|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$237.00 |
$237.00 |
$237.00 |
$236.64
|
|
Renal function panel
|
$351.00 |
$351.00 |
$351.00 |
$95.76
|
|
Reptilase test
|
$127.20 |
$127.20 |
$127.20 |
$65.72
|
|
#resp virpnl dfa-adenovirus
|
$163.20 |
$163.20 |
$163.20 |
$62.40
|
|
Resuscitation cardiopulmonary
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$895.44
|
|
Resuscitation delivery/birthing room
|
$676.20 |
$676.20 |
$676.20 |
$726.60
|
|
Reteplase injection
|
$3,155.69 |
$3,155.69 |
$3,155.69 |
$2,904.58
|
|
Reticulocyte automated
|
$96.00 |
$96.00 |
$96.00 |
$54.27
|
|
Reticulocyte direct measurement automated
|
$121.80 |
$121.80 |
$121.80 |
$32.50
|
|
Rheumatoid factor quantitative
|
$220.80 |
$220.80 |
$220.80 |
$59.80
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$511.80 |
$511.80 |
$511.80 |
$345.07
|
|
Ring fx reform 11-13x17mm
|
$582.00 |
$582.00 |
$582.00 |
$1,059.07
|
|
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln
|
$9,864.87 |
$9,864.87 |
$9,864.87 |
$17,105.60
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$13.05 |
$13.05 |
$13.05 |
$31.05
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$3,921.00 |
$3,921.00 |
$3,921.00 |
$5,400.67
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$251.02 |
$251.02 |
$251.02 |
$60.40
|
|
Rsv assay w/optic
|
$211.80 |
$211.80 |
$211.80 |
$64.13
|
|
Rubella antibody igg
|
$231.60 |
$231.60 |
$231.60 |
$73.05
|
|
Rubeola antibody igg
|
$199.80 |
$199.80 |
$199.80 |
$80.00
|
|
Russell viper venom diluted
|
$247.80 |
$247.80 |
$247.80 |
$73.03
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,724.60 |
$2,724.60 |
$2,724.60 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,279.80 |
$1,279.80 |
$1,279.80 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,102.20 |
$1,102.20 |
$1,102.20 |
$788.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,270.80 |
$1,270.80 |
$1,270.80 |
$507.18
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$987.00 |
$987.00 |
$987.00 |
$586.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,314.60 |
$1,314.60 |
$1,314.60 |
$691.07
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,148.40 |
$1,148.40 |
$1,148.40 |
$612.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$127.20 |
$127.20 |
$127.20 |
$27.44
|
|
Screening Mammogram
|
$295.20 |
$295.20 |
$295.20 |
$287.12
|
|
Screening prostate cancer PSA
|
$235.20 |
$235.20 |
$235.20 |
$96.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$306.00 |
$306.00 |
$306.00 |
$194.35
|
|
Sedimentation rate erythrocyte automated
|
$138.60 |
$138.60 |
$138.60 |
$37.80
|
|
Semen analysis presence/motility
|
$106.80 |
$106.80 |
$106.80 |
$79.92
|
|
Semen analysis w/count
|
$151.80 |
$151.80 |
$151.80 |
$56.44
|
|
Serial casting application 97139app
|
$76.80 |
$76.80 |
$76.80 |
$67.42
|
|
Serpina1 gene
|
$422.40 |
$422.40 |
$422.40 |
$195.65
|
|
Shoulder MRI (with and without contrast)
|
$5,884.80 |
$5,884.80 |
$5,884.80 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$4,904.40 |
$4,904.40 |
$4,904.40 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$3,922.80 |
$3,922.80 |
$3,922.80 |
$1,938.28
|
|
Shoulder X-ray
|
$519.60 |
$519.60 |
$519.60 |
$307.20
|
|
Sialidase enzyme assay
|
$99.60 |
$99.60 |
$99.60 |
$54.60
|
|
Sickling rbc
|
$137.40 |
$137.40 |
$137.40 |
$53.40
|
|
Sinus CT scan (with and without contrast)
|
$2,335.20 |
$2,335.20 |
$2,335.20 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,946.40 |
$1,946.40 |
$1,946.40 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$1,151.00
|
|
Sleep Study (Polysomnography)
|
$4,082.40 |
$4,082.40 |
$4,082.40 |
$4,043.20
|
|
Slp pure tone screening
|
$54.00 |
$54.00 |
$54.00 |
