|
Shrinker prosth below knee
|
$335.00 |
$335.00 |
$335.00 |
$153.13
|
|
Sickling rbc
|
$1,017.53 |
$1,017.53 |
$1,017.53 |
$54.00
|
|
Signal avg ecg w or without ecg 93278
|
$1,674.97 |
$1,674.97 |
$1,674.97 |
$310.05
|
|
Sincalide 5 mcg solution for injection
|
$1,037.56 |
$1,037.56 |
$1,037.56 |
$412.96
|
|
Sleep Study (Polysomnography)
|
$19,161.12 |
$19,161.12 |
$19,161.12 |
$3,920.95
|
|
Sleep study unattended
|
$3,771.39 |
$3,771.39 |
$3,771.39 |
$595.50
|
|
Slp stdy unatnd w/anal
|
$1,807.34 |
$1,807.34 |
$1,807.34 |
$307.50
|
|
Smear nasal eosinophil
|
$542.16 |
$542.16 |
$542.16 |
$50.00
|
|
Snrpn/ube3a gene
|
$2,980.99 |
$2,980.99 |
$2,980.99 |
$230.63
|
|
Sock wool above knee
|
$197.00 |
$197.00 |
$197.00 |
$244.50
|
|
Sodium 24 hour urine
|
$850.87 |
$850.87 |
$850.87 |
$48.50
|
|
Sodium chloride 0.9 % IV bolus
|
$308.00 |
$308.00 |
$308.00 |
$51.51
|
|
Sodium chloride 3 % ivpb
|
$255.10 |
$255.10 |
$255.10 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$38.91 |
$38.91 |
$38.91 |
$104.98
|
|
Sodium serum/plasma/whole blood
|
$520.40 |
$520.40 |
$520.40 |
$43.00
|
|
Sotalol hydrochloride IV
|
$10,636.15 |
$10,636.15 |
$10,636.15 |
$22.83
|
|
Specific gravity body fluid
|
$321.82 |
$321.82 |
$321.82 |
$23.63
|
|
Specimen fat stain
|
$487.05 |
$487.05 |
$487.05 |
$32.76
|
|
Split blood or products
|
$481.52 |
$481.52 |
$481.52 |
$148.92
|
|
Srs multisource
|
$21,916.79 |
$21,916.79 |
$21,916.79 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$717.20 |
$717.20 |
$717.20 |
$302.00
|
|
St evaluate speech sound production
|
$632.09 |
$632.09 |
$632.09 |
$302.40
|
|
Strep a ag ia
|
$907.50 |
$907.50 |
$907.50 |
$75.40
|
|
Strep b assay w/optic
|
$1,735.16 |
$1,735.16 |
$1,735.16 |
$32.00
|
|
Strep b dna amp probe
|
$1,210.07 |
$1,210.07 |
$1,210.07 |
$135.10
|
|
Streptozocin injection
|
$2,314.58 |
$2,314.58 |
$2,314.58 |
$954.71
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$73.70 |
$73.70 |
$73.70 |
$66.80
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,733.76 |
$1,733.76 |
$1,733.76 |
$109.26
|
|
Surgical pathology level 1 gross examination only
|
$1,474.25 |
$1,474.25 |
$1,474.25 |
$92.95
|
|
Surgical pathology level 2 gross & microscopic examination
|
$2,683.18 |
$2,683.18 |
$2,683.18 |
$150.40
|
|
Surgical pathology level 3 gross & microscopic examination
|
$3,419.46 |
$3,419.46 |
$3,419.46 |
$195.06
|
|
Surgical pathology level 4 gross & microscopic examination
|
$3,945.71 |
$3,945.71 |
$3,945.71 |
$254.94
|
|
Surgical pathology level 5 gross & microscopic examination
|
$4,471.91 |
$4,471.91 |
$4,471.91 |
$494.40
|
|
Surgical pathology level 6 gross & microscopic examination
|
$4,998.06 |
$4,998.06 |
$4,998.06 |
$791.85
|
|
Susceptibility enzyme detection per enzyme
|
$432.08 |
$432.08 |
$432.08 |
$35.10
|
|
Susceptibility mic per plate
|
$2,188.85 |
$2,188.85 |
$2,188.85 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$378.32 |
$378.32 |
$378.32 |
$51.50
|
|
Svc venogram s&i
|
$17,758.85 |
$17,758.85 |
$17,758.85 |
$1,908.00
|
|
T3 (triiodothyronine) free
|
$1,680.03 |
$1,680.03 |
$1,680.03 |
$89.82
|
|
T3 (triiodothyronine) total
|
$1,137.90 |
$1,137.90 |
$1,137.90 |
$93.60
|
|
T4 (thyroxine) free
|
$1,094.46 |
$1,094.46 |
$1,094.46 |
$83.65
|
|
T4 (thyroxine) total
|
$1,381.46 |
$1,381.46 |
$1,381.46 |
$73.64
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$2,751.20 |
$2,751.20 |
$2,751.20 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$2,342.55 |
$2,342.55 |
$2,342.55 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$7,262.79 |
$7,262.79 |
$7,262.79 |
$3,817.00
|
|
Target gsa panel hmtlmph neop
|
$17,536.21 |
$17,536.21 |
$17,536.21 |
$1,928.40
|
|
Target gsa panel organ neop
|
$1,701.91 |
$1,701.91 |
$1,701.91 |
$1,913.00
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$2,469.56 |
$2,469.56 |
$2,469.56 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$2,469.56 |
$2,469.56 |
