|
Sinus X-ray (complete)
|
$242.50 |
$242.50 |
$242.50 |
$346.45
|
|
Sinus X-ray (limited)
|
$160.00 |
$160.00 |
$160.00 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$287.50 |
$287.50 |
$287.50 |
$83.85
|
|
Skin Biopsy
|
$212.50 |
$212.50 |
$212.50 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$290.00 |
$290.00 |
$290.00 |
$294.45
|
|
Skull X-ray (complete)
|
$437.50 |
$437.50 |
$437.50 |
$417.50
|
|
Sleep Study (Polysomnography)
|
$3,235.00 |
$3,235.00 |
$3,235.00 |
$3,734.50
|
|
Sleep study unattended
|
$495.00 |
$495.00 |
$495.00 |
$594.00
|
|
Sleeve fing rolyan med
|
$235.00 |
$235.00 |
$235.00 |
$203.58
|
|
Sling suprapubic suburetheral
|
$13,837.20 |
$13,837.20 |
$13,837.20 |
$9,679.96
|
|
Slp ther svc non-spch gen
|
$172.50 |
$172.50 |
$172.50 |
$188.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$397.50 |
$397.50 |
$397.50 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$47.50 |
$47.50 |
$47.50 |
$64.35
|
|
Smear gram stain
|
$45.00 |
$45.00 |
$45.00 |
$55.55
|
|
Smear nasal eosinophil
|
$50.00 |
$50.00 |
$50.00 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$60.00 |
$60.00 |
$60.00 |
$73.50
|
|
Smear wet mount
|
$32.50 |
$32.50 |
$32.50 |
$67.55
|
|
Smpd1 gene common variants
|
$140.00 |
$140.00 |
$140.00 |
$133.84
|
|
Sodium 24 hour urine
|
$47.50 |
$47.50 |
$47.50 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$87.32 |
$87.32 |
$87.32 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$61.28 |
$61.28 |
$61.28 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$60.48 |
$60.48 |
$60.48 |
$37.64
|
|
Sodium serum/plasma/whole blood
|
$45.00 |
$45.00 |
$45.00 |
$46.26
|
|
Special physics consult
|
$485.00 |
$485.00 |
$485.00 |
$725.00
|
|
Special radiation dosimetry
|
$525.00 |
$525.00 |
$525.00 |
$392.50
|
|
Special radiation treatment
|
$1,945.00 |
$1,945.00 |
$1,945.00 |
$2,052.00
|
|
Special teletx port plan
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$1,095.05
|
|
Specimen fat stain
|
$40.00 |
$40.00 |
$40.00 |
$37.40
|
|
Speech and Language Evaluation (comprehensive)
|
$525.00 |
$525.00 |
$525.00 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$220.00 |
$220.00 |
$220.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$755.00 |
$755.00 |
$755.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$220.00 |
$220.00 |
$220.00 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$380.00 |
$380.00 |
$380.00 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$55.00 |
$55.00 |
$55.00 |
$71.44
|
|
Splint finger frog med
|
$35.00 |
$35.00 |
$35.00 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$100.00 |
$100.00 |
$100.00 |
$99.04
|
|
Split blood or products
|
$202.50 |
$202.50 |
$202.50 |
$127.80
|
|
Srs linear based
|
$16,170.00 |
$16,170.00 |
$16,170.00 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$405.00 |
$405.00 |
$405.00 |
$297.60
|
|
Staph a dna amp probe
|
$157.50 |
$157.50 |
$157.50 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$332.50 |
$332.50 |
$332.50 |
$286.00
|
|
Stem cells total count
|
$212.50 |
$212.50 |
$212.50 |
$194.25
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$13,600.00 |
$13,600.00 |
$13,600.00 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$26,739.48 |
$26,739.48 |
$26,739.48 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$347.72 |
$347.72 |
$347.72 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$5,784.79 |
$5,784.79 |
$5,784.79 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$20,120.00 |
$20,120.00 |
$20,120.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$6,255.00 |
$6,255.00 |
$6,255.00 |
$8,925.76
|
|
Stent placemt retro carotid
|
$4,555.00 |
$4,555.00 |
$4,555.00 |
$5,328.00
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$13,395.00 |
$13,395.00 |
