|
Sickling rbc
|
$52.92 |
$52.92 |
$52.92 |
$53.55
|
|
Sigmoidoscopy for bleeding
|
$1,255.38 |
$1,255.38 |
$1,255.38 |
$1,993.08
|
|
Sinus CT scan (with and without contrast)
|
$1,627.92 |
$1,627.92 |
$1,627.92 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,572.48 |
$1,572.48 |
$1,572.48 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$959.28 |
$959.28 |
$959.28 |
$1,279.50
|
|
Skin Biopsy
|
$240.66 |
$240.66 |
$240.66 |
$382.80
|
|
Skyla, 13.5 mg
|
$1,048.41 |
$1,048.41 |
$1,048.41 |
$2,343.60
|
|
Sleep Study (Polysomnography)
|
$4,312.56 |
$4,312.56 |
$4,312.56 |
$3,936.80
|
|
Sling arm deluxe w/pad xs
|
$24.57 |
$24.57 |
$24.57 |
$25.55
|
|
Sling pelv split sam med
|
$163.80 |
$163.80 |
$163.80 |
$124.80
|
|
Sling suprapubic suburetheral
|
$13,632.92 |
$13,632.92 |
$13,632.92 |
$10,395.47
|
|
Slitting of prepuce
|
$2,472.96 |
$2,472.96 |
$2,472.96 |
$2,983.40
|
|
Slp pure tone screening
|
$10.50 |
$10.50 |
$10.50 |
$67.60
|
|
Smear gram stain
|
$29.82 |
$29.82 |
$29.82 |
$57.85
|
|
Smear nasal eosinophil
|
$13.02 |
$13.02 |
$13.02 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$37.38 |
$37.38 |
$37.38 |
$64.35
|
|
Smear wet mount
|
$40.74 |
$40.74 |
$40.74 |
$68.63
|
|
Sodium 24 hour urine
|
$29.82 |
$29.82 |
$29.82 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$48.11 |
$48.11 |
$48.11 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$46.22 |
$46.22 |
$46.22 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$48.74 |
$48.74 |
$48.74 |
$46.35
|
|
Sodium chloride 3 % ivpb
|
$46.85 |
$46.85 |
$46.85 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$68.72 |
$68.72 |
$68.72 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$28.56 |
$28.56 |
$28.56 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$747.18 |
$747.18 |
$747.18 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$236.46 |
$236.46 |
$236.46 |
$559.96
|
|
Splint func pos polyflex ii med
|
$248.57 |
$248.57 |
$248.57 |
$116.40
|
|
Splint rstrc wrst/cmc right med
|
$106.03 |
$106.03 |
$106.03 |
$73.11
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$4,727.52 |
$4,727.52 |
$4,727.52 |
$4,560.66
|
|
Split blood or products
|
$233.10 |
$233.10 |
$233.10 |
$148.98
|
|
Staph a dna amp probe
|
$50.82 |
$50.82 |
$50.82 |
$116.39
|
|
Stent axios caut enh 15x10mm electrocaut
|
$57,771.00 |
$57,771.00 |
$57,771.00 |
$39,270.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$33,488.94 |
$33,488.94 |
$33,488.94 |
$1,206.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$31,250.64 |
$31,250.64 |
$31,250.64 |
$18,472.24
|
|
Stent bronch dumon sil 10x40mm
|
$7,023.54 |
$7,023.54 |
$7,023.54 |
$6,285.56
|
|
St evaluate speech sound production
|
$244.44 |
$244.44 |
$244.44 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$504.00 |
$504.00 |
$504.00 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$199.92 |
$199.92 |
$199.92 |
$406.40
|
|
St evaluation swallow function
|
$152.04 |
$152.04 |
$152.04 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$194.46 |
$194.46 |
$194.46 |
$248.05
|
|
Strapping of chest
|
$194.46 |
$194.46 |
$194.46 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$76.86 |
$76.86 |
$76.86 |
$171.00
|
|
Strapping of hand or finger
|
$133.56 |
$133.56 |
$133.56 |
$194.40
|
|
Strapping of hip
|
$155.40 |
$155.40 |
$155.40 |
$170.08
|
|
Strapping of knee
|
$155.40 |
$155.40 |
$155.40 |
$224.80
|
|
Strapping of toes 29550
|
$118.02 |
$118.02 |
$118.02 |
$185.36
|
|
Strep b dna amp probe
|
$243.60 |
$243.60 |
$243.60 |
$139.20
|
|
St treatment speech individual
|
$167.58 |
$167.58 |
$167.58 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$153.30 |
$153.30 |
$153.30 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$56.70 |
$56.70 |
