|
Shoulder MRI (with contrast)
|
$4,198.32 |
$4,198.32 |
$4,198.32 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$3,339.36 |
$3,339.36 |
$3,339.36 |
$2,065.05
|
|
Shoulder X-ray
|
$590.40 |
$590.40 |
$590.40 |
$339.50
|
|
Shunt glaucoma baerveldt 350mm
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
$4,636.80
|
|
Sialidase enzyme assay
|
$66.96 |
$66.96 |
$66.96 |
$54.60
|
|
Sickling rbc
|
$77.76 |
$77.76 |
$77.76 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$1,380.85 |
$1,380.85 |
$1,380.85 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$3,584.88 |
$3,584.88 |
$3,584.88 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$3,072.24 |
$3,072.24 |
$3,072.24 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,559.60 |
$2,559.60 |
$2,559.60 |
$1,292.04
|
|
Skeletal muscle relaxant 1/2
|
$84.96 |
$84.96 |
$84.96 |
$83.85
|
|
Skin Biopsy
|
$438.48 |
$438.48 |
$438.48 |
$360.34
|
|
Sleep study attended
|
$2,147.04 |
$2,147.04 |
$2,147.04 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$4,080.24 |
$4,080.24 |
$4,080.24 |
$3,607.50
|
|
Sleep study unattended
|
$352.80 |
$352.80 |
$352.80 |
$580.87
|
|
Sling suprapubic suburetheral
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$437.76 |
$437.76 |
$437.76 |
$285.09
|
|
Slp ther svc non-spch gen
|
$70.56 |
$70.56 |
$70.56 |
$188.50
|
|
Smear fluorescent and/or acid fast stain
|
$79.20 |
$79.20 |
$79.20 |
$64.20
|
|
Smear gram stain
|
$38.16 |
$38.16 |
$38.16 |
$55.25
|
|
Smear nasal eosinophil
|
$76.32 |
$76.32 |
$76.32 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$48.24 |
$48.24 |
$48.24 |
$73.15
|
|
Smear wet mount
|
$64.80 |
$64.80 |
$64.80 |
$67.49
|
|
Snrpn/ube3a gene
|
$472.32 |
$472.32 |
$472.32 |
$231.85
|
|
Sodium 24 hour urine
|
$73.44 |
$73.44 |
$73.44 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$2.28 |
$2.28 |
$2.28 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$67.32 |
$67.32 |
$67.32 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$59.04 |
$59.04 |
$59.04 |
$45.60
|
|
Somatosensory testing
|
$757.44 |
$757.44 |
$757.44 |
$816.00
|
|
Specific gravity body fluid
|
$46.08 |
$46.08 |
$46.08 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,400.40 |
$1,400.40 |
$1,400.40 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$437.76 |
$437.76 |
$437.76 |
$543.26
|
|
St analysis behavior qualitative voice/resonance
|
$338.40 |
$338.40 |
$338.40 |
$297.60
|
|
Staph a dna amp probe
|
$177.84 |
$177.84 |
$177.84 |
$125.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$33,523.20 |
$33,523.20 |
$33,523.20 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$10,584.00 |
$10,584.00 |
$10,584.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$432.00 |
$432.00 |
$432.00 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$6,264.00 |
$6,264.00 |
$6,264.00 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$14,770.08 |
$14,770.08 |
$14,770.08 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$10,091.52 |
$10,091.52 |
$10,091.52 |
$9,008.54
|
|
St evaluate speech sound production
|
$364.32 |
$364.32 |
$364.32 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$664.56 |
$664.56 |
$664.56 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$359.28 |
$359.28 |
$359.28 |
$399.60
|
|
St evaluation swallow function
|
$277.20 |
$277.20 |
$277.20 |
$314.40
|
|
Strapping of knee
|
$150.48 |
$150.48 |
$150.48 |
$205.20
|
|
Strapping of toes 29550
|
$119.52 |
$119.52 |
$119.52 |
$164.70
|
|
Strep a ag ia
|
$52.56 |
$52.56 |
$52.56 |
$75.40
|
|
Strep a dna quant
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
Strep b dna amp probe
|
$68.40 |
$68.40 |
$68.40 |
$120.90
|
|
Stress test pulmonary
|
$347.76 |
$347.76 |
$347.76 |
$322.85
|
|
Stress tte complete
|
$2,516.40 |
$2,516.40 |
$2,516.40 |
$1,870.50
|
|
Str markers specimen anal
|
$526.32 |
$526.32 |
$526.32 |
$751.50
|
|
St treatment speech individual
|
$285.84 |
$285.84 |
$285.84 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$198.72 |
$198.72 |
$198.72 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$20.51 |
$20.51 |
$20.51 |
$52.31
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.83 |
$0.83 |
$0.83 |
$82.43
|
|
Sulfonylurea screen qn-sendout
|
$239.76 |
$239.76 |
$239.76 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$540.25 |
$540.25 |
$540.25 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$120.24 |
$120.24 |
$120.24 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$163.44 |
$163.44 |
$163.44 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$289.44 |
$289.44 |
$289.44 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$289.44 |
$289.44 |
$289.44 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$889.20 |
$889.20 |
$889.20 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,426.32 |
$1,426.32 |
$1,426.32 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$77.04 |
$77.04 |
$77.04 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$25.92 |
$25.92 |
$25.92 |
$35.70
|
|
Susceptibility mic per plate
|
$138.96 |
$138.96 |
$138.96 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$65.52 |
$65.52 |
$65.52 |
$59.28
|
|
Svc venogram s&i
|
$2,314.80 |
$2,314.80 |
$2,314.80 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$147.92 |
$147.92 |
$147.92 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$54.00 |
$54.00 |
$54.00 |
$41.60
|
|
System pacing micra av
|
$7,560.00 |
$7,560.00 |
$7,560.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$164.16 |
$164.16 |
$164.16 |
$99.20
|
|
T3 (triiodothyronine) total
|
$231.12 |
$231.12 |
$231.12 |
$93.52
|
|
T4 (thyroxine) free
|
$118.80 |
$118.80 |
$118.80 |
$85.20
|
|
T4 (thyroxine) total
|
$97.20 |
$97.20 |
$97.20 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$6.44 |
$6.44 |
$6.44 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$147.60 |
$147.60 |
$147.60 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$3,061.44 |
$3,061.44 |
$3,061.44 |
$2,246.30
|
|
Target gsa panel organ neop
|
$2,489.76 |
$2,489.76 |
$2,489.76 |
$1,655.52
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$5,049.65 |
$5,049.65 |
$5,049.65 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$109.44 |
$109.44 |
$109.44 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$258.48 |
$258.48 |
$258.48 |
$177.65
|
|
Tc-99m non-heu per study dose
|
$18.72 |
$18.72 |
$18.72 |
$6.60
|
|
T cells absolute cd4/cd8 including ratio
|
$187.92 |
$187.92 |
$187.92 |
$176.40
|
|
T cells absolute cd 4 count
|
$33.84 |
$33.84 |
$33.84 |
$111.20
|
|
T cells total count
|
$136.08 |
$136.08 |
$136.08 |
$126.90
|
|
Telehealth original site facility fee
|
$66.96 |
$66.96 |
$66.96 |
$51.00
|
|
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
|
$42.34 |
$42.34 |
$42.34 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,306.80 |
$1,306.80 |
$1,306.80 |
$949.70
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$152.64 |
$152.64 |
$152.64 |
$108.00
|
|
Therapeutic procd strg endur
|
$46.08 |
$46.08 |
$46.08 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$47.52 |
$47.52 |
$47.52 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$34.56 |
$34.56 |
$34.56 |
$50.00
|
