|
Scan duplex lower extremity arteries unilateral/limited study left
|
$2,213.93 |
$2,213.93 |
$2,213.93 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$683.60 |
$683.60 |
$683.60 |
$601.70
|
|
Sedimentation rate erythrocyte automated
|
$128.36 |
$128.36 |
$128.36 |
$44.20
|
|
Shoulder X-ray
|
$2,047.11 |
$2,047.11 |
$2,047.11 |
$367.02
|
|
Sickling rbc
|
$110.01 |
$110.01 |
$110.01 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$2,710.26 |
$2,710.26 |
$2,710.26 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$9,282.20 |
$9,282.20 |
$9,282.20 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$6,901.87 |
$6,901.87 |
$6,901.87 |
$1,279.50
|
|
Sleeve fing rolyan med
|
$1,370.73 |
$1,370.73 |
$1,370.73 |
$167.31
|
|
Smear fluorescent and/or acid fast stain
|
$107.61 |
$107.61 |
$107.61 |
$64.20
|
|
Smear gram stain
|
$141.66 |
$141.66 |
$141.66 |
$57.85
|
|
Smear special stain inclusion bodies/parasites
|
$119.59 |
$119.59 |
$119.59 |
$64.35
|
|
Sodium 24 hour urine
|
$142.33 |
$142.33 |
$142.33 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$47.56 |
$47.56 |
$47.56 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$157.83 |
$157.83 |
$157.83 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$542.19 |
$542.19 |
$542.19 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$2,313.18 |
$2,313.18 |
$2,313.18 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$358.53 |
$358.53 |
$358.53 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,740.49 |
$1,740.49 |
$1,740.49 |
$1,502.08
|
|
Splint extn xsm w sof-stretch rolyan
|
$407.20 |
$407.20 |
$407.20 |
$41.58
|
|
Splint finger frog med
|
$269.78 |
$269.78 |
$269.78 |
$21.50
|
|
St evaluate speech sound production
|
$581.45 |
$581.45 |
$581.45 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$970.74 |
$970.74 |
$970.74 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$1,538.71 |
$1,538.71 |
$1,538.71 |
$406.40
|
|
St evaluation swallow function
|
$879.37 |
$879.37 |
$879.37 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$2,867.78 |
$2,867.78 |
$2,867.78 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$171.00
|
|
Strapping of hand or finger
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$194.40
|
|
Strapping of knee
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$224.80
|
|
Strapping of toes 29550
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$185.36
|
|
Strep b dna amp probe
|
$700.58 |
$700.58 |
$700.58 |
$139.20
|
|
St treatment speech individual
|
$527.79 |
$527.79 |
$527.79 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$821.26 |
$821.26 |
$821.26 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$248.24 |
$248.24 |
$248.24 |
$49.13
|
|
Sugars single quant
|
$230.21 |
$230.21 |
$230.21 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$305.43 |
$305.43 |
$305.43 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$152.20 |
$152.20 |
$152.20 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$501.52 |
$501.52 |
$501.52 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$501.52 |
$501.52 |
$501.52 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$939.63 |
$939.63 |
$939.63 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,594.54 |
$1,594.54 |
$1,594.54 |
$253.75
|
|
Susceptibility agar dilution per agent
|
$94.84 |
$94.84 |
$94.84 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$94.84 |
$94.84 |
$94.84 |
$34.48
|
|
Susceptibility mic per plate
|
$4,353.57 |
$4,353.57 |
$4,353.57 |
$94.38
|
|
Synvisc or synvisc-one
|
$2,778.46 |
$2,778.46 |
$2,778.46 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$87.85 |
$87.85 |
$87.85 |
$44.85
|
|
T3 (triiodothyronine) free
|
$434.85 |
$434.85 |
$434.85 |
$89.82
|
|
T3 (triiodothyronine) total
|
$261.51 |
$261.51 |
$261.51 |
$94.90
|
|
T4 (thyroxine) free
|
$279.76 |
$279.76 |
$279.76 |
$81.60
|
|
T4 (thyroxine) total
|
$235.66 |
$235.66 |