$56.70 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$112.36 |
$112.36 |
$112.36 |
$71.09
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$56.70 |
$56.70 |
$56.70 |
$91.67
|
|
Support clav 29.6-40.5in med
|
$73.38 |
$73.38 |
$73.38 |
$68.54
|
|
Surgical pathology level 1 gross examination only
|
$87.36 |
$87.36 |
$87.36 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$87.36 |
$87.36 |
$87.36 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$175.98 |
$175.98 |
$175.98 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$175.98 |
$175.98 |
$175.98 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,029.42 |
$1,029.42 |
$1,029.42 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,319.24 |
$2,319.24 |
$2,319.24 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$33.18 |
$33.18 |
$33.18 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$7.14 |
$7.14 |
$7.14 |
$34.48
|
|
Susceptibility mic per plate
|
$60.06 |
$60.06 |
$60.06 |
$94.38
|
|
Svc venogram s&i
|
$3,296.58 |
$3,296.58 |
$3,296.58 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$137.34 |
$137.34 |
$137.34 |
$105.21
|
|
Synvisc or synvisc-one
|
$5.50 |
$5.50 |
$5.50 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$36.54 |
$36.54 |
$36.54 |
$44.85
|
|
System cardiomems hosp electronics
|
$42,700.77 |
$42,700.77 |
$42,700.77 |
$41,360.00
|
|
System pacing micra av
|
$26,599.86 |
$26,599.86 |
$26,599.86 |
$22,733.55
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$7,795.20 |
$7,795.20 |
$7,795.20 |
$9,363.28
|
|
System sealant biosentry tract
|
$1,197.76 |
$1,197.76 |
$1,197.76 |
$888.00
|
|
T3 (triiodothyronine) total
|
$83.58 |
$83.58 |
$83.58 |
$94.90
|
|
T4 (thyroxine) free
|
$53.34 |
$53.34 |
$53.34 |
$81.60
|
|
T4 (thyroxine) total
|
$40.74 |
$40.74 |
$40.74 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$9.99 |
$9.99 |
$9.99 |
$9.99
|
|
Tacrolimus therapeutic drug level
|
$31.08 |
$31.08 |
$31.08 |
$122.40
|
|
T cells absolute cd4/cd8 including ratio
|
$403.62 |
$403.62 |
$403.62 |
$186.00
|
|
T cells absolute cd 4 count
|
$230.16 |
$230.16 |
$230.16 |
$120.25
|
|
T cells total count
|
$324.24 |
$324.24 |
$324.24 |
$124.11
|
|
Tee w or without fol w/cont, mon
|
$654.36 |
$654.36 |
$654.36 |
$934.93
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$42,656.71 |
$42,656.71 |
$42,656.71 |
$17,652.73
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$3,969.00 |
$3,969.00 |
$3,969.00 |
$3,839.54
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$56.70 |
$56.70 |
$56.70 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$86.94 |
$86.94 |
$86.94 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$427.98 |
$427.98 |
$427.98 |
$1,001.55
|
|
Theophylline therapeutic drug level
|
$31.92 |
$31.92 |
$31.92 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$92.40 |
$92.40 |
$92.40 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$86.94 |
$86.94 |
$86.94 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$418.74 |
$418.74 |
$418.74 |
$534.32
|
|
Ther/proph/diag inj ia
|
$239.40 |
$239.40 |
$239.40 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,625.82 |
$1,625.82 |
$1,625.82 |
$1,804.00
|
|
Thoracotomy w/expl
|
$131.88 |
$131.88 |
$131.88 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$1,099.56 |
$1,099.56 |
$1,099.56 |
$2,926.56
|
|
Thrombectmy crnry perq mechanical
|
$429.24 |
$429.24 |
$429.24 |
$3,580.00
|
|
Thrombin time
|
$55.02 |
$55.02 |
$55.02 |
$48.75
|
|
Thyroid imaging
|
$841.26 |
$841.26 |
$841.26 |
$670.80
|
|
Thyroid (TSH) Test
|
$99.54 |
$99.54 |
$99.54 |
$120.00
|
|
Thyroid Ultrasound
|
$375.06 |
$375.06 |
$375.06 |
$589.96
|
|
Thyroid uptake measurement
|
$715.26 |
$715.26 |
$715.26 |
$653.60
|
|
Tissue exam koh skin/hair/nails
|
$29.82 |
$29.82 |
$29.82 |
$47.40
|
