
|
Tc-99m maa
|
$394.05 |
$394.05 |
$394.05 |
$312.06
|
|
Tc-99m mebrofenin
|
$146.52 |
$146.52 |
$146.52 |
$169.53
|
|
Tc-99m medronate
|
$117.75 |
$117.75 |
$117.75 |
$122.46
|
|
Tc-99m mertiatide
|
$862.19 |
$862.19 |
$862.19 |
$757.25
|
|
Tc-99m oxidronate
|
$124.23 |
$124.23 |
$124.23 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$512.08 |
$512.08 |
$512.08 |
$245.85
|
|
Tc-99m pertechnetate per mci
|
$1.48 |
$1.48 |
$1.48 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$198.04 |
$198.04 |
$198.04 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$107.49 |
$107.49 |
$107.49 |
$221.60
|
|
Tc-99m sulfur colloid
|
$356.68 |
$356.68 |
$356.68 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$116.55 |
$116.55 |
$116.55 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,656.03 |
$1,656.03 |
$1,656.03 |
$930.54
|
|
T cells absolute cd 4 count
|
$47.55 |
$47.55 |
$47.55 |
$120.25
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$280.13 |
$280.13 |
$280.13 |
$17,652.73
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$48.29 |
$48.29 |
$48.29 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$41.53 |
$41.53 |
$41.53 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$1,382.69 |
$1,382.69 |
$1,382.69 |
$1,001.55
|
|
Theophylline therapeutic drug level
|
$63.73 |
$63.73 |
$63.73 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$41.14 |
$41.14 |
$41.14 |
$38.64
|
|
Thrombin time
|
$37.65 |
$37.65 |
$37.65 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$40.79 |
$40.79 |
$40.79 |
$56.93
|
|
Thyroglobulin antibody
|
$41.16 |
$41.16 |
$41.16 |
$84.00
|
|
Thyroid mets imag whole body
|
$1,665.83 |
$1,665.83 |
$1,665.83 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$36.17 |
$36.17 |
$36.17 |
$120.00
|
