|
Sleep Study (Polysomnography)
|
$2,265.00 |
$2,265.00 |
$2,265.00 |
$3,734.50
|
|
Sling arm deluxe w/pad xs
|
$198.00 |
$198.00 |
$198.00 |
$30.35
|
|
Sling suprapubic suburetheral
|
$13,321.80 |
$13,321.80 |
$13,321.80 |
$9,679.96
|
|
Slp pure tone screening
|
$37.80 |
$37.80 |
$37.80 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$288.00 |
$288.00 |
$288.00 |
$557.70
|
|
Small bowel endoscopy
|
$3,598.80 |
$3,598.80 |
$3,598.80 |
$2,596.41
|
|
Small bowel endoscopy
|
$3,598.80 |
$3,598.80 |
$3,598.80 |
$2,244.82
|
|
Small bowel endoscopy
|
$3,598.80 |
$3,598.80 |
$3,598.80 |
$2,638.57
|
|
Small bowel endoscopy
|
$3,598.80 |
$3,598.80 |
$3,598.80 |
$2,518.10
|
|
Small bowel endoscopy
|
$1,948.20 |
$1,948.20 |
$1,948.20 |
$2,088.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$3,426.60 |
$3,426.60 |
$3,426.60 |
$2,590.33
|
|
Small bowel endoscopy 44365
|
$3,893.40 |
$3,893.40 |
$3,893.40 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$3,598.80 |
$3,598.80 |
$3,598.80 |
$2,490.15
|
|
Small bowel endoscopy br/wa
|
$1,767.00 |
$1,767.00 |
$1,767.00 |
$1,924.00
|
|
Smear fluorescent and/or acid fast stain
|
$73.80 |
$73.80 |
$73.80 |
$64.20
|
|
Smear gram stain
|
$70.80 |
$70.80 |
$70.80 |
$55.42
|
|
Smear nasal eosinophil
|
$54.60 |
$54.60 |
$54.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$71.40 |
$71.40 |
$71.40 |
$73.15
|
|
Smear wet mount
|
$58.20 |
$58.20 |
$58.20 |
$67.49
|
|
Sodium 24 hour urine
|
$61.80 |
$61.80 |
$61.80 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$84.80 |
$84.80 |
$84.80 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$9.60 |
$9.60 |
$9.60 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$29.20 |
$29.20 |
$29.20 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$21.00 |
$21.00 |
$21.00 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$13.40 |
$13.40 |
$13.40 |
$80.73
|
|
Sodium serum/plasma/whole blood
|
$58.20 |
$58.20 |
$58.20 |
$46.26
|
|
Special physics consult
|
$561.60 |
$561.60 |
$561.60 |
$725.00
|
|
Special radiation treatment
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$2,052.00
|
|
Special supplies phys/qhp
|
$359.40 |
$359.40 |
$359.40 |
$60.00
|
|
Special teletx port plan
|
$1,248.60 |
$1,248.60 |
$1,248.60 |
$1,095.05
|
|
Specific gravity body fluid
|
$35.40 |
$35.40 |
$35.40 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$262.20 |
$262.20 |
$262.20 |
$385.00
|
|
Speech Therapy Session (one-on-one)
|
$199.80 |
$199.80 |
$199.80 |
$248.30
|
|
Sperm antibody test
|
$107.40 |
$107.40 |
$107.40 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$189.60 |
$189.60 |
$189.60 |
$251.00
|
|
Splint rstrc wrst/cmc right med
|
$106.20 |
$106.20 |
$106.20 |
$99.04
|
|
Split blood or products
|
$71.40 |
$71.40 |
$71.40 |
$129.50
|
|
Srs linear based
|
$10,301.40 |
$10,301.40 |
$10,301.40 |
$14,124.25
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$56,509.20 |
$56,509.20 |
$56,509.20 |
$21,568.80
|
|
Stent axios caut enh 15x10mm electrocaut
|
$44,236.80 |
$44,236.80 |
$44,236.80 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$704.40 |
$704.40 |
$704.40 |
$2,649.79
|
|
Stent bili rx wallflx 10x80 uncvr
|
$33,391.20 |
$33,391.20 |
$33,391.20 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$19,532.40 |
$19,532.40 |
$19,532.40 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$17,351.40 |
$17,351.40 |
$17,351.40 |
$8,948.40
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$34,008.60 |
$34,008.60 |
$34,008.60 |
$16,875.93
|
|
Sterile needle
|
$5,988.60 |
$5,988.60 |
$5,988.60 |
$190.13
|
|
Sterile water/saline, 10 ml
|
$15.20 |
$15.20 |
$15.20 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$13.20 |
$13.20 |
$13.20 |
$28.11
|
|
St evaluate speech sound production
|
$262.20 |
$262.20 |