$13,395.00 |
$16,098.16
|
|
St evaluate speech sound production
|
$262.50 |
$262.50 |
$262.50 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$327.50 |
$327.50 |
$327.50 |
$400.00
|
|
Stimulants synthetic
|
$122.50 |
$122.50 |
$122.50 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$1,345.40
|
|
Strep a ag ia
|
$20.00 |
$20.00 |
$20.00 |
$75.40
|
|
Strep b dna amp probe
|
$172.50 |
$172.50 |
$172.50 |
$124.15
|
|
Stress test pulmonary
|
$247.50 |
$247.50 |
$247.50 |
$324.00
|
|
Stress tte complete
|
$1,685.00 |
$1,685.00 |
$1,685.00 |
$1,900.96
|
|
Str markers specimen anal
|
$1,170.00 |
$1,170.00 |
$1,170.00 |
$756.60
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$4,168.29 |
$4,168.29 |
$4,168.29 |
$7,487.55
|
|
Sulfonylurea screen qn-sendout
|
$230.00 |
$230.00 |
$230.00 |
$158.75
|
|
Surgical pathology level 1 gross examination only
|
$117.50 |
$117.50 |
$117.50 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$137.50 |
$137.50 |
$137.50 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$187.50 |
$187.50 |
$187.50 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$237.50 |
$237.50 |
$237.50 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$675.00 |
$675.00 |
$675.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,010.00 |
$1,010.00 |
$1,010.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$25.00 |
$25.00 |
$25.00 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$27.50 |
$27.50 |
$27.50 |
$35.89
|
|
Susceptibility mic per plate
|
$60.00 |
$60.00 |
$60.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$75.00 |
$75.00 |
$75.00 |
$59.28
|
|
Svc venogram s&i
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$200.00 |
$200.00 |
$200.00 |
$316.80
|
|
Swallowing Therapy Session
|
$245.00 |
$245.00 |
$245.00 |
$232.56
|
|
Sweat collection by iontophoresis
|
$177.50 |
$177.50 |
$177.50 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$37.50 |
$37.50 |
$37.50 |
$42.24
|
|
System cardiomems hosp electronics
|
$42,417.25 |
$42,417.25 |
$42,417.25 |
$38,234.70
|
|
System pacing micra av
|
$27,067.30 |
$27,067.30 |
$27,067.30 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,936.20 |
$5,936.20 |
$5,936.20 |
$12,003.00
|
|
System sealant biosentry tract
|
$635.78 |
$635.78 |
$635.78 |
$889.35
|
|
T3 (triiodothyronine) free
|
$82.50 |
$82.50 |
$82.50 |
$100.32
|
|
T3 (triiodothyronine) total
|
$62.50 |
$62.50 |
$62.50 |
$93.52
|
|
T4 (thyroxine) free
|
$65.00 |
$65.00 |
$65.00 |
$89.60
|
|
T4 (thyroxine) total
|
$85.00 |
$85.00 |
$85.00 |
$70.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$31.11 |
$31.11 |
$31.11 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$122.50 |
$122.50 |
$122.50 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$237.50 |
$237.50 |
$237.50 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$2,320.00 |
$2,320.00 |
$2,320.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$3,385.00 |
$3,385.00 |
$3,385.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,270.00 |
$2,270.00 |
$2,270.00 |
$1,701.91
|
|
Tavr perq femoral
|
$14,800.00 |
$14,800.00 |
$14,800.00 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$290.00 |
$290.00 |
$290.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$247.50 |
$247.50 |
$247.50 |
$179.95
|
|
Tc-99m exame autol wbc diag per dose
|
$1,314.50 |
$1,314.50 |
$1,314.50 |
$2,503.15
|
|
Tc-99m maa
|
$150.00 |
$150.00 |
$150.00 |
$312.06
|
|
Tc-99m non-heu per study dose
|
$5.00 |
$5.00 |
$5.00 |
$8.00
|
|
Tc-99m sestamibi p study dose
|
$257.50 |
$257.50 |
$257.50 |
$287.20
|
|
Tc-99m tilmanocept diag
|
$320.00 |
$320.00 |
$320.00 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$237.50 |
$237.50 |
$237.50 |
$184.00
|
|
T cells absolute cd 4 count
|
$95.00 |
$95.00 |
$95.00 |
$111.20
|
