|
Small bowel endoscopy br/wa
|
$2,710.80 |
$2,710.80 |
$2,710.80 |
$1,924.00
|
|
Smear fluorescent and/or acid fast stain
|
$64.20 |
$64.20 |
$64.20 |
$64.35
|
|
Smear gram stain
|
$63.60 |
$63.60 |
$63.60 |
$55.55
|
|
Smear nasal eosinophil
|
$36.60 |
$36.60 |
$36.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$89.40 |
$89.40 |
$89.40 |
$73.50
|
|
Sodium 24 hour urine
|
$72.00 |
$72.00 |
$72.00 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$89.60 |
$89.60 |
$89.60 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$78.80 |
$78.80 |
$78.80 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$78.80 |
$78.80 |
$78.80 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$21.60 |
$21.60 |
$21.60 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$90.40 |
$90.40 |
$90.40 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$71.40 |
$71.40 |
$71.40 |
$46.26
|
|
Spacer bag/reservoir
|
$194.40 |
$194.40 |
$194.40 |
$26.00
|
|
Special physics consult
|
$646.80 |
$646.80 |
$646.80 |
$725.00
|
|
Special radiation dosimetry
|
$338.40 |
$338.40 |
$338.40 |
$392.50
|
|
Special radiation treatment
|
$2,614.20 |
$2,614.20 |
$2,614.20 |
$2,052.00
|
|
Specific gravity body fluid
|
$52.80 |
$52.80 |
$52.80 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$237.00 |
$237.00 |
$237.00 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$225.00 |
$225.00 |
$225.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,439.40 |
$1,439.40 |
$1,439.40 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$436.20 |
$436.20 |
$436.20 |
$251.00
|
|
Splint finger 4 prong foam sm
|
$250.80 |
$250.80 |
$250.80 |
$34.00
|
|
Splint rstrc wrst/cmc right med
|
$49.80 |
$49.80 |
$49.80 |
$99.04
|
|
Split blood or products
|
$786.00 |
$786.00 |
$786.00 |
$127.80
|
|
St analysis behavior qualitative voice/resonance
|
$237.00 |
$237.00 |
$237.00 |
$297.60
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$108,697.20 |
$108,697.20 |
$108,697.20 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$20,259.00 |
$20,259.00 |
$20,259.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$564.00 |
$564.00 |
$564.00 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$9,372.60 |
$9,372.60 |
$9,372.60 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$5,943.00 |
$5,943.00 |
$5,943.00 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$35,121.00 |
$35,121.00 |
$35,121.00 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$23,821.80 |
$23,821.80 |
$23,821.80 |
$8,925.76
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$35,436.00 |
$35,436.00 |
$35,436.00 |
$16,098.16
|
|
Sterile needle
|
$367.80 |
$367.80 |
$367.80 |
$190.13
|
|
Sterile water/saline, 10 ml
|
$10.00 |
$10.00 |
$10.00 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$39.60 |
$39.60 |
$39.60 |
$28.11
|
|
St evaluate speech sound production
|
$237.00 |
$237.00 |
$237.00 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$486.60 |
$486.60 |
$486.60 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$2,135.40 |
$2,135.40 |
$2,135.40 |
$1,345.40
|
|
Strapping of elbow or wrist 29260
|
$518.40 |
$518.40 |
$518.40 |
$157.46
|
|
Strep a ag ia
|
$123.00 |
$123.00 |
$123.00 |
$75.40
|
|
Strep b dna amp probe
|
$406.20 |
$406.20 |
$406.20 |
$124.15
|
|
Stress test pulmonary
|
$492.00 |
$492.00 |
$492.00 |
$324.00
|
|
Stress tte complete
|
$2,528.40 |
$2,528.40 |
$2,528.40 |
$1,900.96
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$11.00 |
$11.00 |
$11.00 |
$54.80
|
|
Sugars single quant
|
$198.60 |
$198.60 |
$198.60 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$6,078.40 |
$6,078.40 |
$6,078.40 |
$7,487.55
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$1.40 |
$1.40 |
$1.40 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$545.60 |
$545.60 |
$545.60 |
