|
Smear special stain inclusion bodies/parasites
|
$57.63 |
$57.63 |
$57.63 |
$64.35
|
|
Smear wet mount
|
$82.62 |
$82.62 |
$82.62 |
$68.63
|
|
Sodium 24 hour urine
|
$73.95 |
$73.95 |
$73.95 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$65.33 |
$65.33 |
$65.33 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$65.33 |
$65.33 |
$65.33 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$65.33 |
$65.33 |
$65.33 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$84.15 |
$84.15 |
$84.15 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$72.93 |
$72.93 |
$72.93 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$6,273.00 |
$6,273.00 |
$6,273.00 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$548.25 |
$548.25 |
$548.25 |
$559.96
|
|
Splint rstrc wrst/cmc right med
|
$84.19 |
$84.19 |
$84.19 |
$101.18
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$4,147.83 |
$4,147.83 |
$4,147.83 |
$4,560.66
|
|
Split blood or products
|
$148.92 |
$148.92 |
$148.92 |
$148.98
|
|
St analysis behavior qualitative voice/resonance
|
$389.64 |
$389.64 |
$389.64 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$389.64 |
$389.64 |
$389.64 |
$313.96
|
|
Stent axios caut enh 15x10mm electrocaut
|
$39,270.00 |
$39,270.00 |
$39,270.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$21,021.03 |
$21,021.03 |
$21,021.03 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$19,616.05 |
$19,616.05 |
$19,616.05 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$4,948.02 |
$4,948.02 |
$4,948.02 |
$5,943.00
|
|
St evaluate speech sound production
|
$389.64 |
$389.64 |
$389.64 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$389.64 |
$389.64 |
$389.64 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$297.84 |
$297.84 |
$297.84 |
$406.40
|
|
St evaluation swallow function
|
$257.55 |
$257.55 |
$257.55 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$419.22 |
$419.22 |
$419.22 |
$248.05
|
|
Strapping of chest
|
$195.33 |
$195.33 |
$195.33 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$236.13 |
$236.13 |
$236.13 |
$171.00
|
|
Strapping of hand or finger
|
$77.01 |
$77.01 |
$77.01 |
$194.40
|
|
Strapping of hip
|
$155.55 |
$155.55 |
$155.55 |
$170.08
|
|
Strapping of knee
|
$155.55 |
$155.55 |
$155.55 |
$224.80
|
|
Strapping of toes 29550
|
$77.01 |
$77.01 |
$77.01 |
$185.36
|
|
Stress test pulmonary
|
$309.57 |
$309.57 |
$309.57 |
$327.20
|
|
St treatment speech individual
|
$234.60 |
$234.60 |
$234.60 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$173.40 |
$173.40 |
$173.40 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$145.10 |
$145.10 |
$145.10 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$84.15 |
$84.15 |
$84.15 |
$74.79
|
|
Sulfonylurea screen qn-sendout
|
$5.56 |
$5.56 |
$5.56 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$84.15 |
$84.15 |
$84.15 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$58.26 |
$58.26 |
$58.26 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$60.18 |
$60.18 |
$60.18 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$96.39 |
$96.39 |
$96.39 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$129.03 |
$129.03 |
$129.03 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$170.85 |
$170.85 |
$170.85 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$452.37 |
$452.37 |
$452.37 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$990.93 |
$990.93 |
$990.93 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$51.51 |
$51.51 |
$51.51 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$62.73 |
$62.73 |
$62.73 |
$34.48
|
|
Susceptibility mic per plate
|
$214.71 |
$214.71 |
$214.71 |
$94.38
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.49 |
$1.49 |
$1.49 |
$44.85
|
|
System cardiomems hosp electronics
|
$27,439.81 |
$27,439.81 |
