|
Rsv assay w/optic
|
$149.04 |
$149.04 |
$149.04 |
$81.90
|
|
Rubella antibody igg
|
$79.20 |
$79.20 |
$79.20 |
$76.70
|
|
Rubeola antibody igg
|
$106.56 |
$106.56 |
$106.56 |
$80.00
|
|
Russell viper venom diluted
|
$51.84 |
$51.84 |
$51.84 |
$71.88
|
|
Sarscov coronavirus ag ia
|
$75.60 |
$75.60 |
$75.60 |
$59.50
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$623.52 |
$623.52 |
$623.52 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,000.08 |
$1,000.08 |
$1,000.08 |
$661.20
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,272.96 |
$1,272.96 |
$1,272.96 |
$757.02
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$300.96 |
$300.96 |
$300.96 |
$475.24
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,295.28 |
$1,295.28 |
$1,295.28 |
$721.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$2,143.44 |
$2,143.44 |
$2,143.44 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,556.64 |
$1,556.64 |
$1,556.64 |
$650.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,260.72 |
$1,260.72 |
$1,260.72 |
$570.00
|
|
Screening Mammogram
|
$320.40 |
$320.40 |
$320.40 |
$313.35
|
|
Screening prostate cancer PSA
|
$224.64 |
$224.64 |
$224.64 |
$98.28
|
|
Screw cortex 2.0 x 10mm
|
$10,152.00 |
$10,152.00 |
$10,152.00 |
$28,563.75
|
|
Sedimentation rate erythrocyte automated
|
$64.80 |
$64.80 |
$64.80 |
$42.25
|
|
Select picture audiometry
|
$104.40 |
$104.40 |
$104.40 |
$105.60
|
|
Semen analysis presence/motility
|
$48.96 |
$48.96 |
$48.96 |
$74.75
|
|
Shoulder MRI (with and without contrast)
|
$4,085.28 |
$4,085.28 |
$4,085.28 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$3,587.04 |
$3,587.04 |
$3,587.04 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$3,338.64 |
$3,338.64 |
$3,338.64 |
$2,088.20
|
|
Shoulder X-ray
|
$515.52 |
$515.52 |
$515.52 |
$340.40
|
|
Sickling rbc
|
$41.04 |
$41.04 |
$41.04 |
$56.00
|
|
Sincalide 5 mcg solution for injection
|
$429.01 |
$429.01 |
$429.01 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,136.96 |
$2,136.96 |
$2,136.96 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$1,941.12 |
$1,941.12 |
$1,941.12 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,744.56 |
$1,744.56 |
$1,744.56 |
$1,292.04
|
|
Skin Biopsy
|
$447.84 |
$447.84 |
$447.84 |
$360.34
|
|
Slco1b1 gene com variants
|
$529.20 |
$529.20 |
$529.20 |
$220.50
|
|
Sleep Study (Polysomnography)
|
$4,370.40 |
$4,370.40 |
$4,370.40 |
$3,598.50
|
|
Sleep study unattended
|
$1,020.96 |
$1,020.96 |
$1,020.96 |
$585.00
|
|
Sling suprapubic suburetheral
|
$3,672.00 |
$3,672.00 |
$3,672.00 |
$9,197.11
|
|
Smear fluorescent and/or acid fast stain
|
$86.40 |
$86.40 |
$86.40 |
$64.00
|
|
Smear gram stain
|
$99.36 |
$99.36 |
$99.36 |
$54.03
|
|
Smear special stain inclusion bodies/parasites
|
$101.52 |
$101.52 |
$101.52 |
$71.40
|
|
Smear wet mount
|
$120.24 |
$120.24 |
$120.24 |
$66.30
|
|
Snrpn/ube3a gene
|
$373.68 |
$373.68 |
$373.68 |
$228.80
|
|
Sodium 24 hour urine
|
$82.08 |
$82.08 |
$82.08 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$43.45
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$37.19
|
|
Sodium chloride 3 % ivpb
|
$0.06 |
$0.06 |
$0.06 |
$37.80
|
|
Sodium serum/plasma/whole blood
|
$72.00 |
$72.00 |
$72.00 |
$45.50
|
|
Speech audiometry complete
|
$136.80 |
$136.80 |
$136.80 |
$109.20
|
|
Speech recep thresh
|
$76.32 |
$76.32 |
$76.32 |
$82.88
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$708.48 |
$708.48 |
$708.48 |
$543.26
|
|
St analysis behavior qualitative voice/resonance
|
$187.92 |
$187.92 |
$187.92 |
$295.10
|
|
Staph a dna amp probe
|
$177.84 |
$177.84 |
$177.84 |
$125.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$270.00 |
$270.00 |
$270.00 |
$2,301.33
|
|
Stent bili rx wallflx 10x80 uncvr
