|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$627.22 |
$627.22 |
$627.22 |
$550.10
|
|
Ring ostmy barr adapt 48mm
|
$84.00 |
$84.00 |
$84.00 |
$5.97
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$11,418.00 |
$11,418.00 |
$11,418.00 |
$9,916.57
|
|
Rp loclzj tum 2+area 1+d img
|
$1,738.00 |
$1,738.00 |
$1,738.00 |
$1,461.75
|
|
Salmonella antibody
|
$366.00 |
$366.00 |
$366.00 |
$37.58
|
|
Sargramostim injection
|
$1,741.00 |
$1,741.00 |
$1,741.00 |
$451.34
|
|
Sarscov coronavirus ag ia
|
$36.00 |
$36.00 |
$36.00 |
$60.40
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,624.00 |
$2,624.00 |
$2,624.00 |
$1,012.55
|
|
Screening Mammogram
|
$1,439.00 |
$1,439.00 |
$1,439.00 |
$299.01
|
|
Semen analysis presence/motility
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$72.42
|
|
Sialography s&i
|
$2,318.00 |
$2,318.00 |
$2,318.00 |
$458.15
|
|
Sincalide 5 mcg solution for injection
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$412.96
|
|
Sinus/juglr venogram s&i
|
$16,728.00 |
$16,728.00 |
$16,728.00 |
$2,489.25
|
|
Sleep Study (Polysomnography)
|
$16,927.00 |
$16,927.00 |
$16,927.00 |
$3,920.95
|
|
Sleep study unattended
|
$1,018.00 |
$1,018.00 |
$1,018.00 |
$595.50
|
|
Smear nasal eosinophil
|
$64.00 |
$64.00 |
$64.00 |
$50.00
|
|
Sodium chloride 0.9 % intravenous solution
|
$681.00 |
$681.00 |
$681.00 |
$46.85
|
|
Sodium chloride 0.9 % IV bolus
|
$230.00 |
$230.00 |
$230.00 |
$51.51
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$1,399.00 |
$1,399.00 |
$1,399.00 |
$228.31
|
|
Specimen fat stain
|
$599.00 |
$599.00 |
$599.00 |
$32.76
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$11,195.00 |
$11,195.00 |
$11,195.00 |
$559.30
|
|
Spleen imaging
|
$5,022.00 |
$5,022.00 |
$5,022.00 |
$539.70
|
|
Sputum specimen collection
|
$2,286.00 |
$2,286.00 |
$2,286.00 |
$180.00
|
|
Sr-89 stront chlor ther / mci
|
$21,089.00 |
$21,089.00 |
$21,089.00 |
$4,588.65
|
|
St evaluate speech sound production
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$302.40
|
|
St evaluate speech sound production comprehensive/expressive
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$389.64
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$406.52
|
|
St evaluation swallow function
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$336.60
|
|
Strapping of hand or finger
|
$317.00 |
$317.00 |
$317.00 |
$197.63
|
|
Streptokinase antibody
|
$480.00 |
$480.00 |
$480.00 |
$13.93
|
|
Streptomycin injection
|
$166.00 |
$166.00 |
$166.00 |
$100.00
|
|
Streptozocin injection
|
$1,256.00 |
$1,256.00 |
$1,256.00 |
$954.71
|
|
St treatment speech individual
|
$2,121.00 |
$2,121.00 |
$2,121.00 |
$256.55
|
|
St treatment swallow dysfunction/oral
|
$2,121.00 |
$2,121.00 |
$2,121.00 |
$260.00
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$185.00 |
$185.00 |
$185.00 |
$66.80
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$821.00 |
$821.00 |
$821.00 |
$109.26
|
|
Surgical pathology level 2 gross & microscopic examination
|
$852.00 |
$852.00 |
$852.00 |
$150.40
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,168.00 |
$2,168.00 |
$2,168.00 |
$791.85
|
|
Svc venogram s&i
|
$5,271.00 |
$5,271.00 |
$5,271.00 |
$1,908.00
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,057.00 |
$1,057.00 |
$1,057.00 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$698.00 |
$698.00 |
$698.00 |
$122.50
|
|
Tc-99m depreotide
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$1,937.35
|
|
Tc-99m disofenin
|
$367.00 |
$367.00 |
$367.00 |
$151.32
|
|
Tc-99m exametazime diag
|
$19,954.00 |
$19,954.00 |
$19,954.00 |
$2,166.26
|
|
Tc-99m maa
|
$504.00 |
$504.00 |
$504.00 |
$312.06
|
|
Tc-99m mebrofenin
|
$249.00 |
$249.00 |
$249.00 |
$169.53
|
|
Tc-99m medronate
|
$816.00 |
$816.00 |
$816.00 |
$122.46
|
|
Tc-99m mertiatide
|
$1,632.00 |
$1,632.00 |
$1,632.00 |
$757.25
|
|
Tc-99m pentetate dtpa aerosol
|
$957.00 |
$957.00 |
$957.00 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$513.00 |
$513.00 |
$513.00 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$509.00 |
