|
Sickling rbc
|
$50.70 |
$50.70 |
$50.70 |
$59.40
|
|
Sincalide 5 mcg solution for injection
|
$651.10 |
$651.10 |
$651.10 |
$309.14
|
|
Sinus CT scan (with contrast)
|
$2,102.10 |
$2,102.10 |
$2,102.10 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,275.30 |
$1,275.30 |
$1,275.30 |
$1,289.00
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$42,938.50 |
$42,938.50 |
$42,938.50 |
$14,361.10
|
|
Sleeve fing rolyan med
|
$37.65 |
$37.65 |
$37.65 |
$203.58
|
|
Sleeve irr assura 1pc disp
|
$0.65 |
$0.65 |
$0.65 |
$0.65
|
|
Sling arm deluxe w/pad xs
|
$529.06 |
$529.06 |
$529.06 |
$30.35
|
|
Sling pelv split sam med
|
$165.55 |
$165.55 |
$165.55 |
$150.00
|
|
Sling suprapubic suburetheral
|
$9,679.96 |
$9,679.96 |
$9,679.96 |
$9,679.96
|
|
Sm-153 lexidron ther
|
$57,456.00 |
$57,456.00 |
$57,456.00 |
$7,320.12
|
|
Smear fluorescent and/or acid fast stain
|
$50.70 |
$50.70 |
$50.70 |
$64.35
|
|
Smear gram stain
|
$35.75 |
$35.75 |
$35.75 |
$55.55
|
|
Smear nasal eosinophil
|
$37.05 |
$37.05 |
$37.05 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$64.35 |
$64.35 |
$64.35 |
$73.50
|
|
Smear wet mount
|
$41.60 |
$41.60 |
$41.60 |
$67.55
|
|
Sock wool above knee
|
$158.68 |
$158.68 |
$158.68 |
$51.18
|
|
Sodium 24 hour urine
|
$74.10 |
$74.10 |
$74.10 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$25.00 |
$25.00 |
$25.00 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$22.50 |
$22.50 |
$22.50 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$20.00 |
$20.00 |
$20.00 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$30.00 |
$30.00 |
$30.00 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$292.60 |
$292.60 |
$292.60 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$39.65 |
$39.65 |
$39.65 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$495.00 |
$495.00 |
$495.00 |
$177.52
|
|
Specific gravity body fluid
|
$30.55 |
$30.55 |
$30.55 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$428.35 |
$428.35 |
$428.35 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$245.70 |
$245.70 |
$245.70 |
$246.87
|
|
Splint arm vnyl coated padded lft med
|
$16.25 |
$16.25 |
$16.25 |
$48.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$43.09 |
$43.09 |
$43.09 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$50.38 |
$50.38 |
$50.38 |
$71.44
|
|
Splint finger 4 prong foam sm
|
$0.55 |
$0.55 |
$0.55 |
$34.00
|
|
Splint finger fold over sm
|
$0.44 |
$0.44 |
$0.44 |
$146.88
|
|
Splint finger frog med
|
$0.54 |
$0.54 |
$0.54 |
$38.08
|
|
Splint fing stax assort 1-7in
|
$1.04 |
$1.04 |
$1.04 |
$5.60
|
|
Splint func pos polyflex ii med
|
$33.60 |
$33.60 |
$33.60 |
$61.64
|
|
Splint rstrc wrst/cmc right med
|
$101.18 |
$101.18 |
$101.18 |
$99.04
|
|
Sr-89 stront chlor ther / mci
|
$40,862.00 |
$40,862.00 |
$40,862.00 |
$2,515.15
|
|
St analysis behavior qualitative voice/resonance
|
$286.65 |
$286.65 |
$286.65 |
$297.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$32,403.15 |
$32,403.15 |
$32,403.15 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$6,063.30 |
$6,063.30 |
$6,063.30 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$18,714.49 |
$18,714.49 |
$18,714.49 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$4,918.86 |
$4,918.86 |
$4,918.86 |
$4,631.82
|
|
St evaluate speech sound production
|
$336.70 |
$336.70 |
$336.70 |
$292.95
|
|
Strap chin dlx f/cpap
|
$34.90 |
$34.90 |
$34.90 |
$34.90
|
|
Strap montgmry ns 8 hl sht 7.25 x 11.25in
|
$0.25 |
$0.25 |
$0.25 |
$5.04
|
|
Strep b dna amp probe
|
$145.60 |
$145.60 |
$145.60 |
$124.15
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$23.00 |
$23.00 |
$23.00 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$17.70 |
$17.70 |
$17.70 |
$129.89
|
|
Support clav 29.6-40.5in med
|
$94.19 |
$94.19 |
$94.19 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$72.15 |
