|
Sinus CT scan (with and without contrast)
|
$3,161.00 |
$3,161.00 |
$3,161.00 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$2,930.00 |
$2,930.00 |
$2,930.00 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,342.00 |
$2,342.00 |
$2,342.00 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$444.00 |
$444.00 |
$444.00 |
$346.45
|
|
Sinus X-ray (limited)
|
$342.00 |
$342.00 |
$342.00 |
$215.40
|
|
Skin Biopsy
|
$803.00 |
$803.00 |
$803.00 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$393.00 |
$393.00 |
$393.00 |
$294.45
|
|
Skull X-ray (complete)
|
$650.00 |
$650.00 |
$650.00 |
$417.50
|
|
Sleep Study (Polysomnography)
|
$4,804.00 |
$4,804.00 |
$4,804.00 |
$3,734.50
|
|
Sleep study unattended
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$594.00
|
|
Slp eval non-spch gen comm dev
|
$479.00 |
$479.00 |
$479.00 |
$285.09
|
|
Slp pure tone screening
|
$97.00 |
$97.00 |
$97.00 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$629.00 |
$629.00 |
$629.00 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$40.00 |
$40.00 |
$40.00 |
$64.35
|
|
Smear gram stain
|
$32.00 |
$32.00 |
$32.00 |
$55.55
|
|
Smear nasal eosinophil
|
$12.00 |
$12.00 |
$12.00 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$36.00 |
$36.00 |
$36.00 |
$73.50
|
|
Smear wet mount
|
$87.00 |
$87.00 |
$87.00 |
$67.55
|
|
Snrpn/ube3a gene
|
$260.00 |
$260.00 |
$260.00 |
$230.63
|
|
Sodium 24 hour urine
|
$42.00 |
$42.00 |
$42.00 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$20.00 |
$20.00 |
$20.00 |
$46.26
|
|
Special physics consult
|
$1,169.00 |
$1,169.00 |
$1,169.00 |
$725.00
|
|
Special radiation dosimetry
|
$988.00 |
$988.00 |
$988.00 |
$392.50
|
|
Special radiation treatment
|
$4,321.00 |
$4,321.00 |
$4,321.00 |
$2,052.00
|
|
Special teletx port plan
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$1,095.05
|
|
Speech and Language Evaluation (comprehensive)
|
$949.00 |
$949.00 |
$949.00 |
$384.80
|
|
Speech audiometry complete
|
$284.00 |
$284.00 |
$284.00 |
$109.20
|
|
Speech recep thresh
|
$209.00 |
$209.00 |
$209.00 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$249.00 |
$249.00 |
$249.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,703.00 |
$2,703.00 |
$2,703.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$359.00 |
$359.00 |
$359.00 |
$251.00
|
|
Split blood or products
|
$279.00 |
$279.00 |
$279.00 |
$127.80
|
|
Srs linear based
|
$26,944.00 |
$26,944.00 |
$26,944.00 |
$14,124.25
|
|
Srs multisource
|
$42,040.00 |
$42,040.00 |
$42,040.00 |
$35,004.79
|
|
St analysis behavior qualitative voice/resonance
|
$476.00 |
$476.00 |
$476.00 |
$297.60
|
|
Staph a dna amp probe
|
$74.00 |
$74.00 |
$74.00 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$759.00 |
$759.00 |
$759.00 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$67,680.00 |
$67,680.00 |
$67,680.00 |
$21,249.26
|
|
Stent iliac/open or perc/uni/init 37221
|
$35,038.00 |
$35,038.00 |
$35,038.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$16,730.00 |
$16,730.00 |
$16,730.00 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$35,884.00 |
$35,884.00 |
$35,884.00 |
$16,098.16
|
|
St evaluate speech sound production
|
$458.00 |
$458.00 |
$458.00 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$748.00 |
$748.00 |
$748.00 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,972.00 |
$1,972.00 |
$1,972.00 |
$1,345.40
|
|
Strapping of hand or finger
|
$434.00 |
$434.00 |
$434.00 |
$177.45
|
|
Strapping of toes 29550
|
$434.00 |
$434.00 |
$434.00 |
$164.70
|
|
Strep b dna amp probe
|
$206.00 |
$206.00 |
$206.00 |
$124.15
|
|
Stress test pulmonary
|
$681.00 |
$681.00 |
$681.00 |
$324.00
|
|
Stress tte complete
|
$3,019.00 |
$3,019.00 |
$3,019.00 |
$1,900.96
|
|
Str markers specimen anal
|
$252.00 |
