|
Shoulder MRI (with contrast)
|
$445.56 |
$445.56 |
$445.56 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$233.59 |
$233.59 |
$233.59 |
$1,938.28
|
|
Shoulder X-ray
|
$266.02 |
$266.02 |
$266.02 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$133.95 |
$133.95 |
$133.95 |
$342.54
|
|
Sialidase enzyme assay
|
$6.58 |
$6.58 |
$6.58 |
$54.60
|
|
Sialography s&i
|
$173.43 |
$173.43 |
$173.43 |
$403.70
|
|
Sickling rbc
|
$10.93 |
$10.93 |
$10.93 |
$53.40
|
|
Sigmoidoscopy w/ablation
|
$893.47 |
$893.47 |
$893.47 |
$2,604.00
|
|
Sincalide 5 mcg solution for injection
|
$91.65 |
$91.65 |
$91.65 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,220.59 |
$1,220.59 |
$1,220.59 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,108.73 |
$1,108.73 |
$1,108.73 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$774.56 |
$774.56 |
$774.56 |
$1,151.00
|
|
Sinus/juglr venogram s&i
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$2,052.67
|
|
Skin Biopsy
|
$236.88 |
$236.88 |
$236.88 |
$362.40
|
|
Smear fluorescent and/or acid fast stain
|
$14.10 |
$14.10 |
$14.10 |
$50.70
|
|
Smear gram stain
|
$10.34 |
$10.34 |
$10.34 |
$48.00
|
|
Smear nasal eosinophil
|
$16.92 |
$16.92 |
$16.92 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$45.75 |
$45.75 |
$45.75 |
$60.00
|
|
Smear wet mount
|
$19.74 |
$19.74 |
$19.74 |
$56.13
|
|
Smpd1 gene common variants
|
$22.09 |
$22.09 |
$22.09 |
$127.86
|
|
Snrpn/ube3a gene
|
$23.97 |
$23.97 |
$23.97 |
$228.80
|
|
Sodium 24 hour urine
|
$9.40 |
$9.40 |
$9.40 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$20.23 |
$20.23 |
$20.23 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$21.44 |
$21.44 |
$21.44 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$21.19 |
$21.19 |
$21.19 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$28.22 |
$28.22 |
$28.22 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$22.61 |
$22.61 |
$22.61 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$8.46 |
$8.46 |
$8.46 |
$42.43
|
|
Special physics consult
|
$174.37 |
$174.37 |
$174.37 |
$688.05
|
|
Special radiation dosimetry
|
$89.30 |
$89.30 |
$89.30 |
$482.08
|
|
Special radiation treatment
|
$554.60 |
$554.60 |
$554.60 |
$1,945.00
|
|
Special teletx port plan
|
$288.58 |
$288.58 |
$288.58 |
$975.60
|
|
Specific gravity body fluid
|
$8.46 |
$8.46 |
$8.46 |
$21.55
|
|
Specimen fat stain
|
$2.82 |
$2.82 |
$2.82 |
$40.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$760.93 |
$760.93 |
$760.93 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$139.59 |
$139.59 |
$139.59 |
$526.80
|
|
Split blood or products
|
$32.90 |
$32.90 |
$32.90 |
$143.64
|
|
St analysis behavior qualitative voice/resonance
|
$215.73 |
$215.73 |
$215.73 |
$295.10
|
|
Staph a dna amp probe
|
$66.74 |
$66.74 |
$66.74 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$146.17 |
$146.17 |
$146.17 |
$313.96
|
|
Stem cells total count
|
$36.66 |
$36.66 |
$36.66 |
$135.62
|
|
St evaluate speech sound production
|
$204.45 |
$204.45 |
$204.45 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$319.13 |
$319.13 |
$319.13 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$185.18 |
$185.18 |
$185.18 |
$336.00
|
|
St evaluation swallow function
|
$204.45 |
$204.45 |
$204.45 |
$323.72
|
|
Strap montgmry ns 8 hl sht 7.25 x 11.25in
|
$15.51 |
$15.51 |
$15.51 |
$0.25
|
|
Strep a ag ia
|
$7.99 |
$7.99 |
$7.99 |
$75.40
|
|
Streptokinase antibody
|
$6.11 |
$6.11 |
$6.11 |
$17.47
|
|
Stress test pulmonary
|
$132.54 |
$132.54 |
$132.54 |
$330.63
|
|
Stress tte complete
|
$1,170.30 |
$1,170.30 |
$1,170.30 |
$1,989.60
|
|
Str markers spec anal addl
|
$143.35 |
$143.35 |
$143.35 |
