|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$123.58 |
$123.58 |
$123.58 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$120.56 |
$120.56 |
$120.56 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$131.80 |
$131.80 |
$131.80 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$169.61 |
$169.61 |
$169.61 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$231.53 |
$231.53 |
$231.53 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$269.07 |
$269.07 |
$269.07 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$721.45 |
$721.45 |
$721.45 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,073.81 |
$1,073.81 |
$1,073.81 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$7.13 |
$7.13 |
$7.13 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$24.66 |
$24.66 |
$24.66 |
$34.48
|
|
Susceptibility mic per plate
|
$63.02 |
$63.02 |
$63.02 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$12.30 |
$12.30 |
$12.30 |
$48.30
|
|
Svc venogram s&i
|
$559.79 |
$559.79 |
$559.79 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$70.15 |
$70.15 |
$70.15 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$10.36 |
$10.36 |
$10.36 |
$44.85
|
|
System cardiomems hosp electronics
|
$32,567.64 |
$32,567.64 |
$32,567.64 |
$41,639.82
|
|
System pacing micra av
|
$24,469.57 |
$24,469.57 |
$24,469.57 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$20,222.57 |
$20,222.57 |
$20,222.57 |
$10,980.00
|
|
System recell skin grafting/harvesting
|
$10,624.35 |
$10,624.35 |
$10,624.35 |
$13,777.23
|
|
System sealant biosentry tract
|
$453.47 |
$453.47 |
$453.47 |
$900.00
|
|
T3 (triiodothyronine) free
|
$62.48 |
$62.48 |
$62.48 |
$89.82
|
|
T3 (triiodothyronine) total
|
$219.48 |
$219.48 |
$219.48 |
$94.90
|
|
T4 (thyroxine) free
|
$210.71 |
$210.71 |
$210.71 |
$81.60
|
|
T4 (thyroxine) total
|
$133.99 |
$133.99 |
$133.99 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$39.46 |
$39.46 |
$39.46 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$197.56 |
$197.56 |
$197.56 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$3.29 |
$3.29 |
$3.29 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$712.40 |
$712.40 |
$712.40 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$808.30 |
$808.30 |
$808.30 |
$3,385.00
|
|
Target gsa panel organ neop
|
$397.30 |
$397.30 |
$397.30 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$301.95 |
$301.95 |
$301.95 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$20.55 |
$20.55 |
$20.55 |
$166.46
|
|
Tc-99m bicisate
|
$1,035.72 |
$1,035.72 |
$1,035.72 |
$1,969.45
|
|
Tc-99m disofenin
|
$93.44 |
$93.44 |
$93.44 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$2,859.19 |
$2,859.19 |
$2,859.19 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$1,547.01 |
$1,547.01 |
$1,547.01 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$152.62 |
$152.62 |
$152.62 |
$323.01
|
|
Tc-99m maa
|
$163.58 |
$163.58 |
$163.58 |
$312.06
|
|
Tc-99m mebrofenin
|
$41.65 |
$41.65 |
$41.65 |
$169.53
|
|
Tc-99m medronate
|
$26.86 |
$26.86 |
$26.86 |
$122.46
|
|
Tc-99m mertiatide
|
$290.44 |
$290.44 |
$290.44 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$25.21 |
$25.21 |
$25.21 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$109.60 |
$109.60 |
$109.60 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$1.10 |
$1.10 |
$1.10 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$46.86 |
$46.86 |
$46.86 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$71.24 |
$71.24 |
$71.24 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$499.23 |
$499.23 |
$499.23 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$97.82 |
$97.82 |
$97.82 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$77.00 |
$77.00 |
$77.00 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,000.10 |
$1,000.10 |
