|
Rx metab gen seq alys pnl 6
|
$4,466.15 |
$4,466.15 |
$4,466.15 |
$1,100.50
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$6,965.24 |
$6,965.24 |
$6,965.24 |
$6,381.30
|
|
Salivary gland imaging
|
$2,219.10 |
$2,219.10 |
$2,219.10 |
$549.70
|
|
Salmonella antibody
|
$59.80 |
$59.80 |
$59.80 |
$37.58
|
|
S bowel endoscope w/stent
|
$4,893.20 |
$4,893.20 |
$4,893.20 |
$4,379.25
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,161.55 |
$1,161.55 |
$1,161.55 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$739.70 |
$739.70 |
$739.70 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,229.80 |
$1,229.80 |
$1,229.80 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$603.85 |
$603.85 |
$603.85 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$630.50 |
$630.50 |
$630.50 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$848.90 |
$848.90 |
$848.90 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,161.55 |
$1,161.55 |
$1,161.55 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$804.70 |
$804.70 |
$804.70 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$750.10 |
$750.10 |
$750.10 |
$601.70
|
|
Sclerotherapy fluid collection pq w/img
|
$2,600.65 |
$2,600.65 |
$2,600.65 |
$2,114.45
|
|
Scope uretscp lithovue dig disp
|
$2,994.91 |
$2,994.91 |
$2,994.91 |
$4,079.62
|
|
Scr c/v cyto,thinlayer,rescr
|
$44.20 |
$44.20 |
$44.20 |
$76.70
|
|
Screening Colonoscopy (average risk)
|
$3,035.50 |
$3,035.50 |
$3,035.50 |
$1,278.72
|
|
Screening Colonoscopy (high risk)
|
$3,035.50 |
$3,035.50 |
$3,035.50 |
$1,575.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$105.30 |
$105.30 |
$105.30 |
$57.60
|
|
Screening Mammogram
|
$157.30 |
$157.30 |
$157.30 |
$303.55
|
|
Screening prostate cancer PSA
|
$48.75 |
$48.75 |
$48.75 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$696.07 |
$696.07 |
$696.07 |
$28,750.65
|
|
Sec art mech thrmbc non-intracranial add-on
|
$4,568.20 |
$4,568.20 |
$4,568.20 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$42.25 |
$42.25 |
$42.25 |
$44.20
|
|
Semen analysis w/count
|
$206.05 |
$206.05 |
$206.05 |
$56.44
|
|
Serpina1 gene
|
$165.10 |
$165.10 |
$165.10 |
$191.73
|
|
Sertraline (zoloft) - sendout
|
$197.60 |
$197.60 |
$197.60 |
$173.16
|
|
Set radiation therapy field
|
$1,695.85 |
$1,695.85 |
$1,695.85 |
$731.50
|
|
Set radiation therapy field
|
$3,032.90 |
$3,032.90 |
$3,032.90 |
$1,102.40
|
|
Set radiation therapy field
|
$6,279.65 |
$6,279.65 |
$6,279.65 |
$1,636.36
|
|
Sgmdsc w/band ligation
|
$3,296.80 |
$3,296.80 |
$3,296.80 |
$1,645.43
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$265.85 |
$265.85 |
$265.85 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$369.20 |
$369.20 |
$369.20 |
$235.13
|
|
Shoe post-op mens m
|
$51.91 |
$51.91 |
$51.91 |
$41.56
|
|
Shoulder MRI (with and without contrast)
|
$6,333.60 |
$6,333.60 |
$6,333.60 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$5,922.80 |
$5,922.80 |
$5,922.80 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$5,521.10 |
$5,521.10 |
$5,521.10 |
$2,051.28
|
|
Shoulder X-ray
|
$660.40 |
$660.40 |
$660.40 |
$367.02
|
|
Shunt glaucoma baerveldt 350mm
|
$2,495.75 |
$2,495.75 |
$2,495.75 |
$4,709.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$913.25 |
$913.25 |
$913.25 |
$345.00
|
|
Sialography s&i
|
$1,373.45 |
$1,373.45 |
$1,373.45 |
$462.40
|
|
Sickling rbc
|
$132.60 |
$132.60 |
$132.60 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$3,389.10 |
$3,389.10 |
$3,389.10 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$3,548.35 |
$3,548.35 |
$3,548.35 |
$1,073.68
|
|
Sigmoidoscopy for bleeding
|
$3,745.95 |
$3,745.95 |
$3,745.95 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,489.20 |
$3,489.20 |
$3,489.20 |
$1,374.60
|
|
Sigmoidoscopy w/ablation
|
$4,334.20 |
$4,334.20 |
$4,334.20 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$3,602.30 |
$3,602.30 |
$3,602.30 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$4,334.20 |