$235.66 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$274.13 |
$274.13 |
$274.13 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$5,146.57 |
$5,146.57 |
$5,146.57 |
$959.55
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$238.62 |
$238.62 |
$238.62 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$358.12 |
$358.12 |
$358.12 |
$186.00
|
|
T cells absolute cd 4 count
|
$534.67 |
$534.67 |
$534.67 |
$120.25
|
|
T cells total count
|
$753.29 |
$753.29 |
$753.29 |
$124.11
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$41.36 |
$41.36 |
$41.36 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$106.50
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$58,106.32 |
$58,106.32 |
$58,106.32 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$294.27 |
$294.27 |
$294.27 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$209.11 |
$209.11 |
$209.11 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$3,266.52 |
$3,266.52 |
$3,266.52 |
$1,804.00
|
|
Thrombin time
|
$95.51 |
$95.51 |
$95.51 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$129.18 |
$129.18 |
$129.18 |
$56.93
|
|
Thyroglobulin antibody
|
$317.65 |
$317.65 |
$317.65 |
$84.00
|
|
Thyroid imaging
|
$6,505.60 |
$6,505.60 |
$6,505.60 |
$670.80
|
|
Thyroid (TSH) Test
|
$348.35 |
$348.35 |
$348.35 |
$120.00
|
|
Thyroid Ultrasound
|
$2,309.91 |
$2,309.91 |
$2,309.91 |
$589.96
|
|
Thyroxine binding globulin (tbg)
|
$295.09 |
$295.09 |
$295.09 |
$63.60
|
|
Tissue exam koh skin/hair/nails
|
$85.26 |
$85.26 |
$85.26 |
$47.40
|
|
Tissue transglutaminase iga
|
$230.21 |
$230.21 |
$230.21 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$146.72 |
$146.72 |
$146.72 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$322.05 |
$322.05 |
$322.05 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$10,451.29 |
$10,451.29 |
$10,451.29 |
$5,790.85
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$338.43 |
$338.43 |
$338.43 |
$303.88
|
|
Toxoplasma antibody igg
|
$287.30 |
$287.30 |
$287.30 |
$84.35
|
|
Toxoplasma antibody igm
|
$287.71 |
$287.71 |
$287.71 |
$83.20
|
|
Tpmt gene com vrnts
|
$3,490.09 |
$3,490.09 |
$3,490.09 |
$381.55
|
|
Transferrin
|
$254.75 |
$254.75 |
$254.75 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$2,025.95 |
$2,025.95 |
$2,025.95 |
$988.24
|
|
Treat foot dislocation
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$527.28
|
|
Treat fracture of ulna
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$766.72
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$241.15
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$612.14 |
$612.14 |
$612.14 |
$210.00
|
|
Treatment of heel fracture 28400
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$494.00
|
|
Treat toe dislocation
|
$4,899.81 |
$4,899.81 |
$4,899.81 |
$855.66
|
|
Treat vaginal bleeding
|
$3,440.37 |
$3,440.37 |
$3,440.37 |
$400.86
|
|
Treat wrist dislocation
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$760.00
|
|
Tremelimumab-actl 20 mg/ml intravenous solution
|
$353,935.63 |
$353,935.63 |
$353,935.63 |
$120,541.18
|
|
Treponema pallidum antibody
|
$264.34 |
$264.34 |
$264.34 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$312.05 |
$312.05 |
$312.05 |
$48.22
|
|
Triglycerides
|
$170.46 |
$170.46 |
$170.46 |
$54.60
|
|
Trimethobenzamide hcl inj
|
$832.69 |
$832.69 |
$832.69 |
$154.09
|
|
Trim nondyst nails
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$124.22
|
|
Troponin quantitative
|
$631.61 |
$631.61 |
$631.61 |
$123.75
|
|
Ultrasound breast complete
|
$2,213.93 |
$2,213.93 |
$2,213.93 |
$519.75
|
|
Ultrasound breast unilateral limited (both sides)
|
$1,624.35 |
$1,624.35 |
$1,624.35 |
$449.35
|
|
Ultrasound chest
|
$2,248.66 |
$2,248.66 |
$2,248.66 |
$459.55
|
|
Ultrasound guidance for vascular access
|
$3,644.88 |
$3,644.88 |
$3,644.88 |
$340.22
|
|
Ultrasound guided needle placement supervision & interpretation
|
$3,545.32 |
$3,545.32 |
$3,545.32 |
$701.35
|