$64.50
|
|
Smear fluorescent and/or acid fast stain
|
$157.80 |
$157.80 |
$157.80 |
$50.70
|
|
Smear gram stain
|
$117.00 |
$117.00 |
$117.00 |
$48.00
|
|
Smear special stain inclusion bodies/parasites
|
$182.40 |
$182.40 |
$182.40 |
$60.00
|
|
Smear wet mount
|
$127.20 |
$127.20 |
$127.20 |
$56.13
|
|
Sodium 24 hour urine
|
$109.80 |
$109.80 |
$109.80 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$49.07 |
$49.07 |
$49.07 |
$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 serum/plasma/whole blood
|
$89.40 |
$89.40 |
$89.40 |
$42.43
|
|
Specific gravity body fluid
|
$56.40 |
$56.40 |
$56.40 |
$21.55
|
|
Speech evaluation complex
|
$786.00 |
$786.00 |
$786.00 |
$409.97
|
|
Sperm antibody test
|
$459.60 |
$459.60 |
$459.60 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,640.40 |
$1,640.40 |
$1,640.40 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$834.60 |
$834.60 |
$834.60 |
$526.80
|
|
St analysis behavior qualitative voice/resonance
|
$151.80 |
$151.80 |
$151.80 |
$295.10
|
|
Staph a dna amp probe
|
$97.80 |
$97.80 |
$97.80 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$255.00 |
$255.00 |
$255.00 |
$313.96
|
|
St evaluate speech sound production
|
$147.60 |
$147.60 |
$147.60 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$304.20 |
$304.20 |
$304.20 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$408.60 |
$408.60 |
$408.60 |
$336.00
|
|
St evaluation swallow function
|
$322.20 |
$322.20 |
$322.20 |
$323.72
|
|
Strep a ag ia
|
$165.60 |
$165.60 |
$165.60 |
$75.40
|
|
Strep b dna amp probe
|
$213.60 |
$213.60 |
$213.60 |
$124.20
|
|
Stress test pulmonary
|
$452.40 |
$452.40 |
$452.40 |
$330.63
|
|
St treatment speech individual
|
$271.80 |
$271.80 |
$271.80 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$232.20 |
$232.20 |
$232.20 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$49.13 |
$49.13 |
$49.13 |
$22.19
|
|
Sugars single quant
|
$124.20 |
$124.20 |
$124.20 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$50.71 |
$50.71 |
$50.71 |
$52.49
|
|
Surgical pathology level 1 gross examination only
|
$191.40 |
$191.40 |
$191.40 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$268.80 |
$268.80 |
$268.80 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$374.40 |
$374.40 |
$374.40 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$471.00 |
$471.00 |
$471.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$797.40 |
$797.40 |
$797.40 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$86.40 |
$86.40 |
$86.40 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$78.00 |
$78.00 |
$78.00 |
$31.85
|
|
Susceptibility mic per plate
|
$183.00 |
$183.00 |
$183.00 |
$89.70
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$98.40 |
$98.40 |
$98.40 |
$45.70
|
|
T3 (triiodothyronine) free
|
$460.20 |
$460.20 |
$460.20 |
$91.20
|
|
T3 (triiodothyronine) total
|
$357.00 |
$357.00 |
$357.00 |
$88.00
|
|
T4 (thyroxine) free
|
$307.20 |
$307.20 |
$307.20 |
$65.00
|
|
T4 (thyroxine) total
|
$194.40 |
$194.40 |
$194.40 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$542.40 |
$542.40 |
$542.40 |
$137.15
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$649.43 |
$649.43 |
$649.43 |
$760.95
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$358.80 |
$358.80 |
$358.80 |
$178.40
|
|
T cells absolute cd4/cd8 including ratio
|
$514.20 |
$514.20 |
$514.20 |
$189.60
|
|
T cells absolute cd 4 count
|
$370.80 |
$370.80 |
$370.80 |
$120.25
|
|
T cells total count
|
$190.20 |
$190.20 |
$190.20 |
$126.90
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$240.21 |
$240.21 |
$240.21 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$39.33 |
$39.33 |
$39.33 |
$39.33
|
