|
Smear special stain inclusion bodies/parasites
|
$372.40 |
$372.40 |
$372.40 |
$64.35
|
|
Smear wet mount
|
$245.35 |
$245.35 |
$245.35 |
$68.63
|
|
Sodium 24 hour urine
|
$107.10 |
$107.10 |
$107.10 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$68.93 |
$68.93 |
$68.93 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$68.93 |
$68.93 |
$68.93 |
$47.27
|
|
Sodium chloride 0.9 % IV bolus
|
$68.93 |
$68.93 |
$68.93 |
$43.78
|
|
Sodium chloride 3 % ivpb
|
$68.93 |
$68.93 |
$68.93 |
$48.11
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$116.38 |
$116.38 |
$116.38 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$89.60 |
$89.60 |
$89.60 |
$42.70
|
|
Soft interface below knee se
|
$136.96 |
$136.96 |
$136.96 |
$209.99
|
|
Specific gravity body fluid
|
$30.80 |
$30.80 |
$30.80 |
$23.63
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,196.30 |
$1,196.30 |
$1,196.30 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$322.00 |
$322.00 |
$322.00 |
$559.96
|
|
Spleen imaging
|
$944.65 |
$944.65 |
$944.65 |
$539.70
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$131.25 |
$131.25 |
$131.25 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$35.00 |
$35.00 |
$35.00 |
$52.65
|
|
Splint finger frog med
|
$19.25 |
$19.25 |
$19.25 |
$34.58
|
|
Splint rstrc wrst/cmc right med
|
$54.25 |
$54.25 |
$54.25 |
$101.18
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$4,619.65 |
$4,619.65 |
$4,619.65 |
$4,560.66
|
|
Split blood or products
|
$103.60 |
$103.60 |
$103.60 |
$148.98
|
|
St analysis behavior qualitative voice/resonance
|
$292.95 |
$292.95 |
$292.95 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$365.05 |
$365.05 |
$365.05 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$19,966.80 |
$19,966.80 |
$19,966.80 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$50,225.00 |
$50,225.00 |
$50,225.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$26,143.55 |
$26,143.55 |
$26,143.55 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$24,396.19 |
$24,396.19 |
$24,396.19 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$5,247.90 |
$5,247.90 |
$5,247.90 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$5,201.70 |
$5,201.70 |
$5,201.70 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,903.55 |
$3,903.55 |
$3,903.55 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$12,412.05 |
$12,412.05 |
$12,412.05 |
$19,765.20
|
|
St evaluate speech sound production
|
$292.95 |
$292.95 |
$292.95 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$416.85 |
$416.85 |
$416.85 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$270.20 |
$270.20 |
$270.20 |
$406.40
|
|
St evaluation swallow function
|
$270.20 |
$270.20 |
$270.20 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$130.55 |
$130.55 |
$130.55 |
$248.05
|
|
Strapping of chest
|
$242.20 |
$242.20 |
$242.20 |
$201.60
|
|
Strapping of elbow or wrist 29260
|
$165.90 |
$165.90 |
$165.90 |
$171.00
|
|
Strapping of hand or finger
|
$130.55 |
$130.55 |
$130.55 |
$194.40
|
|
Strapping of hip
|
$165.90 |
$165.90 |
$165.90 |
$170.08
|
|
Strapping of knee
|
$130.55 |
$130.55 |
$130.55 |
$224.80
|
|
Strapping of toes 29550
|
$130.55 |
$130.55 |
$130.55 |
$185.36
|
|
Strep b dna amp probe
|
$171.50 |
$171.50 |
$171.50 |
$139.20
|
|
Stress test pulmonary
|
$784.00 |
$784.00 |
$784.00 |
$327.20
|
|
Stress tte complete
|
$657.65 |
$657.65 |
$657.65 |
$1,964.95
|
|
St treatment speech individual
|
$225.05 |
$225.05 |
$225.05 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$225.05 |
$225.05 |
$225.05 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$33.19 |
$33.19 |
$33.19 |
$49.13
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,803.50 |
$2,803.50 |
$2,803.50 |
$5,446.00
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$50.06 |
$50.06 |
$50.06 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$35.36 |
$35.36 |
$35.36 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$23.75 |
