|
Sinus CT scan (with contrast)
|
$842.10 |
$842.10 |
$842.10 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$795.90 |
$795.90 |
$795.90 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,245.09 |
$1,245.09 |
$1,245.09 |
$2,489.25
|
|
Sirolimus, oral
|
$255.62 |
$255.62 |
$255.62 |
$41.25
|
|
Skeletal muscle relaxant 1/2
|
$67.41 |
$67.41 |
$67.41 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$77.91 |
$77.91 |
$77.91 |
$16.12
|
|
Skin Biopsy
|
$124.32 |
$124.32 |
$124.32 |
$360.34
|
|
Skin test unlisted antigen ea
|
$34.23 |
$34.23 |
$34.23 |
$48.57
|
|
Sleep study attended
|
$456.75 |
$456.75 |
$456.75 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$1,334.34 |
$1,334.34 |
$1,334.34 |
$3,607.50
|
|
Sleep study unattended
|
$107.31 |
$107.31 |
$107.31 |
$580.87
|
|
Slitting of prepuce
|
$580.65 |
$580.65 |
$580.65 |
$3,365.50
|
|
Slp pure tone screening
|
$10.50 |
$10.50 |
$10.50 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$112.35 |
$112.35 |
$112.35 |
$296.34
|
|
Sm-153 lexidron ther
|
$3,823.89 |
$3,823.89 |
$3,823.89 |
$7,320.12
|
|
Smear fluorescent and/or acid fast stain
|
$55.65 |
$55.65 |
$55.65 |
$64.20
|
|
Smear gram stain
|
$45.78 |
$45.78 |
$45.78 |
$55.25
|
|
Smear nasal eosinophil
|
$24.78 |
$24.78 |
$24.78 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$33.18 |
$33.18 |
$33.18 |
$73.15
|
|
Smear wet mount
|
$25.41 |
$25.41 |
$25.41 |
$67.49
|
|
Snrpn/ube3a gene
|
$39.06 |
$39.06 |
$39.06 |
$231.85
|
|
Sodium 24 hour urine
|
$42.42 |
$42.42 |
$42.42 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$125.58 |
$125.58 |
$125.58 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$115.92 |
$115.92 |
$115.92 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$43.47 |
$43.47 |
$43.47 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$8.66 |
$8.66 |
$8.66 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$12.66 |
$12.66 |
$12.66 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$39.27 |
$39.27 |
$39.27 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$155.92 |
$155.92 |
$155.92 |
$177.52
|
|
Special physics consult
|
$278.46 |
$278.46 |
$278.46 |
$725.00
|
|
Special radiation dosimetry
|
$86.94 |
$86.94 |
$86.94 |
$392.50
|
|
Special radiation treatment
|
$865.20 |
$865.20 |
$865.20 |
$1,986.00
|
|
Special teletx port plan
|
$269.22 |
$269.22 |
$269.22 |
$1,086.99
|
|
Specific gravity body fluid
|
$18.90 |
$18.90 |
$18.90 |
$22.00
|
|
Speech audiometry complete
|
$31.71 |
$31.71 |
$31.71 |
$109.20
|
|
Speech evaluation complex
|
$108.57 |
$108.57 |
$108.57 |
$527.06
|
|
Speech recep thresh
|
$37.17 |
$37.17 |
$37.17 |
$82.88
|
|
Sperm antibody test
|
$40.32 |
$40.32 |
$40.32 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$441.00 |
$441.00 |
$441.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$260.19 |
$260.19 |
$260.19 |
$543.26
|
|
Split blood or products
|
$43.68 |
$43.68 |
$43.68 |
$127.48
|
|
Sputum specimen collection
|
$60.06 |
$60.06 |
$60.06 |
$180.00
|
|
Srs linear based
|
$3,766.56 |
$3,766.56 |
$3,766.56 |
$13,585.00
|
|
Staggered spondaic word test
|
$70.35 |
$70.35 |
$70.35 |
$253.00
|
|
St analysis behavior qualitative voice/resonance
|
$63.00 |
$63.00 |
$63.00 |
$297.60
|
|
Staph a dna amp probe
|
$34.44 |
$34.44 |
$34.44 |
$125.00
|
|
Static or dynami afo pre ots
|
$80.22 |
$80.22 |
$80.22 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$70.14 |
$70.14 |
$70.14 |
$286.00
|
|
Stenger test pure tone
|
$30.87 |
$30.87 |
$30.87 |
$77.84
|
|
Stenger test speech
|
$183.96 |
$183.96 |
$183.96 |
$404.25
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$16,147.11 |
$16,147.11 |
