|
Shuntogram nonvascular supervision & interpretation
|
$89.40 |
$89.40 |
$98.34 |
$349.20
|
|
Sialography s&i
|
$113.10 |
$113.10 |
$113.10 |
$499.20
|
|
Sickling rbc
|
$45.54 |
$45.54 |
$86.94 |
$57.92
|
|
Sim ang w/prs cath rad emb
|
$4,840.80 |
$4,840.80 |
$4,840.80 |
$18,145.20
|
|
Sincalide 5 mcg solution for injection
|
$133.39 |
$133.39 |
$146.72 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$519.00 |
$519.00 |
$570.90 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$346.50 |
$346.50 |
$381.15 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$346.50 |
$346.50 |
$381.15 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,451.70 |
$1,451.70 |
$1,596.87 |
$2,489.25
|
|
Sirolimus, oral
|
$10.53 |
$10.53 |
$11.58 |
$41.25
|
|
Skin Biopsy
|
$186.90 |
$186.90 |
$205.59 |
$360.34
|
|
Skin test unlisted antigen ea
|
$28.50 |
$28.50 |
$31.35 |
$48.57
|
|
Sleep Study (Polysomnography)
|
$846.60 |
$846.60 |
$931.26 |
$3,607.50
|
|
Sleep study unattended
|
$99.30 |
$99.30 |
$109.23 |
$580.87
|
|
Sleeve fing rolyan med
|
$74.10 |
$74.10 |
$81.51 |
$203.58
|
|
Sling suprapubic suburetheral
|
$4,344.45 |
$4,344.45 |
$13,776.75 |
$9,679.96
|
|
Slp pure tone screening
|
$14.10 |
$14.10 |
$15.51 |
$60.48
|
|
Smear fluorescent and/or acid fast stain
|
$15.51 |
$15.51 |
$29.61 |
$64.20
|
|
Smear gram stain
|
$14.19 |
$14.19 |
$27.09 |
$55.25
|
|
Smear nasal eosinophil
|
$13.53 |
$13.53 |
$25.83 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$19.80 |
$19.80 |
$37.80 |
$73.15
|
|
Smear wet mount
|
$13.53 |
$13.53 |
$25.83 |
$67.49
|
|
Sodium 24 hour urine
|
$16.17 |
$16.17 |
$30.87 |
$48.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$18.63 |
$18.63 |
$20.49 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$266.78 |
$266.78 |
$347.61 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$15.84 |
$15.84 |
$30.24 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$187.46 |
$187.46 |
$206.21 |
$177.52
|
|
Somatropin injection
|
$830.53 |
$830.53 |
$913.58 |
$2,381.48
|
|
Special physics consult
|
$165.90 |
$165.90 |
$182.49 |
$725.00
|
|
Special radiation dosimetry
|
$67.20 |
$67.20 |
$73.92 |
$392.50
|
|
Special radiation treatment
|
$389.10 |
$389.10 |
$428.01 |
$1,986.00
|
|
Special teletx port plan
|
$198.90 |
$198.90 |
$218.79 |
$1,086.99
|
|
Specific gravity body fluid
|
$15.12 |
$15.12 |
$15.12 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$324.60 |
$324.60 |
$357.06 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$171.60 |
$171.60 |
$188.76 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$146.40 |
$146.40 |
$161.04 |
$392.09
|
|
Splint finger fold over sm
|
$34.60 |
$34.60 |
$39.58 |
$146.88
|
|
Splint finger frog med
|
$12.00 |
$12.00 |
$13.20 |
$38.08
|
|
Split blood or products
|
$13.86 |
$13.86 |
$26.46 |
$127.48
|
|
Srs linear based
|
$11,004.30 |
$11,004.30 |
$12,104.73 |
$13,585.00
|
|
Srs multisource
|
$14,520.00 |
$14,520.00 |
$14,520.00 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$54.60 |
$54.60 |
$60.06 |
$297.60
|
|
Staph a dna amp probe
|
$211.05 |
$211.05 |
$211.05 |
$125.00
|
|
Static or dynami afo pre ots
|
$511.83 |
$511.83 |
$603.90 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$40.50 |
$40.50 |
$44.55 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$16,979.76 |
$16,979.76 |
$30,214.39 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$1,741.50 |
$1,741.50 |
$1,915.65 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$7,492.50 |
$7,492.50 |
$28,040.10 |
$20,962.50
|
|
Stent placemt retro carotid
|
$630.00 |
$630.00 |
$630.00 |
$5,328.00
|
|
St evaluate speech sound production
|
$54.60 |
$54.60 |
$60.06 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$54.60 |
