|
Scan duplex abd/pelvis/retroperitoneal limited
|
$225.17 |
$225.17 |
$225.17 |
$653.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$337.87 |
$337.87 |
$337.87 |
$744.47
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$225.17 |
$225.17 |
$225.17 |
$468.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$225.17 |
$225.17 |
$225.17 |
$709.76
|
|
Scan duplex lower extremity arteries complete bilateral
|
$337.87 |
$337.87 |
$337.87 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$225.17 |
$225.17 |
$225.17 |
$645.21
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$225.17 |
$225.17 |
$225.17 |
$567.00
|
|
Scope uretscp lithovue dig disp
|
$8,336.73 |
$8,336.73 |
$8,336.73 |
$4,285.86
|
|
Screening HIV antigen/antibody combination assay
|
$41.63 |
$41.63 |
$41.63 |
$42.30
|
|
Screening Mammogram
|
$72.68 |
$72.68 |
$72.68 |
$310.20
|
|
Screening prostate cancer PSA
|
$31.74 |
$31.74 |
$31.74 |
$98.28
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$119.37 |
$119.37 |
$119.37 |
$237.19
|
|
Sedimentation rate erythrocyte automated
|
$4.83 |
$4.83 |
$4.83 |
$44.20
|
|
Semen analysis presence/motility
|
$20.70 |
$20.70 |
$20.70 |
$75.40
|
|
Semen analysis w/count
|
$8.97 |
$8.97 |
$8.97 |
$56.44
|
|
Serpina1 gene
|
$131.33 |
$131.33 |
$131.33 |
$195.65
|
|
Sertraline (zoloft) - sendout
|
$24.38 |
$24.38 |
$24.38 |
$126.43
|
|
Sf3b1 gene common variants
|
$243.34 |
$243.34 |
$243.34 |
$243.34
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$81.88 |
$81.88 |
$81.88 |
$311.40
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$90.39 |
$90.39 |
$90.39 |
$235.13
|
|
Shoulder MRI (with and without contrast)
|
$656.19 |
$656.19 |
$656.19 |
$2,743.02
|
|
Shoulder MRI (without contrast)
|
$624.68 |
$624.68 |
$624.68 |
$2,110.00
|
|
Shoulder X-ray
|
$75.21 |
$75.21 |
$75.21 |
$343.70
|
|
Sickling rbc
|
$9.43 |
$9.43 |
$9.43 |
$54.00
|
|
Sigmoidoscopy w/resection
|
$1,138.04 |
$1,138.04 |
$1,138.04 |
$2,712.75
|
|
Sinus CT scan (with and without contrast)
|
$576.61 |
$576.61 |
$576.61 |
$1,800.90
|
|
Sinus CT scan (with contrast)
|
$549.24 |
$549.24 |
$549.24 |
$1,562.50
|
|
Sinus CT scan (without contrast)
|
$521.87 |
$521.87 |
$521.87 |
$1,281.80
|
|
Skeletal muscle relaxant 1/2
|
$13.34 |
$13.34 |
$13.34 |
$80.08
|
|
Skel musc relaxant 3 or more
|
$13.34 |
$13.34 |
$13.34 |
$13.60
|
|
Skin Biopsy
|
$38.64 |
$38.64 |
$38.64 |
$357.00
|
|
Sleep study unattended
|
$255.76 |
$255.76 |
$255.76 |
$576.54
|
|
Slp eval non-spch gen comm dev
|
$84.87 |
$84.87 |
$84.87 |
$285.09
|
|
Slp ther svc non-spch gen
|
$36.80 |
$36.80 |
$36.80 |
$187.75
|
|
Sm-153 lexidron ther
|
$4,078.82 |
$4,078.82 |
$4,078.82 |
$6,866.16
|
|
Smear fluorescent and/or acid fast stain
|
$8.97 |
$8.97 |
$8.97 |
$64.35
|
|
Smear gram stain
|
$7.36 |
$7.36 |
$7.36 |
$55.35
|
|
Smear special stain inclusion bodies/parasites
|
$10.12 |
$10.12 |
$10.12 |
$68.85
|
|
Smear wet mount
|
$6.90 |
$6.90 |
$6.90 |
$66.30
|
|
Smn1 gene full gene sequence
|
$232.30 |
$232.30 |
$232.30 |
$495.69
|
|
Sodium 24 hour urine
|
$8.51 |
$8.51 |
$8.51 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$11.13 |
$11.13 |
$11.13 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$11.13 |
$11.13 |
$11.13 |
$44.34
|
|
Sodium chloride 0.9 % IV bolus
|
$11.13 |
$11.13 |
$11.13 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$119.24 |
$119.24 |
$119.24 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$8.51 |
$8.51 |
$8.51 |
$45.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$191.13 |
$191.13 |
$191.13 |
$536.34
|
|
Splint finger fold over sm
|
$151.34 |
$151.34 |
$151.34 |
$106.50
|
|
Split blood or products
|
$37.72 |
$37.72 |
$37.72 |
$125.72
|
|
Sputum specimen collection
