|
Sickling rbc
|
$28.88 |
$28.88 |
$28.88 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$11.16 |
$11.16 |
$11.16 |
$354.67
|
|
Sinus CT scan (with and without contrast)
|
$793.10 |
$793.10 |
$793.10 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$734.48 |
$734.48 |
$734.48 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$550.73 |
$550.73 |
$550.73 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$580.65 |
$580.65 |
$580.65 |
$2,489.25
|
|
Sirolimus, oral
|
$1.06 |
$1.06 |
$1.06 |
$42.11
|
|
Skin Biopsy
|
$83.30 |
$83.30 |
$83.30 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$1,780.45 |
$1,780.45 |
$1,780.45 |
$3,936.80
|
|
Sleep study unattended
|
$253.75 |
$253.75 |
$253.75 |
$595.50
|
|
Sling arm deluxe w/pad xs
|
$1.23 |
$1.23 |
$1.23 |
$25.55
|
|
Sling suprapubic suburetheral
|
$9,077.08 |
$9,077.08 |
$9,077.08 |
$10,328.15
|
|
Slitting of prepuce
|
$736.40 |
$736.40 |
$736.40 |
$2,983.40
|
|
Slp pure tone screening
|
$7.00 |
$7.00 |
$7.00 |
$67.60
|
|
Slp stdy unatnd w/anal
|
$187.43 |
$187.43 |
$187.43 |
$307.50
|
|
Sm-153 lexidron ther
|
$5,363.75 |
$5,363.75 |
$5,363.75 |
$11,563.30
|
|
Smear fluorescent and/or acid fast stain
|
$37.10 |
$37.10 |
$37.10 |
$64.20
|
|
Smear gram stain
|
$32.90 |
$32.90 |
$32.90 |
$57.85
|
|
Smear nasal eosinophil
|
$20.13 |
$20.13 |
$20.13 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$25.73 |
$25.73 |
$25.73 |
$64.35
|
|
Smear wet mount
|
$24.50 |
$24.50 |
$24.50 |
$68.63
|
|
Sodium 24 hour urine
|
$21.53 |
$21.53 |
$21.53 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$1.23 |
$1.23 |
$1.23 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$4.55 |
$4.55 |
$4.55 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$0.38 |
$0.38 |
$0.38 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$4.04 |
$4.04 |
$4.04 |
$84.80
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$41.65 |
$41.65 |
$41.65 |
$539.57
|
|
Sodium serum/plasma/whole blood
|
$21.18 |
$21.18 |
$21.18 |
$42.70
|
|
Special physics consult
|
$394.98 |
$394.98 |
$394.98 |
$700.74
|
|
Special radiation dosimetry
|
$153.30 |
$153.30 |
$153.30 |
$445.50
|
|
Special radiation treatment
|
$690.38 |
$690.38 |
$690.38 |
$1,934.03
|
|
Special teletx port plan
|
$588.35 |
$588.35 |
$588.35 |
$1,046.65
|
|
Speech audiometry complete
|
$8.23 |
$8.23 |
$8.23 |
$104.25
|
|
Speech evaluation complex
|
$99.58 |
$99.58 |
$99.58 |
$527.06
|
|
Speech recep thresh
|
$6.30 |
$6.30 |
$6.30 |
$90.60
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$308.88 |
$308.88 |
$308.88 |
$559.96
|
|
Splint arm vnyl coated padded lft med
|
$2.80 |
$2.80 |
$2.80 |
$37.05
|
|
Splint extn xsm w sof-stretch rolyan
|
$6.65 |
$6.65 |
$6.65 |
$52.65
|
|
Splint finger 4 prong foam sm
|
$78.23 |
$78.23 |
$78.23 |
$22.62
|
|
Splint fing stax assort 1-7in
|
$7.88 |
$7.88 |
$7.88 |
$5.60
|
|
Split blood or products
|
$50.23 |
$50.23 |
$50.23 |
$148.98
|
|
Sputum specimen collection
|
$36.23 |
$36.23 |
$36.23 |
$180.00
|
|
Sr-89 stront chlor ther / mci
|
$1,818.43 |
$1,818.43 |
$1,818.43 |
$4,588.65
|
|
Srs linear based
|
$7,263.90 |
$7,263.90 |
$7,263.90 |
$14,124.25
|
|
Srs multisource
|
$15,441.30 |
$15,441.30 |
$15,441.30 |
$31,800.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$9,795.28 |
$9,795.28 |
$9,795.28 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$21,256.90 |
$21,256.90 |
$21,256.90 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$17,726.10 |
$17,726.10 |
$17,726.10 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$10,038.35 |
$10,038.35 |
$10,038.35 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$4,014.68 |
$4,014.68 |
