|
Sodium chloride 3 % ivpb
|
$16.22 |
$16.22 |
$16.22 |
$37.80
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$83.88 |
$83.88 |
$83.88 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$43.92 |
$43.92 |
$43.92 |
$45.60
|
|
Special supplies phys/qhp
|
$1,325.52 |
$1,325.52 |
$1,325.52 |
$60.00
|
|
Specific gravity body fluid
|
$12.24 |
$12.24 |
$12.24 |
$21.60
|
|
Sperm antibody test
|
$17.37 |
$17.37 |
$17.37 |
$57.85
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$619.92 |
$619.92 |
$619.92 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$210.24 |
$210.24 |
$210.24 |
$392.09
|
|
Splint finger 4 prong foam sm
|
$90.00 |
$90.00 |
$90.00 |
$34.00
|
|
St analysis behavior qualitative voice/resonance
|
$276.84 |
$276.84 |
$276.84 |
$295.10
|
|
Staph a dna amp probe
|
$67.32 |
$67.32 |
$67.32 |
$129.00
|
|
St cognitve performance testing healthcare professional each hour
|
$118.80 |
$118.80 |
$118.80 |
$281.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$468.00 |
$468.00 |
$468.00 |
$2,408.90
|
|
Sterile water/saline, 10 ml
|
$20.70 |
$20.70 |
$20.70 |
$13.32
|
|
St evaluate speech sound production
|
$254.52 |
$254.52 |
$254.52 |
$289.25
|
|
St evaluate speech sound production comprehensive/expressive
|
$276.84 |
$276.84 |
$276.84 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$127.80 |
$127.80 |
$127.80 |
$370.50
|
|
St evaluation swallow function
|
$221.76 |
$221.76 |
$221.76 |
$309.60
|
|
Stimulants synthetic
|
$54.00 |
$54.00 |
$54.00 |
$80.08
|
|
Strep b dna amp probe
|
$10.99 |
$10.99 |
$10.99 |
$126.54
|
|
Stress test pulmonary
|
$58.68 |
$58.68 |
$58.68 |
$322.85
|
|
Stress tte complete
|
$648.72 |
$648.72 |
$648.72 |
$1,818.30
|
|
Str markers specimen anal
|
$108.00 |
$108.00 |
$108.00 |
$804.16
|
|
St treatment speech individual
|
$213.12 |
$213.12 |
$213.12 |
$249.00
|
|
St treatment swallow dysfunction/oral
|
$216.72 |
$216.72 |
$216.72 |
$243.99
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$6.45 |
$6.45 |
$6.45 |
$54.55
|
|
Sugars single quant
|
$3.69 |
$3.69 |
$3.69 |
$58.80
|
|
Sulfonylurea screen qn-sendout
|
$45.21 |
$45.21 |
$45.21 |
$151.45
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$75.96 |
$75.96 |
$75.96 |
$121.84
|
|
Surgical pathology level 1 gross examination only
|
$46.80 |
$46.80 |
$46.80 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$93.60 |
$93.60 |
$93.60 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$108.36 |
$108.36 |
$108.36 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$196.92 |
$196.92 |
$196.92 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$462.24 |
$462.24 |
$462.24 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$855.72 |
$855.72 |
$855.72 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$16.92 |
$16.92 |
$16.92 |
$43.20
|
|
Susceptibility enzyme detection per enzyme
|
$16.92 |
$16.92 |
$16.92 |
$35.40
|
|
Susceptibility mic per plate
|
$162.16 |
$162.16 |
$162.16 |
$104.65
|
|
Suscept studies macrobroth dilution ea
|
$2.12 |
$2.12 |
$2.12 |
$59.28
|
|
Synvisc or synvisc-one
|
$109.44 |
$109.44 |
$109.44 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$20.88 |
$20.88 |
$20.88 |
$40.00
|
|
T3 (triiodothyronine) free
|
$93.60 |
$93.60 |
$93.60 |
$99.00
|
|
T3 (triiodothyronine) total
|
$64.80 |
$64.80 |
$64.80 |
$93.52
|
|
T4 (thyroxine) free
|
$80.64 |
$80.64 |
$80.64 |
$84.44
|
|
T4 (thyroxine) total
|
$51.12 |
$51.12 |
$51.12 |
$67.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$8.35 |
$8.35 |
$8.35 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$24.84 |
$24.84 |
$24.84 |
$120.60
|
|
Target gsa panel hmtlmph neop
|
$882.00 |
$882.00 |
$882.00 |
