|
Sodium serum/plasma/whole blood
|
$50.14 |
$50.14 |
$50.14 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$204.38 |
$204.38 |
$204.38 |
$195.48
|
|
Special physics consult
|
$1,318.90 |
$1,318.90 |
$1,318.90 |
$700.74
|
|
Special radiation dosimetry
|
$173.31 |
$173.31 |
$173.31 |
$445.50
|
|
Special radiation treatment
|
$2,314.07 |
$2,314.07 |
$2,314.07 |
$1,934.03
|
|
Special teletx port plan
|
$1,346.15 |
$1,346.15 |
$1,346.15 |
$1,046.65
|
|
Specific gravity body fluid
|
$210.92 |
$210.92 |
$210.92 |
$23.63
|
|
Sperm antibody test
|
$26.30 |
$26.30 |
$26.30 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,137.96 |
$1,137.96 |
$1,137.96 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$715.59 |
$715.59 |
$715.59 |
$559.96
|
|
Splint extn xsm w sof-stretch rolyan
|
$98.10 |
$98.10 |
$98.10 |
$52.65
|
|
Splint finger frog med
|
$24.53 |
$24.53 |
$24.53 |
$27.95
|
|
Splint func pos polyflex ii med
|
$251.25 |
$251.25 |
$251.25 |
$52.22
|
|
Splint rstrc wrst/cmc right med
|
$115.00 |
$115.00 |
$115.00 |
$101.18
|
|
Split blood or products
|
$82.30 |
$82.30 |
$82.30 |
$148.98
|
|
Staph a dna amp probe
|
$210.37 |
$210.37 |
$210.37 |
$116.39
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$22,972.30 |
$22,972.30 |
$22,972.30 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$40,698.97 |
$40,698.97 |
$40,698.97 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,108.61 |
$2,108.61 |
$2,108.61 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$6,935.67 |
$6,935.67 |
$6,935.67 |
$18,714.49
|
|
Stent iliac/open or perc/uni/init 37221
|
$17,723.95 |
$17,723.95 |
$17,723.95 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$10,971.94 |
$10,971.94 |
$10,971.94 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$16,875.93 |
$16,875.93 |
$16,875.93 |
$19,765.20
|
|
Strep b dna amp probe
|
$194.57 |
$194.57 |
$194.57 |
$139.20
|
|
Streptomycin injection
|
$43.06 |
$43.06 |
$43.06 |
$138.30
|
|
Stress tte complete
|
$2,433.97 |
$2,433.97 |
$2,433.97 |
$1,964.95
|
|
Str markers specimen anal
|
$127.60 |
$127.60 |
$127.60 |
$835.28
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$198.93 |
$198.93 |
$198.93 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$87.20 |
$87.20 |
$87.20 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$214.73 |
$214.73 |
$214.73 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$24.53 |
$24.53 |
$24.53 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$246.89 |
$246.89 |
$246.89 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$246.89 |
$246.89 |
$246.89 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$404.94 |
$404.94 |
$404.94 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$493.77 |
$493.77 |
$493.77 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$991.36 |
$991.36 |
$991.36 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,643.72 |
$1,643.72 |
$1,643.72 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$77.94 |
$77.94 |
$77.94 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$29.43 |
$29.43 |
$29.43 |
$34.48
|
|
Susceptibility mic per plate
|
$173.31 |
$173.31 |
$173.31 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$24.46 |
$24.46 |
$24.46 |
$48.30
|
|
Sweat collection by iontophoresis
|
$227.81 |
$227.81 |
$227.81 |
$105.21
|
|
Synvisc or synvisc-one
|
$2,491.74 |
$2,491.74 |
$2,491.74 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$20.61 |
$20.61 |
$20.61 |
$44.85
|
|
System pacing micra av
|
$15,243.11 |
$15,243.11 |
$15,243.11 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$19,815.11 |
$19,815.11 |
$19,815.11 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$112.82 |
$112.82 |
$112.82 |
$89.82
|
|
T3 (triiodothyronine) total
|
$416.93 |
$416.93 |
$416.93 |
$94.90
|
|
T4 (thyroxine) free
|
$114.45 |
$114.45 |
$114.45 |
$81.60
|
|
T4 (thyroxine) total
