|
Sinus CT scan (with contrast)
|
$8,727.97 |
$8,727.97 |
$8,727.97 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$7,459.52 |
$7,459.52 |
$7,459.52 |
$1,279.50
|
|
Skin Biopsy
|
$726.73 |
$726.73 |
$726.73 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$13,059.54 |
$13,059.54 |
$13,059.54 |
$3,936.80
|
|
Smear fluorescent and/or acid fast stain
|
$57.67 |
$57.67 |
$57.67 |
$64.20
|
|
Smear gram stain
|
$112.07 |
$112.07 |
$112.07 |
$57.85
|
|
Smear special stain inclusion bodies/parasites
|
$64.09 |
$64.09 |
$64.09 |
$64.35
|
|
Smear wet mount
|
$62.27 |
$62.27 |
$62.27 |
$68.63
|
|
Sodium 24 hour urine
|
$113.11 |
$113.11 |
$113.11 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$45.25 |
$45.25 |
$45.25 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$178.48 |
$178.48 |
$178.48 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$777.31 |
$777.31 |
$777.31 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,889.11 |
$1,889.11 |
$1,889.11 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$90.98 |
$90.98 |
$90.98 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,529.90 |
$1,529.90 |
$1,529.90 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,502.53 |
$1,502.53 |
$1,502.53 |
$559.96
|
|
Srs multisource
|
$32,360.11 |
$32,360.11 |
$32,360.11 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$624.16 |
$624.16 |
$624.16 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$352.32 |
$352.32 |
$352.32 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$37,373.77 |
$37,373.77 |
$37,373.77 |
$23,387.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$27,442.31 |
$27,442.31 |
$27,442.31 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$18,842.60 |
$18,842.60 |
$18,842.60 |
$9,276.80
|
|
St evaluate speech sound production
|
$475.59 |
$475.59 |
$475.59 |
$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
|
$903.33 |
$903.33 |
$903.33 |
$406.40
|
|
St evaluation swallow function
|
$722.10 |
$722.10 |
$722.10 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$1,998.03 |
$1,998.03 |
$1,998.03 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$768.81 |
$768.81 |
$768.81 |
$171.00
|
|
Strapping of hand or finger
|
$768.81 |
$768.81 |
$768.81 |
$194.40
|
|
Strapping of knee
|
$1,436.07 |
$1,436.07 |
$1,436.07 |
$224.80
|
|
Strapping of toes 29550
|
$768.81 |
$768.81 |
$768.81 |
$185.36
|
|
Stress test pulmonary
|
$1,436.07 |
$1,436.07 |
$1,436.07 |
$327.20
|
|
St treatment speech individual
|
$430.59 |
$430.59 |
$430.59 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$418.49 |
$418.49 |
$418.49 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$238.83 |
$238.83 |
$238.83 |
$49.13
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$144.79 |
$144.79 |
$144.79 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$199.05 |
$199.05 |
$199.05 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$354.47 |
$354.47 |
$354.47 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$485.28 |
$485.28 |
$485.28 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$641.89 |
$641.89 |
$641.89 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,058.89 |
$1,058.89 |
$1,058.89 |
$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
|
$50.83 |
$50.83 |
$50.83 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$50.83 |
$50.83 |
$50.83 |
$34.48
|
|
Susceptibility mic per plate
|
$2,333.24 |
$2,333.24 |
$2,333.24 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$71.05 |
$71.05 |
$71.05 |
$48.30
|
|
Svc venogram s&i
|
$14,882.87 |
$14,882.87 |
$14,882.87 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$2,268.75 |
$2,268.75 |
$2,268.75 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$47.08 |
$47.08 |
$47.08 |
$44.85
|
|
T3 (triiodothyronine) free
|
$267.21 |
$267.21 |
$267.21 |
$89.82
|
|
T3 (triiodothyronine) total
|
$230.42 |