$2,176.05
|
|
Target gsa panel organ/hmtlmph neop
|
$887.40 |
$887.40 |
$887.40 |
$3,746.70
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$339.84 |
$339.84 |
$339.84 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$150.88 |
$150.88 |
$150.88 |
$176.28
|
|
Tc-99m apcitide diag
|
$82.80 |
$82.80 |
$82.80 |
$1,181.70
|
|
Tc-99m depreotide
|
$82.80 |
$82.80 |
$82.80 |
$1,486.80
|
|
Tc-99m disofenin
|
$132.12 |
$132.12 |
$132.12 |
$131.20
|
|
Tc-99m fanolesomab diag
|
$1,140.84 |
$1,140.84 |
$1,140.84 |
$2,115.12
|
|
Tc-99m gluceptate
|
$82.80 |
$82.80 |
$82.80 |
$31.35
|
|
Tc-99m labeled rbc
|
$227.88 |
$227.88 |
$227.88 |
$302.40
|
|
Tc-99m maa
|
$134.28 |
$134.28 |
$134.28 |
$288.75
|
|
Tc-99m mebrofenin
|
$84.96 |
$84.96 |
$84.96 |
$157.65
|
|
Tc-99m medronate
|
$106.20 |
$106.20 |
$106.20 |
$111.01
|
|
Tc-99m pentetate dtpa
|
$101.16 |
$101.16 |
$101.16 |
$224.40
|
|
Tc-99m pertechnetate per mci
|
$81.00 |
$81.00 |
$81.00 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$103.68 |
$103.68 |
$103.68 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$538.20 |
$538.20 |
$538.20 |
$289.80
|
|
Tc-99m succimer (dmsa)
|
$82.80 |
$82.80 |
$82.80 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$81.00 |
$81.00 |
$81.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$84.96 |
$84.96 |
$84.96 |
$188.50
|
|
T cells absolute cd4/cd8 including ratio
|
$14.96 |
$14.96 |
$14.96 |
$175.00
|
|
T cells absolute cd 4 count
|
$8.57 |
$8.57 |
$8.57 |
$110.72
|
|
T cells total count
|
$12.15 |
$12.15 |
$12.15 |
$123.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,857.15 |
$9,857.15 |
$9,857.15 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$31.24 |
$31.24 |
$31.24 |
$37.76
|
|
Test for chlorohydrocarbons
|
$42.12 |
$42.12 |
$42.12 |
$61.60
|
|
Test stress cardiovascular tracing only
|
$541.80 |
$541.80 |
$541.80 |
$951.60
|
|
Theophylline therapeutic drug level
|
$107.28 |
$107.28 |
$107.28 |
$108.00
|
|
Therapeutic procd strg endur
|
$99.36 |
$99.36 |
$99.36 |
$83.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$24.48 |
$24.48 |
$24.48 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$1,687.50
|
|
Thrombin time
|
$3.47 |
$3.47 |
$3.47 |
$53.76
|
|
Thromboplastin inhibition
|
$46.80 |
$46.80 |
$46.80 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$2.07 |
$2.07 |
$2.07 |
$61.50
|
|
Thyroglobulin antibody
|
$72.72 |
$72.72 |
$72.72 |
$81.90
|
|
Thyroid imaging
|
$480.24 |
$480.24 |
$480.24 |
$695.02
|
|
Thyroid met imaging
|
$1,467.36 |
$1,467.36 |
$1,467.36 |
$838.25
|
|
Thyroid (TSH) Test
|
$101.52 |
$101.52 |
$101.52 |
$112.00
|
|
Thyroid Ultrasound
|
$460.08 |
$460.08 |
$460.08 |
$588.50
|
|
Thyroid uptake measurement
|
$480.24 |
$480.24 |
$480.24 |
$590.05
|
|
Thyroxine binding globulin (tbg)
|
$4.73 |
$4.73 |
$4.73 |
$64.35
|
|
Tissue culture placenta
|
$63.18 |
$63.18 |
$63.18 |
$457.00
|
|
Tissue culture skin/biopsy
|
$85.91 |
$85.91 |
$85.91 |
$488.74
|
|
Tissue culture tumor
|
$63.00 |
$63.00 |
$63.00 |
$493.92
|
|
Tissue exam koh skin/hair/nails
|
$20.52 |
$20.52 |
$20.52 |
$47.52
|
|
Tissue transglutaminase iga
|
$23.40 |
$23.40 |
$23.40 |
$44.25
|
|
Tl-201 thallium diag per mci
|
$581.04 |
$581.04 |
$581.04 |
$78.40
|
|
Tobramycin peak therapeutic drug level
|
$110.16 |
$110.16 |
$110.16 |
$121.55
|
|
Tomosynthesis breast diagnostic left
|
$125.28 |
$125.28 |
$125.28 |
$71.40
|
|
Tomosynthesis breast screen bilateral
|
$125.64 |
$125.64 |
$125.64 |
$68.80
|
|
Total tau
|
$108.00 |
$108.00 |
$108.00 |
$312.00
|
|
Toxoplasma antibody igg
|
$75.60 |
$75.60 |
$75.60 |
$89.24
|
|
Toxoplasma antibody igm
|
$4.61 |
$4.61 |
$4.61 |
$87.00
|