$129.89
|
|
Supp non-insulin inf cath/wk
|
$12.60 |
$12.60 |
$12.60 |
$8.45
|
|
Support clav 29.6-40.5in med
|
$47.40 |
$47.40 |
$47.40 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$55.80 |
$55.80 |
$55.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$121.20 |
$121.20 |
$121.20 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$156.00 |
$156.00 |
$156.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$255.60 |
$255.60 |
$255.60 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$379.20 |
$379.20 |
$379.20 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$516.00 |
$516.00 |
$516.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$93.60 |
$93.60 |
$93.60 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$49.20 |
$49.20 |
$49.20 |
$35.89
|
|
Susceptibility mic per plate
|
$129.60 |
$129.60 |
$129.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$137.40 |
$137.40 |
$137.40 |
$59.28
|
|
Svc venogram s&i
|
$5,562.00 |
$5,562.00 |
$5,562.00 |
$1,990.95
|
|
Swallowing Evaluation (Bedside)
|
$486.60 |
$486.60 |
$486.60 |
$316.80
|
|
Swallowing Therapy Session
|
$316.20 |
$316.20 |
$316.20 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$91.80 |
$91.80 |
$91.80 |
$42.24
|
|
System pacing micra av
|
$27,721.80 |
$27,721.80 |
$27,721.80 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$25,932.00 |
$25,932.00 |
$25,932.00 |
$12,003.00
|
|
System sealant biosentry tract
|
$888.00 |
$888.00 |
$888.00 |
$889.35
|
|
T3 (triiodothyronine) free
|
$253.20 |
$253.20 |
$253.20 |
$100.32
|
|
T3 (triiodothyronine) total
|
$213.00 |
$213.00 |
$213.00 |
$93.52
|
|
T4 (thyroxine) free
|
$136.20 |
$136.20 |
$136.20 |
$89.60
|
|
T4 (thyroxine) total
|
$102.60 |
$102.60 |
$102.60 |
$70.20
|
|
Tacrol envarsus ex rel oral
|
$3.40 |
$3.40 |
$3.40 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$34.00 |
$34.00 |
$34.00 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$282.60 |
$282.60 |
$282.60 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$436.20 |
$436.20 |
$436.20 |
$289.20
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$0.80 |
$0.80 |
$0.80 |
$14.62
|
|
Tap block uni by cont infusion 64487
|
$1,370.40 |
$1,370.40 |
$1,370.40 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$3,169.80 |
$3,169.80 |
$3,169.80 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$7,632.00 |
$7,632.00 |
$7,632.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$1,701.91
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$3.00 |
$3.00 |
$3.00 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$581.40 |
$581.40 |
$581.40 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$510.00 |
$510.00 |
$510.00 |
$179.95
|
|
Tc-99m exametazime diag
|
$9,442.80 |
$9,442.80 |
$9,442.80 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$815.40 |
$815.40 |
$815.40 |
$306.00
|
|
Tc-99m maa
|
$235.20 |
$235.20 |
$235.20 |
$312.06
|
|
Tc-99m mebrofenin
|
$571.20 |
$571.20 |
$571.20 |
$157.65
|
|
Tc-99m medronate
|
$471.00 |
$471.00 |
$471.00 |
$111.01
|
|
Tc-99m mertiatide
|
$4,724.40 |
$4,724.40 |
$4,724.40 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$15.00 |
$15.00 |
$15.00 |
$8.00
|
|
Tc-99m pentetate dtpa aerosol
|
$231.60 |
$231.60 |
$231.60 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$42.60 |
$42.60 |
$42.60 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$287.20
|
|
Tc-99m sulfur colloid
|
$681.00 |
$681.00 |
$681.00 |
$245.70
|
|
T cells absolute cd4/cd8 including ratio
|
$975.00 |
$975.00 |
$975.00 |
$184.00
|
|
T cells absolute cd 4 count
|
$860.40 |
$860.40 |
$860.40 |
$111.20
|
|
T cells total count
|
$741.00 |
$741.00 |
$741.00 |
$130.20
|
|
Telavancin injection
|
$631.80 |
$631.80 |
$631.80 |
$1,191.80
|
|
Telethx isodose plan cplx
|
$2,166.00 |
$2,166.00 |
$2,166.00 |
$1,526.85
|
