|
Sleep study unattended
|
$148.80 |
$148.80 |
$148.80 |
$594.00
|
|
Sling arm deluxe w/pad xs
|
$177.00 |
$177.00 |
$177.00 |
$30.35
|
|
Sling suprapubic suburetheral
|
$3,395.40 |
$3,395.40 |
$3,395.40 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$103.80 |
$103.80 |
$103.80 |
$285.09
|
|
Slp ther svc non-spch gen
|
$103.80 |
$103.80 |
$103.80 |
$188.50
|
|
Sm-153 lexidron ther
|
$4,290.00 |
$4,290.00 |
$4,290.00 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$393.00 |
$393.00 |
$393.00 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$32.40 |
$32.40 |
$32.40 |
$64.35
|
|
Smear gram stain
|
$32.40 |
$32.40 |
$32.40 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$24.00 |
$24.00 |
$24.00 |
$73.50
|
|
Smear wet mount
|
$12.60 |
$12.60 |
$12.60 |
$67.55
|
|
Sodium 24 hour urine
|
$16.20 |
$16.20 |
$16.20 |
$48.98
|
|
Sodium chloride 0.9 % IV bolus
|
$75.00 |
$75.00 |
$75.00 |
$37.64
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$9.60 |
$9.60 |
$9.60 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$3.00 |
$3.00 |
$3.00 |
$46.26
|
|
Special physics consult
|
$192.60 |
$192.60 |
$192.60 |
$725.00
|
|
Special radiation dosimetry
|
$30.00 |
$30.00 |
$30.00 |
$392.50
|
|
Special radiation treatment
|
$78.00 |
$78.00 |
$78.00 |
$2,052.00
|
|
Special teletx port plan
|
$72.00 |
$72.00 |
$72.00 |
$1,095.05
|
|
Specific gravity body fluid
|
$6.00 |
$6.00 |
$6.00 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$334.80 |
$334.80 |
$334.80 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$103.80 |
$103.80 |
$103.80 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$0.60 |
$0.60 |
$0.60 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$71.40 |
$71.40 |
$71.40 |
$251.00
|
|
Splint arm vnyl coated padded lft med
|
$49.80 |
$49.80 |
$49.80 |
$48.00
|
|
Split blood or products
|
$32.40 |
$32.40 |
$32.40 |
$127.80
|
|
Srs linear based
|
$1,790.40 |
$1,790.40 |
$1,790.40 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$150.00 |
$150.00 |
$150.00 |
$297.60
|
|
Staph a dna amp probe
|
$194.40 |
$194.40 |
$194.40 |
$125.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$0.60 |
$0.60 |
$0.60 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$26,519.40 |
$26,519.40 |
$26,519.40 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$447.60 |
$447.60 |
$447.60 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$3,783.00 |
$3,783.00 |
$3,783.00 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$544.20 |
$544.20 |
$544.20 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$0.60 |
$0.60 |
$0.60 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$0.60 |
$0.60 |
$0.60 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$0.60 |
$0.60 |
$0.60 |
$16,098.16
|
|
St evaluate speech sound production
|
$150.00 |
$150.00 |
$150.00 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$265.20 |
$265.20 |
$265.20 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$318.60 |
$318.60 |
$318.60 |
$1,345.40
|
|
Strep a ag ia
|
$40.20 |
$40.20 |
$40.20 |
$75.40
|
|
Strep b dna amp probe
|
$194.40 |
$194.40 |
$194.40 |
$124.15
|
|
Streptozocin injection
|
$375.60 |
$375.60 |
$375.60 |
$785.95
|
|
Stress test pulmonary
|
$98.40 |
$98.40 |
$98.40 |
$324.00
|
|
Sugars single quant
|
$6.00 |
$6.00 |
$6.00 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$5.40 |
$5.40 |
$5.40 |
$129.89
|
|
Support clav 29.6-40.5in med
|
$86.40 |
$86.40 |
$86.40 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$32.40 |
$32.40 |
$32.40 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$40.20 |
$40.20 |
$40.20 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$64.80 |