$27,439.81 |
$41,639.82
|
|
System pacing micra av
|
$16,932.51 |
$16,932.51 |
$16,932.51 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$5,324.40 |
$5,324.40 |
$5,324.40 |
$10,980.00
|
|
System sealant biosentry tract
|
$1,311.98 |
$1,311.98 |
$1,311.98 |
$900.00
|
|
T3 (triiodothyronine) free
|
$81.09 |
$81.09 |
$81.09 |
$89.82
|
|
T3 (triiodothyronine) total
|
$63.50 |
$63.50 |
$63.50 |
$94.90
|
|
T4 (thyroxine) free
|
$145.35 |
$145.35 |
$145.35 |
$81.60
|
|
T4 (thyroxine) total
|
$55.59 |
$55.59 |
$55.59 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$5.61 |
$5.61 |
$5.61 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$138.72 |
$138.72 |
$138.72 |
$122.40
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$808.35 |
$808.35 |
$808.35 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$159.96 |
$159.96 |
$159.96 |
$186.00
|
|
T cells absolute cd 4 count
|
$65.10 |
$65.10 |
$65.10 |
$120.25
|
|
T cells total count
|
$47.89 |
$47.89 |
$47.89 |
$124.11
|
|
Telehealth original site facility fee
|
$120.36 |
$120.36 |
$120.36 |
$60.80
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$16,531.64 |
$16,531.64 |
$16,531.64 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$3,981.06 |
$3,981.06 |
$3,981.06 |
$3,839.54
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$84.15 |
$84.15 |
$84.15 |
$46.10
|
|
Test pathogen(s) for platelets reference
|
$84.15 |
$84.15 |
$84.15 |
$73.45
|
|
Tetanus immune globulin inj
|
$1,440.92 |
$1,440.92 |
$1,440.92 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$202.98 |
$202.98 |
$202.98 |
$108.00
|
|
Ther/proph/diag inj ia
|
$263.67 |
$263.67 |
$263.67 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$4,137.63 |
$4,137.63 |
$4,137.63 |
$1,804.00
|
|
Thoracotomy w/expl
|
$30,240.45 |
$30,240.45 |
$30,240.45 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$49,128.30 |
$49,128.30 |
$49,128.30 |
$2,926.56
|
|
Thrombectomy/inf pq dialysis circuit
|
$6,769.23 |
$6,769.23 |
$6,769.23 |
$7,828.60
|
|
Thrombin time
|
$21.14 |
$21.14 |
$21.14 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$35.02 |
$35.02 |
$35.02 |
$56.93
|
|
Thyroglobulin antibody
|
$30.57 |
$30.57 |
$30.57 |
$84.00
|
|
Thyroid imaging
|
$737.46 |
$737.46 |
$737.46 |
$670.80
|
|
Thyroid (TSH) Test
|
$254.49 |
$254.49 |
$254.49 |
$120.00
|
|
Thyroid Ultrasound
|
$1,168.92 |
$1,168.92 |
$1,168.92 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$63.72 |
$63.72 |
$63.72 |
$63.60
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$3,930.80 |
$3,930.80 |
$3,930.80 |
$2,516.07
|
|
Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm
|
$1,578.39 |
$1,578.39 |
$1,578.39 |
$2,085.14
|
|
Tissue transglutaminase iga
|
$61.71 |
$61.71 |
$61.71 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$84.15 |
$84.15 |
$84.15 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$149.94 |
$149.94 |
$149.94 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$5,938.96 |
$5,938.96 |
$5,938.96 |
$4,711.84
|
|
Tomosynthesis breast diagnostic left
|
$50.49 |
$50.49 |
$50.49 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$55.59 |
$55.59 |
$55.59 |
$73.45
|
|
Toxoplasma antibody igg
|
$45.06 |
$45.06 |
$45.06 |
$84.35
|
|
Toxoplasma antibody igm
|
$36.20 |
$36.20 |
$36.20 |
$83.20
|
|
Tpmt gene com vrnts
|
$76.50 |
$76.50 |
$76.50 |
$381.55
|
|
Tracheobrnchsc thru est trachs incisn
|
$699.72 |
$699.72 |
$699.72 |
$1,459.48
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$84.15 |
$84.15 |
$84.15 |
$77.65
|
|
Transcath closure of asd
|
$29,141.40 |
$29,141.40 |
$29,141.40 |
$18,772.00
|
|
Transferrin
|
$172.89 |
$172.89 |
$172.89 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$2,032.35 |
$2,032.35 |
$2,032.35 |
$988.24
|
|
Tray bonemarrw oncontrol 102mm
|
$3,888.75 |
$3,888.75 |
$3,888.75 |
$1,013.83
|
