|
Sinus CT scan (without contrast)
|
$1,464.60 |
$1,464.60 |
$1,464.60 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$1,674.00 |
$1,674.00 |
$1,674.00 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$370.80 |
$370.80 |
$370.80 |
$347.10
|
|
Sinus X-ray (limited)
|
$341.40 |
$341.40 |
$341.40 |
$215.75
|
|
Sirolimus, oral
|
$61.20 |
$61.20 |
$61.20 |
$41.70
|
|
Skull X-ray (1 to 3 views)
|
$289.80 |
$289.80 |
$289.80 |
$294.66
|
|
Skull X-ray (complete)
|
$370.80 |
$370.80 |
$370.80 |
$423.15
|
|
Sleep Study (Polysomnography)
|
$2,098.80 |
$2,098.80 |
$2,098.80 |
$3,734.50
|
|
Sling arm deluxe w/pad xs
|
$182.40 |
$182.40 |
$182.40 |
$30.35
|
|
Sling suprapubic suburetheral
|
$4,768.80 |
$4,768.80 |
$4,768.80 |
$9,679.96
|
|
Slp pure tone screening
|
$93.60 |
$93.60 |
$93.60 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$596.40 |
$596.40 |
$596.40 |
$557.70
|
|
Small bowel endoscopy
|
$3,124.80 |
$3,124.80 |
$3,124.80 |
$2,596.41
|
|
Small bowel endoscopy
|
$3,124.20 |
$3,124.20 |
$3,124.20 |
$2,244.82
|
|
Small bowel endoscopy
|
$3,123.00 |
$3,123.00 |
$3,123.00 |
$2,638.57
|
|
Small bowel endoscopy
|
$3,099.00 |
$3,099.00 |
$3,099.00 |
$2,518.10
|
|
Small bowel endoscopy
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$2,088.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$3,097.20 |
$3,097.20 |
$3,097.20 |
$2,590.33
|
|
Small bowel endoscopy/biopsy
|
$3,124.20 |
$3,124.20 |
$3,124.20 |
$2,490.15
|
|
Small bowel endoscopy br/wa
|
$2,310.60 |
$2,310.60 |
$2,310.60 |
$1,924.00
|
|
Small bowel endoscopy/stent 44370
|
$6,265.20 |
$6,265.20 |
$6,265.20 |
$4,992.00
|
|
Smear fluorescent and/or acid fast stain
|
$91.20 |
$91.20 |
$91.20 |
$64.20
|
|
Smear gram stain
|
$87.00 |
$87.00 |
$87.00 |
$55.42
|
|
Smear special stain inclusion bodies/parasites
|
$130.80 |
$130.80 |
$130.80 |
$73.15
|
|
Smear wet mount
|
$161.40 |
$161.40 |
$161.40 |
$67.49
|
|
Sodium 24 hour urine
|
$102.60 |
$102.60 |
$102.60 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$108.00 |
$108.00 |
$108.00 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$101.60 |
$101.60 |
$101.60 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$121.60 |
$121.60 |
$121.60 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$36.00 |
$36.00 |
$36.00 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$164.80 |
$164.80 |
$164.80 |
$80.73
|
|
Sodium serum/plasma/whole blood
|
$68.40 |
$68.40 |
$68.40 |
$46.26
|
|
Somatropin injection
|
$2,557.80 |
$2,557.80 |
$2,557.80 |
$2,111.40
|
|
Special physics consult
|
$876.00 |
$876.00 |
$876.00 |
$725.00
|
|
Specific gravity body fluid
|
$56.40 |
$56.40 |
$56.40 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$508.80 |
$508.80 |
$508.80 |
$385.00
|
|
Speech audiometry complete
|
$207.00 |
$207.00 |
$207.00 |
$109.20
|
|
Speech recep thresh
|
$97.20 |
$97.20 |
$97.20 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$180.00 |
$180.00 |
$180.00 |
$248.30
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,505.40 |
$1,505.40 |
$1,505.40 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$379.80 |
$379.80 |
$379.80 |
$251.00
|
|
Splint rstrc wrst/cmc right med
|
$134.40 |
$134.40 |
$134.40 |
$99.04
|
|
Split blood or products
|
$284.40 |
$284.40 |
$284.40 |
$129.50
|
|
St analysis behavior qualitative voice/resonance
|
$508.80 |
$508.80 |
$508.80 |
$297.60
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$54,766.80 |
$54,766.80 |
$54,766.80 |
$21,568.80
|
|
Stent axios caut enh 15x10mm electrocaut
|
$56,324.40 |
$56,324.40 |
$56,324.40 |
$32,403.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$36,111.00 |
$36,111.00 |
$36,111.00 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$14,054.40 |
$14,054.40 |
$14,054.40 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$17,695.80 |
$17,695.80 |
$17,695.80 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$10,869.00 |
