|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$55.90 |
$55.90 |
$55.90 |
$286.89
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$58.50 |
$58.50 |
$58.50 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$74.10 |
$74.10 |
$74.10 |
$513.33
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$174.85 |
$174.85 |
$174.85 |
$258.40
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$174.20 |
$174.20 |
$174.20 |
$231.75
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$58.50 |
$58.50 |
$58.50 |
$259.58
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$141.70 |
$141.70 |
$141.70 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$160.55 |
$160.55 |
$160.55 |
$231.52
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$213.85 |
$213.85 |
$213.85 |
$304.50
|
|
Shoulder MRI (with and without contrast)
|
$2,843.10 |
$2,843.10 |
$2,843.10 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$2,483.00 |
$2,483.00 |
$2,483.00 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$3,392.35 |
$3,392.35 |
$3,392.35 |
$1,938.28
|
|
Shoulder X-ray
|
$592.15 |
$592.15 |
$592.15 |
$307.20
|
|
Sickling rbc
|
$66.95 |
$66.95 |
$66.95 |
$53.40
|
|
Sincalide 5 mcg solution for injection
|
$424.01 |
$424.01 |
$424.01 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,824.55 |
$1,824.55 |
$1,824.55 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,520.35 |
$1,520.35 |
$1,520.35 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$1,229.15 |
$1,229.15 |
$1,229.15 |
$1,151.00
|
|
Skin Biopsy
|
$343.20 |
$343.20 |
$343.20 |
$362.40
|
|
Sleep study attended
|
$1,629.55 |
$1,629.55 |
$1,629.55 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$4,093.05 |
$4,093.05 |
$4,093.05 |
$4,043.20
|
|
Sleep study unattended
|
$960.70 |
$960.70 |
$960.70 |
$631.55
|
|
Slitting of prepuce
|
$400.40 |
$400.40 |
$400.40 |
$3,176.92
|
|
Smear fluorescent and/or acid fast stain
|
$86.45 |
$86.45 |
$86.45 |
$50.70
|
|
Smear gram stain
|
$59.15 |
$59.15 |
$59.15 |
$48.00
|
|
Smear nasal eosinophil
|
$55.25 |
$55.25 |
$55.25 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$90.35 |
$90.35 |
$90.35 |
$60.00
|
|
Smear wet mount
|
$64.35 |
$64.35 |
$64.35 |
$56.13
|
|
Snrpn/ube3a gene
|
$351.65 |
$351.65 |
$351.65 |
$228.80
|
|
Sodium 24 hour urine
|
$51.35 |
$51.35 |
$51.35 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$40.30 |
$40.30 |
$40.30 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$40.30 |
$40.30 |
$40.30 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$40.30 |
$40.30 |
$40.30 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$27.30 |
$27.30 |
$27.30 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$103.35 |
$103.35 |
$103.35 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$48.75 |
$48.75 |
$48.75 |
$42.43
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$9.36 |
$9.36 |
$9.36 |
$8.89
|
|
Specific gravity body fluid
|
$22.10 |
$22.10 |
$22.10 |
$21.55
|
|
Specimen fat stain
|
$77.35 |
$77.35 |
$77.35 |
$40.00
|
|
Sperm antibody test
|
$107.90 |
$107.90 |
$107.90 |
$56.44
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$535.60 |
$535.60 |
$535.60 |
$526.80
|
|
Split blood or products
|
$98.80 |
$98.80 |
$98.80 |
$143.64
|
|
St analysis behavior qualitative voice/resonance
|
$448.50 |
$448.50 |
$448.50 |
$295.10
|
|
Staph a dna amp probe
|
$106.60 |
$106.60 |
$106.60 |
$116.39
|
|
St evaluate speech sound production
|
$448.50 |
$448.50 |
$448.50 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$448.50 |
$448.50 |
$448.50 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$534.30 |
$534.30 |
$534.30 |
$336.00
|
|
St evaluation swallow function
|
$482.95 |
$482.95 |
$482.95 |
$323.72
|
|
Strapping of ankle and/or ft 29540
|
$164.45 |
$164.45 |
$164.45 |
$185.36
|
|
Strapping of chest
|
$87.75 |
$87.75 |
$87.75 |
$196.93
|
|