$4,334.20 |
$4,334.20 |
$4,379.25
|
|
Sigmoidoscopy w/resection
|
$4,334.20 |
$4,334.20 |
$4,334.20 |
$3,245.23
|
|
Sigmoidoscopy w/tumr remove
|
$3,290.95 |
$3,290.95 |
$3,290.95 |
$1,395.28
|
|
Sigmoidoscopy w/ultrasound
|
$3,361.15 |
$3,361.15 |
$3,361.15 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$4,334.20 |
$4,334.20 |
$4,334.20 |
$2,314.50
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,888.30 |
$3,888.30 |
$3,888.30 |
$1,664.40
|
|
Signal avg ecg w or without ecg 93278
|
$555.10 |
$555.10 |
$555.10 |
$309.52
|
|
Sig w/tndsc balloon dilation
|
$3,888.30 |
$3,888.30 |
$3,888.30 |
$1,813.80
|
|
Sincalide 5 mcg solution for injection
|
$422.50 |
$422.50 |
$422.50 |
$355.41
|
|
Sinus CT scan (with and without contrast)
|
$1,587.30 |
$1,587.30 |
$1,587.30 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,443.00 |
$1,443.00 |
$1,443.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,313.00 |
$1,313.00 |
$1,313.00 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$2,603.25 |
$2,603.25 |
$2,603.25 |
$2,489.25
|
|
Sirolimus, oral
|
$16.31 |
$16.31 |
$16.31 |
$40.61
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$0.42 |
$0.42 |
$0.42 |
$114.21
|
|
Skin Biopsy
|
$148.20 |
$148.20 |
$148.20 |
$382.80
|
|
Sleep study attended
|
$1,346.15 |
$1,346.15 |
$1,346.15 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$3,161.60 |
$3,161.60 |
$3,161.60 |
$3,936.80
|
|
Sleep study unattended
|
$1,138.15 |
$1,138.15 |
$1,138.15 |
$595.50
|
|
Sleeve fing rolyan med
|
$415.29 |
$415.29 |
$415.29 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$19.30 |
$19.30 |
$19.30 |
$25.55
|
|
Sling pelv split sam med
|
$87.72 |
$87.72 |
$87.72 |
$132.60
|
|
Sling suprapubic suburetheral
|
$2,629.53 |
$2,629.53 |
$2,629.53 |
$10,439.00
|
|
Slp pure tone screening
|
$102.05 |
$102.05 |
$102.05 |
$67.60
|
|
Small bowel endoscopy
|
$3,135.60 |
$3,135.60 |
$3,135.60 |
$2,466.10
|
|
Small bowel endoscopy
|
$3,282.50 |
$3,282.50 |
$3,282.50 |
$2,244.82
|
|
Small bowel endoscopy
|
$3,791.45 |
$3,791.45 |
$3,791.45 |
$2,638.57
|
|
Small bowel endoscopy
|
$3,234.40 |
$3,234.40 |
$3,234.40 |
$2,244.82
|
|
Small bowel endoscopy
|
$3,803.80 |
$3,803.80 |
$3,803.80 |
$2,638.57
|
|
Small bowel endoscopy
|
$4,622.80 |
$4,622.80 |
$4,622.80 |
$2,734.20
|
|
Small bowel endoscopy
|
$4,219.80 |
$4,219.80 |
$4,219.80 |
$1,294.80
|
|
Small bowel endoscopy
|
$4,336.15 |
$4,336.15 |
$4,336.15 |
$2,244.82
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$3,836.95 |
$3,836.95 |
$3,836.95 |
$2,244.82
|
|
Small bowel endoscopy 44365
|
$3,188.90 |
$3,188.90 |
$3,188.90 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$3,232.45 |
$3,232.45 |
$3,232.45 |
$2,442.70
|
|
Small bowel endoscopy/biopsy
|
$4,169.75 |
$4,169.75 |
$4,169.75 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$3,444.35 |
$3,444.35 |
$3,444.35 |
$1,261.31
|
|
Small bowel endoscopy br/wa
|
$4,219.80 |
$4,219.80 |
$4,219.80 |
$2,381.60
|
|
Small bowel endoscopy/stent 44370
|
$6,396.65 |
$6,396.65 |
$6,396.65 |
$6,104.15
|
|
Smear fluorescent and/or acid fast stain
|
$100.75 |
$100.75 |
$100.75 |
$64.20
|
|
Smear gram stain
|
$76.05 |
$76.05 |
$76.05 |
$57.85
|
|
Smear nasal eosinophil
|
$93.60 |
$93.60 |
$93.60 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$376.35 |
$376.35 |
$376.35 |
$64.35
|
|
Smear wet mount
|
$172.90 |
$172.90 |
$172.90 |
$68.63
|
|
Smn1 gene full gene sequence
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$495.69
|
|
Smpd1 gene common variants
|
$725.40 |
$725.40 |
$725.40 |
$140.00
|
|
Snrpn/ube3a gene
|
$772.85 |
$772.85 |
$772.85 |
$228.80
|
|
Sodium 24 hour urine
|
$70.85 |
$70.85 |
$70.85 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$45.20 |
$45.20 |
$45.20 |
$47.56
|
|
Sodium chloride 0.9 % IV bolus
|
$42.07 |
$42.07 |
$42.07 |
$46.38
|
|
Sodium chloride 0.9 % IV bolus
|
$43.78 |
$43.78 |
$43.78 |
$43.30
|
