|
Shoulder X-ray
|
$496.08 |
$496.08 |
$496.08 |
$339.50
|
|
Sickling rbc
|
$7.20 |
$7.20 |
$7.20 |
$57.00
|
|
Sincalide 5 mcg solution for injection
|
$472.21 |
$472.21 |
$472.21 |
$309.04
|
|
Sinus CT scan (with and without contrast)
|
$2,041.20 |
$2,041.20 |
$2,041.20 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,987.20 |
$1,987.20 |
$1,987.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,719.36 |
$1,719.36 |
$1,719.36 |
$1,292.04
|
|
Skin Biopsy
|
$1,933.92 |
$1,933.92 |
$1,933.92 |
$360.34
|
|
Sleep Study (Polysomnography)
|
$4,026.24 |
$4,026.24 |
$4,026.24 |
$3,598.50
|
|
Sleep study unattended
|
$1,259.28 |
$1,259.28 |
$1,259.28 |
$579.26
|
|
Smear fluorescent and/or acid fast stain
|
$74.88 |
$74.88 |
$74.88 |
$64.20
|
|
Smear gram stain
|
$124.56 |
$124.56 |
$124.56 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$23.04 |
$23.04 |
$23.04 |
$73.15
|
|
Sodium 24 hour urine
|
$123.84 |
$123.84 |
$123.84 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$0.06 |
$0.06 |
$0.06 |
$40.61
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$623.18 |
$623.18 |
$623.18 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$95.04 |
$95.04 |
$95.04 |
$45.50
|
|
So gsap dna cpy nmbr&mcrstl
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$1,046.35
|
|
Specific gravity body fluid
|
$44.64 |
$44.64 |
$44.64 |
$22.00
|
|
Sperm identification
|
$685.44 |
$685.44 |
$685.44 |
$101.55
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$822.24 |
$822.24 |
$822.24 |
$536.34
|
|
Staph a dna amp probe
|
$177.84 |
$177.84 |
$177.84 |
$125.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$369.30 |
$369.30 |
$369.30 |
$2,520.08
|
|
St evaluate speech sound production comprehensive/expressive
|
$408.24 |
$408.24 |
$408.24 |
$376.84
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$232.56 |
$232.56 |
$232.56 |
$395.28
|
|
St evaluation swallow function
|
$441.36 |
$441.36 |
$441.36 |
$310.50
|
|
Strapping of elbow or wrist 29260
|
$208.80 |
$208.80 |
$208.80 |
$154.50
|
|
Strapping of hand or finger
|
$208.80 |
$208.80 |
$208.80 |
$174.82
|
|
Strapping of knee
|
$278.64 |
$278.64 |
$278.64 |
$205.20
|
|
Strapping of toes 29550
|
$208.80 |
$208.80 |
$208.80 |
$164.70
|
|
Strep a dna quant
|
$75.60 |
$75.60 |
$75.60 |
$75.60
|
|
Strep b dna amp probe
|
$495.36 |
$495.36 |
$495.36 |
$120.90
|
|
Stress test pulmonary
|
$478.80 |
$478.80 |
$478.80 |
$322.85
|
|
St treatment speech individual
|
$205.92 |
$205.92 |
$205.92 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$679.68 |
$679.68 |
$679.68 |
$232.20
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$6.70 |
$6.70 |
$6.70 |
$52.31
|
|
Sulfonylurea screen qn-sendout
|
$187.92 |
$187.92 |
$187.92 |
$156.16
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$38.02 |
$38.02 |
$38.02 |
$112.74
|
|
Support clav 29.6-40.5in med
|
$46.08 |
$46.08 |
$46.08 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$106.56 |
$106.56 |
$106.56 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$225.36 |
$225.36 |
$225.36 |
$141.33
|
|
Surgical pathology level 3 gross & microscopic examination
|
$274.32 |
$274.32 |
$274.32 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$339.84 |
$339.84 |
$339.84 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$723.60 |
$723.60 |
$723.60 |
$477.24
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,043.28 |
$1,043.28 |
$1,043.28 |
$716.00
|
|
Susceptibility agar dilution per agent
|
$254.16 |
$254.16 |
$254.16 |
$45.00
|
|
Susceptibility enzyme detection per enzyme
|
$43.20 |
$43.20 |
$43.20 |
$35.70
|
|
Susceptibility mic per plate
|
$822.24 |
$822.24 |
$822.24 |
$106.20
|
|
Suscept studies macrobroth dilution ea
