|
Shoulder X-ray
|
$663.24 |
$663.24 |
$663.24 |
$367.02
|
|
Sickling rbc
|
$111.25 |
$111.25 |
$111.25 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$4,017.97 |
$4,017.97 |
$4,017.97 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,830.52 |
$3,830.52 |
$3,830.52 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$3,743.14 |
$3,743.14 |
$3,743.14 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$12,652.35 |
$12,652.35 |
$12,652.35 |
$2,489.25
|
|
Skin Biopsy
|
$735.39 |
$735.39 |
$735.39 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$6,709.09 |
$6,709.09 |
$6,709.09 |
$3,936.80
|
|
Smear fluorescent and/or acid fast stain
|
$197.58 |
$197.58 |
$197.58 |
$64.20
|
|
Smear gram stain
|
$149.97 |
$149.97 |
$149.97 |
$57.85
|
|
Smear nasal eosinophil
|
$102.77 |
$102.77 |
$102.77 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$189.18 |
$189.18 |
$189.18 |
$64.35
|
|
Sodium 24 hour urine
|
$105.23 |
$105.23 |
$105.23 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$25.45 |
$25.45 |
$25.45 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$65.86 |
$65.86 |
$65.86 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$260.56 |
$260.56 |
$260.56 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$648.52 |
$648.52 |
$648.52 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$133.46 |
$133.46 |
$133.46 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,715.13 |
$1,715.13 |
$1,715.13 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,372.83 |
$1,372.83 |
$1,372.83 |
$559.96
|
|
St analysis behavior qualitative voice/resonance
|
$523.82 |
$523.82 |
$523.82 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$335.34 |
$335.34 |
$335.34 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$82,468.13 |
$82,468.13 |
$82,468.13 |
$23,387.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$22,413.21 |
$22,413.21 |
$22,413.21 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$22,413.21 |
$22,413.21 |
$22,413.21 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$47,582.20 |
$47,582.20 |
$47,582.20 |
$19,765.20
|
|
St evaluate speech sound production
|
$523.82 |
$523.82 |
$523.82 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$523.82 |
$523.82 |
$523.82 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$599.18 |
$599.18 |
$599.18 |
$406.40
|
|
St evaluation swallow function
|
$797.65 |
$797.65 |
$797.65 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$898.32 |
$898.32 |
$898.32 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$400.35 |
$400.35 |
$400.35 |
$171.00
|
|
Strapping of hand or finger
|
$492.03 |
$492.03 |
$492.03 |
$194.40
|
|
Strapping of knee
|
$709.95 |
$709.95 |
$709.95 |
$224.80
|
|
Stress test pulmonary
|
$1,073.81 |
$1,073.81 |
$1,073.81 |
$327.20
|
|
Stress tte complete
|
$6,106.82 |
$6,106.82 |
$6,106.82 |
$1,964.95
|
|
St treatment speech individual
|
$402.19 |
$402.19 |
$402.19 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$422.72 |
$422.72 |
$422.72 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$103.08 |
$103.08 |
$103.08 |
$49.13
|
|
Sugars single quant
|
$118.19 |
$118.19 |
$118.19 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$270.40 |
$270.40 |
$270.40 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$65.34 |
$65.34 |
$65.34 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$196.56 |
$196.56 |
$196.56 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$363.60 |
$363.60 |
$363.60 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$499.86 |
$499.86 |
$499.86 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$735.97 |
$735.97 |
$735.97 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,021.37 |
$1,021.37 |
$1,021.37 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,147.30 |
$1,147.30 |
$1,147.30 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$75.52 |
$75.52 |
$75.52 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$79.20 |
$79.20 |
$79.20 |
$34.48
|