$2,469.56 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$1,558.34 |
$1,558.34 |
$1,558.34 |
$185.28
|
|
T cells total count
|
$952.38 |
$952.38 |
$952.38 |
$124.11
|
|
Telavancin injection
|
$1,173.73 |
$1,173.73 |
$1,173.73 |
$1,216.45
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$182.46 |
$182.46 |
$182.46 |
$44.76
|
|
Test for porphobilinogen
|
$1,326.33 |
$1,326.33 |
$1,326.33 |
$33.57
|
|
Test urine for porphyrins
|
$1,194.52 |
$1,194.52 |
$1,194.52 |
$27.30
|
|
Tetanus immune globulin inj
|
$4,004.12 |
$4,004.12 |
$4,004.12 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$1,137.90 |
$1,137.90 |
$1,137.90 |
$108.00
|
|
Therapeutic procd strg endur
|
$312.86 |
$312.86 |
$312.86 |
$85.80
|
|
Thrombin time
|
$1,049.51 |
$1,049.51 |
$1,049.51 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$537.80 |
$537.80 |
$537.80 |
$57.17
|
|
Thromboxane urine
|
$1,306.35 |
$1,306.35 |
$1,306.35 |
$48.45
|
|
Thyroid (TSH) Test
|
$1,746.70 |
$1,746.70 |
$1,746.70 |
$118.80
|
|
Thyroxine binding globulin (tbg)
|
$1,704.71 |
$1,704.71 |
$1,704.71 |
$63.05
|
|
Tigecycline injection
|
$549.48 |
$549.48 |
$549.48 |
$317.36
|
|
Tilt table study
|
$4,130.46 |
$4,130.46 |
$4,130.46 |
$1,507.01
|
|
Tissue culture placenta
|
$1,444.03 |
$1,444.03 |
$1,444.03 |
$520.91
|
|
Tissue culture skin/biopsy
|
$2,828.12 |
$2,828.12 |
$2,828.12 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$288.44 |
$288.44 |
$288.44 |
$47.40
|
|
Tobramycin non-comp unit
|
$23.25 |
$23.25 |
$23.25 |
$107.07
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$720.85 |
$720.85 |
$720.85 |
$298.27
|
|
Toxoplasma antibody igg
|
$819.04 |
$819.04 |
$819.04 |
$84.60
|
|
Toxoplasma antibody igm
|
$984.21 |
$984.21 |
$984.21 |
$84.00
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$203.35 |
$203.35 |
$203.35 |
$93.24
|
|
Transcatheter bx s&i
|
$9,823.61 |
$9,823.61 |
$9,823.61 |
$1,875.96
|
|
Transferrin
|
$1,735.16 |
$1,735.16 |
$1,735.16 |
$85.56
|
|
Trastuzumab 150 mg intravenous solution
|
$783.69 |
$783.69 |
$783.69 |
$3,236.45
|
|
Trg gene rearrangement anal
|
$2,946.09 |
$2,946.09 |
$2,946.09 |
$455.70
|
|
Trichinella antibody
|
$1,078.51 |
$1,078.51 |
$1,078.51 |
$72.15
|
|
Triglycerides
|
$862.49 |
$862.49 |
$862.49 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$283.48 |
$283.48 |
$283.48 |
$154.09
|
|
Troponin quantitative
|
$1,713.38 |
$1,713.38 |
$1,713.38 |
$123.75
|
|
Tte w or without fol w/con,stres
|
$10,218.15 |
$10,218.15 |
$10,218.15 |
$1,417.90
|
|
Tx atrial fib pulm vein isol
|
$127,559.46 |
$127,559.46 |
$127,559.46 |
$32,208.35
|
|
Ultrasound abdomen aorta screening study aaa
|
$540.09 |
$540.09 |
$540.09 |
$402.00
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$1,843.44 |
$1,843.44 |
$1,843.44 |
$477.10
|
|
Unsched dialysis esrd pt hos
|
$8,880.47 |
$8,880.47 |
$8,880.47 |
$1,469.76
|
|
Urea nitrogen 24 hour urine
|
$1,393.04 |
$1,393.04 |
$1,393.04 |
$50.40
|
|
Urea nitrogen clearance
|
$845.13 |
$845.13 |
$845.13 |
$33.57
|
|
Uric acid blood
|
$1,448.11 |
$1,448.11 |
$1,448.11 |
$46.64
|
|
Urinalysis microscopic only
|
$552.38 |
$552.38 |
$552.38 |
$26.46
|
|
Urinalysis qual/semiquant excpt ia
|
$355.15 |
$355.15 |
$355.15 |
$25.72
|
|
Urinalysis (with microscopy)
|
$1,127.81 |
$1,127.81 |
$1,127.81 |
$48.14
|
|
Urine Culture Test
|
$1,194.52 |
$1,194.52 |
$1,194.52 |
$86.45
|
|
Urine pregnancy test
|
$719.00 |
$719.00 |
$719.00 |
$66.60
|
|
Vaccine dtap < 7 years im
|
$135.53 |
$135.53 |
$135.53 |
$87.80
|
|
Vaccine dtap-ipv/hib im
|
$1,253.10 |
$1,253.10 |
$1,253.10 |
$248.80
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$197.01 |
$197.01 |
$197.01 |
$85.00
|
|
Vaccine hepatitis a (hepa) adult im
|
$548.25 |
$548.25 |
$548.25 |
$178.07
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$530.13 |
$530.13 |
$530.13 |
$173.98
|
|
Vaccine influenza nos 0.5ml dose im
|
$280.44 |
$280.44 |
$280.44 |
$36.80
|