$64.80 |
$64.80 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$97.20 |
$97.20 |
$97.20 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$162.00 |
$162.00 |
$162.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$202.80 |
$202.80 |
$202.80 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$16.20 |
$16.20 |
$16.20 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$7.80 |
$7.80 |
$7.80 |
$35.89
|
|
Susceptibility mic per plate
|
$16.20 |
$16.20 |
$16.20 |
$106.00
|
|
Svc venogram s&i
|
$0.60 |
$0.60 |
$0.60 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$138.00 |
$138.00 |
$138.00 |
$316.80
|
|
Swallowing Therapy Session
|
$138.00 |
$138.00 |
$138.00 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$16.20 |
$16.20 |
$16.20 |
$42.24
|
|
System pacing micra av
|
$6,455.40 |
$6,455.40 |
$6,455.40 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$7,971.60 |
$7,971.60 |
$7,971.60 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$24.00 |
$24.00 |
$24.00 |
$100.32
|
|
T3 (triiodothyronine) total
|
$24.00 |
$24.00 |
$24.00 |
$93.52
|
|
T4 (thyroxine) free
|
$24.00 |
$24.00 |
$24.00 |
$89.60
|
|
T4 (thyroxine) total
|
$24.00 |
$24.00 |
$24.00 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$48.60 |
$48.60 |
$48.60 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$89.40 |
$89.40 |
$89.40 |
$289.20
|
|
Target gsa panel organ neop
|
$828.00 |
$828.00 |
$828.00 |
$1,701.91
|
|
Tavr perq femoral
|
$0.60 |
$0.60 |
$0.60 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$56.40 |
$56.40 |
$56.40 |
$179.95
|
|
Tc-99m apcitide diag
|
$420.00 |
$420.00 |
$420.00 |
$1,181.70
|
|
Tc-99m diag per dose
|
$240.00 |
$240.00 |
$240.00 |
$470.40
|
|
Tc-99m disofenin
|
$51.60 |
$51.60 |
$51.60 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$576.00 |
$576.00 |
$576.00 |
$2,503.15
|
|
Tc-99m fanolesomab diag
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$2,115.12
|
|
Tc-99m labeled rbc
|
$49.20 |
$49.20 |
$49.20 |
$306.00
|
|
Tc-99m maa
|
$165.60 |
$165.60 |
$165.60 |
$312.06
|
|
Tc-99m mebrofenin
|
$48.00 |
$48.00 |
$48.00 |
$157.65
|
|
Tc-99m oxidronate
|
$15.00 |
$15.00 |
$15.00 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$22.20 |
$22.20 |
$22.20 |
$222.60
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$51.60 |
$51.60 |
$51.60 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$103.20 |
$103.20 |
$103.20 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$129.60 |
$129.60 |
$129.60 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$49.20 |
$49.20 |
$49.20 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$162.00 |
$162.00 |
$162.00 |
$184.00
|
|
T cells absolute cd 4 count
|
$81.00 |
$81.00 |
$81.00 |
$111.20
|
|
T cells total count
|
$81.00 |
$81.00 |
$81.00 |
$130.20
|
|
Telethx isodose plan cplx
|
$222.60 |
$222.60 |
$222.60 |
$1,526.85
|
|
Telethx isodose plan simple
|
$120.60 |
$120.60 |
$120.60 |
$880.61
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$77.40 |
$77.40 |
$77.40 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$8,405.40 |
$8,405.40 |
$8,405.40 |
$14,951.87
|
|
Test for porphobilinogen
|
$19.20 |
$19.20 |
$19.20 |
$33.57
|
|
Test stress cardiovascular tracing only
|
$199.20 |
$199.20 |
$199.20 |
$953.40
|
|
Test urine for porphyrins
|
$25.80 |
$25.80 |
$25.80 |
$49.98
|
|
Tetanus immune globulin inj
|
$676.80 |
$676.80 |
$676.80 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$49.20 |
$49.20 |
$49.20 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$480.00 |
$480.00 |
$480.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$182.40 |
$182.40 |
$182.40 |
$98.58
|