|
Susceptibility mic per plate
|
$487.88 |
$487.88 |
$487.88 |
$94.38
|
|
Svc venogram s&i
|
$9,073.81 |
$9,073.81 |
$9,073.81 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$777.17 |
$777.17 |
$777.17 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$78.49 |
$78.49 |
$78.49 |
$44.85
|
|
T3 (triiodothyronine) free
|
$362.66 |
$362.66 |
$362.66 |
$89.82
|
|
T3 (triiodothyronine) total
|
$262.04 |
$262.04 |
$262.04 |
$94.90
|
|
T4 (thyroxine) free
|
$246.99 |
$246.99 |
$246.99 |
$81.60
|
|
T4 (thyroxine) total
|
$248.23 |
$248.23 |
$248.23 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$358.87 |
$358.87 |
$358.87 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$2,702.38 |
$2,702.38 |
$2,702.38 |
$1,928.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,431.93 |
$1,431.93 |
$1,431.93 |
$959.55
|
|
Tbs techl calculation only
|
$216.33 |
$216.33 |
$216.33 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$495.47 |
$495.47 |
$495.47 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$375.21 |
$375.21 |
$375.21 |
$186.00
|
|
T cells absolute cd 4 count
|
$213.81 |
$213.81 |
$213.81 |
$120.25
|
|
T cells total count
|
$757.90 |
$757.90 |
$757.90 |
$124.11
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$22.99 |
$22.99 |
$22.99 |
$44.49
|
|
Test for chlorohydrocarbons
|
$134.68 |
$134.68 |
$134.68 |
$71.04
|
|
Test pathogen(s) for platelets reference
|
$465.78 |
$465.78 |
$465.78 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$2,067.99 |
$2,067.99 |
$2,067.99 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$16,074.99 |
$16,074.99 |
$16,074.99 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$226.99 |
$226.99 |
$226.99 |
$108.00
|
|
Therapeutic procd strg endur
|
$228.97 |
$228.97 |
$228.97 |
$81.36
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$186.73 |
$186.73 |
$186.73 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$186.73 |
$186.73 |
$186.73 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$1,695.86 |
$1,695.86 |
$1,695.86 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$71.17 |
$71.17 |
$71.17 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,868.98 |
$3,868.98 |
$3,868.98 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$10,116.84 |
$10,116.84 |
$10,116.84 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$31,027.81 |
$31,027.81 |
$31,027.81 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$75,917.16 |
$75,917.16 |
$75,917.16 |
$24,605.30
|
|
Thrombin time
|
$133.59 |
$133.59 |
$133.59 |
$48.75
|
|
Thromboendarterectomy common femoral
|
$38,713.19 |
$38,713.19 |
$38,713.19 |
$7,431.06
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$75.99 |
$75.99 |
$75.99 |
$56.93
|
|
Thyroglobulin antibody
|
$191.44 |
$191.44 |
$191.44 |
$84.00
|
|
Thyroid (TSH) Test
|
$470.35 |
$470.35 |
$470.35 |
$120.00
|
|
Thyroid Ultrasound
|
$1,429.79 |
$1,429.79 |
$1,429.79 |
$589.96
|
|
Thyroid uptake measurement
|
$1,357.06 |
$1,357.06 |
$1,357.06 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$201.99 |
$201.99 |
$201.99 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$82,406.39 |
$82,406.39 |
$82,406.39 |
$21,900.00
|
|
Tib/per revasc w/ather add-on 37233
|
$39,821.32 |
$39,821.32 |
$39,821.32 |
$10,406.14
|
|
Tissue culture tumor
|
$1,313.80 |
$1,313.80 |
$1,313.80 |
$529.23
|
|
Tissue transglutaminase iga
|
$201.99 |
$201.99 |
$201.99 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$63.23 |
$63.23 |
$63.23 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$308.64 |
$308.64 |
$308.64 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,898.66 |
$2,898.66 |
$2,898.66 |
$5,790.85
|
|
Tomosynthesis breast screen bilateral
|
$354.68 |
$354.68 |
$354.68 |
$73.45
|
|
Tonsillectomy (age 12+)
|
$19,719.95 |
$19,719.95 |
$19,719.95 |
$3,837.72
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$171.13 |
$171.13 |
$171.13 |
$303.88
|
|
Toxoplasma antibody igg
|
$314.63 |
$314.63 |
$314.63 |
$84.35
|
