|
Sinus CT scan (with contrast)
|
$1,258.85 |
$1,258.85 |
$1,258.85 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$953.45 |
$953.45 |
$953.45 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$875.61 |
$875.61 |
$875.61 |
$2,489.25
|
|
Sirolimus, oral
|
$3,101.27 |
$3,101.27 |
$3,101.27 |
$42.11
|
|
Skin Biopsy
|
$369.28 |
$369.28 |
$369.28 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$3,136.97 |
$3,136.97 |
$3,136.97 |
$3,936.80
|
|
Sleep study unattended
|
$363.78 |
$363.78 |
$363.78 |
$595.50
|
|
Slp stdy unatnd w/anal
|
$90.95 |
$90.95 |
$90.95 |
$307.50
|
|
Small bowel endoscopy
|
$2,555.35 |
$2,555.35 |
$2,555.35 |
$2,244.82
|
|
Smallpox&monkeypox vac 0.5ml
|
$0.11 |
$0.11 |
$0.11 |
$318.64
|
|
Smear fluorescent and/or acid fast stain
|
$133.67 |
$133.67 |
$133.67 |
$64.20
|
|
Smear gram stain
|
$79.53 |
$79.53 |
$79.53 |
$57.85
|
|
Smear nasal eosinophil
|
$43.57 |
$43.57 |
$43.57 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$11.43 |
$11.43 |
$11.43 |
$64.35
|
|
Smear wet mount
|
$96.45 |
$96.45 |
$96.45 |
$68.63
|
|
Sodium 24 hour urine
|
$18.62 |
$18.62 |
$18.62 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$8.89 |
$8.89 |
$8.89 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$8.79 |
$8.79 |
$8.79 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$7.78 |
$7.78 |
$7.78 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$11.10 |
$11.10 |
$11.10 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$75.67 |
$75.67 |
$75.67 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$11.85 |
$11.85 |
$11.85 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$181.61 |
$181.61 |
$181.61 |
$195.48
|
|
Special physics consult
|
$326.56 |
$326.56 |
$326.56 |
$700.74
|
|
Special radiation dosimetry
|
$357.02 |
$357.02 |
$357.02 |
$445.50
|
|
Special radiation treatment
|
$512.68 |
$512.68 |
$512.68 |
$1,934.03
|
|
Special teletx port plan
|
$1,085.42 |
$1,085.42 |
$1,085.42 |
$1,046.65
|
|
Specific gravity body fluid
|
$23.27 |
$23.27 |
$23.27 |
$23.63
|
|
Specimen fat stain
|
$84.18 |
$84.18 |
$84.18 |
$32.76
|
|
Sperm antibody test
|
$76.99 |
$76.99 |
$76.99 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,060.47 |
$1,060.47 |
$1,060.47 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$419.62 |
$419.62 |
$419.62 |
$559.96
|
|
Srs linear based
|
$5,735.46 |
$5,735.46 |
$5,735.46 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$120.56 |
$120.56 |
$120.56 |
$300.00
|
|
Staph a dna amp probe
|
$59.22 |
$59.22 |
$59.22 |
$116.39
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$22,783.21 |
$22,783.21 |
$22,783.21 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$3,429.69 |
$3,429.69 |
$3,429.69 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$340.52 |
$340.52 |
$340.52 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,590.48 |
$1,590.48 |
$1,590.48 |
$18,714.49
|
|
Stent iliac/open or perc/uni/init 37221
|
$24,457.02 |
$24,457.02 |
$24,457.02 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$6,521.82 |
$6,521.82 |
$6,521.82 |
$9,276.80
|
|
Stent placemt retro carotid
|
$2,076.09 |
$2,076.09 |
$2,076.09 |
$9,313.36
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$7,837.35 |
$7,837.35 |
$7,837.35 |
$19,765.20
|
|
St evaluate speech sound production
|
$109.14 |
$109.14 |
$109.14 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$206.01 |
$206.01 |
$206.01 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$376.47 |
$376.47 |
$376.47 |
$406.40
|
|
St evaluation swallow function
|
$223.35 |
$223.35 |
$223.35 |
$336.60
|
|
Strep b assay w/optic
|
$37.65 |
$37.65 |
$37.65 |
$32.00
|
|
Strep b dna amp probe
|
$44.00 |
$44.00 |
$44.00 |
$139.20
|
|
Stress test pulmonary
|
$201.78 |
$201.78 |
$201.78 |
$327.20
|
|
St treatment speech individual
