|
Rsv assay w/optic
|
$175.20 |
$175.20 |
$175.20 |
$64.13
|
|
Rubella antibody igg
|
$214.20 |
$214.20 |
$214.20 |
$73.05
|
|
Rubeola antibody igg
|
$142.20 |
$142.20 |
$142.20 |
$80.00
|
|
Russell viper venom diluted
|
$234.00 |
$234.00 |
$234.00 |
$73.03
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$25.22 |
$25.22 |
$25.22 |
$1,441.80
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,194.80 |
$2,194.80 |
$2,194.80 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$788.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$986.40 |
$986.40 |
$986.40 |
$507.18
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$729.00 |
$729.00 |
$729.00 |
$586.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,120.20 |
$1,120.20 |
$1,120.20 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$934.20 |
$934.20 |
$934.20 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$872.40 |
$872.40 |
$872.40 |
$527.80
|
|
Screening Mammogram
|
$249.60 |
$249.60 |
$249.60 |
$287.12
|
|
Screening prostate cancer PSA
|
$315.60 |
$315.60 |
$315.60 |
$96.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$293.40 |
$293.40 |
$293.40 |
$194.35
|
|
Sedimentation rate erythrocyte automated
|
$128.40 |
$128.40 |
$128.40 |
$37.80
|
|
Select picture audiometry
|
$110.40 |
$110.40 |
$110.40 |
$84.00
|
|
Shoe post-op mens m
|
$23.40 |
$23.40 |
$23.40 |
$29.76
|
|
Shoulder MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$1,938.28
|
|
Shoulder X-ray
|
$391.20 |
$391.20 |
$391.20 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$285.00 |
$285.00 |
$285.00 |
$342.54
|
|
Sialidase enzyme assay
|
$88.80 |
$88.80 |
$88.80 |
$54.60
|
|
Sickling rbc
|
$131.40 |
$131.40 |
$131.40 |
$53.40
|
|
Sincalide 5 mcg solution for injection
|
$309.14 |
$309.14 |
$309.14 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,151.00
|
|
Sirolimus, oral
|
$2,477.76 |
$2,477.76 |
$2,477.76 |
$19.16
|
|
Sleep Study (Polysomnography)
|
$5,539.20 |
$5,539.20 |
$5,539.20 |
$4,043.20
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$106.80 |
$106.80 |
$106.80 |
$142.35
|
|
Slp eval non-spch gen comm dev
|
$211.80 |
$211.80 |
$211.80 |
$285.09
|
|
Slp pure tone screening
|
$47.40 |
$47.40 |
$47.40 |
$64.50
|
|
Slp ther svc non-spch gen
|
$270.00 |
$270.00 |
$270.00 |
$172.50
|
|
Smear fluorescent and/or acid fast stain
|
$150.00 |
$150.00 |
$150.00 |
$50.70
|
|
Smear gram stain
|
$105.00 |
$105.00 |
$105.00 |
$48.00
|
|
Smear nasal eosinophil
|
$122.40 |
$122.40 |
$122.40 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$162.60 |
$162.60 |
$162.60 |
$60.00
|
|
Smear wet mount
|
$112.80 |
$112.80 |
$112.80 |
$56.13
|
|
Sodium 24 hour urine
|
$99.00 |
$99.00 |
$99.00 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$49.32 |
$49.32 |
$49.32 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$79.09 |
$79.09 |
$79.09 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$79.66 |
$79.66 |
$79.66 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$79.30 |
$79.30 |
$79.30 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$104.98 |
$104.98 |
$104.98 |
$28.46
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$328.05 |
$328.05 |
$328.05 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$90.60 |
$90.60 |
$90.60 |
$42.43
|
|
Specific gravity body fluid
|
$11.40 |
$11.40 |
$11.40 |
$21.55
|
|
Speech audiometry complete
|
$201.60 |
$201.60 |
$201.60 |
$112.45
|
|
Speech recep thresh
|
$90.60 |
$90.60 |
$90.60 |
$90.60
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,619.40 |
$1,619.40 |
