|
Skin Biopsy
|
$420.80 |
$420.80 |
$420.80 |
$361.20
|
|
Skull X-ray (1 to 3 views)
|
$220.80 |
$220.80 |
$220.80 |
$294.66
|
|
Skull X-ray (complete)
|
$251.20 |
$251.20 |
$251.20 |
$423.15
|
|
Skyla, 13.5 mg
|
$754.71 |
$754.71 |
$754.71 |
$1,643.47
|
|
Sleep Study (Polysomnography)
|
$3,659.20 |
$3,659.20 |
$3,659.20 |
$3,734.50
|
|
Sleep study unattended
|
$763.20 |
$763.20 |
$763.20 |
$594.00
|
|
Sleeve fing rolyan med
|
$276.80 |
$276.80 |
$276.80 |
$203.58
|
|
Sling pelv split sam med
|
$215.23 |
$215.23 |
$215.23 |
$150.00
|
|
Sling suprapubic suburetheral
|
$17,960.80 |
$17,960.80 |
$17,960.80 |
$9,679.96
|
|
Slitting of prepuce
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$3,376.23
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$236.80 |
$236.80 |
$236.80 |
$139.44
|
|
Slp eval non-spch gen comm dev
|
$461.60 |
$461.60 |
$461.60 |
$285.09
|
|
Slp ther svc non-spch gen
|
$284.80 |
$284.80 |
$284.80 |
$188.00
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$405.60 |
$405.60 |
$405.60 |
$557.70
|
|
So cap design without jnts cf
|
$1,104.80 |
$1,104.80 |
$1,104.80 |
$606.35
|
|
Sock fracture or equal each
|
$41.60 |
$41.60 |
$41.60 |
$74.51
|
|
Sodium chloride 0.9 % intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$60.00 |
$60.00 |
$60.00 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$200.00 |
$200.00 |
$200.00 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$5.08 |
$5.08 |
$5.08 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$63.99 |
$63.99 |
$63.99 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$373.91 |
$373.91 |
$373.91 |
$410.40
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$71.86 |
$71.86 |
$71.86 |
$177.52
|
|
Somatosensory testing
|
$531.20 |
$531.20 |
$531.20 |
$816.00
|
|
So vest canvas/web pre ots
|
$342.33 |
$342.33 |
$342.33 |
$256.54
|
|
Special physics consult
|
$492.80 |
$492.80 |
$492.80 |
$725.00
|
|
Special radiation dosimetry
|
$62.40 |
$62.40 |
$62.40 |
$392.50
|
|
Special radiation treatment
|
$291.20 |
$291.20 |
$291.20 |
$2,052.00
|
|
Special teletx port plan
|
$276.80 |
$276.80 |
$276.80 |
$1,095.05
|
|
Speech and Language Evaluation (comprehensive)
|
$568.80 |
$568.80 |
$568.80 |
$385.00
|
|
Speech evaluation complex
|
$415.20 |
$415.20 |
$415.20 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$276.80 |
$276.80 |
$276.80 |
$248.30
|
|
Sperm isolation complex
|
$260.00 |
$260.00 |
$260.00 |
$176.28
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,774.40 |
$1,774.40 |
$1,774.40 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$154.40 |
$154.40 |
$154.40 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$526.40 |
$526.40 |
$526.40 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$64.80 |
$64.80 |
$64.80 |
$71.44
|
|
Splint finger fold over sm
|
$112.80 |
$112.80 |
$112.80 |
$146.88
|
|
Splint finger frog med
|
$46.40 |
$46.40 |
$46.40 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$146.04 |
$146.04 |
$146.04 |
$99.04
|
|
Srs linear based
|
$3,042.40 |
$3,042.40 |
$3,042.40 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$333.60 |
$333.60 |
$333.60 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$344.00 |
$344.00 |
$344.00 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$32,911.99 |
$32,911.99 |
$32,911.99 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,631.20 |
$2,631.20 |
$2,631.20 |
$2,649.79
|
|
Stent bili rx wallflx 10x80 uncvr
|
$27,447.61 |
$27,447.61 |
$27,447.61 |
$20,962.50
|
|
Stent placemt retro carotid
|
$8,657.60 |
$8,657.60 |
$8,657.60 |
$5,328.00
|
|
Sterile water/saline, 10 ml
|
$2.40 |
$2.40 |
$2.40 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$40.00 |
$40.00 |
$40.00 |
$28.11
|
|
St evaluate speech sound production
|
$333.60 |
$333.60 |