|
$263.11 |
$263.11 |
$263.11 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$213.20 |
$213.20 |
$213.20 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$29.76 |
$29.76 |
$29.76 |
$49.13
|
|
Sugars single quant
|
$72.76 |
$72.76 |
$72.76 |
$52.47
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$5,084.55 |
$5,084.55 |
$5,084.55 |
$5,446.00
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$31.27 |
$31.27 |
$31.27 |
$151.29
|
|
Surgical pathology level 1 gross examination only
|
$63.88 |
$63.88 |
$63.88 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$136.63 |
$136.63 |
$136.63 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$248.31 |
$248.31 |
$248.31 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$111.68 |
$111.68 |
$111.68 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$421.31 |
$421.31 |
$421.31 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$588.82 |
$588.82 |
$588.82 |
$790.00
|
|
Susceptibility enzyme detection per enzyme
|
$8.46 |
$8.46 |
$8.46 |
$34.48
|
|
Susceptibility mic per plate
|
$31.31 |
$31.31 |
$31.31 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$11.43 |
$11.43 |
$11.43 |
$48.30
|
|
Svc venogram s&i
|
$1,839.63 |
$1,839.63 |
$1,839.63 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$51.19 |
$51.19 |
$51.19 |
$44.85
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$0.43 |
$0.43 |
$0.43 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$48.23 |
$48.23 |
$48.23 |
$89.82
|
|
T3 (triiodothyronine) total
|
$33.42 |
$33.42 |
$33.42 |
$94.90
|
|
T4 (thyroxine) free
|
$74.45 |
$74.45 |
$74.45 |
$81.60
|
|
T4 (thyroxine) total
|
$22.00 |
$22.00 |
$22.00 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$198.24 |
$198.24 |
$198.24 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$450.81 |
$450.81 |
$450.81 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$294.84 |
$294.84 |
$294.84 |
$122.40
|
|
Tavr perq femoral
|
$4,598.01 |
$4,598.01 |
$4,598.01 |
$16,357.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$35.54 |
$35.54 |
$35.54 |
$166.46
|
|
Tc-99m exame autol wbc diag per dose
|
$3,159.39 |
$3,159.39 |
$3,159.39 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$1,567.22 |
$1,567.22 |
$1,567.22 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$175.13 |
$175.13 |
$175.13 |
$323.01
|
|
Tc-99m maa
|
$138.33 |
$138.33 |
$138.33 |
$312.06
|
|
Tc-99m mebrofenin
|
$33.42 |
$33.42 |
$33.42 |
$169.53
|
|
Tc-99m mertiatide
|
$311.76 |
$311.76 |
$311.76 |
$757.25
|
|
Tc-99m oxidronate
|
$44.00 |
$44.00 |
$44.00 |
$124.23
|
|
Tc-99m pentetate dtpa aerosol
|
$93.49 |
$93.49 |
$93.49 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$22.85 |
$22.85 |
$22.85 |
$28.08
|
|
Tc-99m sestamibi p study dose
|
$56.26 |
$56.26 |
$56.26 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$1,484.73 |
$1,484.73 |
$1,484.73 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$237.73 |
$237.73 |
$237.73 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$100.68 |
$100.68 |
$100.68 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$717.84 |
$717.84 |
$717.84 |
$930.54
|
|
Tcd emboli detect w/inj
|
$261.00 |
$261.00 |
$261.00 |
$404.68
|
|
Tcd emboli detect without inj
|
$261.00 |
$261.00 |
$261.00 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$99.83 |
$99.83 |
$99.83 |
$186.00
|
|
T cells absolute cd 4 count
|
$54.57 |
$54.57 |
$54.57 |
$120.25
|
|
T cells total count
|
$63.45 |
$63.45 |
$63.45 |
$124.11
|
|
Telethx isodose plan cplx
|
$1,278.31 |
$1,278.31 |
$1,278.31 |
$1,617.00
|
|
Telethx isodose plan simple
|
$652.27 |
$652.27 |
$652.27 |
$848.72
|
|
Temozolomide
|
$155.75 |
$155.75 |
$155.75 |
$374.66
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$21,334.59 |
$21,334.59 |
$21,334.59 |
$16,531.64
|
