|
Sodium chloride 0.9 % IV bolus
|
$30.35 |
$30.35 |
$30.35 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$61.47 |
$61.47 |
$61.47 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$92.98 |
$92.98 |
$92.98 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$59.52 |
$59.52 |
$59.52 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$55.24 |
$55.24 |
$55.24 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$166.50 |
$166.50 |
$166.50 |
$195.48
|
|
Special physics consult
|
$328.32 |
$328.32 |
$328.32 |
$700.74
|
|
Specific gravity body fluid
|
$3.51 |
$3.51 |
$3.51 |
$23.63
|
|
Speech evaluation complex
|
$947.61 |
$947.61 |
$947.61 |
$527.06
|
|
Sperm antibody test
|
$18.77 |
$18.77 |
$18.77 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$931.27 |
$931.27 |
$931.27 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$502.98 |
$502.98 |
$502.98 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$52.91 |
$52.91 |
$52.91 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$77.80 |
$77.80 |
$77.80 |
$52.65
|
|
Splint finger frog med
|
$70.80 |
$70.80 |
$70.80 |
$27.95
|
|
Splint func pos polyflex ii med
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$52.22
|
|
Splint rstrc wrst/cmc right med
|
$49.02 |
$49.02 |
$49.02 |
$101.18
|
|
Split blood or products
|
$45.13 |
$45.13 |
$45.13 |
$148.98
|
|
Staph a dna amp probe
|
$184.00 |
$184.00 |
$184.00 |
$116.39
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$14,820.90 |
$14,820.90 |
$14,820.90 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$74,462.38 |
$74,462.38 |
$74,462.38 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$6,863.91 |
$6,863.91 |
$6,863.91 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$34,739.65 |
$34,739.65 |
$34,739.65 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$8,923.66 |
$8,923.66 |
$8,923.66 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$11,833.77 |
$11,833.77 |
$11,833.77 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$8,846.64 |
$8,846.64 |
$8,846.64 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$11,497.68 |
$11,497.68 |
$11,497.68 |
$19,765.20
|
|
Strep b dna amp probe
|
$75.86 |
$75.86 |
$75.86 |
$139.20
|
|
Streptomycin injection
|
$35.01 |
$35.01 |
$35.01 |
$138.30
|
|
Stress test pulmonary
|
$253.24 |
$253.24 |
$253.24 |
$327.20
|
|
Str markers specimen anal
|
$91.08 |
$91.08 |
$91.08 |
$835.28
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$162.22 |
$162.22 |
$162.22 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$71.19 |
$71.19 |
$71.19 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$175.44 |
$175.44 |
$175.44 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$171.16 |
$171.16 |
$171.16 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$187.11 |
$187.11 |
$187.11 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$240.80 |
$240.80 |
$240.80 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$328.71 |
$328.71 |
$328.71 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$382.00 |
$382.00 |
$382.00 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,024.24 |
$1,024.24 |
$1,024.24 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,524.50 |
$1,524.50 |
$1,524.50 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$10.12 |
$10.12 |
$10.12 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$35.01 |
$35.01 |
$35.01 |
$34.48
|
|
Susceptibility mic per plate
|
$89.47 |
$89.47 |
$89.47 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$17.46 |
$17.46 |
$17.46 |
$48.30
|
|
Svc venogram s&i
|
$794.73 |
$794.73 |
$794.73 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$99.59 |
$99.59 |
$99.59 |
$105.21
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$14.71 |
$14.71 |
$14.71 |
$44.85
|
|
System cardiomems hosp electronics
|
$46,236.54 |
$46,236.54 |
$46,236.54 |
$41,639.82
|
|
System pacing micra av
