|
Renal function panel
|
$72.72 |
$72.72 |
$72.72 |
$95.76
|
|
Reptilase test
|
$40.82 |
$40.82 |
$40.82 |
$65.72
|
|
Resuscitation cardiopulmonary
|
$656.27 |
$656.27 |
$656.27 |
$895.44
|
|
Reticulocyte automated
|
$81.84 |
$81.84 |
$81.84 |
$54.27
|
|
Reticulocyte direct measurement automated
|
$54.54 |
$54.54 |
$54.54 |
$32.50
|
|
Rheumatoid factor quantitative
|
$44.87 |
$44.87 |
$44.87 |
$59.80
|
|
Rho d immune globulin inj
|
$111.17 |
$111.17 |
$111.17 |
$232.72
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$201.92 |
$201.92 |
$201.92 |
$201.92
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$181.74 |
$181.74 |
$181.74 |
$1,848.99
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$0.33 |
$0.33 |
$0.33 |
$60.40
|
|
Rp loclzj tum 2+area 1+d img
|
$721.88 |
$721.88 |
$721.88 |
$1,283.66
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$1,496.51 |
$1,496.51 |
$1,496.51 |
$2,182.05
|
|
Rubella antibody igg
|
$73.10 |
$73.10 |
$73.10 |
$73.05
|
|
Rubeola antibody igg
|
$74.43 |
$74.43 |
$74.43 |
$80.00
|
|
Russell viper venom diluted
|
$108.20 |
$108.20 |
$108.20 |
$73.03
|
|
Salmonella antibody
|
$37.58 |
$37.58 |
$37.58 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$523.35 |
$523.35 |
$523.35 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$440.79 |
$440.79 |
$440.79 |
$662.40
|
|
Scan duplex extremity veins unilateral/limited study
|
$444.86 |
$444.86 |
$444.86 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$389.69 |
$389.69 |
$389.69 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$369.29 |
$369.29 |
$369.29 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$366.44 |
$366.44 |
$366.44 |
$527.80
|
|
Screening Colonoscopy (average risk)
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,093.16
|
|
Screening Colonoscopy (high risk)
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,575.00
|
|
Screening Mammogram
|
$189.54 |
$189.54 |
$189.54 |
$287.12
|
|
Screen pap by tech w md supv
|
$27.65 |
$27.65 |
$27.65 |
$27.65
|
|
Semen analysis presence/motility
|
$51.29 |
$51.29 |
$51.29 |
$79.92
|
|
Shoulder MRI (with and without contrast)
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$972.71 |
$972.71 |
$972.71 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$936.15 |
$936.15 |
$936.15 |
$1,938.28
|
|
Shoulder X-ray
|
$150.29 |
$150.29 |
$150.29 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$142.49 |
$142.49 |
$142.49 |
$342.54
|
|
Sickling rbc
|
$156.71 |
$156.71 |
$156.71 |
$53.40
|
|
Sigmoidoscopy and biopsy
|
$672.75 |
$672.75 |
$672.75 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$672.75 |
$672.75 |
$672.75 |
$1,009.14
|
|
Sigmoidoscopy for bleeding
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,594.50
|
|
Sigmoidoscopy/submucosal injection 45335
|
$672.75 |
$672.75 |
$672.75 |
$1,278.72
|
|
Sigmoidoscopy w/ablation
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$672.75 |
$672.75 |
$672.75 |
$1,370.25
|
|
Sigmoidoscopy w/plcmt stent
|
$2,859.02 |
$2,859.02 |
$2,859.02 |
$4,379.25
|
|
Sigmoidoscopy w/tumr remove
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,350.83
|
|
Sigmoidoscopy w/ultrasound
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,233.60
|
|
Sigmoidoscopy w/us guide bx
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,388.56
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,183.20
|
|
Sig w/tndsc balloon dilation
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,364.66
|
|
Sincalide 5 mcg solution for injection
|
$280.40 |
$280.40 |
$280.40 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$691.10 |
$691.10 |
$691.10 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$622.91 |
$622.91 |
$622.91 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$554.03 |
$554.03 |
