|
Sugars single quant
|
$13.95 |
$13.95 |
$14.10 |
$52.47
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$940.12 |
$940.12 |
$13,649.84 |
$24,392.40
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$22.64 |
$22.64 |
$66.80 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$164.42 |
$164.42 |
$166.21 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$64.23 |
$64.23 |
$64.93 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$37.81 |
$37.81 |
$38.22 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$83.31 |
$83.31 |
$84.22 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$104.23 |
$104.23 |
$105.37 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$134.33 |
$134.33 |
$135.79 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$189.38 |
$189.38 |
$191.44 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$302.78 |
$302.78 |
$306.08 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$23.34 |
$23.34 |
$23.59 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$14.54 |
$14.54 |
$14.70 |
$34.48
|
|
Susceptibility mic per plate
|
$50.65 |
$50.65 |
$51.20 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$16.48 |
$16.48 |
$16.66 |
$48.30
|
|
Svc venogram s&i
|
$847.41 |
$847.41 |
$856.64 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$153.41 |
$153.41 |
$155.08 |
$105.21
|
|
Synvisc or synvisc-one
|
$1,928.83 |
$1,928.83 |
$1,928.83 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$9.77 |
$9.77 |
$9.88 |
$44.85
|
|
System cardiomems hosp electronics
|
$41,639.82 |
$41,639.82 |
$41,639.82 |
$41,518.75
|
|
System pacing micra av
|
$25,855.15 |
$25,855.15 |
$26,136.95 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$12,588.10 |
$12,588.10 |
$12,725.30 |
$10,980.00
|
|
System recell skin grafting/harvesting
|
$12,588.10 |
$12,588.10 |
$12,725.30 |
$13,777.23
|
|
System sealant biosentry tract
|
$537.66 |
$537.66 |
$543.52 |
$900.00
|
|
T3 (triiodothyronine) free
|
$17.99 |
$17.99 |
$18.18 |
$89.82
|
|
T3 (triiodothyronine) total
|
$34.14 |
$34.14 |
$34.51 |
$94.90
|
|
T4 (thyroxine) free
|
$108.64 |
$108.64 |
$109.82 |
$81.60
|
|
T4 (thyroxine) total
|
$159.65 |
$159.65 |
$161.39 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$52.49 |
$52.49 |
$53.06 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$266.38 |
$266.38 |
$266.38 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$37.81 |
$37.81 |
$38.22 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$2,135.21 |
$2,135.21 |
$2,135.21 |
$3,817.00
|
|
Target gsa panel hmtlmph neop
|
$811.07 |
$811.07 |
$819.91 |
$1,928.40
|
|
Tavr perq femoral
|
$48,246.56 |
$48,246.56 |
$48,246.56 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$760.43 |
$760.43 |
$760.43 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$30.43 |
$30.43 |
$30.43 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$12.85 |
$12.85 |
$12.99 |
$166.46
|
|
Tc-99m bicisate
|
$3.67 |
$3.67 |
$3.71 |
$1,969.45
|
|
Tc-99m depreotide
|
$1,501.40 |
$1,501.40 |
$1,517.77 |
$1,937.35
|
|
Tc-99m diag per dose
|
$23.49 |
$23.49 |
$23.75 |
$279.95
|
|
Tc-99m exame autol wbc diag per dose
|
$1,495.90 |
$1,495.90 |
$1,512.20 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$832.73 |
$832.73 |
$841.80 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$190.48 |
$190.48 |
$192.55 |
$323.01
|
|
Tc-99m maa
|
$142.03 |
$142.03 |
$143.58 |
$312.06
|
|
Tc-99m mebrofenin
|
$140.20 |
$140.20 |
$141.73 |
$169.53
|
|
Tc-99m medronate
|
$190.48 |
$190.48 |
$192.55 |
$122.46
|
|
Tc-99m mertiatide
|
$279.66 |
$279.66 |
$282.71 |
$757.25
|
|
Tc-99m oxidronate
|
$44.04 |
$44.04 |
$44.04 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$194.88 |
$194.88 |
$197.01 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$237.45 |
$237.45 |
$240.04 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$5.88 |
