|
Sodium 24 hour urine
|
$39.50 |
$39.50 |
$39.50 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$71.00 |
$71.00 |
$71.00 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$66.00 |
$66.00 |
$66.00 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$66.12 |
$66.12 |
$66.12 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$62.00 |
$62.00 |
$62.00 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$61.22 |
$61.22 |
$61.22 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,063.10 |
$1,063.10 |
$1,063.10 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$43.00 |
$43.00 |
$43.00 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$537.10 |
$537.10 |
$537.10 |
$177.52
|
|
Special physics consult
|
$1,127.00 |
$1,127.00 |
$1,127.00 |
$725.00
|
|
Special radiation treatment
|
$2,766.00 |
$2,766.00 |
$2,766.00 |
$1,986.00
|
|
Speech audiometry complete
|
$200.50 |
$200.50 |
$200.50 |
$109.20
|
|
Speech recep thresh
|
$136.50 |
$136.50 |
$136.50 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,936.50 |
$1,936.50 |
$1,936.50 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$794.50 |
$794.50 |
$794.50 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$246.50 |
$246.50 |
$246.50 |
$392.09
|
|
Split blood or products
|
$133.50 |
$133.50 |
$133.50 |
$127.48
|
|
Sr-89 stront chlor ther / mci
|
$10,484.52 |
$10,484.52 |
$10,484.52 |
$2,667.94
|
|
St analysis behavior qualitative voice/resonance
|
$210.00 |
$210.00 |
$210.00 |
$297.60
|
|
Staph a dna amp probe
|
$152.50 |
$152.50 |
$152.50 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$370.00 |
$370.00 |
$370.00 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$58,000.00 |
$58,000.00 |
$58,000.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$13,260.25 |
$13,260.25 |
$13,260.25 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$20,300.00 |
$20,300.00 |
$20,300.00 |
$20,962.50
|
|
St evaluate speech sound production
|
$287.50 |
$287.50 |
$287.50 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$264.00 |
$264.00 |
$264.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$363.50 |
$363.50 |
$363.50 |
$399.60
|
|
St evaluation swallow function
|
$211.00 |
$211.00 |
$211.00 |
$314.40
|
|
Strapping of elbow or wrist 29260
|
$151.50 |
$151.50 |
$151.50 |
$154.70
|
|
Strapping of knee
|
$206.50 |
$206.50 |
$206.50 |
$205.20
|
|
Strep b dna amp probe
|
$108.00 |
$108.00 |
$108.00 |
$120.90
|
|
Streptomycin injection
|
$393.36 |
$393.36 |
$393.36 |
$138.30
|
|
Streptozocin injection
|
$1,407.52 |
$1,407.52 |
$1,407.52 |
$785.95
|
|
Stress test pulmonary
|
$137.00 |
$137.00 |
$137.00 |
$322.85
|
|
Stress tte complete
|
$1,763.50 |
$1,763.50 |
$1,763.50 |
$1,870.50
|
|
St treatment speech individual
|
$220.50 |
$220.50 |
$220.50 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$222.50 |
$222.50 |
$222.50 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$54.80 |
$54.80 |
$54.80 |
$52.31
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$24,736.00 |
$24,736.00 |
$24,736.00 |
$7,345.98
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$25.36 |
$25.36 |
$25.36 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$91.50 |
$91.50 |
$91.50 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$143.00 |
$143.00 |
$143.00 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$263.50 |
$263.50 |
$263.50 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$333.50 |
$333.50 |
$333.50 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$592.00 |
$592.00 |
$592.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$728.50 |
$728.50 |
$728.50 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$44.00 |
$44.00 |
$44.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$37.00 |
$37.00 |
$37.00 |
$35.70
|
|
Susceptibility mic per plate
|
$55.50 |
$55.50 |
$55.50 |
$106.00
|
|
Sweat collection by iontophoresis
|
$195.00 |
$195.00 |
$195.00 |
$125.40
|
|