|
$46.69 |
$46.69 |
$46.69 |
$171.52
|
|
Sr-89 stront chlor ther / mci
|
$812.13 |
$812.13 |
$812.13 |
$2,882.09
|
|
Staph a dna amp probe
|
$60.03 |
$60.03 |
$60.03 |
$129.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$173.88 |
$173.88 |
$173.88 |
$376.84
|
|
St evaluation swallow function
|
$80.73 |
$80.73 |
$80.73 |
$311.36
|
|
Stimulants synthetic
|
$20.93 |
$20.93 |
$20.93 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$50.83 |
$50.83 |
$50.83 |
$205.38
|
|
Strapping of elbow or wrist 29260
|
$36.80 |
$36.80 |
$36.80 |
$157.46
|
|
Strapping of hand or finger
|
$55.89 |
$55.89 |
$55.89 |
$177.45
|
|
Strapping of knee
|
$55.89 |
$55.89 |
$55.89 |
$205.20
|
|
Strapping of toes 29550
|
$50.83 |
$50.83 |
$50.83 |
$164.70
|
|
Strep b dna amp probe
|
$60.03 |
$60.03 |
$60.03 |
$122.43
|
|
Stress test pulmonary
|
$90.16 |
$90.16 |
$90.16 |
$311.40
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$72.63 |
$72.63 |
$72.63 |
$50.22
|
|
Sugars multiple quant
|
$11.96 |
$11.96 |
$11.96 |
$47.95
|
|
Sulfonylurea screen qn-sendout
|
$18.40 |
$18.40 |
$18.40 |
$152.64
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$433.78 |
$433.78 |
$433.78 |
$123.58
|
|
Surgical pathology level 3 gross & microscopic examination
|
$44.39 |
$44.39 |
$44.39 |
$184.50
|
|
Surgical pathology level 4 gross & microscopic examination
|
$74.06 |
$74.06 |
$74.06 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$230.92 |
$230.92 |
$230.92 |
$489.00
|
|
Susceptibility agar dilution per agent
|
$8.28 |
$8.28 |
$8.28 |
$42.70
|
|
Susceptibility enzyme detection per enzyme
|
$3.91 |
$3.91 |
$3.91 |
$35.10
|
|
Susceptibility mic per plate
|
$14.95 |
$14.95 |
$14.95 |
$104.00
|
|
Suscept studies macrobroth dilution ea
|
$7.13 |
$7.13 |
$7.13 |
$59.28
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$7.82 |
$7.82 |
$7.82 |
$40.11
|
|
T3 (triiodothyronine) free
|
$29.21 |
$29.21 |
$29.21 |
$99.20
|
|
T3 (triiodothyronine) total
|
$24.38 |
$24.38 |
$24.38 |
$93.52
|
|
T4 (thyroxine) free
|
$15.41 |
$15.41 |
$15.41 |
$85.20
|
|
T4 (thyroxine) total
|
$11.73 |
$11.73 |
$11.73 |
$67.80
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.34 |
$0.34 |
$0.34 |
$10.03
|
|
Tacrolimus therapeutic drug level
|
$23.69 |
$23.69 |
$23.69 |
$120.60
|
|
Target gsa panel hmtlmph neop
|
$816.50 |
$816.50 |
$816.50 |
$2,160.00
|
|
Target gsa panel organ/hmtlmph neop
|
$3,676.78 |
$3,676.78 |
$3,676.78 |
$3,678.78
|
|
Tbp gene detc abnor alleles
|
$105.80 |
$105.80 |
$105.80 |
$150.70
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$106.49 |
$106.49 |
$106.49 |
$175.00
|
|
Tc-99m disofenin
|
$35.65 |
$35.65 |
$35.65 |
$131.30
|
|
Tc-99m exame autol wbc diag per dose
|
$1,255.34 |
$1,255.34 |
$1,255.34 |
$2,431.95
|
|
Tc-99m exametazime diag
|
$713.00 |
$713.00 |
$713.00 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$291.87 |
$291.87 |
$291.87 |
$302.40
|
|
Tc-99m maa
|
$48.07 |
$48.07 |
$48.07 |
$283.41
|
|
Tc-99m mebrofenin
|
$51.52 |
$51.52 |
$51.52 |
$160.58
|
|
Tc-99m medronate
|
$26.45 |
$26.45 |
$26.45 |
$109.50
|
|
Tc-99m mertiatide
|
$356.27 |
$356.27 |
$356.27 |
$756.00
|
|
Tc-99m oxidronate
|
$26.45 |
$26.45 |
$26.45 |
$105.30
|
|
Tc-99m pentetate dtpa
|
$63.94 |
$63.94 |
$63.94 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$5.29 |
$5.29 |
$5.29 |
$27.20
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$169.05 |
$169.05 |
$169.05 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$65.32 |
$65.32 |
$65.32 |
$293.73
|
|
Tc-99m sulfur colloid
|
$63.48 |
$63.48 |
$63.48 |
$239.40
|
|
Tc-99m tetrofosmin p study dose
|
$214.59 |
$214.59 |
$214.59 |
$188.50
|
|
T cells absolute cd4/cd8 including ratio
|
$80.73 |
$80.73 |
$80.73 |
$175.00
|