|
Set radiation therapy field
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$1,102.40
|
|
Set radiation therapy field
|
$7,893.00 |
$7,893.00 |
$7,893.00 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$19.37 |
$19.37 |
$19.37 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$58.41 |
$58.41 |
$58.41 |
$21.42
|
|
Sex chromatin identification
|
$149.00 |
$149.00 |
$149.00 |
$25.35
|
|
Shoulder MRI (with and without contrast)
|
$9,983.00 |
$9,983.00 |
$9,983.00 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$3,976.00 |
$3,976.00 |
$3,976.00 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$3,949.00 |
$3,949.00 |
$3,949.00 |
$2,051.28
|
|
Shoulder X-ray
|
$773.00 |
$773.00 |
$773.00 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$345.00
|
|
Sialography s&i
|
$574.00 |
$574.00 |
$574.00 |
$462.40
|
|
Sickling rbc
|
$96.00 |
$96.00 |
$96.00 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$426.94 |
$426.94 |
$426.94 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$3,965.00 |
$3,965.00 |
$3,965.00 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$4,163.00 |
$4,163.00 |
$4,163.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$3,321.00 |
$3,321.00 |
$3,321.00 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$5,262.00 |
$5,262.00 |
$5,262.00 |
$2,489.25
|
|
Sipuleucel-t - su
|
$1,023.15 |
$1,023.15 |
$1,023.15 |
$95,750.46
|
|
Sirolimus, oral
|
$35.72 |
$35.72 |
$35.72 |
$42.11
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$23,744.00 |
$23,744.00 |
$23,744.00 |
$114.21
|
|
Skin Biopsy
|
$857.00 |
$857.00 |
$857.00 |
$382.80
|
|
Skyla, 13.5 mg
|
$3,371.27 |
$3,371.27 |
$3,371.27 |
$1,801.20
|
|
Slitting of prepuce
|
$6,576.00 |
$6,576.00 |
$6,576.00 |
$2,983.40
|
|
Sm-153 lexidron ther
|
$53,776.45 |
$53,776.45 |
$53,776.45 |
$11,563.30
|
|
Smallpox&monkeypox vac 0.5ml
|
$1,833.30 |
$1,833.30 |
$1,833.30 |
$318.64
|
|
Smear fluorescent and/or acid fast stain
|
$57.00 |
$57.00 |
$57.00 |
$64.20
|
|
Smear gram stain
|
$75.00 |
$75.00 |
$75.00 |
$57.85
|
|
Smear nasal eosinophil
|
$96.00 |
$96.00 |
$96.00 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$190.00 |
$190.00 |
$190.00 |
$64.35
|
|
Smear wet mount
|
$27.00 |
$27.00 |
$27.00 |
$68.63
|
|
Smpd1 gene common variants
|
$965.00 |
$965.00 |
$965.00 |
$140.00
|
|
Sodium 24 hour urine
|
$71.00 |
$71.00 |
$71.00 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$0.02 |
$0.02 |
$0.02 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$4.71 |
$4.71 |
$4.71 |
$43.78
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$20.81 |
$20.81 |
$20.81 |
$84.80
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$332.50 |
$332.50 |
$332.50 |
$539.57
|
|
Sodium serum/plasma/whole blood
|
$36.00 |
$36.00 |
$36.00 |
$42.70
|
|
Sotalol hydrochloride IV
|
$1,153.60 |
$1,153.60 |
$1,153.60 |
$1,153.60
|
|
Special physics consult
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$700.74
|
|
Special radiation dosimetry
|
$1,623.00 |
$1,623.00 |
$1,623.00 |
$445.50
|
|
Special radiation treatment
|
$5,402.00 |
$5,402.00 |
$5,402.00 |
$1,934.03
|
|
Speech evaluation complex
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$527.06
|
|
Sperm antibody test
|
$756.00 |
$756.00 |
$756.00 |
$56.44
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,508.00 |
$1,508.00 |
$1,508.00 |
$559.96
|
|
Split blood or products
|
$56.00 |
$56.00 |
$56.00 |
$148.98
|
|
Srs linear based
|
$27,021.00 |
$27,021.00 |
$27,021.00 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
$300.00
|
|
Staph a dna amp probe
|
$196.00 |
$196.00 |
$196.00 |
$116.39
|
|
St evaluate speech sound production
|
$834.00 |
$834.00 |
$834.00 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$936.00 |
$936.00 |
$936.00 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$1,408.00 |