|
$120.24 |
$120.24 |
$120.24 |
$59.28
|
|
Synvisc or synvisc-one
|
$98.61 |
$98.61 |
$98.61 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$51.84 |
$51.84 |
$51.84 |
$41.60
|
|
T3 (triiodothyronine) free
|
$92.16 |
$92.16 |
$92.16 |
$98.80
|
|
T3 (triiodothyronine) total
|
$92.16 |
$92.16 |
$92.16 |
$93.52
|
|
T4 (thyroxine) free
|
$112.32 |
$112.32 |
$112.32 |
$85.20
|
|
T4 (thyroxine) total
|
$77.76 |
$77.76 |
$77.76 |
$68.40
|
|
Tacrolimus therapeutic drug level
|
$189.36 |
$189.36 |
$189.36 |
$121.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$30.87 |
$30.87 |
$30.87 |
$2,762.00
|
|
Target gsa panel hmtlmph neop
|
$2,984.40 |
$2,984.40 |
$2,984.40 |
$2,246.30
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,382.00 |
$1,382.00 |
$1,382.00 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$260.64 |
$260.64 |
$260.64 |
$176.92
|
|
Tc-99m non-heu per study dose
|
$18.72 |
$18.72 |
$18.72 |
$6.60
|
|
T cells absolute cd4/cd8 including ratio
|
$188.64 |
$188.64 |
$188.64 |
$176.00
|
|
T cells total count
|
$188.64 |
$188.64 |
$188.64 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$36,342.72 |
$36,342.72 |
$36,342.72 |
$40,114.80
|
|
Telehealth original site facility fee
|
$82.08 |
$82.08 |
$82.08 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$573.51 |
$573.51 |
$573.51 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$68.11 |
$68.11 |
$68.11 |
$39.31
|
|
Test stress cardiovascular tracing only
|
$1,052.64 |
$1,052.64 |
$1,052.64 |
$949.70
|
|
Test urine urobilinogen
|
$27.36 |
$27.36 |
$27.36 |
$9.75
|
|
Tgsap so neo 5-50 rna alys
|
$2,255.04 |
$2,255.04 |
$2,255.04 |
$1,019.60
|
|
Theophylline therapeutic drug level
|
$167.76 |
$167.76 |
$167.76 |
$107.94
|
|
Therapeutic procd strg endur
|
$63.36 |
$63.36 |
$63.36 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$79.20 |
$79.20 |
$79.20 |
$57.08
|
|
Ther/proph/diag inj ia
|
$455.04 |
$455.04 |
$455.04 |
$240.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.21 |
$17.21 |
$17.21 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,229.04 |
$1,229.04 |
$1,229.04 |
$1,687.50
|
|
Thrombin time
|
$34.56 |
$34.56 |
$34.56 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$95.76 |
$95.76 |
$95.76 |
$61.50
|
|
Thyroglobulin antibody
|
$97.92 |
$97.92 |
$97.92 |
$81.90
|
|
Thyroid imaging
|
$867.60 |
$867.60 |
$867.60 |
$695.02
|
|
Thyroid (TSH) Test
|
$138.96 |
$138.96 |
$138.96 |
$111.00
|
|
Thyroid Ultrasound
|
$743.04 |
$743.04 |
$743.04 |
$586.95
|
|
Thyroxine binding globulin (tbg)
|
$33.84 |
$33.84 |
$33.84 |
$63.90
|
|
Tissue exam koh skin/hair/nails
|
$41.76 |
$41.76 |
$41.76 |
$47.20
|
|
Tissue transglutaminase iga
|
$95.76 |
$95.76 |
$95.76 |
$44.16
|
|
Tixagev and cilgav inj
|
$325.44 |
$325.44 |
$325.44 |
$224.55
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$12.96 |
$12.96 |
$12.96 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$101.52 |
$101.52 |
$101.52 |
$118.30
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$22.95 |
$22.95 |
$22.95 |
$5,258.52
|
|
Tomosynthesis breast diagnostic left
|
$84.96 |
$84.96 |
$84.96 |
$72.66
|
|
Tomosynthesis breast screen bilateral
|
$105.12 |
$105.12 |
$105.12 |
$72.68
|
|
Total tau
|
$511.20 |
$511.20 |
$511.20 |
$312.50
|
|
Toxoplasma antibody igg
|
$98.64 |
$98.64 |
$98.64 |
$89.40
|
|
Toxoplasma antibody igm
|
$98.64 |
$98.64 |
$98.64 |
$87.00
|
|
Tp53 gene full gene sequence
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$709.80
|
|
Tp53 gene trgt sequence alys
|
$1,349.28 |
$1,349.28 |
$1,349.28 |
$790.68
|
|
Tpmt gene com vrnts
|
$723.60 |
$723.60 |
$723.60 |
$370.92
|
|
Transabdom amnioinfus w/us
|
$657.36 |
$657.36 |
$657.36 |
$678.70
|
