|
Rmvl tv pm lead sgl
|
$8,236.70 |
$8,236.70 |
$8,236.70 |
$4,195.80
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$20,784.58 |
$20,784.58 |
$20,784.58 |
$7,269.05
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$3,120.85 |
$3,120.85 |
$3,120.85 |
$180.55
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$4,656.60 |
$4,656.60 |
$4,656.60 |
$2,331.08
|
|
Rp loclzj tum spect w/ct 1
|
$3,862.48 |
$3,862.48 |
$3,862.48 |
$2,531.25
|
|
Rpl tun-cvad w subq pump
|
$16,913.77 |
$16,913.77 |
$16,913.77 |
$4,602.08
|
|
Rpl tun cvc wo subq port
|
$284.57 |
$284.57 |
$284.57 |
$4,201.80
|
|
Rsv assay w/optic
|
$234.03 |
$234.03 |
$234.03 |
$73.80
|
|
Rubella antibody igg
|
$244.31 |
$244.31 |
$244.31 |
$73.10
|
|
Rubeola antibody igg
|
$44.00 |
$44.00 |
$44.00 |
$79.68
|
|
Russell viper venom diluted
|
$28.47 |
$28.47 |
$28.47 |
$70.16
|
|
Salmonella antibody
|
$45.81 |
$45.81 |
$45.81 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,606.73 |
$2,606.73 |
$2,606.73 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$2,177.01 |
$2,177.01 |
$2,177.01 |
$670.00
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$925.34 |
$925.34 |
$925.34 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,962.14 |
$1,962.14 |
$1,962.14 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$2,366.42 |
$2,366.42 |
$2,366.42 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,628.53 |
$1,628.53 |
$1,628.53 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,266.62 |
$1,266.62 |
$1,266.62 |
$601.70
|
|
Screening Mammogram
|
$1,168.92 |
$1,168.92 |
$1,168.92 |
$303.55
|
|
Screening pap smear by phys
|
$75.85 |
$75.85 |
$75.85 |
$40.59
|
|
Sec art mech thrmbc non-intracranial add-on
|
$9,578.19 |
$9,578.19 |
$9,578.19 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$232.59 |
$232.59 |
$232.59 |
$44.20
|
|
Semen analysis w/count
|
$129.96 |
$129.96 |
$129.96 |
$56.44
|
|
Set radiation therapy field
|
$2,135.45 |
$2,135.45 |
$2,135.45 |
$731.50
|
|
Set radiation therapy field
|
$3,855.39 |
$3,855.39 |
$3,855.39 |
$1,636.36
|
|
Shoe post-op mens m
|
$90.84 |
$90.84 |
$90.84 |
$31.88
|
|
Shoulder MRI (with and without contrast)
|
$7,208.44 |
$7,208.44 |
$7,208.44 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$6,555.23 |
$6,555.23 |
$6,555.23 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$5,569.42 |
$5,569.42 |
$5,569.42 |
$2,051.28
|
|
Shoulder X-ray
|
$1,220.87 |
$1,220.87 |
$1,220.87 |
$367.02
|
|
Sickling rbc
|
$80.98 |
$80.98 |
$80.98 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$7,125.86 |
$7,125.86 |
$7,125.86 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$6,895.00 |
$6,895.00 |
$6,895.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$5,969.13 |
$5,969.13 |
$5,969.13 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$2,565.95 |
$2,565.95 |
$2,565.95 |
$2,489.25
|
|
Skin Biopsy
|
$1,453.91 |
$1,453.91 |
$1,453.91 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$6,418.48 |
$6,418.48 |
$6,418.48 |
$3,936.80
|
|
Smear fluorescent and/or acid fast stain
|
$284.68 |
$284.68 |
$284.68 |
$64.20
|
|
Smear gram stain
|
$244.78 |
$244.78 |
$244.78 |
$57.85
|
|
Smear nasal eosinophil
|
$159.84 |
$159.84 |
$159.84 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$40.18 |
$40.18 |
$40.18 |
$64.35
|
|
Smear wet mount
|
$397.27 |
$397.27 |
$397.27 |
$68.63
|
|
Sodium 24 hour urine
|
$102.04 |
$102.04 |
$102.04 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$35.76 |
$35.76 |
$35.76 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$168.41 |
$168.41 |
$168.41 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$563.51 |
$563.51 |
$563.51 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,473.88 |
$1,473.88 |
$1,473.88 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$148.87 |
$148.87 |
$148.87 |
$42.70
|
|
Special physics consult
|
$2,127.99 |
$2,127.99 |
$2,127.99 |
$700.74
|
|