Synvisc or synvisc-one
|
$352.60 |
$352.60 |
$352.60 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$79.50 |
$79.50 |
$79.50 |
$41.60
|
|
System cardiomems hosp electronics
|
$58,750.00 |
$58,750.00 |
$58,750.00 |
$39,037.95
|
|
System pacing micra av
|
$35,112.50 |
$35,112.50 |
$35,112.50 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$14,337.00 |
$14,337.00 |
$14,337.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$101.00 |
$101.00 |
$101.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$122.50 |
$122.50 |
$122.50 |
$93.52
|
|
T4 (thyroxine) free
|
$73.00 |
$73.00 |
$73.00 |
$85.20
|
|
T4 (thyroxine) total
|
$46.50 |
$46.50 |
$46.50 |
$69.00
|
|
Tacrol envarsus ex rel oral
|
$44.23 |
$44.23 |
$44.23 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$47.54 |
$47.54 |
$47.54 |
$9.84
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,108.20 |
$1,108.20 |
$1,108.20 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$228.00 |
$228.00 |
$228.00 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$3,396.50 |
$3,396.50 |
$3,396.50 |
$2,762.00
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$16,658.82 |
$16,658.82 |
$16,658.82 |
$2,369.70
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$19,613.80 |
$19,613.80 |
$19,613.80 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$1,323.50 |
$1,323.50 |
$1,323.50 |
$2,246.30
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$388.50 |
$388.50 |
$388.50 |
$194.35
|
|
Tc-99m bicisate
|
$1,718.19 |
$1,718.19 |
$1,718.19 |
$1,969.45
|
|
Tc-99m exametazime diag
|
$2,007.92 |
$2,007.92 |
$2,007.92 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$88.76 |
$88.76 |
$88.76 |
$302.40
|
|
Tc-99m maa
|
$68.80 |
$68.80 |
$68.80 |
$292.80
|
|
Tc-99m mebrofenin
|
$393.50 |
$393.50 |
$393.50 |
$157.65
|
|
Tc-99m medronate
|
$120.97 |
$120.97 |
$120.97 |
$111.01
|
|
Tc-99m mertiatide
|
$877.24 |
$877.24 |
$877.24 |
$756.00
|
|
Tc-99m oxidronate
|
$121.16 |
$121.16 |
$121.16 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$1,849.72 |
$1,849.72 |
$1,849.72 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$88.80 |
$88.80 |
$88.80 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$274.68 |
$274.68 |
$274.68 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$150.50 |
$150.50 |
$150.50 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$1,732.16 |
$1,732.16 |
$1,732.16 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$335.12 |
$335.12 |
$335.12 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$150.50 |
$150.50 |
$150.50 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$1,602.65 |
$1,602.65 |
$1,602.65 |
$955.60
|
|
Tcd emboli detect without inj
|
$598.00 |
$598.00 |
$598.00 |
$475.28
|
|
T cells absolute cd4/cd8 including ratio
|
$224.00 |
$224.00 |
$224.00 |
$176.40
|
|
T cells total count
|
$174.00 |
$174.00 |
$174.00 |
$126.90
|
|
Telavancin injection
|
$1,710.70 |
$1,710.70 |
$1,710.70 |
$1,191.80
|
|
Telehealth original site facility fee
|
$37.50 |
$37.50 |
$37.50 |
$51.00
|
|
Temozolomide
|
$10.74 |
$10.74 |
$10.74 |
$588.46
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$2,197.78 |
$2,197.78 |
$2,197.78 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$18,255.45 |
$18,255.45 |
$18,255.45 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$29.20 |
$29.20 |
$29.20 |
$39.33
|
|
Test pathogen(s) for platelets reference
|
$53.50 |
$53.50 |
$53.50 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$641.50 |
$641.50 |
$641.50 |
$949.70
|
|
Tetanus immune globulin inj
|
$1,913.96 |
$1,913.96 |
$1,913.96 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$10,424.22 |
$10,424.22 |
$10,424.22 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$175.00 |
$175.00 |
$175.00 |
$108.00
|
|
Therapeutic procd strg endur
|
$166.00 |
$166.00 |
$166.00 |
$85.68
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$34.00 |
$34.00 |
$34.00 |
$57.31
|