|
$34,739.65 |
$34,739.65 |
$34,739.65 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$28,710.15 |
$28,710.15 |
$28,710.15 |
$10,980.00
|
|
System recell skin grafting/harvesting
|
$15,083.48 |
$15,083.48 |
$15,083.48 |
$13,777.23
|
|
System sealant biosentry tract
|
$643.80 |
$643.80 |
$643.80 |
$900.00
|
|
T3 (triiodothyronine) free
|
$88.70 |
$88.70 |
$88.70 |
$89.82
|
|
T3 (triiodothyronine) total
|
$311.59 |
$311.59 |
$311.59 |
$94.90
|
|
T4 (thyroxine) free
|
$299.15 |
$299.15 |
$299.15 |
$81.60
|
|
T4 (thyroxine) total
|
$190.23 |
$190.23 |
$190.23 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$11.29 |
$11.29 |
$11.29 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$4.67 |
$4.67 |
$4.67 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,011.40 |
$1,011.40 |
$1,011.40 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,147.55 |
$1,147.55 |
$1,147.55 |
$3,385.00
|
|
Target gsa panel organ neop
|
$564.05 |
$564.05 |
$564.05 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$809.90 |
$809.90 |
$809.90 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$29.18 |
$29.18 |
$29.18 |
$166.46
|
|
Tc-99m bicisate
|
$1,470.42 |
$1,470.42 |
$1,470.42 |
$1,969.45
|
|
Tc-99m disofenin
|
$132.65 |
$132.65 |
$132.65 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$4,059.22 |
$4,059.22 |
$4,059.22 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,196.30 |
$2,196.30 |
$2,196.30 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$216.68 |
$216.68 |
$216.68 |
$323.01
|
|
Tc-99m maa
|
$232.24 |
$232.24 |
$232.24 |
$312.06
|
|
Tc-99m mebrofenin
|
$59.13 |
$59.13 |
$59.13 |
$169.53
|
|
Tc-99m medronate
|
$38.13 |
$38.13 |
$38.13 |
$122.46
|
|
Tc-99m mertiatide
|
$412.34 |
$412.34 |
$412.34 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$35.79 |
$35.79 |
$35.79 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$155.60 |
$155.60 |
$155.60 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$1.56 |
$1.56 |
$1.56 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$66.52 |
$66.52 |
$66.52 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$101.14 |
$101.14 |
$101.14 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$708.76 |
$708.76 |
$708.76 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$138.88 |
$138.88 |
$138.88 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$109.31 |
$109.31 |
$109.31 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,419.85 |
$1,419.85 |
$1,419.85 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$8.76 |
$8.76 |
$8.76 |
$186.00
|
|
T cells absolute cd 4 count
|
$10.90 |
$10.90 |
$10.90 |
$120.25
|
|
T cells total count
|
$8.76 |
$8.76 |
$8.76 |
$124.11
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$13,776.83 |
$13,776.83 |
$13,776.83 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$33.85 |
$33.85 |
$33.85 |
$46.10
|
|
Tert gene targeted seq alys
|
$81.69 |
$81.69 |
$81.69 |
$304.59
|
|
Test stress cardiovascular tracing only
|
$868.64 |
$868.64 |
$868.64 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$705.26 |
$705.26 |
$705.26 |
$1,204.50
|
|
Tgsap so neo 5-50 rna alys
|
$389.00 |
$389.00 |
$389.00 |
$816.27
|
|
Theophylline therapeutic drug level
|
$28.01 |
$28.01 |
$28.01 |
$108.00
|
|
Therapeutic procd strg endur
|
$66.13 |
$66.13 |
$66.13 |
$85.80
|
|
Therapy activation ipnss
|
$1,315.21 |
$1,315.21 |
$1,315.21 |
$228.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$93.75 |
$93.75 |
$93.75 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$80.14 |
$80.14 |
$80.14 |
$50.40
|
|
Ther/proph/diag inj ia
|
$311.20 |
$311.20 |
$311.20 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$19.45 |
$19.45 |
$19.45 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,637.69 |
$1,637.69 |
$1,637.69 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$10,286.33 |
$10,286.33 |
$10,286.33 |
$3,580.00
|