|
$162.00 |
$162.00 |
$162.00 |
$20,300.00
|
|
Sterile gauze <= 16 sq in
|
$4.32 |
$4.32 |
$4.32 |
$1.52
|
|
Sterile needle
|
$11.52 |
$11.52 |
$11.52 |
$190.13
|
|
St evaluate speech sound production comprehensive/expressive
|
$203.76 |
$203.76 |
$203.76 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$403.92 |
$403.92 |
$403.92 |
$370.50
|
|
St evaluation swallow function
|
$187.92 |
$187.92 |
$187.92 |
$309.60
|
|
Strapping of knee
|
$200.88 |
$200.88 |
$200.88 |
$206.50
|
|
Strep a dna quant
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
Strep b dna amp probe
|
$200.88 |
$200.88 |
$200.88 |
$126.10
|
|
Stress test pulmonary
|
$289.44 |
$289.44 |
$289.44 |
$322.85
|
|
Stress tte complete
|
$1,361.52 |
$1,361.52 |
$1,361.52 |
$1,797.59
|
|
St treatment speech individual
|
$110.16 |
$110.16 |
$110.16 |
$249.00
|
|
St treatment swallow dysfunction/oral
|
$103.68 |
$103.68 |
$103.68 |
$243.99
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$6.21 |
$6.21 |
$6.21 |
$54.55
|
|
Sulfonylurea screen qn-sendout
|
$152.64 |
$152.64 |
$152.64 |
$151.45
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$38.02 |
$38.02 |
$38.02 |
$122.16
|
|
Surgical pathology level 1 gross examination only
|
$136.80 |
$136.80 |
$136.80 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$259.92 |
$259.92 |
$259.92 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$324.00 |
$324.00 |
$324.00 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$410.40 |
$410.40 |
$410.40 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$746.64 |
$746.64 |
$746.64 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,029.60 |
$1,029.60 |
$1,029.60 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$44.64 |
$44.64 |
$44.64 |
$43.20
|
|
Susceptibility enzyme detection per enzyme
|
$20.88 |
$20.88 |
$20.88 |
$35.40
|
|
Susceptibility mic per plate
|
$208.80 |
$208.80 |
$208.80 |
$104.58
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$42.48 |
$42.48 |
$42.48 |
$40.00
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,424.00 |
$8,424.00 |
$8,424.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$127.44 |
$127.44 |
$127.44 |
$99.00
|
|
T3 (triiodothyronine) total
|
$117.36 |
$117.36 |
$117.36 |
$93.52
|
|
T4 (thyroxine) free
|
$141.12 |
$141.12 |
$141.12 |
$84.15
|
|
T4 (thyroxine) total
|
$74.88 |
$74.88 |
$74.88 |
$67.10
|
|
Tacrolimus therapeutic drug level
|
$79.92 |
$79.92 |
$79.92 |
$120.60
|
|
Target gsa panel hmtlmph neop
|
$6,035.04 |
$6,035.04 |
$6,035.04 |
$2,160.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,382.04 |
$1,382.04 |
$1,382.04 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$126.00 |
$126.00 |
$126.00 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$238.32 |
$238.32 |
$238.32 |
$175.92
|
|
Tc-99m non-heu per study dose
|
$18.72 |
$18.72 |
$18.72 |
$6.50
|
|
T cells absolute cd4/cd8 including ratio
|
$185.04 |
$185.04 |
$185.04 |
$175.00
|
|
T cells absolute cd 4 count
|
$33.84 |
$33.84 |
$33.84 |
$110.72
|
|
T cells total count
|
$175.68 |
$175.68 |
$175.68 |
$123.00
|
|
Telehealth original site facility fee
|
$99.36 |
$99.36 |
$99.36 |
$51.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$573.51 |
$573.51 |
$573.51 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$13.82 |
$13.82 |
$13.82 |
$37.76
|
|
Test stress cardiovascular tracing only
|
$1,567.44 |
$1,567.44 |
$1,567.44 |
$949.92
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$112.32 |
$112.32 |
$112.32 |
$108.00
|
|
Therapeutic procd strg endur
|
$66.96 |
$66.96 |
$66.96 |
$83.16
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$28.80 |
$28.80 |
$28.80 |
$55.98
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$28.08 |
$28.08 |
$28.08 |
$50.00
|