$1,000.10 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$6.17 |
$6.17 |
$6.17 |
$186.00
|
|
T cells absolute cd 4 count
|
$7.68 |
$7.68 |
$7.68 |
$120.25
|
|
T cells total count
|
$6.17 |
$6.17 |
$6.17 |
$124.11
|
|
Temozolomide
|
$788.85 |
$788.85 |
$788.85 |
$374.66
|
|
Temozolomide 100 mg intravenous solution
|
$1,319.31 |
$1,319.31 |
$1,319.31 |
$3,129.70
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,094.46 |
$2,094.46 |
$2,094.46 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,703.99 |
$9,703.99 |
$9,703.99 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$23.84 |
$23.84 |
$23.84 |
$46.10
|
|
Tert gene targeted seq alys
|
$57.54 |
$57.54 |
$57.54 |
$304.59
|
|
Test stress cardiovascular tracing only
|
$611.85 |
$611.85 |
$611.85 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$496.77 |
$496.77 |
$496.77 |
$1,204.50
|
|
Tgsap so neo 5-50 rna alys
|
$274.00 |
$274.00 |
$274.00 |
$816.27
|
|
Theophylline therapeutic drug level
|
$19.73 |
$19.73 |
$19.73 |
$108.00
|
|
Therapeutic procd strg endur
|
$46.58 |
$46.58 |
$46.58 |
$85.80
|
|
Therapy activation ipnss
|
$926.40 |
$926.40 |
$926.40 |
$228.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$66.04 |
$66.04 |
$66.04 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$56.45 |
$56.45 |
$56.45 |
$50.40
|
|
Ther/proph/diag inj ia
|
$219.20 |
$219.20 |
$219.20 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$13.70 |
$13.70 |
$13.70 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,153.54 |
$1,153.54 |
$1,153.54 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$7,245.39 |
$7,245.39 |
$7,245.39 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,667.52 |
$6,667.52 |
$6,667.52 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$7,334.16 |
$7,334.16 |
$7,334.16 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$6,800.96 |
$6,800.96 |
$6,800.96 |
$24,605.30
|
|
Thrombin time
|
$13.29 |
$13.29 |
$13.29 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$53.71 |
$53.71 |
$53.71 |
$56.93
|
|
Thyroglobulin antibody
|
$1.79 |
$1.79 |
$1.79 |
$84.00
|
|
Thyroid mets imag whole body
|
$1,520.70 |
$1,520.70 |
$1,520.70 |
$1,524.99
|
|
Thyroid met uptake
|
$258.39 |
$258.39 |
$258.39 |
$380.00
|
|
Thyroid (TSH) Test
|
$69.05 |
$69.05 |
$69.05 |
$120.00
|
|
Thyroid Ultrasound
|
$513.48 |
$513.48 |
$513.48 |
$589.96
|
|
Thyroid uptake measurement
|
$1,390.83 |
$1,390.83 |
$1,390.83 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$2,334.76 |
$2,334.76 |
$2,334.76 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$3.92 |
$3.92 |
$3.92 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$10,445.43 |
$10,445.43 |
$10,445.43 |
$21,900.00
|
|
Tib/per revasc stnt & ather
|
$1,289.17 |
$1,289.17 |
$1,289.17 |
$11,121.63
|
|
Tib/per revasc w/ather add-on 37233
|
$8,032.59 |
$8,032.59 |
$8,032.59 |
$10,406.14
|
|
Tigecycline injection
|
$205.23 |
$205.23 |
$205.23 |
$277.31
|
|
Tilt table study
|
$1,125.05 |
$1,125.05 |
$1,125.05 |
$1,495.00
|
|
Tissue amnio epifix inj 100mg
|
$4,834.73 |
$4,834.73 |
$4,834.73 |
$3,846.61
|
|
Tissue culture placenta
|
$26.03 |
$26.03 |
$26.03 |
$520.91
|
|
Tissue culture skin/biopsy
|
$54.26 |
$54.26 |
$54.26 |
$558.87
|
|
Tissue culture tumor
|
$26.03 |
$26.03 |
$26.03 |
$529.23
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$4,834.73 |
$4,834.73 |
$4,834.73 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$6,285.56 |
$6,285.56 |
$6,285.56 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$3.29 |
$3.29 |
$3.29 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$23.57 |
$23.57 |
$23.57 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$239.75 |
$239.75 |
$239.75 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$107.96 |
$107.96 |
$107.96 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$2,746.03 |
$2,746.03 |
$2,746.03 |
$4,711.84
|
