|
Sinus CT scan (without contrast)
|
$3,743.14 |
$3,743.14 |
$3,743.14 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$14,751.30 |
$14,751.30 |
$14,751.30 |
$2,489.25
|
|
Sinusotomy maxillary sinus 31020
|
$18,708.99 |
$18,708.99 |
$18,708.99 |
$3,592.74
|
|
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
|
|
Sleeve fing rolyan med
|
$1,194.44 |
$1,194.44 |
$1,194.44 |
$178.85
|
|
Slp pure tone screening
|
$102.84 |
$102.84 |
$102.84 |
$67.60
|
|
Slp stdy unatnd w/anal
|
$542.76 |
$542.76 |
$542.76 |
$307.50
|
|
Slp ther svc non-spch gen
|
$469.40 |
$469.40 |
$469.40 |
$186.40
|
|
Small bowel endoscopy
|
$9,293.52 |
$9,293.52 |
$9,293.52 |
$2,466.10
|
|
Small bowel endoscopy 44365
|
$17,786.16 |
$17,786.16 |
$17,786.16 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$10,935.35 |
$10,935.35 |
$10,935.35 |
$2,442.70
|
|
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
|
|
Smear wet mount
|
$191.21 |
$191.21 |
$191.21 |
$68.63
|
|
Snrpn/ube3a gene
|
$502.95 |
$502.95 |
$502.95 |
$228.80
|
|
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 |
$45.01
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$260.56 |
$260.56 |
$260.56 |
$84.15
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$648.52 |
$648.52 |
$648.52 |
$539.57
|
|
Sodium serum/plasma/whole blood
|
$133.46 |
$133.46 |
$133.46 |
$42.70
|
|
Special physics consult
|
$703.62 |
$703.62 |
$703.62 |
$700.74
|
|
Special radiation dosimetry
|
$2,110.84 |
$2,110.84 |
$2,110.84 |
$445.50
|
|
Special radiation treatment
|
$2,322.53 |
$2,322.53 |
$2,322.53 |
$1,934.03
|
|
Special teletx port plan
|
$1,597.16 |
$1,597.16 |
$1,597.16 |
$1,046.65
|
|
Specific gravity body fluid
|
$52.16 |
$52.16 |
$52.16 |
$23.63
|
|
Speech audiometry complete
|
$365.31 |
$365.31 |
$365.31 |
$104.25
|
|
Speech evaluation complex
|
$1,204.60 |
$1,204.60 |
$1,204.60 |
$527.06
|
|
Speech recep thresh
|
$254.00 |
$254.00 |
$254.00 |
$90.60
|
|
Sperm antibody test
|
$151.48 |
$151.48 |
$151.48 |
$56.44
|
|
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
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$2,212.08 |
$2,212.08 |
$2,212.08 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$300.82 |
$300.82 |
$300.82 |
$52.65
|
|
Splint finger fold over sm
|
$486.98 |
$486.98 |
$486.98 |
$67.10
|
|
Splint finger frog med
|
$195.88 |
$195.88 |
$195.88 |
$27.95
|
|
Split blood or products
|
$204.07 |
$204.07 |
$204.07 |
$148.98
|
|
Srs linear based
|
$34,094.20 |
$34,094.20 |
$34,094.20 |
$14,124.25
|
|
Srs multisource
|
$96,478.93 |
$96,478.93 |
$96,478.93 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$523.82 |
$523.82 |
$523.82 |
$300.00
|
|
Staph a dna amp probe
|
$422.24 |
$422.24 |
$422.24 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$335.34 |
$335.34 |
$335.34 |
$313.96
|
|
Stem cells total count
|
$960.66 |
$960.66 |
$960.66 |
$130.90
|
|
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 placemt retro carotid
|
$21,803.81 |
$21,803.81 |
$21,803.81 |
$9,313.36
|
|
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
|
$937.02 |
$937.02 |
$937.02 |
$248.05
|
|
Strapping of chest
|
$998.40 |
$998.40 |
$998.40 |
$201.60
|
|
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 hip
|
$1,289.72 |
$1,289.72 |
$1,289.72 |
$170.08
|
|
Strapping of knee
|
$709.95 |
$709.95 |
$709.95 |
$224.80
|
|
Strapping of toes 29550
|
$520.46 |
$520.46 |
$520.46 |
$185.36
|
|
Strep a ag ia
|
$168.38 |
$168.38 |
$168.38 |
$75.40
|
|
Strep b assay w/optic
|
$104.20 |
$104.20 |
$104.20 |
$32.00
|
|
Strep b dna amp probe
|
$179.39 |
$179.39 |
$179.39 |
$139.20
|
|
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
|
|
Str markers spec anal addl
|
$4,609.78 |
$4,609.78 |
$4,609.78 |
$468.00
|
|
Str markers specimen anal
|
$3,745.57 |
$3,745.57 |
$3,745.57 |
$835.28
|
|
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
|
|
Subq njx filling matrl 1cc/<
|
$536.92 |
$536.92 |
$536.92 |
$235.13
|
|
Subq njx fil matrl 5.1-10cc
|
$1,585.38 |
$1,585.38 |
$1,585.38 |
$748.14
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$103.08 |
$103.08 |
$103.08 |
$50.70
|
|
Sugars single quant
|
$138.74 |
$138.74 |
$138.74 |
$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 |
$144.79
|
|
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
|
$328.73 |
$328.73 |
$328.73 |
$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
|
|
Suscept studies macrobroth dilution ea
|
$89.30 |
$89.30 |
$89.30 |
$48.30
|
|
Svc venogram s&i
|
$10,197.49 |
$10,197.49 |
$10,197.49 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$866.59 |
$866.59 |
$866.59 |
$105.21
|
|
Synvisc or synvisc-one
|
$777.17 |
$777.17 |
$777.17 |
$1,232.66
|
|
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
|
|
Target gsa panel organ/hmtlmph neop
|
$46,420.23 |
$46,420.23 |
$46,420.23 |
$3,385.00
|
|
Target gsa panel organ neop
|
$10,025.90 |
$10,025.90 |
$10,025.90 |
$1,913.00
|
|
Tas congenital car anomal
|
$22,953.72 |
$22,953.72 |
$22,953.72 |
$6,003.27
|
