|
Sodium chloride 0.9 % intravenous solution
|
$61.31 |
$61.31 |
$61.31 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$100.51 |
$100.51 |
$100.51 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$612.78 |
$612.78 |
$612.78 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$3,388.07 |
$3,388.07 |
$3,388.07 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$260.16 |
$260.16 |
$260.16 |
$42.70
|
|
Special physics consult
|
$1,661.78 |
$1,661.78 |
$1,661.78 |
$700.74
|
|
Special radiation dosimetry
|
$942.28 |
$942.28 |
$942.28 |
$445.50
|
|
Special radiation treatment
|
$3,449.00 |
$3,449.00 |
$3,449.00 |
$1,934.03
|
|
Special teletx port plan
|
$1,624.09 |
$1,624.09 |
$1,624.09 |
$1,046.65
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$3,196.41 |
$3,196.41 |
$3,196.41 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,635.78 |
$1,635.78 |
$1,635.78 |
$559.96
|
|
Split blood or products
|
$1,666.44 |
$1,666.44 |
$1,666.44 |
$148.98
|
|
Srs linear based
|
$28,702.20 |
$28,702.20 |
$28,702.20 |
$14,124.25
|
|
Srs multisource
|
$35,192.81 |
$35,192.81 |
$35,192.81 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$689.48 |
$689.48 |
$689.48 |
$300.00
|
|
Staph a dna amp probe
|
$541.61 |
$541.61 |
$541.61 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$346.05 |
$346.05 |
$346.05 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$37,386.81 |
$37,386.81 |
$37,386.81 |
$23,387.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$23,093.66 |
$23,093.66 |
$23,093.66 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$14,512.66 |
$14,512.66 |
$14,512.66 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$27,689.11 |
$27,689.11 |
$27,689.11 |
$19,765.20
|
|
St evaluate speech sound production
|
$460.08 |
$460.08 |
$460.08 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$769.30 |
$769.30 |
$769.30 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$1,196.99 |
$1,196.99 |
$1,196.99 |
$406.40
|
|
St evaluation swallow function
|
$612.12 |
$612.12 |
$612.12 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$1,741.99 |
$1,741.99 |
$1,741.99 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$670.29 |
$670.29 |
$670.29 |
$171.00
|
|
Strapping of hand or finger
|
$670.29 |
$670.29 |
$670.29 |
$194.40
|
|
Strapping of hip
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$170.08
|
|
Strapping of knee
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$224.80
|
|
Strapping of toes 29550
|
$670.29 |
$670.29 |
$670.29 |
$185.36
|
|
Strep b dna amp probe
|
$174.15 |
$174.15 |
$174.15 |
$139.20
|
|
Stress test pulmonary
|
$1,042.44 |
$1,042.44 |
$1,042.44 |
$327.20
|
|
Stress tte complete
|
$5,928.41 |
$5,928.41 |
$5,928.41 |
$1,964.95
|
|
Str markers specimen anal
|
$3,597.44 |
$3,597.44 |
$3,597.44 |
$835.28
|
|
St treatment speech individual
|
$417.93 |
$417.93 |
$417.93 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$563.80 |
$563.80 |
$563.80 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$382.79 |
$382.79 |
$382.79 |
$49.13
|
|
Sugars single quant
|
$177.96 |
$177.96 |
$177.96 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$247.93 |
$247.93 |
$247.93 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$232.50 |
$232.50 |
$232.50 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$287.01 |
$287.01 |
$287.01 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$688.96 |
$688.96 |
$688.96 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$887.67 |
$887.67 |
$887.67 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,206.51 |
$1,206.51 |
$1,206.51 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,494.75 |
$1,494.75 |
$1,494.75 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,669.63 |
$2,669.63 |
$2,669.63 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$73.32 |
$73.32 |
$73.32 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$73.32 |
$73.32 |
$73.32 |
$34.48
|
|
Susceptibility mic per plate
|
$3,365.75 |
$3,365.75 |