$4,014.68 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$7,389.20 |
$7,389.20 |
$7,389.20 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,277.58 |
$3,277.58 |
$3,277.58 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$5,951.58 |
$5,951.58 |
$5,951.58 |
$19,765.20
|
|
Strapping of ankle and/or ft 29540
|
$83.83 |
$83.83 |
$83.83 |
$248.05
|
|
Strapping of chest
|
$47.08 |
$47.08 |
$47.08 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$49.00 |
$49.00 |
$49.00 |
$171.00
|
|
Strapping of hand or finger
|
$64.58 |
$64.58 |
$64.58 |
$194.40
|
|
Strapping of hip
|
$23.45 |
$23.45 |
$23.45 |
$170.08
|
|
Strapping of knee
|
$68.60 |
$68.60 |
$68.60 |
$224.80
|
|
Strapping of toes 29550
|
$70.18 |
$70.18 |
$70.18 |
$185.36
|
|
Strep a ag ia
|
$88.38 |
$88.38 |
$88.38 |
$75.40
|
|
Strep b dna amp probe
|
$54.78 |
$54.78 |
$54.78 |
$139.20
|
|
Stress test pulmonary
|
$50.93 |
$50.93 |
$50.93 |
$327.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$3.57 |
$3.57 |
$3.57 |
$49.13
|
|
Sulfonylurea screen qn-sendout
|
$3.68 |
$3.68 |
$3.68 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$8.23 |
$8.23 |
$8.23 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$77.18 |
$77.18 |
$77.18 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$139.65 |
$139.65 |
$139.65 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$160.48 |
$160.48 |
$160.48 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$181.30 |
$181.30 |
$181.30 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$208.43 |
$208.43 |
$208.43 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$243.78 |
$243.78 |
$243.78 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$277.03 |
$277.03 |
$277.03 |
$790.00
|
|
Susceptibility mic per plate
|
$51.80 |
$51.80 |
$51.80 |
$94.38
|
|
Svc venogram s&i
|
$536.90 |
$536.90 |
$536.90 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$111.60 |
$111.60 |
$111.60 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$24.68 |
$24.68 |
$24.68 |
$44.85
|
|
System cardiomems hosp electronics
|
$19,865.30 |
$19,865.30 |
$19,865.30 |
$41,639.82
|
|
System pacing micra av
|
$26,522.48 |
$26,522.48 |
$26,522.48 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$18,998.53 |
$18,998.53 |
$18,998.53 |
$10,980.00
|
|
System sealant biosentry tract
|
$7,683.90 |
$7,683.90 |
$7,683.90 |
$900.00
|
|
T3 (triiodothyronine) free
|
$46.55 |
$46.55 |
$46.55 |
$89.82
|
|
T3 (triiodothyronine) total
|
$54.78 |
$54.78 |
$54.78 |
$94.90
|
|
T4 (thyroxine) free
|
$33.43 |
$33.43 |
$33.43 |
$81.60
|
|
T4 (thyroxine) total
|
$32.73 |
$32.73 |
$32.73 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.14 |
$0.14 |
$0.14 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$33.16 |
$33.16 |
$33.16 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$95.38 |
$95.38 |
$95.38 |
$122.40
|
|
Target gsa panel organ neop
|
$631.05 |
$631.05 |
$631.05 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$44.76 |
$44.76 |
$44.76 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$169.75 |
$169.75 |
$169.75 |
$166.46
|
|
Tc-99m arcitumomab
|
$587.30 |
$587.30 |
$587.30 |
$2,159.40
|
|
Tc-99m bicisate
|
$374.68 |
$374.68 |
$374.68 |
$1,969.45
|
|
Tc-99m depreotide
|
$540.40 |
$540.40 |
$540.40 |
$1,937.35
|
|
Tc-99m diag per dose
|
$3,620.05 |
$3,620.05 |
$3,620.05 |
$279.95
|
|
Tc-99m disofenin
|
$85.40 |
$85.40 |
$85.40 |
$151.32
|
|
Tc-99m exametazime diag
|
$494.55 |
$494.55 |
$494.55 |
$2,166.26
|
|
Tc-99m gluceptate
|
$27.65 |
$27.65 |
$27.65 |
$1,105.40
|
|
Tc-99m labeled rbc
|
$99.40 |
$99.40 |
$99.40 |
$323.01
|
|
Tc-99m maa
|
$85.58 |
$85.58 |
$85.58 |
$312.06
|