|
$248.52 |
$248.52 |
$248.52 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$15.26 |
$15.26 |
$15.26 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$6.54 |
$6.54 |
$6.54 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$3,027.48 |
$3,027.48 |
$3,027.48 |
$3,817.00
|
|
Target gsa panel hmtlmph neop
|
$1,417.00 |
$1,417.00 |
$1,417.00 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,607.75 |
$1,607.75 |
$1,607.75 |
$3,385.00
|
|
Target gsa panel organ neop
|
$790.25 |
$790.25 |
$790.25 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$40.88 |
$40.88 |
$40.88 |
$166.46
|
|
Tc-99m exametazime diag
|
$3,172.99 |
$3,172.99 |
$3,172.99 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$476.88 |
$476.88 |
$476.88 |
$323.01
|
|
Tc-99m maa
|
$469.25 |
$469.25 |
$469.25 |
$312.06
|
|
Tc-99m mebrofenin
|
$76.30 |
$76.30 |
$76.30 |
$169.53
|
|
Tc-99m medronate
|
$29.43 |
$29.43 |
$29.43 |
$122.46
|
|
Tc-99m mertiatide
|
$571.71 |
$571.71 |
$571.71 |
$757.25
|
|
Tc-99m pentetate dtpa aerosol
|
$571.71 |
$571.71 |
$571.71 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$116.09 |
$116.09 |
$116.09 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$93.20 |
$93.20 |
$93.20 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$674.71 |
$674.71 |
$674.71 |
$221.60
|
|
Tc-99m sulfur colloid
|
$358.61 |
$358.61 |
$358.61 |
$245.70
|
|
Tc-99m tilmanocept diag
|
$1,989.25 |
$1,989.25 |
$1,989.25 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$12.27 |
$12.27 |
$12.27 |
$186.00
|
|
T cells absolute cd 4 count
|
$15.26 |
$15.26 |
$15.26 |
$120.25
|
|
T cells total count
|
$12.27 |
$12.27 |
$12.27 |
$124.11
|
|
Telehealth original site facility fee
|
$41.42 |
$41.42 |
$41.42 |
$60.80
|
|
Telethx isodose plan cplx
|
$970.10 |
$970.10 |
$970.10 |
$1,617.00
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,957.79 |
$3,957.79 |
$3,957.79 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$16,889.01 |
$16,889.01 |
$16,889.01 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$59.95 |
$59.95 |
$59.95 |
$46.10
|
|
Tert gene targeted seq alys
|
$114.45 |
$114.45 |
$114.45 |
$304.59
|
|
Test stress cardiovascular tracing only
|
$1,071.47 |
$1,071.47 |
$1,071.47 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$864.37 |
$864.37 |
$864.37 |
$1,204.50
|
|
Tgsap so neo 5-50 rna alys
|
$545.00 |
$545.00 |
$545.00 |
$816.27
|
|
Theophylline therapeutic drug level
|
$483.96 |
$483.96 |
$483.96 |
$108.00
|
|
Therapeutic procd strg endur
|
$73.58 |
$73.58 |
$73.58 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$18.53 |
$18.53 |
$18.53 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$15.26 |
$15.26 |
$15.26 |
$50.40
|
|
Ther/proph/diag inj ia
|
$281.77 |
$281.77 |
$281.77 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$35.43 |
$35.43 |
$35.43 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,964.73 |
$1,964.73 |
$1,964.73 |
$1,804.00
|
|
Thrombin time
|
$26.44 |
$26.44 |
$26.44 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$107.91 |
$107.91 |
$107.91 |
$56.93
|
|
Thyroglobulin antibody
|
$3.55 |
$3.55 |
$3.55 |
$84.00
|
|
Thyroid (TSH) Test
|
$161.32 |
$161.32 |
$161.32 |
$120.00
|
|
Thyroid Ultrasound
|
$988.09 |
$988.09 |
$988.09 |
$589.96
|
|
Thyroid uptake measurement
|
$2,348.95 |
$2,348.95 |
$2,348.95 |
$653.60
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$4,063.52 |
$4,063.52 |
$4,063.52 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$7.79 |
$7.79 |
$7.79 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$16,875.93 |
$16,875.93 |
$16,875.93 |
$21,900.00
|
|
Tilt table study
|
$1,654.62 |
$1,654.62 |
$1,654.62 |
$1,495.00
|
|
Tisotumab vedotin-tftv 40 mg intravenous solution
|
$14,625.62 |
$14,625.62 |
$14,625.62 |
$14,271.00
|
|
Tissue amnio epifix inj 100mg
|
$9,018.12 |
$9,018.12 |
$9,018.12 |
$3,846.61
|