|
Sodium 24 hour urine
|
$99.00 |
$99.00 |
$99.00 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$49.07 |
$49.07 |
$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
|
|
Special physics consult
|
$1,099.80 |
$1,099.80 |
$1,099.80 |
$688.05
|
|
Special radiation dosimetry
|
$676.80 |
$676.80 |
$676.80 |
$482.08
|
|
Special radiation treatment
|
$3,580.80 |
$3,580.80 |
$3,580.80 |
$1,945.00
|
|
Special teletx port plan
|
$1,456.80 |
$1,456.80 |
$1,456.80 |
$1,035.60
|
|
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
|
$44.40 |
$44.40 |
$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 |
$525.20
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$1,022.40 |
$1,022.40 |
$1,022.40 |
$542.40
|
|
Splint finger 4 prong foam sm
|
$22.20 |
$22.20 |
$22.20 |
$20.80
|
|
Split blood or products
|
$97.20 |
$97.20 |
$97.20 |
$143.64
|
|
Srs linear based
|
$20,627.40 |
$20,627.40 |
$20,627.40 |
$14,124.25
|
|
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
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$38,692.80 |
$38,692.80 |
$38,692.80 |
$28,126.65
|
|
Stent iliac/open or perc/uni/init 37221
|
$26,824.20 |
$26,824.20 |
$26,824.20 |
$19,385.83
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$26,824.20 |
$26,824.20 |
$26,824.20 |
$10,086.20
|
|
Stent placemt retro carotid
|
$11,623.20 |
$11,623.20 |
$11,623.20 |
$5,623.15
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$27,333.00 |
$27,333.00 |
$27,333.00 |
$24,161.40
|
|
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 |
$323.05
|
|
Strapping of ankle and/or ft 29540
|
$93.60 |
$93.60 |
$93.60 |
$185.36
|
|
Strapping of chest
|
$141.60 |
$141.60 |
$141.60 |
$196.93
|
|
Strapping of knee
|
$107.40 |
$107.40 |
$107.40 |
$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
|
|
Streptomycin injection
|
$41.56 |
$41.56 |
$41.56 |
$26.21
|
|
Streptozocin injection
|
$397.01 |
$397.01 |
$397.01 |
$459.11
|
|
Stress test pulmonary
|
$482.40 |
$482.40 |
$482.40 |
$330.63
|
|
Stress tte complete
|
$2,572.80 |
$2,572.80 |
$2,572.80 |
$1,989.60
|
|
Str markers spec anal addl
|
$264.00 |
$264.00 |
$264.00 |
$479.17
|
|
Str markers specimen anal
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$978.25
|
|
St treatment speech individual
|
$190.20 |
$190.20 |
$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
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.71 |
$50.71 |
$50.71 |
$50.71
|
|
Support clav 29.6-40.5in med
|
$57.00 |
$57.00 |
$57.00 |
$105.75
|
|
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 |
$137.50
|
|
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 |
$32.50
|
|
Susceptibility mic per plate
|
$163.80 |
$163.80 |
$163.80 |
$89.70
|
|
Svc venogram s&i
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$165.60 |
$165.60 |
$165.60 |
$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 |
$90.40
|
|
T3 (triiodothyronine) total
|
$363.60 |
$363.60 |
$363.60 |
$83.40
|
|
T4 (thyroxine) free
|
$304.80 |
$304.80 |
$304.80 |
$65.00
|
|
T4 (thyroxine) total
|
$172.20 |
$172.20 |
$172.20 |
$59.80
|
|
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 hmtlmph neop
|
$1,928.40 |
$1,928.40 |
$1,928.40 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$3,567.96
|
|
Tas congenital car anomal
|
$11,593.20 |
$11,593.20 |
$11,593.20 |
$6,003.27
|
|
Tavr perq femoral
|
$19,833.60 |
$19,833.60 |
$19,833.60 |
$15,614.00
|
|
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
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$222.00 |
$222.00 |
$222.00 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$332.40 |
$332.40 |
$332.40 |
$178.40
|
|
Tc-99m bicisate
|
$2,398.20 |
$2,398.20 |
$2,398.20 |
$2,398.20
|
|
Tc-99m exame autol wbc diag per dose
|
$2,393.40 |
$2,393.40 |
$2,393.40 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$2,236.65
|
|
Tc-99m labeled rbc
|
$302.40 |
$302.40 |
$302.40 |
$312.70
|
|
Tc-99m maa
|
$1,019.40 |
$1,019.40 |
$1,019.40 |
$306.60
|
|
Tc-99m mebrofenin
|
$58.80 |
$58.80 |
$58.80 |
$169.53
|
|
Tc-99m medronate
|
$69.00 |
$69.00 |
$69.00 |
$120.35
|
|
Tc-99m mertiatide
|
$465.60 |
$465.60 |
$465.60 |
$757.25
|
|
Tc-99m non-heu per study dose
|
$6.00 |
$6.00 |
$6.00 |
$10.00
|
|
Tc-99m oxidronate
|
$63.60 |
$63.60 |
$63.60 |
$132.05
|
|
Tc-99m pentetate dtpa
|
$222.60 |
$222.60 |
$222.60 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$190.80 |
$190.80 |
$190.80 |
$231.60
|
|
Tc-99m pertechnetate per mci
|
$17.40 |
$17.40 |
$17.40 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$94.20 |
$94.20 |
$94.20 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$55.80 |
$55.80 |
$55.80 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$2,315.40 |
$2,315.40 |
$2,315.40 |
$1,749.60
|
|
Tc-99m sulfur colloid
|
$912.00 |
$912.00 |
$912.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$68.40 |
$68.40 |
$68.40 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,007.79
|
