|
Shoulder MRI (without contrast)
|
$3,591.70 |
$3,591.70 |
$3,591.70 |
$2,065.05
|
|
Shoulder X-ray
|
$623.00 |
$623.00 |
$623.00 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$523.60 |
$523.60 |
$523.60 |
$349.20
|
|
Sialidase enzyme assay
|
$62.30 |
$62.30 |
$62.30 |
$54.60
|
|
Sialography s&i
|
$1,460.20 |
$1,460.20 |
$1,460.20 |
$499.20
|
|
Sickling rbc
|
$150.50 |
$150.50 |
$150.50 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$3,440.53 |
$3,440.53 |
$3,440.53 |
$1,351.63
|
|
Sigmoidoscopy for bleeding
|
$3,413.99 |
$3,413.99 |
$3,413.99 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,355.11 |
$3,355.11 |
$3,355.11 |
$1,444.83
|
|
Sigmoidoscopy w/tumr remove
|
$3,589.49 |
$3,589.49 |
$3,589.49 |
$1,558.80
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$2,308.60 |
$2,308.60 |
$2,308.60 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$3,187.80 |
$3,187.80 |
$3,187.80 |
$1,901.90
|
|
Sim ang w/prs cath rad emb
|
$24,825.50 |
$24,825.50 |
$24,825.50 |
$18,145.20
|
|
Sincalide 5 mcg solution for injection
|
$814.97 |
$814.97 |
$814.97 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$3,656.10 |
$3,656.10 |
$3,656.10 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$3,161.20 |
$3,161.20 |
$3,161.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,606.10 |
$2,606.10 |
$2,606.10 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$2,597.00 |
$2,597.00 |
$2,597.00 |
$2,489.25
|
|
Sipuleucel-t - su
|
$421,172.66 |
$421,172.66 |
$421,172.66 |
$100,990.51
|
|
Sirolimus, oral
|
$128.97 |
$128.97 |
$128.97 |
$41.25
|
|
Skeletal muscle relaxant 1/2
|
$228.90 |
$228.90 |
$228.90 |
$83.85
|
|
Skyla, 13.5 mg
|
$5,562.20 |
$5,562.20 |
$5,562.20 |
$1,643.47
|
|
Slco1b1 gene com variants
|
$403.20 |
$403.20 |
$403.20 |
$241.24
|
|
Sleep Study (Polysomnography)
|
$3,509.80 |
$3,509.80 |
$3,509.80 |
$3,607.50
|
|
Sleeve fing rolyan med
|
$188.30 |
$188.30 |
$188.30 |
$203.58
|
|
Sling arm deluxe w/pad xs
|
$450.80 |
$450.80 |
$450.80 |
$30.35
|
|
Sling suprapubic suburetheral
|
$4,361.06 |
$4,361.06 |
$4,361.06 |
$9,679.96
|
|
Sm-153 lexidron ther
|
$28,298.90 |
$28,298.90 |
$28,298.90 |
$7,320.12
|
|
Small bowel endoscopy
|
$981.40 |
$981.40 |
$981.40 |
$2,463.36
|
|
Small bowel endoscopy
|
$4,324.60 |
$4,324.60 |
$4,324.60 |
$2,244.82
|
|
Small bowel endoscopy
|
$5,375.96 |
$5,375.96 |
$5,375.96 |
$2,638.57
|
|
Small bowel endoscopy
|
$4,167.10 |
$4,167.10 |
$4,167.10 |
$2,638.57
|
|
Small bowel endoscopy
|
$4,866.40 |
$4,866.40 |
$4,866.40 |
$2,842.50
|
|
Small bowel endoscopy
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$1,620.78
|
|
Small bowel endoscopy
|
$2,193.10 |
$2,193.10 |
$2,193.10 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$3,824.80 |
$3,824.80 |
$3,824.80 |
$2,389.40
|
|
Small bowel endoscopy 44365
|
$3,395.00 |
$3,395.00 |
$3,395.00 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$7,968.45 |
$7,968.45 |
$7,968.45 |
$2,413.20
|
|
Small bowel endoscopy br/wa
|
$6,678.20 |
$6,678.20 |
$6,678.20 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$2,164.40 |
$2,164.40 |
$2,164.40 |
$2,381.60
|
|
Smear fluorescent and/or acid fast stain
|
$74.20 |
$74.20 |
$74.20 |
$64.20
|
|
Smear gram stain
|
$95.90 |
$95.90 |
$95.90 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$127.40 |
$127.40 |
$127.40 |
$73.15
|
|
Smear wet mount
|
$90.30 |
$90.30 |
$90.30 |
$67.49
|
|
Smpd1 gene common variants
|
$114.10 |
$114.10 |
$114.10 |
$133.84
|
|
Snrpn/ube3a gene
|
$610.40 |
$610.40 |
$610.40 |
$231.85
|
|
So cap design without jnts cf
|
$596.40 |
$596.40 |
$596.40 |
$606.35
|
|
Sodium 24 hour urine
|
$56.00 |
$56.00 |
$56.00 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$279.65 |
$279.65 |
$279.65 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$279.65 |
$279.65 |
$279.65 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$279.65 |