$252.00 |
$252.00 |
$756.60
|
|
Surgical pathology level 1 gross examination only
|
$75.00 |
$75.00 |
$75.00 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$140.00 |
$140.00 |
$140.00 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$167.00 |
$167.00 |
$167.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$208.00 |
$208.00 |
$208.00 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$450.00 |
$450.00 |
$450.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$940.00 |
$940.00 |
$940.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$20.00 |
$20.00 |
$20.00 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$26.00 |
$26.00 |
$26.00 |
$35.89
|
|
Susceptibility mic per plate
|
$67.00 |
$67.00 |
$67.00 |
$106.00
|
|
Svc venogram s&i
|
$2,465.00 |
$2,465.00 |
$2,465.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$351.00 |
$351.00 |
$351.00 |
$316.80
|
|
Swallowing Therapy Session
|
$552.00 |
$552.00 |
$552.00 |
$232.56
|
|
Sweat collection by iontophoresis
|
$106.00 |
$106.00 |
$106.00 |
$123.78
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$46.00 |
$46.00 |
$46.00 |
$42.24
|
|
T3 (triiodothyronine) free
|
$76.00 |
$76.00 |
$76.00 |
$100.32
|
|
T4 (thyroxine) free
|
$40.00 |
$40.00 |
$40.00 |
$89.60
|
|
Tacrolimus therapeutic drug level
|
$87.00 |
$87.00 |
$87.00 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$391.00 |
$391.00 |
$391.00 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$4,297.00 |
$4,297.00 |
$4,297.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$5,609.00 |
$5,609.00 |
$5,609.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,913.00 |
$1,913.00 |
$1,913.00 |
$1,701.91
|
|
Tavr perq femoral
|
$15,614.00 |
$15,614.00 |
$15,614.00 |
$15,454.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$233.00 |
$233.00 |
$233.00 |
$179.95
|
|
Tc-99m bicisate
|
$7,561.72 |
$7,561.72 |
$7,561.72 |
$2,070.00
|
|
Tc-99m exame autol wbc diag per dose
|
$4,500.49 |
$4,500.49 |
$4,500.49 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$5,883.57 |
$5,883.57 |
$5,883.57 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$422.63 |
$422.63 |
$422.63 |
$306.00
|
|
Tc-99m maa
|
$458.34 |
$458.34 |
$458.34 |
$312.06
|
|
Tc-99m mebrofenin
|
$130.50 |
$130.50 |
$130.50 |
$157.65
|
|
Tc-99m medronate
|
$120.35 |
$120.35 |
$120.35 |
$111.01
|
|
Tc-99m mertiatide
|
$1,044.51 |
$1,044.51 |
$1,044.51 |
$756.00
|
|
Tc-99m oxidronate
|
$133.35 |
$133.35 |
$133.35 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$487.14 |
$487.14 |
$487.14 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$646.90 |
$646.90 |
$646.90 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$9.26 |
$9.26 |
$9.26 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$194.57 |
$194.57 |
$194.57 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$89.43 |
$89.43 |
$89.43 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$4,785.00 |
$4,785.00 |
$4,785.00 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$340.53 |
$340.53 |
$340.53 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$93.84 |
$93.84 |
$93.84 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$1,991.18 |
$1,991.18 |
$1,991.18 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$296.00 |
$296.00 |
$296.00 |
$184.00
|
|
T cells total count
|
$275.00 |
$275.00 |
$275.00 |
$130.20
|
|
Team conf w/pat by hc prof
|
$197.00 |
$197.00 |
$197.00 |
$107.10
|
|
Telethx isodose plan cplx
|
$1,631.00 |
$1,631.00 |
$1,631.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$880.61
|
|
Test stress cardiovascular tracing only
|
$1,412.00 |
$1,412.00 |
$1,412.00 |
$953.40
|
|
Tgsap so/hl 51/< rna alys
|
$5,447.00 |
$5,447.00 |
$5,447.00 |
$4,347.00
|
|
Theophylline therapeutic drug level
|
$98.00 |
$98.00 |
$98.00 |
$108.00
|
