|
Sincalide 5 mcg solution for injection
|
$280.40 |
$280.40 |
$280.40 |
|
|
Sinus CT scan (with and without contrast)
|
$658.53 |
$658.53 |
$691.10 |
|
|
Sinus CT scan (with contrast)
|
$622.91 |
$622.91 |
$622.91 |
|
|
Sinus CT scan (without contrast)
|
$554.03 |
$554.03 |
$554.03 |
|
|
Sinus/juglr venogram s&i
|
$911.27 |
$911.27 |
$911.27 |
|
|
Sirolimus, oral
|
$13.29 |
$13.29 |
$13.29 |
|
|
Sleep Study (Polysomnography)
|
$1,237.68 |
$1,237.68 |
$1,237.68 |
|
|
Sm-153 lexidron ther
|
$17,839.89 |
$17,839.89 |
$17,839.89 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy 44365
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy/biopsy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy/biopsy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy br/wa
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
|
|
Small bowel endoscopy br/wa
|
$1,201.23 |
$1,201.23 |
$1,201.25 |
|
|
Smear fluorescent and/or acid fast stain
|
$46.43 |
$46.43 |
$46.43 |
|
|
Smear gram stain
|
$41.24 |
$41.24 |
$41.27 |
|
|
Smear special stain inclusion bodies/parasites
|
$58.32 |
$58.32 |
$58.32 |
|
|
Smear wet mount
|
$42.57 |
$42.57 |
$75.90 |
|
|
Sodium 24 hour urine
|
$40.10 |
$40.10 |
$40.10 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$46.35 |
$46.35 |
$46.35 |
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$13.67 |
$13.67 |
$13.67 |
|
|
Sodium serum/plasma/whole blood
|
$26.93 |
$26.93 |
$64.82 |
|
|
Special physics consult
|
$396.15 |
$396.15 |
$396.15 |
|
|
Special radiation dosimetry
|
$244.74 |
$244.74 |
$244.74 |
|
|
Special radiation treatment
|
$785.24 |
$785.24 |
$785.24 |
|
|
Special teletx port plan
|
$1,086.99 |
$1,086.99 |
$1,086.99 |
|
|
Specific gravity body fluid
|
$29.67 |
$29.67 |
$29.67 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$869.79 |
$869.79 |
$869.79 |
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$536.34 |
$536.34 |
$536.34 |
|
|
Sputum specimen collection
|
$34.44 |
$34.44 |
$101.01 |
|
|
Sr-89 stront chlor ther / mci
|
$2,617.05 |
$2,617.05 |
$2,617.05 |
|
|
Srs linear based
|
$3,525.80 |
$3,525.80 |
$3,525.80 |
|
|
Staph a dna amp probe
|
$94.53 |
$94.53 |
$94.53 |
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$27,301.35 |
$27,301.35 |
$27,301.35 |
|
|
Stent iliac/open or perc/uni/init 37221
|
$22,106.90 |
$22,106.90 |
$22,106.90 |
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$12,015.15 |
$12,015.15 |
$12,015.15 |
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$21,166.35 |
$21,166.35 |
$21,166.35 |
|
|
St evaluate speech sound production comprehensive/expressive
|
$141.20 |
$146.49 |
$148.26 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$154.22 |
$161.94 |
$212.79 |
|
|
St evaluation swallow function
|
$111.96 |
$146.93 |
$154.29 |
|
|
Streptomycin injection
|
$167.91 |
$167.91 |
$167.91 |
|
|
Stress test pulmonary
|
$118.40 |
$118.40 |
$118.40 |
|
|
St treatment speech individual
|
$73.11 |
$76.77 |
$111.56 |
|
|
St treatment swallow dysfunction/oral
|
$107.12 |
$112.47 |
$130.97 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$5.33 |
$5.33 |
$5.33 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$23.64 |