$262.20 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$373.80 |
$373.80 |
$373.80 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$536.40 |
$536.40 |
$536.40 |
$1,342.00
|
|
Strep a ag ia
|
$46.80 |
$46.80 |
$46.80 |
$75.40
|
|
Strep b dna amp probe
|
$411.60 |
$411.60 |
$411.60 |
$122.43
|
|
Stress test pulmonary
|
$188.40 |
$188.40 |
$188.40 |
$324.00
|
|
Stress tte complete
|
$1,218.60 |
$1,218.60 |
$1,218.60 |
$1,894.20
|
|
Str markers specimen anal
|
$262.80 |
$262.80 |
$262.80 |
$751.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$54.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$25,164.00 |
$25,164.00 |
$25,164.00 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.20 |
$0.20 |
$0.20 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$107.20 |
$107.20 |
$107.20 |
$126.63
|
|
Supp non-insulin inf cath/wk
|
$14.40 |
$14.40 |
$14.40 |
$8.45
|
|
Support clav 29.6-40.5in med
|
$180.60 |
$180.60 |
$180.60 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$68.40 |
$68.40 |
$68.40 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$128.40 |
$128.40 |
$128.40 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$148.80 |
$148.80 |
$148.80 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$197.40 |
$197.40 |
$197.40 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$234.60 |
$234.60 |
$234.60 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$336.00 |
$336.00 |
$336.00 |
$720.75
|
|
Surgical trays
|
$80.40 |
$80.40 |
$80.40 |
$694.80
|
|
Susceptibility agar dilution per agent
|
$64.20 |
$64.20 |
$64.20 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$62.40 |
$62.40 |
$62.40 |
$35.75
|
|
Susceptibility mic per plate
|
$85.20 |
$85.20 |
$85.20 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$87.00 |
$87.00 |
$87.00 |
$59.28
|
|
Svc venogram s&i
|
$1,540.20 |
$1,540.20 |
$1,540.20 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$373.80 |
$373.80 |
$373.80 |
$316.55
|
|
Swallowing Therapy Session
|
$199.20 |
$199.20 |
$199.20 |
$240.31
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$30.60 |
$30.60 |
$30.60 |
$41.60
|
|
System pacing micra av
|
$23,908.80 |
$23,908.80 |
$23,908.80 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$11,250.00 |
$11,250.00 |
$11,250.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$385.80 |
$385.80 |
$385.80 |
$100.32
|
|
T3 (triiodothyronine) total
|
$83.40 |
$83.40 |
$83.40 |
$93.52
|
|
T4 (thyroxine) free
|
$121.80 |
$121.80 |
$121.80 |
$88.44
|
|
T4 (thyroxine) total
|
$89.40 |
$89.40 |
$89.40 |
$69.58
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$28.80 |
$28.80 |
$28.80 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$441.60 |
$441.60 |
$441.60 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$178.80 |
$178.80 |
$178.80 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$27.60 |
$27.60 |
$27.60 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$171.00 |
$171.00 |
$171.00 |
$289.90
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$0.40 |
$0.40 |
$0.40 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$5,594.40 |
$5,594.40 |
$5,594.40 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$8,581.80 |
$8,581.80 |
$8,581.80 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,932.20 |
$2,932.20 |
$2,932.20 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$2,801.40 |
$2,801.40 |
$2,801.40 |
$24,217.20
|
|
Tavr perq femoral
|
$7,418.40 |
$7,418.40 |
$7,418.40 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$3.60 |
$3.60 |
$3.60 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$759.00 |
$759.00 |
$759.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$373.80 |
$373.80 |
$373.80 |
$180.80
|
|
Tc-99m bicisate
|
$1,556.40 |
$1,556.40 |
$1,556.40 |
$2,070.00
|
|
Tc-99m exametazime diag
|
$9,344.40 |
$9,344.40 |
$9,344.40 |
$2,135.70
|