Special radiation dosimetry
|
$1,184.54 |
$1,184.54 |
$1,184.54 |
$445.50
|
|
Special radiation treatment
|
$4,956.32 |
$4,956.32 |
$4,956.32 |
$1,934.03
|
|
Special teletx port plan
|
$2,109.73 |
$2,109.73 |
$2,109.73 |
$1,046.65
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,502.08 |
$1,502.08 |
$1,502.08 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,388.52 |
$1,388.52 |
$1,388.52 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$1,885.73 |
$1,885.73 |
$1,885.73 |
$366.66
|
|
Splint finger fold over sm
|
$583.23 |
$583.23 |
$583.23 |
$57.33
|
|
Srs linear based
|
$44,880.59 |
$44,880.59 |
$44,880.59 |
$14,124.25
|
|
Srs multisource
|
$27,584.98 |
$27,584.98 |
$27,584.98 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$270.39 |
$270.39 |
$270.39 |
$300.00
|
|
Staph a dna amp probe
|
$245.39 |
$245.39 |
$245.39 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$343.06 |
$343.06 |
$343.06 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$49,501.04 |
$49,501.04 |
$49,501.04 |
$23,387.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$13,390.98 |
$13,390.98 |
$13,390.98 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$13,462.00 |
$13,462.00 |
$13,462.00 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$26,964.57 |
$26,964.57 |
$26,964.57 |
$19,765.20
|
|
St evaluate speech sound production
|
$257.26 |
$257.26 |
$257.26 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$534.52 |
$534.52 |
$534.52 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$296.14 |
$296.14 |
$296.14 |
$406.40
|
|
St evaluation swallow function
|
$406.94 |
$406.94 |
$406.94 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$501.10 |
$501.10 |
$501.10 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$185.22 |
$185.22 |
$185.22 |
$171.00
|
|
Strapping of hand or finger
|
$491.21 |
$491.21 |
$491.21 |
$194.40
|
|
Strapping of knee
|
$491.21 |
$491.21 |
$491.21 |
$224.80
|
|
Strapping of toes 29550
|
$491.21 |
$491.21 |
$491.21 |
$185.36
|
|
Strep b dna amp probe
|
$31.49 |
$31.49 |
$31.49 |
$139.20
|
|
St treatment speech individual
|
$187.46 |
$187.46 |
$187.46 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$217.57 |
$217.57 |
$217.57 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$185.30 |
$185.30 |
$185.30 |
$49.13
|
|
Sugars single quant
|
$110.62 |
$110.62 |
$110.62 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$284.78 |
$284.78 |
$284.78 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$111.46 |
$111.46 |
$111.46 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$222.20 |
$222.20 |
$222.20 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$233.63 |
$233.63 |
$233.63 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$434.96 |
$434.96 |
$434.96 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$567.88 |
$567.88 |
$567.88 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$784.39 |
$784.39 |
$784.39 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$869.86 |
$869.86 |
$869.86 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$208.82 |
$208.82 |
$208.82 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$75.37 |
$75.37 |
$75.37 |
$34.48
|
|
Susceptibility mic per plate
|
$631.08 |
$631.08 |
$631.08 |
$94.38
|
|
Svc venogram s&i
|
$4,524.78 |
$4,524.78 |
$4,524.78 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$1,769.73 |
$1,769.73 |
$1,769.73 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$263.36 |
$263.36 |
$263.36 |
$44.85
|
|
T3 (triiodothyronine) free
|
$281.03 |
$281.03 |
$281.03 |
$89.82
|
|
T3 (triiodothyronine) total
|
$253.38 |
$253.38 |
$253.38 |
$94.90
|
|
T4 (thyroxine) free
|
$142.84 |
$142.84 |
$142.84 |
$81.60
|
|
T4 (thyroxine) total
|
$216.78 |
$216.78 |
$216.78 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$46.98 |
$46.98 |
$46.98 |
$122.40
|
|
Target gsa panel organ/hmtlmph neop
|
$10,139.41 |
$10,139.41 |
$10,139.41 |
$3,385.00
|