$5.88 |
$5.94 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$206.26 |
$206.26 |
$208.51 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$389.76 |
$389.76 |
$394.01 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$60.56 |
$60.56 |
$61.22 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$130.29 |
$130.29 |
$131.71 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$86.62 |
$86.62 |
$87.56 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$364.80 |
$364.80 |
$368.78 |
$930.54
|
|
Tcd emboli detect w/inj
|
$123.68 |
$123.68 |
$125.03 |
$404.68
|
|
Tcd emboli detect without inj
|
$123.68 |
$123.68 |
$125.03 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$8.26 |
$8.26 |
$8.35 |
$186.00
|
|
T cells absolute cd 4 count
|
$14.24 |
$14.24 |
$14.40 |
$120.25
|
|
T cells total count
|
$8.26 |
$8.26 |
$8.35 |
$124.11
|
|
Team conf without pat by hc pro
|
$105.70 |
$105.70 |
$105.70 |
$101.20
|
|
Team conf w/pat by hc prof
|
$105.70 |
$105.70 |
$105.70 |
$102.48
|
|
Telehealth original site facility fee
|
$42.94 |
$42.94 |
$45.64 |
$60.80
|
|
Temozolomide
|
$607.33 |
$607.33 |
$607.33 |
$374.66
|
|
Temozolomide 100 mg intravenous solution
|
$1,758.30 |
$1,758.30 |
$1,777.47 |
$3,129.70
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,791.41 |
$2,791.41 |
$2,821.83 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$12,932.72 |
$12,932.72 |
$13,073.67 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$31.91 |
$31.91 |
$45.88 |
$46.10
|
|
Teriparatide injection
|
$3,252.56 |
$3,252.56 |
$3,252.56 |
$7,403.20
|
|
Test for chlorohydrocarbons
|
$36.70 |
$36.70 |
$37.10 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$869.06 |
$869.06 |
$878.53 |
$780.48
|
|
Test pathogen(s) for platelets reference
|
$41.84 |
$41.84 |
$42.30 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$1,172.94 |
$1,172.94 |
$1,185.72 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$662.07 |
$662.07 |
$669.29 |
$1,204.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$6,368.19 |
$6,368.19 |
$6,368.19 |
$9,460.16
|
|
Theophylline therapeutic drug level
|
$100.93 |
$100.93 |
$113.16 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$69.73 |
$69.73 |
$69.73 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$65.33 |
$65.33 |
$65.33 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$289.93 |
$289.93 |
$293.09 |
$534.32
|
|
Ther/proph/diag inj ia
|
$136.90 |
$136.90 |
$136.90 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$18.35 |
$18.35 |
$18.55 |
$35.72
|
|
Thiotepa injection
|
$2,480.88 |
$2,480.88 |
$2,480.88 |
$1,618.85
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,531.50 |
$1,531.50 |
$1,548.19 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$12,977.86 |
$12,977.86 |
$12,977.86 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$9,349.70 |
$9,349.70 |
$11,153.01 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$11,032.76 |
$11,032.76 |
$11,247.24 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$14,082.79 |
$14,082.79 |
$14,118.13 |
$24,605.30
|
|
Thrombin time
|
$4.81 |
$4.81 |
$4.86 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$131.39 |
$131.39 |
$132.82 |
$56.93
|
|
Thyroglobulin antibody
|
$7.71 |
$7.71 |
$7.80 |
$84.00
|
|
Thyroid imaging
|
$201.85 |
$201.85 |
$204.05 |
$670.80
|
|
Thyroid met imaging
|
$360.77 |
$360.77 |
$364.70 |
$549.70
|
|
Thyroid met imaging/studies
|
$763.73 |
$763.73 |
$772.06 |
$607.23
|
|
Thyroid mets imag whole body
|
$763.73 |
$763.73 |
$772.06 |
$1,524.99
|
|
Thyroid met uptake
|
$142.03 |
$142.03 |
$143.58 |
$380.00
|
|
Thyroid (TSH) Test
|
$181.67 |
$181.67 |
$183.65 |
$120.00
|
|
Thyroid Ultrasound
|
$438.20 |
$438.20 |
$442.98 |
$589.96
|
|
Thyroid uptake measurement
|
$184.61 |
$184.61 |
$186.62 |
$653.60
|