$23.64 |
$23.64 |
|
|
Surg dx exam anorectal
|
$2,363.76 |
$2,363.76 |
$2,363.76 |
|
|
Surgical pathology level 1 gross examination only
|
$30.20 |
$30.20 |
$30.20 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$65.42 |
$65.42 |
$65.42 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$104.06 |
$104.06 |
$104.06 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$112.20 |
$112.20 |
$112.20 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$161.76 |
$161.76 |
$161.76 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$368.46 |
$368.46 |
$368.46 |
|
|
Susceptibility enzyme detection per enzyme
|
$46.89 |
$46.89 |
$46.89 |
|
|
Susceptibility mic per plate
|
$107.91 |
$107.91 |
$107.91 |
|
|
Suscept studies macrobroth dilution ea
|
$67.58 |
$67.58 |
$67.58 |
|
|
Svc venogram s&i
|
$1,419.30 |
$1,419.30 |
$1,419.30 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$118.29 |
$118.29 |
$118.29 |
|
|
T3 (triiodothyronine) free
|
$82.88 |
$82.88 |
$82.88 |
|
|
T3 (triiodothyronine) total
|
$52.46 |
$52.46 |
$52.46 |
|
|
T4 (thyroxine) free
|
$161.18 |
$161.18 |
$161.18 |
|
|
T4 (thyroxine) total
|
$44.97 |
$44.97 |
$44.97 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.48 |
$3.48 |
$3.48 |
|
|
Tacrolimus therapeutic drug level
|
$173.70 |
$173.70 |
$173.70 |
|
|
Target gsa panel hmtlmph neop
|
$4,117.83 |
$4,117.83 |
$4,117.83 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.79 |
$1.79 |
$1.79 |
|
|
Tbs techl calculation only
|
$129.47 |
$129.47 |
$129.47 |
|
|
Tbs techl prep&transmis data
|
$129.47 |
$129.47 |
$129.47 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$166.46 |
$166.46 |
$166.46 |
|
|
Tc-99m exame autol wbc diag per dose
|
$3,612.03 |
$3,612.06 |
$3,612.06 |
|
|
Tc-99m exametazime diag
|
$3,089.18 |
$3,089.18 |
$3,089.18 |
|
|
Tc-99m labeled rbc
|
$298.40 |
$298.40 |
$299.49 |
|
|
Tc-99m maa
|
$216.27 |
$267.74 |
$267.74 |
|
|
Tc-99m mebrofenin
|
$57.54 |
$99.54 |
$109.50 |
|
|
Tc-99m medronate
|
$39.08 |
$39.09 |
$107.13 |
|
|
Tc-99m mertiatide
|
$554.84 |
$554.84 |
$615.42 |
|
|
Tc-99m pentetate dtpa
|
$161.51 |
$161.52 |
$229.71 |
|
|
Tc-99m pentetate dtpa aerosol
|
$181.37 |
$181.37 |
$229.71 |
|
|
Tc-99m pertechnetate per mci
|
$22.07 |
$49.20 |
$49.20 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$77.01 |
$77.01 |
$137.01 |
|
|
Tc-99m sestamibi p study dose
|
$144.12 |
$251.54 |
$251.54 |
|
|
Tc-99m sulfur colloid
|
$229.62 |
$229.64 |
$401.36 |
|
|
Tc-99m tilmanocept diag
|
$1,108.52 |
$1,108.52 |
$1,108.52 |
|
|
T cells absolute cd4/cd8 including ratio
|
$255.23 |
$255.24 |
$255.24 |
|
|
Telethx isodose plan cplx
|
$1,086.99 |
$1,086.99 |
$1,086.99 |
|
|
Telethx isodose plan simple
|
$370.44 |
$370.44 |
$370.44 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$213.27 |
$213.27 |
$213.27 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$8.60 |
$8.60 |
$8.60 |
|
|
Test for chlorohydrocarbons
|
$254.78 |
$254.81 |
$254.81 |
|
|
Testicular imaging w/vasc flow
|
$329.15 |
$329.15 |
$329.15 |
|
|
Test pathogen(s) for platelets reference
|
$146.37 |
$146.37 |
$146.37 |
|
|
Test stress cardiovascular tracing only
|
$614.06 |
$614.07 |
$713.27 |
|