$54.60 |
$60.06 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$90.30 |
$90.30 |
$99.33 |
$399.60
|
|
St evaluation swallow function
|
$54.60 |
$54.60 |
$60.06 |
$314.40
|
|
Stress test pulmonary
|
$72.27 |
$72.27 |
$72.27 |
$322.85
|
|
Stress tte complete
|
$403.50 |
$403.50 |
$443.85 |
$1,870.50
|
|
Str markers spec anal addl
|
$208.89 |
$208.89 |
$208.89 |
$479.17
|
|
Str markers specimen anal
|
$297.66 |
$297.66 |
$297.66 |
$751.50
|
|
St treatment speech individual
|
$50.10 |
$50.10 |
$55.11 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$57.90 |
$57.90 |
$63.69 |
$240.31
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$3.96 |
$3.96 |
$4.36 |
$114.88
|
|
Support clav 29.6-40.5in med
|
$28.92 |
$28.92 |
$31.81 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$12.21 |
$12.21 |
$23.31 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$27.06 |
$27.06 |
$51.66 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$32.34 |
$32.34 |
$61.74 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$139.92 |
$139.92 |
$267.12 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$211.86 |
$211.86 |
$404.46 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$297.00 |
$297.00 |
$567.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$15.84 |
$15.84 |
$30.24 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$15.84 |
$15.84 |
$30.24 |
$35.70
|
|
Susceptibility mic per plate
|
$306.90 |
$306.90 |
$585.90 |
$106.00
|
|
Svc venogram s&i
|
$723.60 |
$723.60 |
$795.96 |
$1,934.62
|
|
Synvisc or synvisc-one
|
$1,400.30 |
$1,400.30 |
$1,540.32 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$13.53 |
$13.53 |
$25.83 |
$41.60
|
|
System pacing micra av
|
$18,330.00 |
$18,330.00 |
$20,163.00 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,678.00 |
$6,678.00 |
$7,345.80 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$56.43 |
$56.43 |
$107.73 |
$99.20
|
|
T3 (triiodothyronine) total
|
$47.19 |
$47.19 |
$90.09 |
$93.52
|
|
T4 (thyroxine) free
|
$30.03 |
$30.03 |
$57.33 |
$85.20
|
|
T4 (thyroxine) total
|
$22.77 |
$22.77 |
$43.47 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$17.70 |
$17.70 |
$19.47 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$31.68 |
$31.68 |
$60.48 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,427.14 |
$1,427.14 |
$1,569.85 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$11,811.82 |
$11,811.82 |
$12,993.00 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$891.00 |
$891.00 |
$1,701.00 |
$2,246.30
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$15,336.00 |
$15,336.00 |
$16,869.60 |
$24,217.20
|
|
Tavr perq femoral
|
$13,035.00 |
$13,035.00 |
$13,035.00 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$371.68 |
$371.68 |
$408.85 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$32.01 |
$32.01 |
$61.11 |
$177.65
|
|
Tc-99m exame autol wbc diag per dose
|
$1,471.19 |
$1,471.19 |
$1,618.30 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$1,164.58 |
$1,164.58 |
$1,281.04 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$100.23 |
$100.23 |
$110.25 |
$302.40
|
|
Tc-99m maa
|
$89.62 |
$89.62 |
$98.58 |
$292.80
|
|
Tc-99m mebrofenin
|
$37.82 |
$37.82 |
$41.60 |
$157.65
|
|
Tc-99m medronate
|
$41.05 |
$41.05 |
$45.15 |
$111.01
|
|
Tc-99m mertiatide
|
$183.42 |
$183.42 |
$201.77 |
$756.00
|
|
Tc-99m oxidronate
|
$50.32 |
$50.32 |
$55.35 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$141.16 |
$141.16 |
$155.27 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$31.64 |
$31.64 |
$34.80 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$53.51 |
$53.51 |
$58.86 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$30.91 |
$30.91 |
$34.00 |
$274.45
|