$279.65 |
$279.65 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$309.05 |
$309.05 |
$309.05 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$418.25 |
$418.25 |
$418.25 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$51.80 |
$51.80 |
$51.80 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$22.92 |
$22.92 |
$22.92 |
$177.52
|
|
So neo gsap dna mcrstl ins
|
$1,831.90 |
$1,831.90 |
$1,831.90 |
$2,296.00
|
|
Special physics consult
|
$14,184.80 |
$14,184.80 |
$14,184.80 |
$725.00
|
|
Special radiation treatment
|
$25,070.50 |
$25,070.50 |
$25,070.50 |
$1,986.00
|
|
Special teletx port plan
|
$15,739.50 |
$15,739.50 |
$15,739.50 |
$1,086.99
|
|
Specific gravity body fluid
|
$26.60 |
$26.60 |
$26.60 |
$22.00
|
|
Speech audiometry complete
|
$89.60 |
$89.60 |
$89.60 |
$109.20
|
|
Sperm antibody test
|
$262.50 |
$262.50 |
$262.50 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$4,091.68 |
$4,091.68 |
$4,091.68 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$529.90 |
$529.90 |
$529.90 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$664.30 |
$664.30 |
$664.30 |
$392.09
|
|
Splint finger fold over sm
|
$158.20 |
$158.20 |
$158.20 |
$146.88
|
|
Splint rstrc wrst/cmc right med
|
$369.60 |
$369.60 |
$369.60 |
$99.04
|
|
Split blood or products
|
$125.30 |
$125.30 |
$125.30 |
$127.48
|
|
Srs cranial lesion complex
|
$9,470.30 |
$9,470.30 |
$9,470.30 |
$3,244.00
|
|
Srs cranial lesion simple
|
$6,274.10 |
$6,274.10 |
$6,274.10 |
$2,384.00
|
|
Srs cran les simple addl
|
$1,498.70 |
$1,498.70 |
$1,498.70 |
$719.20
|
|
Srs linear based
|
$25,706.80 |
$25,706.80 |
$25,706.80 |
$13,585.00
|
|
Srs multisource
|
$65,189.60 |
$65,189.60 |
$65,189.60 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$769.30 |
$769.30 |
$769.30 |
$297.60
|
|
Staph a dna amp probe
|
$180.60 |
$180.60 |
$180.60 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$277.20 |
$277.20 |
$277.20 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$100,938.33 |
$100,938.33 |
$100,938.33 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$49,244.78 |
$49,244.78 |
$49,244.78 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$4,515.41 |
$4,515.41 |
$4,515.41 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$43,603.98 |
$43,603.98 |
$43,603.98 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$44,443.22 |
$44,443.22 |
$44,443.22 |
$14,356.50
|
|
Sterile water/saline, 10 ml
|
$279.65 |
$279.65 |
$279.65 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$926.97 |
$926.97 |
$926.97 |
$28.11
|
|
St evaluate speech sound production
|
$787.50 |
$787.50 |
$787.50 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$564.20 |
$564.20 |
$564.20 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$893.90 |
$893.90 |
$893.90 |
$399.60
|
|
St evaluation swallow function
|
$709.10 |
$709.10 |
$709.10 |
$314.40
|
|
Strapping of ankle and/or ft 29540
|
$592.90 |
$592.90 |
$592.90 |
$223.45
|
|
Strep b dna amp probe
|
$131.60 |
$131.60 |
$131.60 |
$120.90
|
|
Stress test pulmonary
|
$228.90 |
$228.90 |
$228.90 |
$322.85
|
|
Stress tte complete
|
$4,490.50 |
$4,490.50 |
$4,490.50 |
$1,870.50
|
|
Str markers spec anal addl
|
$703.50 |
$703.50 |
$703.50 |
$479.17
|
|
Str markers specimen anal
|
$1,036.70 |
$1,036.70 |
$1,036.70 |
$751.50
|
|
St treatment speech individual
|
$355.60 |
$355.60 |
$355.60 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$517.30 |
$517.30 |
$517.30 |
$240.31
|
|
Subtalar arthro w/deb
|
$27,227.38 |
$27,227.38 |
$27,227.38 |
$3,839.54
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$452.72 |
$452.72 |
$452.72 |
$52.31
|
|
Sugars single quant
|
$202.30 |
$202.30 |
$202.30 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$27,613.77 |
$27,613.77 |
$27,613.77 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$315.70 |
$315.70 |
$315.70 |
$82.43
|