$23.75 |
$23.75 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$77.70 |
$77.70 |
$77.70 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$94.85 |
$94.85 |
$94.85 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$129.50 |
$129.50 |
$129.50 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$161.00 |
$161.00 |
$161.00 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$210.35 |
$210.35 |
$210.35 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$479.85 |
$479.85 |
$479.85 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$393.75 |
$393.75 |
$393.75 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$393.75 |
$393.75 |
$393.75 |
$34.48
|
|
Susceptibility mic per plate
|
$394.45 |
$394.45 |
$394.45 |
$94.38
|
|
Svc venogram s&i
|
$2,325.40 |
$2,325.40 |
$2,325.40 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$94.50 |
$94.50 |
$94.50 |
$44.85
|
|
System cardiomems hosp electronics
|
$33,334.88 |
$33,334.88 |
$33,334.88 |
$41,518.75
|
|
System pacing micra av
|
$20,408.85 |
$20,408.85 |
$20,408.85 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,593.33 |
$6,593.33 |
$6,593.33 |
$10,980.00
|
|
System sealant biosentry tract
|
$630.26 |
$630.26 |
$630.26 |
$900.00
|
|
T3 (triiodothyronine) free
|
$103.60 |
$103.60 |
$103.60 |
$89.82
|
|
T3 (triiodothyronine) total
|
$203.70 |
$203.70 |
$203.70 |
$94.90
|
|
T4 (thyroxine) free
|
$83.65 |
$83.65 |
$83.65 |
$81.60
|
|
T4 (thyroxine) total
|
$129.50 |
$129.50 |
$129.50 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.56 |
$3.56 |
$3.56 |
$12.25
|
|
Tacrolimus therapeutic drug level
|
$16.86 |
$16.86 |
$16.86 |
$122.40
|
|
T cells absolute cd4/cd8 including ratio
|
$38.52 |
$38.52 |
$38.52 |
$186.00
|
|
T cells total count
|
$30.99 |
$30.99 |
$30.99 |
$124.11
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$29,822.42 |
$29,822.42 |
$29,822.42 |
$16,531.64
|
|
Tenotomy length/rls abductor hallucis musc 28240
|
$2,150.75 |
$2,150.75 |
$2,150.75 |
$3,839.54
|
|
Tension based scoliosis orth
|
$1,953.00 |
$1,953.00 |
$1,953.00 |
$2,851.20
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$33.14 |
$33.14 |
$33.14 |
$46.10
|
|
Test pathogen(s) for platelets reference
|
$72.59 |
$72.59 |
$72.59 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$612.15 |
$612.15 |
$612.15 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$2,048.35 |
$2,048.35 |
$2,048.35 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$260.40 |
$260.40 |
$260.40 |
$108.00
|
|
Therapeutic procd strg endur
|
$137.20 |
$137.20 |
$137.20 |
$85.80
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$61.95 |
$61.95 |
$61.95 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$61.95 |
$61.95 |
$61.95 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$808.85 |
$808.85 |
$808.85 |
$534.32
|
|
Ther/proph/diag inj ia
|
$231.35 |
$231.35 |
$231.35 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$34.02 |
$34.02 |
$34.02 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$834.05 |
$834.05 |
$834.05 |
$1,804.00
|
|
Thoracotomy w/expl
|
$3,020.15 |
$3,020.15 |
$3,020.15 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$3,020.15 |
$3,020.15 |
$3,020.15 |
$2,926.56
|
|
Thrombectomy/inf pq dialysis circuit
|
$5,980.80 |
$5,980.80 |
$5,980.80 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$11,960.90 |
$11,960.90 |
$11,960.90 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$18,293.45 |
$18,293.45 |
$18,293.45 |
$24,605.30
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$95.90 |
$95.90 |
$95.90 |
$56.93
|
|
Thyroglobulin antibody
|
$67.20 |
$67.20 |
$67.20 |
$84.00
|
|
Thyroid imaging
|
$373.10 |
$373.10 |
$373.10 |
$670.80
|
|
Thyroid met imaging
|
$449.05 |
$449.05 |
$449.05 |
$549.70
|
|
Thyroid mets imag whole body
|
$1,345.40 |
$1,345.40 |
$1,345.40 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$203.70 |
$203.70 |
$203.70 |
$120.00
|