$230.42 |
$230.42 |
$94.90
|
|
T4 (thyroxine) free
|
$215.38 |
$215.38 |
$215.38 |
$81.60
|
|
T4 (thyroxine) total
|
$161.26 |
$161.26 |
$161.26 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$48.06 |
$48.06 |
$48.06 |
$122.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$4,200.97 |
$4,200.97 |
$4,200.97 |
$959.55
|
|
Tbs techl calculation only
|
$295.04 |
$295.04 |
$295.04 |
$123.30
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$278.03 |
$278.03 |
$278.03 |
$166.46
|
|
T cells absolute cd4/cd8 including ratio
|
$164.43 |
$164.43 |
$164.43 |
$186.00
|
|
T cells absolute cd 4 count
|
$286.55 |
$286.55 |
$286.55 |
$120.25
|
|
T cells total count
|
$403.71 |
$403.71 |
$403.71 |
$124.11
|
|
Telethx isodose plan cplx
|
$1,627.54 |
$1,627.54 |
$1,627.54 |
$1,617.00
|
|
Telethx isodose plan simple
|
$1,226.75 |
$1,226.75 |
$1,226.75 |
$848.72
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$39.14 |
$39.14 |
$39.14 |
$44.49
|
|
Test pathogen(s) for platelets reference
|
$768.81 |
$768.81 |
$768.81 |
$106.50
|
|
Test stress cardiovascular tracing only
|
$3,685.18 |
$3,685.18 |
$3,685.18 |
$1,001.55
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$47,412.76 |
$47,412.76 |
$47,412.76 |
$12,080.29
|
|
Theophylline therapeutic drug level
|
$257.89 |
$257.89 |
$257.89 |
$108.00
|
|
Therapeutic procd strg endur
|
$349.42 |
$349.42 |
$349.42 |
$81.36
|
|
Ther nma rdctj intus/obstrcj
|
$1,888.28 |
$1,888.28 |
$1,888.28 |
$534.32
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$198.24 |
$198.24 |
$198.24 |
$38.64
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$1,804.00
|
|
Thrombectmy crnry perq mechanical
|
$6,554.99 |
$6,554.99 |
$6,554.99 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$47,534.36 |
$47,534.36 |
$47,534.36 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$30,794.80 |
$30,794.80 |
$30,794.80 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$31,888.94 |
$31,888.94 |
$31,888.94 |
$24,605.30
|
|
Thrombin time
|
$78.12 |
$78.12 |
$78.12 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$69.23 |
$69.23 |
$69.23 |
$56.93
|
|
Thyroglobulin antibody
|
$170.24 |
$170.24 |
$170.24 |
$84.00
|
|
Thyroid (TSH) Test
|
$291.13 |
$291.13 |
$291.13 |
$120.00
|
|
Thyroid Ultrasound
|
$2,075.77 |
$2,075.77 |
$2,075.77 |
$589.96
|
|
Thyroid uptake measurement
|
$3,658.02 |
$3,658.02 |
$3,658.02 |
$653.60
|
|
Thyroxine binding globulin (tbg)
|
$158.15 |
$158.15 |
$158.15 |
$63.60
|
|
Tilt table study
|
$3,432.34 |
$3,432.34 |
$3,432.34 |
$1,495.00
|
|
Tissue culture skin/biopsy
|
$1,505.81 |
$1,505.81 |
$1,505.81 |
$558.87
|
|
Tissue culture tumor
|
$1,578.46 |
$1,578.46 |
$1,578.46 |
$529.23
|
|
Tissue exam koh skin/hair/nails
|
$95.96 |
$95.96 |
$95.96 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$296.22 |
$296.22 |
$296.22 |
$4,293.26
|
|
Tissue transglutaminase iga
|
$66.92 |
$66.92 |
$66.92 |
$48.57
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$139.53 |
$139.53 |
$139.53 |
$125.87
|
|
Tobramycin peak therapeutic drug level
|
$172.59 |
$172.59 |
$172.59 |
$121.55
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$8,529.29 |
$8,529.29 |
$8,529.29 |
$5,790.85
|
|
Tomosynthesis breast screen bilateral
|
$216.58 |
$216.58 |
$216.58 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$329.63 |
$329.63 |
$329.63 |
$303.88
|
|
Toxoplasma antibody igg
|
$165.14 |
$165.14 |
$165.14 |
$84.35
|
|
Toxoplasma antibody igm
|
$154.19 |
$154.19 |
$154.19 |
$83.20
|
|
Transferrin
|
$47.73 |
$47.73 |
$47.73 |
$87.30
|
|
Transfusion blood/blood component(s)
|
$1,188.30 |
$1,188.30 |
$1,188.30 |
$988.24
|
|
Treat elbow fracture
|
$18,750.12 |
$18,750.12 |
$18,750.12 |
$2,125.60
|
|
Treat finger fracture each
|
$18,750.12 |
$18,750.12 |
$18,750.12 |
$1,815.75
|
|
Treat foot dislocation
|
$2,909.55 |
$2,909.55 |
$2,909.55 |
$527.28
|