$1,619.40 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$937.20 |
$937.20 |
$937.20 |
$526.80
|
|
Split blood or products
|
$97.20 |
$97.20 |
$97.20 |
$143.64
|
|
St analysis behavior qualitative voice/resonance
|
$132.00 |
$132.00 |
$132.00 |
$295.10
|
|
Staph a dna amp probe
|
$102.60 |
$102.60 |
$102.60 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$157.20 |
$157.20 |
$157.20 |
$313.96
|
|
Stenger test pure tone
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
St evaluate speech sound production
|
$128.40 |
$128.40 |
$128.40 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$264.00 |
$264.00 |
$264.00 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$336.00 |
$336.00 |
$336.00 |
$336.00
|
|
St evaluation swallow function
|
$240.00 |
$240.00 |
$240.00 |
$323.72
|
|
Strapping of ankle and/or ft 29540
|
$120.00 |
$120.00 |
$120.00 |
$185.36
|
|
Strapping of knee
|
$148.20 |
$148.20 |
$148.20 |
$216.34
|
|
Strep a ag ia
|
$148.20 |
$148.20 |
$148.20 |
$75.40
|
|
Strep b dna amp probe
|
$250.80 |
$250.80 |
$250.80 |
$124.20
|
|
Streptokinase 1.5 m-units inj
|
$635.54 |
$635.54 |
$635.54 |
$635.54
|
|
Streptozocin injection
|
$397.01 |
$397.01 |
$397.01 |
$400.68
|
|
Stress tte complete
|
$2,572.80 |
$2,572.80 |
$2,572.80 |
$1,989.60
|
|
St treatment speech individual
|
$253.80 |
$253.80 |
$253.80 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$211.20 |
$211.20 |
$211.20 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$49.13 |
$49.13 |
$49.13 |
$22.19
|
|
Sugars single quant
|
$98.40 |
$98.40 |
$98.40 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.71 |
$50.71 |
$50.71 |
$52.49
|
|
Supprelin la implant
|
$75,272.43 |
$75,272.43 |
$75,272.43 |
$45,560.39
|
|
Surgical pathology level 1 gross examination only
|
$184.80 |
$184.80 |
$184.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$275.40 |
$275.40 |
$275.40 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$363.60 |
$363.60 |
$363.60 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$487.20 |
$487.20 |
$487.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$794.40 |
$794.40 |
$794.40 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$910.80 |
$910.80 |
$910.80 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$184.80 |
$184.80 |
$184.80 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$128.40 |
$128.40 |
$128.40 |
$31.85
|
|
Susceptibility mic per plate
|
$163.80 |
$163.80 |
$163.80 |
$89.70
|
|
Sweat collection by iontophoresis
|
$92.40 |
$92.40 |
$92.40 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$97.20 |
$97.20 |
$97.20 |
$45.70
|
|
T3 (triiodothyronine) free
|
$517.20 |
$517.20 |
$517.20 |
$91.20
|
|
T3 (triiodothyronine) total
|
$363.60 |
$363.60 |
$363.60 |
$88.00
|
|
T4 (thyroxine) free
|
$304.80 |
$304.80 |
$304.80 |
$65.00
|
|
T4 (thyroxine) total
|
$172.20 |
$172.20 |
$172.20 |
$62.40
|
|
Tacrol astagraf ex rel oral
|
$39.65 |
$39.65 |
$39.65 |
$16.80
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$98.02 |
$98.02 |
$98.02 |
$4.87
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$612.11 |
$612.11 |
$612.11 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$487.80 |
$487.80 |
$487.80 |
$137.15
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$1,036.35 |
$1,036.35 |
$1,036.35 |
$133.80
|
|
Target gsa panel organ/hmtlmph neop
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$3,567.96
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$649.43 |
$649.43 |
$649.43 |
$760.95
|
|
Tbs techl calculation only
|
$153.60 |
$153.60 |
$153.60 |
$119.66
|