$16,147.11 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$1,980.51 |
$1,980.51 |
$1,980.51 |
$32,403.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,342.95 |
$1,342.95 |
$1,342.95 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$10,640.28 |
$10,640.28 |
$10,640.28 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$8,717.31 |
$8,717.31 |
$8,717.31 |
$9,008.54
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$10,691.31 |
$10,691.31 |
$10,691.31 |
$17,271.50
|
|
St evaluate speech sound production
|
$61.32 |
$61.32 |
$61.32 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$126.21 |
$126.21 |
$126.21 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$165.06 |
$165.06 |
$165.06 |
$399.60
|
|
St evaluation swallow function
|
$114.66 |
$114.66 |
$114.66 |
$314.40
|
|
Stimulants synthetic
|
$15.96 |
$15.96 |
$15.96 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$62.37 |
$62.37 |
$62.37 |
$223.45
|
|
Strapping of chest
|
$49.98 |
$49.98 |
$49.98 |
$195.33
|
|
Strapping of hand or finger
|
$30.87 |
$30.87 |
$30.87 |
$174.82
|
|
Strapping of knee
|
$34.86 |
$34.86 |
$34.86 |
$205.20
|
|
Strapping of toes 29550
|
$30.87 |
$30.87 |
$30.87 |
$164.70
|
|
Strep b dna amp probe
|
$28.56 |
$28.56 |
$28.56 |
$120.90
|
|
Streptomycin injection
|
$61.10 |
$61.10 |
$61.10 |
$138.30
|
|
Stress test pulmonary
|
$47.04 |
$47.04 |
$47.04 |
$322.85
|
|
Stress tte complete
|
$411.18 |
$411.18 |
$411.18 |
$1,870.50
|
|
Str markers spec anal addl
|
$164.64 |
$164.64 |
$164.64 |
$479.17
|
|
Str markers specimen anal
|
$558.60 |
$558.60 |
$558.60 |
$751.50
|
|
St treatment speech individual
|
$173.04 |
$173.04 |
$173.04 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$173.04 |
$173.04 |
$173.04 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$43.94 |
$43.94 |
$43.94 |
$52.31
|
|
Sugars single quant
|
$7.98 |
$7.98 |
$7.98 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$64.89 |
$64.89 |
$64.89 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$36.43 |
$36.43 |
$36.43 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$16.59 |
$16.59 |
$16.59 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$13.23 |
$13.23 |
$13.23 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$29.19 |
$29.19 |
$29.19 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$29.19 |
$29.19 |
$29.19 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$115.29 |
$115.29 |
$115.29 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$242.76 |
$242.76 |
$242.76 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$7.14 |
$7.14 |
$7.14 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$12.39 |
$12.39 |
$12.39 |
$35.70
|
|
Susceptibility mic per plate
|
$130.41 |
$130.41 |
$130.41 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$4.41 |
$4.41 |
$4.41 |
$59.28
|
|
Svc venogram s&i
|
$609.21 |
$609.21 |
$609.21 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$34.02 |
$34.02 |
$34.02 |
$125.40
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$40.11 |
$40.11 |
$40.11 |
$41.60
|
|
T3 (triiodothyronine) free
|
$130.41 |
$130.41 |
$130.41 |
$99.20
|
|
T3 (triiodothyronine) total
|
$49.14 |
$49.14 |
$49.14 |
$93.52
|
|
T4 (thyroxine) free
|
$43.47 |
$43.47 |
$43.47 |
$85.20
|
|
T4 (thyroxine) total
|
$46.62 |
$46.62 |
$46.62 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.74 |
$2.74 |
$2.74 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$200.34 |
$200.34 |
$200.34 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$862.15 |
$862.15 |
$862.15 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$326.34 |
$326.34 |
$326.34 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,206.87 |
$1,206.87 |
$1,206.87 |
$3,746.70
|