|
Shoulder MRI (without contrast)
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$2,096.84
|
|
Shoulder X-ray
|
$225.00 |
$225.00 |
$225.00 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$165.00 |
$165.00 |
$165.00 |
$263.25
|
|
Shunt glaucoma baerveldt 350mm
|
$3,340.71 |
$3,340.71 |
$3,340.71 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$345.00 |
$345.00 |
$345.00 |
$355.80
|
|
Sialography s&i
|
$472.50 |
$472.50 |
$472.50 |
$499.20
|
|
Sickling rbc
|
$187.50 |
$187.50 |
$187.50 |
$59.40
|
|
Sim ang w/prs cath rad emb
|
$12,785.00 |
$12,785.00 |
$12,785.00 |
$18,145.20
|
|
Sinus CT scan (with and without contrast)
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$780.00 |
$780.00 |
$780.00 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$3,295.00 |
$3,295.00 |
$3,295.00 |
$2,517.48
|
|
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
|
$390.00 |
$390.00 |
$390.00 |
$360.34
|
|
Skin split graft addl 100sq cm 15101
|
$230.00 |
$230.00 |
$230.00 |
$1,793.40
|
|
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
|
$11,775.67 |
$11,775.67 |
$11,775.67 |
$9,679.96
|
|
Slitting of prepuce
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,376.23
|
|
Slp eval non-spch gen comm dev
|
$342.50 |
$342.50 |
$342.50 |
$285.09
|
|
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
|
$82.11 |
$82.11 |
$82.11 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$61.79 |
$61.79 |
$61.79 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$60.59 |
$60.59 |
$60.59 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$34.23 |
$34.23 |
$34.23 |
$40.61
|
|
Sodium serum/plasma/whole blood
|
$45.00 |
$45.00 |
$45.00 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$2.62 |
$2.62 |
$2.62 |
$177.52
|
|
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)
|
$470.00 |
$470.00 |
$470.00 |
$384.80
|
|
Speech audiometry complete
|
$100.00 |
$100.00 |
$100.00 |
$109.20
|
|
Speech recep thresh
|
$77.50 |
$77.50 |
$77.50 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$195.00 |
$195.00 |
$195.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,405.00 |
$1,405.00 |
$1,405.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$140.00 |
$140.00 |
$140.00 |
$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 fold over sm
|
$20.00 |
$20.00 |
$20.00 |
$146.88
|
|
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 atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$4,440.00 |
$4,440.00 |
$4,440.00 |
$4,703.00
|
|
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
|
$14,800.00 |
$14,800.00 |
$14,800.00 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$37,858.34 |
$37,858.34 |
$37,858.34 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$530.04 |
$530.04 |
$530.04 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$32,883.39 |
$32,883.39 |
$32,883.39 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$11,100.00 |
$11,100.00 |
$11,100.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,550.00 |
$3,550.00 |
$3,550.00 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$8,870.00 |
$8,870.00 |
$8,870.00 |
$16,098.16
|
|
St evaluate speech sound production
|
$390.00 |
$390.00 |
$390.00 |
$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
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$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
|
$5,773.50 |
$5,773.50 |
$5,773.50 |
$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
|
$910.00 |
$910.00 |
$910.00 |
$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
|
$260.00 |
$260.00 |
$260.00 |
$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
|
$35,343.75 |
$35,343.75 |
$35,343.75 |
$38,234.70
|
|
System pacing micra av
|
$24,316.50 |
$24,316.50 |
$24,316.50 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,051.80 |
$5,051.80 |
$5,051.80 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$12,582.38 |
$12,582.38 |
$12,582.38 |
$11,183.00
|
|
T3 (triiodothyronine) free
|
$82.50 |
$82.50 |
$82.50 |
$100.32
|