Strapping of elbow or wrist 29260
|
$104.00 |
$104.00 |
$104.00 |
$176.31
|
|
Strapping of hand or finger
|
$194.35 |
$194.35 |
$194.35 |
$197.63
|
|
Strapping of hip
|
$88.40 |
$88.40 |
$88.40 |
$164.70
|
|
Strapping of knee
|
$98.80 |
$98.80 |
$98.80 |
$216.34
|
|
Strapping of toes 29550
|
$63.05 |
$63.05 |
$63.05 |
$183.30
|
|
Strep a ag ia
|
$92.95 |
$92.95 |
$92.95 |
$75.40
|
|
Strep b dna amp probe
|
$130.00 |
$130.00 |
$130.00 |
$124.20
|
|
Stress test pulmonary
|
$318.50 |
$318.50 |
$318.50 |
$330.63
|
|
Stress tte complete
|
$1,784.25 |
$1,784.25 |
$1,784.25 |
$1,989.60
|
|
Str markers specimen anal
|
$776.75 |
$776.75 |
$776.75 |
$978.25
|
|
St treatment speech individual
|
$1,155.05 |
$1,155.05 |
$1,155.05 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$503.75 |
$503.75 |
$503.75 |
$221.00
|
|
Subtalar arthro w/deb
|
$12,484.71 |
$12,484.71 |
$12,484.71 |
$3,296.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$22.19
|
|
Sugars single quant
|
$66.95 |
$66.95 |
$66.95 |
$64.28
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$40.75 |
$40.75 |
$40.75 |
$0.60
|
|
Sulfonylurea screen qn-sendout
|
$60.45 |
$60.45 |
$60.45 |
$151.45
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$35.75 |
$35.75 |
$35.75 |
$52.49
|
|
Surgical pathology level 1 gross examination only
|
$92.95 |
$92.95 |
$92.95 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$10,087.16 |
$10,087.16 |
$10,087.16 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$10,447.81 |
$10,447.81 |
$10,447.81 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$4,626.90 |
$4,626.90 |
$4,626.90 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$8,599.49 |
$8,599.49 |
$8,599.49 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$554.45 |
$554.45 |
$554.45 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$79.30 |
$79.30 |
$79.30 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$29.25 |
$29.25 |
$29.25 |
$31.85
|
|
Susceptibility mic per plate
|
$116.35 |
$116.35 |
$116.35 |
$89.70
|
|
Sweat collection by iontophoresis
|
$121.55 |
$121.55 |
$121.55 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$70.20 |
$70.20 |
$70.20 |
$45.70
|
|
T3 (triiodothyronine) free
|
$137.80 |
$137.80 |
$137.80 |
$91.20
|
|
T3 (triiodothyronine) total
|
$122.20 |
$122.20 |
$122.20 |
$88.00
|
|
T4 (thyroxine) free
|
$115.05 |
$115.05 |
$115.05 |
$65.00
|
|
T4 (thyroxine) total
|
$91.00 |
$91.00 |
$91.00 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$210.60 |
$210.60 |
$210.60 |
$137.15
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$3,728.06 |
$3,728.06 |
$3,728.06 |
$5,161.23
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$35.75 |
$35.75 |
$35.75 |
$35.75
|
|
Target gsa panel hmtlmph neop
|
$1,566.50 |
$1,566.50 |
$1,566.50 |
$1,928.40
|
|
Target gsa panel organ neop
|
$2,243.15 |
$2,243.15 |
$2,243.15 |
$1,913.00
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$40,378.00 |
$40,378.00 |
$40,378.00 |
$1,567.49
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$974.73 |
$974.73 |
$974.73 |
$760.95
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$141.05 |
$141.05 |
$141.05 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$208.65 |
$208.65 |
$208.65 |
$178.40
|
|
Tc-99m mebrofenin
|
$159.25 |
$159.25 |
$159.25 |
$169.53
|
|
Tc-99m sestamibi p study dose
|
$306.15 |
$306.15 |
$306.15 |
$221.60
|
|
Tc-99m sulfur colloid
|
$312.65 |
$312.65 |
$312.65 |
$240.50
|
|
T cells absolute cd4/cd8 including ratio
|
$179.40 |
$179.40 |
$179.40 |
$189.60
|
|
T cells total count
|
$154.05 |
$154.05 |
$154.05 |
$126.90
|
|
Telehealth original site facility fee
|
$35.10 |
$35.10 |
$35.10 |
$55.65
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$5,081.76 |
$5,081.76 |
$5,081.76 |
$116.48
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$20,224.57 |
$20,224.57 |
$20,224.57 |
$16,233.59
|