$10,869.00 |
$10,869.00 |
$8,948.40
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$31,604.40 |
$31,604.40 |
$31,604.40 |
$16,875.93
|
|
Sterile gauze <= 16 sq in
|
$1.20 |
$1.20 |
$1.20 |
$1.52
|
|
Sterile needle
|
$259.20 |
$259.20 |
$259.20 |
$190.13
|
|
Sterile water/saline, 10 ml
|
$31.00 |
$31.00 |
$31.00 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$70.80 |
$70.80 |
$70.80 |
$28.11
|
|
St evaluate speech sound production
|
$508.80 |
$508.80 |
$508.80 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$489.00 |
$489.00 |
$489.00 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$700.20 |
$700.20 |
$700.20 |
$1,342.00
|
|
Strep a ag ia
|
$87.00 |
$87.00 |
$87.00 |
$75.40
|
|
Streptozocin injection
|
$1,356.60 |
$1,356.60 |
$1,356.60 |
$785.95
|
|
Stress test pulmonary
|
$525.60 |
$525.60 |
$525.60 |
$324.00
|
|
Stress tte complete
|
$2,143.80 |
$2,143.80 |
$2,143.80 |
$1,894.20
|
|
Str markers specimen anal
|
$1,709.40 |
$1,709.40 |
$1,709.40 |
$751.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$64.60 |
$64.60 |
$64.60 |
$54.80
|
|
Sugars single quant
|
$111.60 |
$111.60 |
$111.60 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$26,679.00 |
$26,679.00 |
$26,679.00 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$1.00 |
$1.00 |
$1.00 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$126.63
|
|
Supp non-insulin inf cath/wk
|
$19.20 |
$19.20 |
$19.20 |
$8.45
|
|
Support clav 29.6-40.5in med
|
$170.40 |
$170.40 |
$170.40 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$102.60 |
$102.60 |
$102.60 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$138.00 |
$138.00 |
$138.00 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$211.80 |
$211.80 |
$211.80 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$250.20 |
$250.20 |
$250.20 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$360.60 |
$360.60 |
$360.60 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$320.40 |
$320.40 |
$320.40 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$75.60 |
$75.60 |
$75.60 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$64.20 |
$64.20 |
$64.20 |
$35.75
|
|
Susceptibility mic per plate
|
$106.20 |
$106.20 |
$106.20 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$88.80 |
$88.80 |
$88.80 |
$59.28
|
|
Svc venogram s&i
|
$3,039.00 |
$3,039.00 |
$3,039.00 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$489.00 |
$489.00 |
$489.00 |
$316.55
|
|
Swallowing Therapy Session
|
$316.20 |
$316.20 |
$316.20 |
$240.31
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$87.00 |
$87.00 |
$87.00 |
$41.60
|
|
System pacing micra av
|
$34,719.00 |
$34,719.00 |
$34,719.00 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$24,756.60 |
$24,756.60 |
$24,756.60 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$435.60 |
$435.60 |
$435.60 |
$100.32
|
|
T3 (triiodothyronine) total
|
$181.20 |
$181.20 |
$181.20 |
$93.52
|
|
T4 (thyroxine) free
|
$379.80 |
$379.80 |
$379.80 |
$88.44
|
|
T4 (thyroxine) total
|
$109.20 |
$109.20 |
$109.20 |
$69.58
|
|
Tacrol astagraf ex rel oral
|
$13.20 |
$13.20 |
$13.20 |
$62.32
|
|
Tacrol envarsus ex rel oral
|
$9.60 |
$9.60 |
$9.60 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$30.20 |
$30.20 |
$30.20 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$724.80 |
$724.80 |
$724.80 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$231.60 |
$231.60 |
$231.60 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$29.40 |
$29.40 |
$29.40 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$282.60 |
$282.60 |
$282.60 |
$289.90
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$155.40 |
$155.40 |
$155.40 |
$1,223.36
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$20.00 |
$20.00 |
$20.00 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$9,390.00 |
$9,390.00 |
$9,390.00 |
$2,246.30
|
