|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$591.00 |
$591.00 |
$591.00 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,074.50 |
$1,074.50 |
$1,074.50 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$851.50 |
$851.50 |
$851.50 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,147.00 |
$1,147.00 |
$1,147.00 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,809.00 |
$1,809.00 |
$1,809.00 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,061.00 |
$1,061.00 |
$1,061.00 |
$595.35
|
|
Scope uretscp lithovue dig disp
|
$2,996.25 |
$2,996.25 |
$2,996.25 |
$4,490.64
|
|
Screening Mammogram
|
$381.00 |
$381.00 |
$381.00 |
$312.55
|
|
Serpina1 gene
|
$154.00 |
$154.00 |
$154.00 |
$197.00
|
|
Sertraline (zoloft) - sendout
|
$97.50 |
$97.50 |
$97.50 |
$126.43
|
|
Set radiation therapy field
|
$3,679.50 |
$3,679.50 |
$3,679.50 |
$762.40
|
|
Set radiation therapy field
|
$3,679.50 |
$3,679.50 |
$3,679.50 |
$1,636.36
|
|
Shoulder MRI (with and without contrast)
|
$3,110.00 |
$3,110.00 |
$3,110.00 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$2,751.50 |
$2,751.50 |
$2,751.50 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$2,392.00 |
$2,392.00 |
$2,392.00 |
$2,065.05
|
|
Shoulder X-ray
|
$339.50 |
$339.50 |
$339.50 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$235.00 |
$235.00 |
$235.00 |
$349.20
|
|
Sialography s&i
|
$300.50 |
$300.50 |
$300.50 |
$499.20
|
|
Sickling rbc
|
$74.00 |
$74.00 |
$74.00 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$254.25 |
$254.25 |
$254.25 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$2,208.00 |
$2,208.00 |
$2,208.00 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,952.50 |
$1,952.50 |
$1,952.50 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,698.50 |
$1,698.50 |
$1,698.50 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,810.50 |
$1,810.50 |
$1,810.50 |
$2,489.25
|
|
Skeletal muscle relaxant 1/2
|
$133.50 |
$133.50 |
$133.50 |
$83.85
|
|
Sleep Study (Polysomnography)
|
$3,734.50 |
$3,734.50 |
$3,734.50 |
$3,607.50
|
|
Sleep study unattended
|
$359.00 |
$359.00 |
$359.00 |
$580.87
|
|
Sleeve fing rolyan med
|
$206.00 |
$206.00 |
$206.00 |
$203.58
|
|
Small animal inoculation
|
$16.00 |
$16.00 |
$16.00 |
$23.24
|
|
Smear fluorescent and/or acid fast stain
|
$29.50 |
$29.50 |
$29.50 |
$64.20
|
|
Smear gram stain
|
$70.50 |
$70.50 |
$70.50 |
$55.25
|
|
Smear nasal eosinophil
|
$69.00 |
$69.00 |
$69.00 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$115.50 |
$115.50 |
$115.50 |
$73.15
|
|
Smear wet mount
|
$70.50 |
$70.50 |
$70.50 |
$67.49
|
|
Smpd1 gene common variants
|
$43.00 |
$43.00 |
$43.00 |
$133.84
|
|
Snrpn/ube3a gene
|
$251.50 |
$251.50 |
$251.50 |
$231.85
|
|
Sodium 24 hour urine
|
$134.00 |
$134.00 |
$134.00 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$134.50 |
$134.50 |
$134.50 |
$45.60
|
|
So gsap cll fr mcrstl ins
|
$1,751.50 |
$1,751.50 |
$1,751.50 |
$3,279.92
|
|
Somatosensory testing
|
$1,439.50 |
$1,439.50 |
$1,439.50 |
$816.00
|
|
Special physics consult
|
$812.50 |
$812.50 |
$812.50 |
$725.00
|
|
Special radiation dosimetry
|
$346.50 |
$346.50 |
$346.50 |
$392.50
|
|
Special radiation treatment
|
$2,966.00 |
$2,966.00 |
$2,966.00 |
$1,986.00
|
|
Special teletx port plan
|
$1,166.00 |
$1,166.00 |
$1,166.00 |
$1,086.99
|
|
Specimen fat stain
|
$11.50 |
$11.50 |
$11.50 |
$35.10
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$629.50 |
$629.50 |
$629.50 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$381.50 |
$381.50 |
$381.50 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$73.00 |
$73.00 |
$73.00 |
$68.25
|
|
Splint finger frog med
|
$77.00 |
$77.00 |
$77.00 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$71.00 |
