|
Small bowel endoscopy
|
$328.80 |
$328.80 |
$328.80 |
$2,389.40
|
|
Small bowel endoscopy
|
$380.64 |
$380.64 |
$380.64 |
$2,638.57
|
|
Small bowel endoscopy
|
$515.52 |
$515.52 |
$515.52 |
$2,842.50
|
|
Small bowel endoscopy
|
$419.52 |
$419.52 |
$419.52 |
$1,620.78
|
|
Small bowel endoscopy
|
$205.92 |
$205.92 |
$205.92 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$256.32 |
$256.32 |
$256.32 |
$2,389.40
|
|
Small bowel endoscopy 44365
|
$243.36 |
$243.36 |
$243.36 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$212.16 |
$212.16 |
$212.16 |
$2,413.20
|
|
Small bowel endoscopy/biopsy
|
$400.32 |
$400.32 |
$400.32 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$271.20 |
$271.20 |
$271.20 |
$1,924.00
|
|
Small bowel endoscopy/stent 44370
|
$356.64 |
$356.64 |
$356.64 |
$4,925.70
|
|
Smear fluorescent and/or acid fast stain
|
$94.08 |
$94.08 |
$94.08 |
$64.20
|
|
Smear gram stain
|
$55.68 |
$55.68 |
$55.68 |
$55.25
|
|
Smear nasal eosinophil
|
$44.64 |
$44.64 |
$44.64 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$121.92 |
$121.92 |
$121.92 |
$73.15
|
|
Smear wet mount
|
$68.16 |
$68.16 |
$68.16 |
$67.49
|
|
Sock fracture or equal each
|
$20.59 |
$20.59 |
$20.59 |
$74.51
|
|
Sodium 24 hour urine
|
$47.04 |
$47.04 |
$47.04 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$99.24 |
$99.24 |
$99.24 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$99.24 |
$99.24 |
$99.24 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$47.76 |
$47.76 |
$47.76 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$99.24 |
$99.24 |
$99.24 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$69.81 |
$69.81 |
$69.81 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$434.00 |
$434.00 |
$434.00 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$58.08 |
$58.08 |
$58.08 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$237.60 |
$237.60 |
$237.60 |
$177.52
|
|
Somatropin injection
|
$671.64 |
$671.64 |
$671.64 |
$2,381.48
|
|
Specific gravity body fluid
|
$21.60 |
$21.60 |
$21.60 |
$22.00
|
|
Specimen fat stain
|
$26.88 |
$26.88 |
$26.88 |
$35.10
|
|
Speech audiometry complete
|
$32.64 |
$32.64 |
$32.64 |
$109.20
|
|
Speech evaluation complex
|
$269.28 |
$269.28 |
$269.28 |
$527.06
|
|
Speech recep thresh
|
$32.64 |
$32.64 |
$32.64 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$499.68 |
$499.68 |
$499.68 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$358.56 |
$358.56 |
$358.56 |
$543.26
|
|
Splenectomy total open 38100
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$2,166.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$49.13 |
$49.13 |
$49.13 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$63.03 |
$63.03 |
$63.03 |
$34.00
|
|
Split blood or products
|
$68.64 |
$68.64 |
$68.64 |
$127.48
|
|
St analysis behavior qualitative voice/resonance
|
$577.92 |
$577.92 |
$577.92 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$577.92 |
$577.92 |
$577.92 |
$286.00
|
|
Stem cells total count
|
$499.68 |
$499.68 |
$499.68 |
$179.64
|
|
Stent axios caut enh 15x10mm electrocaut
|
$14,799.12 |
$14,799.12 |
$14,799.12 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,836.08 |
$2,836.08 |
$2,836.08 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$14,810.92 |
$14,810.92 |
$14,810.92 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$472.80 |
$472.80 |
$472.80 |
$4,939.20
|
|
Sternal debridement
|
$708.96 |
$708.96 |
$708.96 |
$1,318.40
|
|
St evaluate speech sound production
|
$577.92 |
$577.92 |
$577.92 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$285.60 |
$285.60 |
$285.60 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$577.92 |
$577.92 |
$577.92 |
$399.60
|
|
St evaluation swallow function
|
$287.04 |
$287.04 |
$287.04 |
$314.40
|
|
Strap montgmry ns 8 hl sht 7.25 x 11.25in