$479.17
|
|
St treatment speech individual
|
$156.51 |
$156.51 |
$156.51 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$156.51 |
$156.51 |
$156.51 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$9.87 |
$9.87 |
$9.87 |
$22.19
|
|
Sugars single quant
|
$56.09 |
$56.09 |
$56.09 |
$64.28
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$32.32 |
$32.32 |
$32.32 |
$52.49
|
|
Surgical pathology level 1 gross examination only
|
$31.96 |
$31.96 |
$31.96 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$141.94 |
$141.94 |
$141.94 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$141.94 |
$141.94 |
$141.94 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$46.53 |
$46.53 |
$46.53 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$340.75 |
$340.75 |
$340.75 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$693.25 |
$693.25 |
$693.25 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$2.35 |
$2.35 |
$2.35 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$2.35 |
$2.35 |
$2.35 |
$31.85
|
|
Susceptibility mic per plate
|
$36.66 |
$36.66 |
$36.66 |
$89.70
|
|
Svc venogram s&i
|
$1,204.61 |
$1,204.61 |
$1,204.61 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$10.34 |
$10.34 |
$10.34 |
$45.70
|
|
System cardiomems hosp electronics
|
$41,360.00 |
$41,360.00 |
$41,360.00 |
$53,437.50
|
|
T3 (triiodothyronine) free
|
$16.92 |
$16.92 |
$16.92 |
$91.20
|
|
T3 (triiodothyronine) total
|
$57.34 |
$57.34 |
$57.34 |
$88.00
|
|
T4 (thyroxine) free
|
$13.63 |
$13.63 |
$13.63 |
$65.00
|
|
T4 (thyroxine) total
|
$82.25 |
$82.25 |
$82.25 |
$62.40
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$10.76 |
$10.76 |
$10.76 |
$4.87
|
|
Tacrolimus therapeutic drug level
|
$14.57 |
$14.57 |
$14.57 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$357.20 |
$357.20 |
$357.20 |
$1,928.40
|
|
Target gsa panel organ neop
|
$281.02 |
$281.02 |
$281.02 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.13 |
$1.13 |
$1.13 |
$760.95
|
|
Tbs techl calculation only
|
$78.49 |
$78.49 |
$78.49 |
$119.66
|
|
Tbs techl prep&transmis data
|
$78.49 |
$78.49 |
$78.49 |
$105.08
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$47.00 |
$47.00 |
$47.00 |
$221.65
|
|
Tcd emboli detect w/inj
|
$253.80 |
$253.80 |
$253.80 |
$475.80
|
|
Tcd emboli detect without inj
|
$226.54 |
$226.54 |
$226.54 |
$430.89
|
|
T cells absolute cd 4 count
|
$28.20 |
$28.20 |
$28.20 |
$120.25
|
|
Tee w or without fol w/cont,cong
|
$825.79 |
$825.79 |
$825.79 |
$1,826.25
|
|
Telethx isodose plan cplx
|
$242.05 |
$242.05 |
$242.05 |
$1,526.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$3,423.25 |
$3,423.25 |
$3,423.25 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$19.14 |
$19.14 |
$19.14 |
$39.33
|
|
Test for porphobilinogen
|
$2.82 |
$2.82 |
$2.82 |
$33.57
|
|
Test for urine cystines
|
$4.70 |
$4.70 |
$4.70 |
$23.20
|
|
Test pathogen(s) for platelets reference
|
$23.97 |
$23.97 |
$23.97 |
$52.00
|
|
Test stress cardiovascular tracing only
|
$746.36 |
$746.36 |
$746.36 |
$1,016.00
|
|
Test urine for lactose
|
$5.17 |
$5.17 |
$5.17 |
$15.53
|
|
Test urine for porphyrins
|
$6.11 |
$6.11 |
$6.11 |
$27.30
|
|
Test urine urobilinogen
|
$3.76 |
$3.76 |
$3.76 |
$9.60
|
|
Tetanus immune globulin inj
|
$511.29 |
$511.29 |
$511.29 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$31.49 |
$31.49 |
$31.49 |
$101.40
|
|
Therapeutic procd strg endur
|
$38.07 |
$38.07 |
$38.07 |
$72.39
|
|
Ther/proph/diag inj ia
|
$94.94 |
$94.94 |
$94.94 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$22.26 |
$22.26 |
$22.26 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$841.77 |
$841.77 |
$841.77 |
$1,658.70
|