$333.60 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$436.80 |
$436.80 |
$436.80 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,665.60 |
$1,665.60 |
$1,665.60 |
$1,342.00
|
|
Strapping of ankle and/or ft 29540
|
$230.40 |
$230.40 |
$230.40 |
$223.45
|
|
Strapping of chest
|
$202.40 |
$202.40 |
$202.40 |
$194.46
|
|
Strapping of elbow or wrist 29260
|
$210.40 |
$210.40 |
$210.40 |
$157.46
|
|
Strapping of hand or finger
|
$191.20 |
$191.20 |
$191.20 |
$174.82
|
|
Strapping of knee
|
$228.80 |
$228.80 |
$228.80 |
$205.20
|
|
Strapping of toes 29550
|
$197.60 |
$197.60 |
$197.60 |
$164.70
|
|
Streptozocin injection
|
$726.64 |
$726.64 |
$726.64 |
$785.95
|
|
Stress test pulmonary
|
$304.00 |
$304.00 |
$304.00 |
$324.00
|
|
Stress tte complete
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
$1,894.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$81.20 |
$81.20 |
$81.20 |
$54.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,782.75 |
$2,782.75 |
$2,782.75 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$67.10 |
$67.10 |
$67.10 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$173.55 |
$173.55 |
$173.55 |
$126.63
|
|
Support clav 29.6-40.5in med
|
$156.84 |
$156.84 |
$156.84 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$88.00 |
$88.00 |
$88.00 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$124.80 |
$124.80 |
$124.80 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$136.00 |
$136.00 |
$136.00 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$180.80 |
$180.80 |
$180.80 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$508.00 |
$508.00 |
$508.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$720.75
|
|
Svc venogram s&i
|
$1,859.20 |
$1,859.20 |
$1,859.20 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$350.40 |
$350.40 |
$350.40 |
$316.55
|
|
Swallowing Therapy Session
|
$307.20 |
$307.20 |
$307.20 |
$240.31
|
|
Synvisc or synvisc-one
|
$307.91 |
$307.91 |
$307.91 |
$1,242.63
|
|
System cardiomems hosp electronics
|
$39,600.00 |
$39,600.00 |
$39,600.00 |
$38,234.70
|
|
System pacing micra av
|
$22,264.00 |
$22,264.00 |
$22,264.00 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$19,407.52 |
$19,407.52 |
$19,407.52 |
$12,003.00
|
|
System sealant biosentry tract
|
$1,029.28 |
$1,029.28 |
$1,029.28 |
$889.35
|
|
Tacrol envarsus ex rel oral
|
$8.43 |
$8.43 |
$8.43 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$14.44 |
$14.44 |
$14.44 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$314.39 |
$314.39 |
$314.39 |
$596.76
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$160.80 |
$160.80 |
$160.80 |
$289.90
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$15,403.51 |
$15,403.51 |
$15,403.51 |
$24,217.20
|
|
Tavr perq femoral
|
$21,020.80 |
$21,020.80 |
$21,020.80 |
$15,454.40
|
|
Tc-99m labeled rbc
|
$743.20 |
$743.20 |
$743.20 |
$306.00
|
|
Tc-99m maa
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$312.06
|
|
Tc-99m mebrofenin
|
$106.40 |
$106.40 |
$106.40 |
$157.65
|
|
Tc-99m medronate
|
$240.00 |
$240.00 |
$240.00 |
$111.01
|
|
Tc-99m mertiatide
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$756.00
|
|
Tc-99m oxidronate
|
$460.00 |
$460.00 |
$460.00 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$752.00 |
$752.00 |
$752.00 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$752.00 |
$752.00 |
$752.00 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$54.40 |
$54.40 |
$54.40 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$639.20 |
$639.20 |
$639.20 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$174.40 |
$174.40 |
$174.40 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$1,916.80 |
$1,916.80 |
$1,916.80 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$245.70
|
