|
Skull X-ray (1 to 3 views)
|
$182.00 |
$182.00 |
$182.00 |
$294.66
|
|
Skull X-ray (complete)
|
$338.00 |
$338.00 |
$338.00 |
$423.15
|
|
Sleep Study (Polysomnography)
|
$3,779.10 |
$3,779.10 |
$3,779.10 |
$3,734.50
|
|
Sleep study unattended
|
$653.00 |
$653.00 |
$653.00 |
$594.00
|
|
Sleeve fing rolyan med
|
$37.65 |
$37.65 |
$37.65 |
$203.58
|
|
Sleeve irr assura 1pc disp
|
$0.65 |
$0.65 |
$0.65 |
$0.65
|
|
Sling arm deluxe w/pad xs
|
$529.06 |
$529.06 |
$529.06 |
$30.35
|
|
Sling pelv split sam med
|
$165.55 |
$165.55 |
$165.55 |
$150.00
|
|
Sling suprapubic suburetheral
|
$9,679.96 |
$9,679.96 |
$9,679.96 |
$9,679.96
|
|
Sm-153 lexidron ther
|
$57,456.00 |
$57,456.00 |
$57,456.00 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$365.95 |
$365.95 |
$365.95 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$50.70 |
$50.70 |
$50.70 |
$64.20
|
|
Smear gram stain
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$55.42
|
|
Smear special stain inclusion bodies/parasites
|
$100.10 |
$100.10 |
$100.10 |
$73.15
|
|
Smear wet mount
|
$70.20 |
$70.20 |
$70.20 |
$67.49
|
|
Sock wool above knee
|
$158.68 |
$158.68 |
$158.68 |
$51.18
|
|
Sodium 24 hour urine
|
$44.85 |
$44.85 |
$44.85 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$23,334.26 |
$23,334.26 |
$23,334.26 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$23,203.65 |
$23,203.65 |
$23,203.65 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$24,687.86 |
$24,687.86 |
$24,687.86 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$30.00 |
$30.00 |
$30.00 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$40.85 |
$40.85 |
$40.85 |
$80.73
|
|
Sodium serum/plasma/whole blood
|
$260.00 |
$260.00 |
$260.00 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$495.00 |
$495.00 |
$495.00 |
$177.52
|
|
Sp bone agrft morsel add-on
|
$75,121.10 |
$75,121.10 |
$75,121.10 |
$406.40
|
|
Sp bone agrft struct add-on
|
$72,062.62 |
$72,062.62 |
$72,062.62 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$86,480.76 |
$86,480.76 |
$86,480.76 |
$498.55
|
|
Special radiation dosimetry
|
$415.35 |
$415.35 |
$415.35 |
$392.50
|
|
Special radiation treatment
|
$1,960.40 |
$1,960.40 |
$1,960.40 |
$2,052.00
|
|
Special teletx port plan
|
$1,037.40 |
$1,037.40 |
$1,037.40 |
$1,095.05
|
|
Specific gravity body fluid
|
$39.00 |
$39.00 |
$39.00 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$276.25 |
$276.25 |
$276.25 |
$385.00
|
|
Speech Therapy Session (one-on-one)
|
$216.45 |
$216.45 |
$216.45 |
$248.30
|
|
Spinal bone allograftstructural 20931
|
$94,507.40 |
$94,507.40 |
$94,507.40 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$86,113.86 |
$86,113.86 |
$86,113.86 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,785.55 |
$1,785.55 |
$1,785.55 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$60,206.23 |
$60,206.23 |
$60,206.23 |
$251.00
|
|
Splint arm vnyl coated padded lft med
|
$16.25 |
$16.25 |
$16.25 |
$48.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$43.09 |
$43.09 |
$43.09 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$50.38 |
$50.38 |
$50.38 |
$71.44
|
|
Splint finger 4 prong foam sm
|
$0.55 |
$0.55 |
$0.55 |
$34.00
|
|
Splint finger fold over sm
|
$0.44 |
$0.44 |
$0.44 |
$146.88
|
|
Splint finger frog med
|
$0.54 |
$0.54 |
$0.54 |
$38.08
|
|
Splint fing stax assort 1-7in
|
$1.04 |
$1.04 |
$1.04 |
$5.60
|
|
Splint func pos polyflex ii med
|
$33.60 |
$33.60 |
$33.60 |
$61.64
|
|
Splint rstrc wrst/cmc right med
|
$101.18 |
$101.18 |
$101.18 |
$99.04
|
|
Sr-89 stront chlor ther / mci
|
$40,862.00 |
$40,862.00 |
$40,862.00 |
$2,515.15
|
|
St analysis behavior qualitative voice/resonance
|
$228.80 |
$228.80 |
$228.80 |
$297.60
|
|
Staph a dna amp probe
|
$100.10 |
$100.10 |
$100.10 |
$125.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$45,431.10 |
$45,431.10 |
$45,431.10 |
$21,568.80
|
|