$1,408.00 |
$1,408.00 |
$406.40
|
|
St evaluation swallow function
|
$1,247.00 |
$1,247.00 |
$1,247.00 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$813.00 |
$813.00 |
$813.00 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$557.00 |
$557.00 |
$557.00 |
$171.00
|
|
Strapping of hand or finger
|
$486.00 |
$486.00 |
$486.00 |
$194.40
|
|
Strapping of hip
|
$226.00 |
$226.00 |
$226.00 |
$170.08
|
|
Strapping of knee
|
$609.00 |
$609.00 |
$609.00 |
$224.80
|
|
Strapping of toes 29550
|
$486.00 |
$486.00 |
$486.00 |
$185.36
|
|
Strep b assay w/optic
|
$131.00 |
$131.00 |
$131.00 |
$32.00
|
|
Strep b dna amp probe
|
$150.00 |
$150.00 |
$150.00 |
$139.20
|
|
Streptomycin injection
|
$143.47 |
$143.47 |
$143.47 |
$138.30
|
|
Streptozocin injection
|
$1,132.15 |
$1,132.15 |
$1,132.15 |
$943.23
|
|
Stress test pulmonary
|
$956.00 |
$956.00 |
$956.00 |
$327.20
|
|
Stress tte complete
|
$3,039.00 |
$3,039.00 |
$3,039.00 |
$1,964.95
|
|
Str markers spec anal addl
|
$1,961.00 |
$1,961.00 |
$1,961.00 |
$468.00
|
|
Str markers specimen anal
|
$2,374.00 |
$2,374.00 |
$2,374.00 |
$835.28
|
|
St treatment speech individual
|
$674.00 |
$674.00 |
$674.00 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$511.00 |
$511.00 |
$511.00 |
$261.60
|
|
Sugars single quant
|
$52.00 |
$52.00 |
$52.00 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$408.00 |
$408.00 |
$408.00 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$39.34 |
$39.34 |
$39.34 |
$151.29
|
|
Supprelin la implant
|
$170,685.80 |
$170,685.80 |
$170,685.80 |
$72,648.14
|
|
Surgical pathology level 1 gross examination only
|
$174.00 |
$174.00 |
$174.00 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$318.00 |
$318.00 |
$318.00 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$389.00 |
$389.00 |
$389.00 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$485.00 |
$485.00 |
$485.00 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$996.00 |
$996.00 |
$996.00 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,498.00 |
$1,498.00 |
$1,498.00 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$133.00 |
$133.00 |
$133.00 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$32.00 |
$32.00 |
$32.00 |
$34.48
|
|
Susceptibility mic per plate
|
$188.00 |
$188.00 |
$188.00 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$335.00 |
$335.00 |
$335.00 |
$48.30
|
|
Svc venogram s&i
|
$5,262.00 |
$5,262.00 |
$5,262.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$72.00 |
$72.00 |
$72.00 |
$105.21
|
|
Synvisc or synvisc-one
|
$239.98 |
$239.98 |
$239.98 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$114.00 |
$114.00 |
$114.00 |
$44.85
|
|
T3 (triiodothyronine) free
|
$397.00 |
$397.00 |
$397.00 |
$89.82
|
|
T3 (triiodothyronine) total
|
$150.00 |
$150.00 |
$150.00 |
$94.90
|
|
T4 (thyroxine) free
|
$152.00 |
$152.00 |
$152.00 |
$81.60
|
|
T4 (thyroxine) total
|
$148.00 |
$148.00 |
$148.00 |
$73.64
|
|
Tacrol astagraf ex rel oral
|
$18.35 |
$18.35 |
$18.35 |
$9.01
|
|
Tacrol envarsus ex rel oral
|
$76.52 |
$76.52 |
$76.52 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$27.81 |
$27.81 |
$27.81 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$810.27 |
$810.27 |
$810.27 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$252.00 |
$252.00 |
$252.00 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,718.70 |
$4,718.70 |
$4,718.70 |
$3,817.00
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$23,283.61 |
$23,283.61 |
$23,283.61 |
$21,795.67
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$27,488.34 |
$27,488.34 |
$27,488.34 |
$31,080.00
|
|
Target gsa panel hmtlmph neop
|
$6,067.00 |
$6,067.00 |
$6,067.00 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$11,128.00 |
$11,128.00 |
$11,128.00 |
$3,385.00
|