$509.00 |
$509.00 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$1,365.00 |
$1,365.00 |
$1,365.00 |
$221.60
|
|
Tc-99m sulfur colloid
|
$948.00 |
$948.00 |
$948.00 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$198.05
|
|
T cells total count
|
$534.00 |
$534.00 |
$534.00 |
$124.11
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$69,163.00 |
$69,163.00 |
$69,163.00 |
$17,652.73
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$230.00 |
$230.00 |
$230.00 |
$44.76
|
|
Test for porphobilinogen
|
$42.90 |
$42.90 |
$42.90 |
$33.57
|
|
Test for urine cystines
|
$39.60 |
$39.60 |
$39.60 |
$26.00
|
|
Tetanus immune globulin inj
|
$4,985.00 |
$4,985.00 |
$4,985.00 |
$1,395.20
|
|
Theophylline therapeutic drug level
|
$1,294.00 |
$1,294.00 |
$1,294.00 |
$108.00
|
|
Ther nma rdctj intus/obstrcj
|
$2,725.00 |
$2,725.00 |
$2,725.00 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$139.00 |
$139.00 |
$139.00 |
$37.12
|
|
Thyroid imaging
|
$5,448.00 |
$5,448.00 |
$5,448.00 |
$662.20
|
|
Thyroid mets imag whole body
|
$4,728.00 |
$4,728.00 |
$4,728.00 |
$1,524.99
|
|
Thyroid uptake measurement
|
$5,406.00 |
$5,406.00 |
$5,406.00 |
$619.20
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$11,417.00 |
$11,417.00 |
$11,417.00 |
$4,852.41
|
|
Thyroxine binding globulin (tbg)
|
$249.00 |
$249.00 |
$249.00 |
$63.05
|
|
Tigecycline injection
|
$1,661.00 |
$1,661.00 |
$1,661.00 |
$317.36
|
|
Tissue culture skin/biopsy
|
$257.00 |
$257.00 |
$257.00 |
$558.87
|
|
Tissue culture tumor
|
$658.00 |
$658.00 |
$658.00 |
$529.23
|
|
Tomosynthesis breast diagnostic left
|
$1,166.00 |
$1,166.00 |
$1,166.00 |
$63.00
|
|
Tomosynthesis breast screen bilateral
|
$1,616.00 |
$1,616.00 |
$1,616.00 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$1,278.00 |
$1,278.00 |
$1,278.00 |
$298.27
|
|
Toxoplasma antibody igg
|
$177.00 |
$177.00 |
$177.00 |
$84.60
|
|
Toxoplasma antibody igm
|
$249.00 |
$249.00 |
$249.00 |
$84.00
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$512.00 |
$512.00 |
$512.00 |
$82.60
|
|
Transcatheter bx s&i
|
$7,221.00 |
$7,221.00 |
$7,221.00 |
$1,875.96
|
|
Trastuzumab 150 mg intravenous solution
|
$1,249.00 |
$1,249.00 |
$1,249.00 |
$3,236.45
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$2,340.00 |
$2,340.00 |
$2,340.00 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$150.53
|
|
Trichinella antibody
|
$233.00 |
$233.00 |
$233.00 |
$72.15
|
|
Trimethobenzamide hcl inj
|
$332.00 |
$332.00 |
$332.00 |
$154.09
|
|
Tube drain vert dev st 5-40f
|
$168.00 |
$168.00 |
$168.00 |
$72.21
|
|
Ultrasound abdomen aorta screening study aaa
|
$1,133.00 |
$1,133.00 |
$1,133.00 |
$402.00
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$1,629.00 |
$1,629.00 |
$1,629.00 |
$340.14
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$3,036.00 |
$3,036.00 |
$3,036.00 |
$477.10
|
|
Ultrasound guided needle placement supervision & interpretation
|
$5,068.00 |
$5,068.00 |
$5,068.00 |
$701.35
|
|
Ultrasound guide intraoperative
|
$2,164.00 |
$2,164.00 |
$2,164.00 |
$632.90
|
|
Ultrasound ob >=14wks ea addl gest
|
$1,410.00 |
$1,410.00 |
$1,410.00 |
$453.09
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$3,543.00 |
$3,543.00 |
$3,543.00 |
$326.15
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,819.00 |
$1,819.00 |
$1,819.00 |
$690.48
|
|
Ultrasound pregnant uterus follow up per fetus
|
$1,819.00 |
$1,819.00 |
$1,819.00 |
$450.75
|
|
Ultrasound prostate/transrectal
|
$3,173.00 |
$3,173.00 |
$3,173.00 |
$545.16
|
|
Ultrasound spinal canal and contents
|
$3,374.00 |
$3,374.00 |
$3,374.00 |
$450.60
|
|
Ultrasound transabd ea addl gest
|
$4,089.00 |
$4,089.00 |
$4,089.00 |
$425.10
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$12,195.00 |
$12,195.00 |
$12,195.00 |
$2,919.75
|
|
Upper Back (Thoracic Spine) MRI (with contrast)
|
$6,263.00 |
$6,263.00 |
$6,263.00 |
$2,364.35
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$8,817.00 |
$8,817.00 |
$8,817.00 |
$2,013.08
|
|
Urethrcystgrphy rtrgrde s&i
|
$5,432.00 |
$5,432.00 |
$5,432.00 |
$574.40
|