$72.15 |
$72.15 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$116.35 |
$116.35 |
$116.35 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$122.20 |
$122.20 |
$122.20 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$265.00 |
$265.00 |
$265.00 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$321.10 |
$321.10 |
$321.10 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$531.05 |
$531.05 |
$531.05 |
$720.75
|
|
Susceptibility mic per plate
|
$89.70 |
$89.70 |
$89.70 |
$106.00
|
|
Swallowing Evaluation (Bedside)
|
$293.15 |
$293.15 |
$293.15 |
$316.80
|
|
Swallowing Therapy Session
|
$221.00 |
$221.00 |
$221.00 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$21.45 |
$21.45 |
$21.45 |
$42.24
|
|
System cardiomems hosp electronics
|
$24,023.02 |
$24,023.02 |
$24,023.02 |
$38,234.70
|
|
System pacing micra av
|
$16,760.25 |
$16,760.25 |
$16,760.25 |
$24,316.50
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$27,099.09 |
$27,099.09 |
$27,099.09 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$8,955.20 |
$8,955.20 |
$8,955.20 |
$11,183.00
|
|
System sealant biosentry tract
|
$652.35 |
$652.35 |
$652.35 |
$889.35
|
|
T3 (triiodothyronine) free
|
$122.20 |
$122.20 |
$122.20 |
$100.32
|
|
T3 (triiodothyronine) total
|
$96.85 |
$96.85 |
$96.85 |
$93.52
|
|
T4 (thyroxine) free
|
$78.65 |
$78.65 |
$78.65 |
$89.60
|
|
T4 (thyroxine) total
|
$52.65 |
$52.65 |
$52.65 |
$70.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$170.70 |
$170.70 |
$170.70 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,208.10 |
$1,208.10 |
$1,208.10 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$158.60 |
$158.60 |
$158.60 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,272.00 |
$4,272.00 |
$4,272.00 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$221.65 |
$221.65 |
$221.65 |
$289.20
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$88,021.00 |
$88,021.00 |
$88,021.00 |
$1,223.36
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$35,941.50 |
$35,941.50 |
$35,941.50 |
$21,745.13
|
|
Tape plstc 1inx5yd hosp tb pk
|
$3.02 |
$3.02 |
$3.02 |
$2.06
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$46,350.00 |
$46,350.00 |
$46,350.00 |
$24,217.20
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$463.10 |
$463.10 |
$463.10 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$221.65 |
$221.65 |
$221.65 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$164.45 |
$164.45 |
$164.45 |
$179.95
|
|
Tc-99m apcitide diag
|
$1,765.30 |
$1,765.30 |
$1,765.30 |
$1,181.70
|
|
Tc-99m arcitumomab
|
$4,224.15 |
$4,224.15 |
$4,224.15 |
$2,085.68
|
|
Tc-99m bicisate
|
$7,128.20 |
$7,128.20 |
$7,128.20 |
$2,070.00
|
|
Tc-99m depreotide
|
$1,937.35 |
$1,937.35 |
$1,937.35 |
$1,486.80
|
|
Tc-99m diag per dose
|
$575.50 |
$575.50 |
$575.50 |
$470.40
|
|
Tc-99m disofenin
|
$339.80 |
$339.80 |
$339.80 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$8,194.15 |
$8,194.15 |
$8,194.15 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$7,382.05 |
$7,382.05 |
$7,382.05 |
$2,135.70
|
|
Tc-99m fanolesomab diag
|
$17,688.75 |
$17,688.75 |
$17,688.75 |
$2,115.12
|
|
Tc-99m gluceptate
|
$1,105.40 |
$1,105.40 |
$1,105.40 |
$31.35
|
|
Tc-99m labeled rbc
|
$857.40 |
$857.40 |
$857.40 |
$306.00
|
|
Tc-99m maa
|
$760.95 |
$760.95 |
$760.95 |
$312.06
|
|
Tc-99m mebrofenin
|
$308.25 |
$308.25 |
$308.25 |
$157.65
|
|
Tc-99m medronate
|
$210.35 |
$210.35 |
$210.35 |
$111.01
|
|
Tc-99m mertiatide
|
$1,340.90 |
$1,340.90 |
$1,340.90 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$1.00 |
$1.00 |
$1.00 |
$8.00
|
|
Tc-99m oxidronate
|
$199.60 |
$199.60 |
$199.60 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$627.25 |
$627.25 |
$627.25 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$627.25 |
$627.25 |
$627.25 |
$191.50
|