$71.00 |
$71.00 |
$99.04
|
|
Split blood or products
|
$63.00 |
$63.00 |
$63.00 |
$127.48
|
|
Srs linear based
|
$11,659.00 |
$11,659.00 |
$11,659.00 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$433.00 |
$433.00 |
$433.00 |
$297.60
|
|
Staph a dna amp probe
|
$97.00 |
$97.00 |
$97.00 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$425.00 |
$425.00 |
$425.00 |
$286.00
|
|
St evaluate speech sound production
|
$433.00 |
$433.00 |
$433.00 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$433.00 |
$433.00 |
$433.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$433.00 |
$433.00 |
$433.00 |
$399.60
|
|
St evaluation swallow function
|
$324.00 |
$324.00 |
$324.00 |
$314.40
|
|
Stimulants synthetic
|
$117.00 |
$117.00 |
$117.00 |
$80.08
|
|
Strep a ag ia
|
$231.00 |
$231.00 |
$231.00 |
$75.40
|
|
Strep b dna amp probe
|
$74.50 |
$74.50 |
$74.50 |
$120.90
|
|
Stress test pulmonary
|
$166.00 |
$166.00 |
$166.00 |
$322.85
|
|
Stress tte complete
|
$3,013.50 |
$3,013.50 |
$3,013.50 |
$1,870.50
|
|
Str markers spec anal addl
|
$292.00 |
$292.00 |
$292.00 |
$479.17
|
|
Str markers specimen anal
|
$535.00 |
$535.00 |
$535.00 |
$751.50
|
|
St treatment speech individual
|
$216.50 |
$216.50 |
$216.50 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$216.50 |
$216.50 |
$216.50 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$39.75 |
$39.75 |
$39.75 |
$52.31
|
|
Sugars single quant
|
$48.50 |
$48.50 |
$48.50 |
$64.28
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$7.00 |
$7.00 |
$7.00 |
$82.43
|
|
Sulfonylurea screen qn-sendout
|
$96.00 |
$96.00 |
$96.00 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$25.25 |
$25.25 |
$25.25 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$94.50 |
$94.50 |
$94.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$124.00 |
$124.00 |
$124.00 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$154.50 |
$154.50 |
$154.50 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$185.00 |
$185.00 |
$185.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$214.50 |
$214.50 |
$214.50 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$244.00 |
$244.00 |
$244.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$188.00 |
$188.00 |
$188.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$188.00 |
$188.00 |
$188.00 |
$35.70
|
|
Susceptibility mic per plate
|
$188.00 |
$188.00 |
$188.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$35.50 |
$35.50 |
$35.50 |
$59.28
|
|
Svc venogram s&i
|
$1,749.50 |
$1,749.50 |
$1,749.50 |
$1,934.62
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$97.00 |
$97.00 |
$97.00 |
$41.60
|
|
System recell skin grafting/harvesting
|
$4,640.62 |
$4,640.62 |
$4,640.62 |
$11,183.00
|
|
System sealant biosentry tract
|
$300.00 |
$300.00 |
$300.00 |
$889.35
|
|
T3 (triiodothyronine) free
|
$188.00 |
$188.00 |
$188.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$208.00 |
$208.00 |
$208.00 |
$93.52
|
|
T4 (thyroxine) free
|
$188.00 |
$188.00 |
$188.00 |
$85.20
|
|
T4 (thyroxine) total
|
$208.00 |
$208.00 |
$208.00 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$7.00 |
$7.00 |
$7.00 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$479.00 |
$479.00 |
$479.00 |
$122.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,496.50 |
$1,496.50 |
$1,496.50 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,376.50 |
$1,376.50 |
$1,376.50 |
$1,655.52
|
|
Tbs techl calculation only
|
$89.50 |
$89.50 |
$89.50 |
$153.60
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$45.00 |
$45.00 |
$45.00 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$139.00 |
$139.00 |
$139.00 |
$177.65
|
|
Tc-99m bicisate
|
$2,270.12 |
$2,270.12 |
$2,270.12 |
$1,969.45
|