$3,365.75 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$102.49 |
$102.49 |
$102.49 |
$48.30
|
|
Svc venogram s&i
|
$12,975.70 |
$12,975.70 |
$12,975.70 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$4,072.09 |
$4,072.09 |
$4,072.09 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.55 |
$76.55 |
$76.55 |
$44.85
|
|
T3 (triiodothyronine) free
|
$115.69 |
$115.69 |
$115.69 |
$89.82
|
|
T3 (triiodothyronine) total
|
$174.27 |
$174.27 |
$174.27 |
$94.90
|
|
T4 (thyroxine) free
|
$252.67 |
$252.67 |
$252.67 |
$81.60
|
|
T4 (thyroxine) total
|
$106.04 |
$106.04 |
$106.04 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$182.41 |
$182.41 |
$182.41 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$11,723.34 |
$11,723.34 |
$11,723.34 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$45,064.03 |
$45,064.03 |
$45,064.03 |
$3,385.00
|
|
Tas congenital car anomal
|
$19,966.72 |
$19,966.72 |
$19,966.72 |
$6,003.27
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$7,553.49 |
$7,553.49 |
$7,553.49 |
$959.55
|
|
Tbs techl calculation only
|
$299.00 |
$299.00 |
$299.00 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$307.63 |
$307.63 |
$307.63 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$233.18 |
$233.18 |
$233.18 |
$186.00
|
|
T cells absolute cd 4 count
|
$413.35 |
$413.35 |
$413.35 |
$120.25
|
|
T cells total count
|
$582.36 |
$582.36 |
$582.36 |
$124.11
|
|
Telehealth original site facility fee
|
$113.37 |
$113.37 |
$113.37 |
$44.85
|
|
Telethx isodose plan cplx
|
$1,770.01 |
$1,770.01 |
$1,770.01 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,226.75 |
$1,226.75 |
$1,226.75 |
$848.72
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,139.67
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$51.31 |
$51.31 |
$51.31 |
$44.49
|
|
Test for chlorohydrocarbons
|
$92.77 |
$92.77 |
$92.77 |
$71.04
|
|
Test pathogen(s) for platelets reference
|
$670.29 |
$670.29 |
$670.29 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$3,212.94 |
$3,212.94 |
$3,212.94 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$85,410.67 |
$85,410.67 |
$85,410.67 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$220.19 |
$220.19 |
$220.19 |
$108.00
|
|
Therapeutic procd strg endur
|
$184.71 |
$184.71 |
$184.71 |
$81.36
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$107.42 |
$107.42 |
$107.42 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$91.47 |
$91.47 |
$91.47 |
$50.40
|
|
Ther nma rdctj intus/obstrcj
|
$1,646.31 |
$1,646.31 |
$1,646.31 |
$534.32
|
|
Ther/proph/diag inj ia
|
$329.02 |
$329.02 |
$329.02 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$326.61 |
$326.61 |
$326.61 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,539.66 |
$2,539.66 |
$2,539.66 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$6,630.39 |
$6,630.39 |
$6,630.39 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$12,965.82 |
$12,965.82 |
$12,965.82 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$35,207.30 |
$35,207.30 |
$35,207.30 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$45,979.75 |
$45,979.75 |
$45,979.75 |
$24,605.30
|
|
Thrombin time
|
$68.34 |
$68.34 |
$68.34 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$99.87 |
$99.87 |
$99.87 |
$56.93
|
|
Thyroglobulin antibody
|
$245.57 |
$245.57 |
$245.57 |
$84.00
|
|
Thyroid imaging
|
$3,951.75 |
$3,951.75 |
$3,951.75 |
$670.80
|
|
Thyroid mets imag whole body
|
$3,425.59 |
$3,425.59 |
$3,425.59 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$402.85 |
$402.85 |
$402.85 |
$120.00
|
|
Thyroid Ultrasound
|
$2,443.11 |
$2,443.11 |
$2,443.11 |
$589.96
|
|
Thyroid uptake measurement
|
$4,194.99 |
$4,194.99 |
$4,194.99 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$228.13 |
$228.13 |
$228.13 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$92,656.53 |
$92,656.53 |
$92,656.53 |
$21,900.00
|
|
Tib/per revasc w/ather add-on 37233
|
$20,979.80 |
$20,979.80 |
$20,979.80 |
$10,406.14
|