|
$48.60 |
$48.60 |
$48.60 |
$5.04
|
|
Strapping of ankle and/or ft 29540
|
$144.48 |
$144.48 |
$144.48 |
$223.45
|
|
Strapping of chest
|
$157.92 |
$157.92 |
$157.92 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$206.88 |
$206.88 |
$206.88 |
$154.70
|
|
Strapping of hand or finger
|
$115.68 |
$115.68 |
$115.68 |
$174.82
|
|
Strapping of hip
|
$197.28 |
$197.28 |
$197.28 |
$164.70
|
|
Strapping of knee
|
$144.48 |
$144.48 |
$144.48 |
$205.20
|
|
Strapping of toes 29550
|
$144.48 |
$144.48 |
$144.48 |
$164.70
|
|
Strep a ag ia
|
$79.68 |
$79.68 |
$79.68 |
$75.40
|
|
Strep b dna amp probe
|
$52.80 |
$52.80 |
$52.80 |
$120.90
|
|
Stress test pulmonary
|
$88.80 |
$88.80 |
$88.80 |
$322.85
|
|
Stress tte complete
|
$1,514.40 |
$1,514.40 |
$1,514.40 |
$1,870.50
|
|
St treatment speech individual
|
$745.44 |
$745.44 |
$745.44 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$734.40 |
$734.40 |
$734.40 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$99.24 |
$99.24 |
$99.24 |
$52.31
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$16,817.67 |
$16,817.67 |
$16,817.67 |
$7,345.98
|
|
Sulfonylurea screen qn-sendout
|
$231.36 |
$231.36 |
$231.36 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$365.31 |
$365.31 |
$365.31 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$16.04 |
$16.04 |
$16.04 |
$94.19
|
|
Surg dx exam anorectal
|
$138.24 |
$138.24 |
$138.24 |
$3,245.23
|
|
Surgical pathology level 1 gross examination only
|
$77.28 |
$77.28 |
$77.28 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$88.80 |
$88.80 |
$88.80 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$132.96 |
$132.96 |
$132.96 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$192.96 |
$192.96 |
$192.96 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$250.56 |
$250.56 |
$250.56 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$333.60 |
$333.60 |
$333.60 |
$718.00
|
|
Surg tx anal fistula 2nd stage 46285
|
$760.80 |
$760.80 |
$760.80 |
$3,245.23
|
|
Susceptibility agar dilution per agent
|
$40.32 |
$40.32 |
$40.32 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$40.32 |
$40.32 |
$40.32 |
$35.70
|
|
Susceptibility mic per plate
|
$99.84 |
$99.84 |
$99.84 |
$106.00
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$1,362.72 |
$1,362.72 |
$1,362.72 |
$1,995.00
|
|
Synvisc or synvisc-one
|
$987.77 |
$987.77 |
$987.77 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$32.64 |
$32.64 |
$32.64 |
$41.60
|
|
System cardiomems hosp electronics
|
$19,958.40 |
$19,958.40 |
$19,958.40 |
$39,037.95
|
|
System pacing micra av
|
$19,764.00 |
$19,764.00 |
$19,764.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$9,223.20 |
$9,223.20 |
$9,223.20 |
$12,003.00
|
|
System sealant biosentry tract
|
$502.61 |
$502.61 |
$502.61 |
$889.35
|
|
T3 (triiodothyronine) free
|
$127.68 |
$127.68 |
$127.68 |
$99.20
|
|
T3 (triiodothyronine) total
|
$55.20 |
$55.20 |
$55.20 |
$93.52
|
|
T4 (thyroxine) free
|
$80.16 |
$80.16 |
$80.16 |
$85.20
|
|
T4 (thyroxine) total
|
$68.16 |
$68.16 |
$68.16 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$201.99 |
$201.99 |
$201.99 |
$9.84
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$559.80 |
$559.80 |
$559.80 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$208.32 |
$208.32 |
$208.32 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$3,056.72 |
$3,056.72 |
$3,056.72 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$24,851.57 |
$24,851.57 |
$24,851.57 |
$21,745.13
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$972.39 |
$972.39 |
$972.39 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$230.40 |
$230.40 |
$230.40 |
$177.65
|
|
Tc-99m bicisate
|
$2,820.48 |
$2,820.48 |
$2,820.48 |
$1,969.45
|
|
Tc-99m depreotide
|
$787.20 |
$787.20 |
$787.20 |
$1,486.80
|