$554.03 |
$1,151.00
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,200.46
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,101.52
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,455.20
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,101.52
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,200.46
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$1,104.13
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,101.52
|
|
Small bowel endoscopy 44365
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,073.18
|
|
Small bowel endoscopy/biopsy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,178.16
|
|
Small bowel endoscopy br/wa
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$1,247.13
|
|
Small bowel endoscopy br/wa
|
$1,201.25 |
$1,201.25 |
$1,201.25 |
$2,218.50
|
|
Smear fluorescent and/or acid fast stain
|
$46.43 |
$46.43 |
$46.43 |
$50.70
|
|
Smear gram stain
|
$41.27 |
$41.27 |
$41.27 |
$48.00
|
|
Smear special stain inclusion bodies/parasites
|
$58.32 |
$58.32 |
$58.32 |
$60.00
|
|
Smear wet mount
|
$42.57 |
$42.57 |
$42.57 |
$56.13
|
|
Sodium 24 hour urine
|
$40.10 |
$40.10 |
$40.10 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$46.35 |
$46.35 |
$46.35 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$42.25
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$13.67 |
$13.67 |
$13.67 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$26.93 |
$26.93 |
$26.93 |
$42.43
|
|
Specific gravity body fluid
|
$29.67 |
$29.67 |
$29.67 |
$21.55
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$869.79 |
$869.79 |
$869.79 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$536.34 |
$536.34 |
$536.34 |
$526.80
|
|
Sputum specimen collection
|
$34.44 |
$34.44 |
$34.44 |
$180.00
|
|
Staph a dna amp probe
|
$94.53 |
$94.53 |
$94.53 |
$116.39
|
|
St evaluate speech sound production comprehensive/expressive
|
$148.26 |
$148.26 |
$148.26 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$161.94 |
$161.94 |
$161.94 |
$336.00
|
|
St evaluation swallow function
|
$154.29 |
$154.29 |
$154.29 |
$323.72
|
|
Stress test pulmonary
|
$118.40 |
$118.40 |
$118.40 |
$330.63
|
|
St treatment speech individual
|
$76.77 |
$76.77 |
$76.77 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$112.47 |
$112.47 |
$112.47 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$5.33 |
$5.33 |
$5.33 |
$22.19
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$23.64 |
$23.64 |
$23.64 |
$52.49
|
|
Surg dx exam anorectal
|
$2,363.76 |
$2,363.76 |
$2,363.76 |
$2,814.85
|
|
Surgical pathology level 1 gross examination only
|
$30.20 |
$30.20 |
$30.20 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$65.42 |
$65.42 |
$65.42 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$104.06 |
$104.06 |
$104.06 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$112.20 |
$112.20 |
$112.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$161.76 |
$161.76 |
$161.76 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$368.46 |
$368.46 |
$368.46 |
$720.75
|
|
Susceptibility enzyme detection per enzyme
|
$46.89 |
$46.89 |
$46.89 |
$31.85
|
|
Susceptibility mic per plate
|
$107.91 |
$107.91 |
$107.91 |
$89.70
|
|
Suscept studies macrobroth dilution ea
|
$67.58 |
$67.58 |
$67.58 |
$47.17
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$118.29 |
$118.29 |
$118.29 |
$45.70
|
|
T3 (triiodothyronine) free
|
$82.88 |
$82.88 |
$82.88 |
$91.20
|
|
T3 (triiodothyronine) total
|
$52.46 |
$52.46 |
$52.46 |
$88.00
|
|
T4 (thyroxine) free
|
$161.18 |
$161.18 |
$161.18 |
$65.00
|
|
T4 (thyroxine) total
|
$44.97 |
$44.97 |
$44.97 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$173.70 |
$173.70 |
$173.70 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$4,117.83 |
$4,117.83 |
$4,117.83 |
$1,928.40
|