Stent axios caut enh 15x10mm electrocaut
|
$32,403.15 |
$32,403.15 |
$32,403.15 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$6,063.30 |
$6,063.30 |
$6,063.30 |
$2,649.79
|
|
Stent bili rx wallflx 10x80 uncvr
|
$18,714.49 |
$18,714.49 |
$18,714.49 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$4,918.86 |
$4,918.86 |
$4,918.86 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$91,192.46 |
$91,192.46 |
$91,192.46 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$7,801.95 |
$7,801.95 |
$7,801.95 |
$8,948.40
|
|
Stereoscopic x-ray guidance
|
$236.00 |
$236.00 |
$236.00 |
$136.00
|
|
St evaluate speech sound production
|
$228.80 |
$228.80 |
$228.80 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$1,412.00 |
$1,412.00 |
$1,412.00 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,120.60 |
$1,120.60 |
$1,120.60 |
$1,342.00
|
|
Strap chin dlx f/cpap
|
$34.90 |
$34.90 |
$34.90 |
$34.90
|
|
Strap montgmry ns 8 hl sht 7.25 x 11.25in
|
$0.25 |
$0.25 |
$0.25 |
$5.04
|
|
Strapping of hand or finger
|
$105.00 |
$105.00 |
$105.00 |
$174.82
|
|
Stress test pulmonary
|
$202.15 |
$202.15 |
$202.15 |
$324.00
|
|
Stress tte complete
|
$945.10 |
$945.10 |
$945.10 |
$1,894.20
|
|
Str markers specimen anal
|
$1,240.85 |
$1,240.85 |
$1,240.85 |
$751.50
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$316.00 |
$316.00 |
$316.00 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$304.00 |
$304.00 |
$304.00 |
$216.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$77.20 |
$77.20 |
$77.20 |
$54.80
|
|
Suction lipectomy trunk
|
$53,854.76 |
$53,854.76 |
$53,854.76 |
$4,385.50
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$3,881.35 |
$3,881.35 |
$3,881.35 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$57.70 |
$57.70 |
$57.70 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$148.93 |
$148.93 |
$148.93 |
$126.63
|
|
Support clav 29.6-40.5in med
|
$94.19 |
$94.19 |
$94.19 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$87.10 |
$87.10 |
$87.10 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$181.35 |
$181.35 |
$181.35 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$202.80 |
$202.80 |
$202.80 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$9,342.77 |
$9,342.77 |
$9,342.77 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$324.35 |
$324.35 |
$324.35 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$445.90 |
$445.90 |
$445.90 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$55.25 |
$55.25 |
$55.25 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$28.60 |
$28.60 |
$28.60 |
$35.75
|
|
Susceptibility mic per plate
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$105.75
|
|
Svc venogram s&i
|
$1,990.95 |
$1,990.95 |
$1,990.95 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$731.00 |
$731.00 |
$731.00 |
$316.55
|
|
Swallowing Therapy Session
|
$206.05 |
$206.05 |
$206.05 |
$240.31
|
|
Synch audio-only est low 20
|
$160.00 |
$160.00 |
$160.00 |
$90.60
|
|
Synch audio-only est mod 30
|
$235.00 |
$235.00 |
$235.00 |
$136.64
|
|
Synvisc or synvisc-one
|
$272.00 |
$272.00 |
$272.00 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$44.85 |
$44.85 |
$44.85 |
$41.60
|
|
System cardiomems hosp electronics
|
$24,023.02 |
$24,023.02 |
$24,023.02 |
$38,234.70
|
|
System pacing micra av
|
$16,760.25 |
$16,760.25 |
$16,760.25 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$27,099.09 |
$27,099.09 |
$27,099.09 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$8,955.20 |
$8,955.20 |
$8,955.20 |
$11,183.00
|
|
System sealant biosentry tract
|
$652.35 |
$652.35 |
$652.35 |
$889.35
|
|
T3 (triiodothyronine) free
|
$109.85 |
$109.85 |
$109.85 |
$100.32
|
|
T3 (triiodothyronine) total
|
$813.00 |
$813.00 |
$813.00 |
$93.52
|
|
T4 (thyroxine) free
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$88.44
|
|
T4 (thyroxine) total
|
$55.25 |
$55.25 |
$55.25 |
$69.58
|
