|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$79.93 |
$79.93 |
$79.93 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$70.12 |
$70.12 |
$70.12 |
$129.89
|
|
Surgical pathology level 1 gross examination only
|
$98.50 |
$98.50 |
$98.50 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$139.70 |
$139.70 |
$139.70 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$165.00 |
$165.00 |
$165.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$256.80 |
$256.80 |
$256.80 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$330.00 |
$330.00 |
$330.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$447.20 |
$447.20 |
$447.20 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$167.65 |
$167.65 |
$167.65 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$11.55 |
$11.55 |
$11.55 |
$35.89
|
|
Susceptibility mic per plate
|
$167.65 |
$167.65 |
$167.65 |
$106.00
|
|
Swallowing Evaluation (Bedside)
|
$545.70 |
$545.70 |
$545.70 |
$316.80
|
|
Swallowing Therapy Session
|
$547.15 |
$547.15 |
$547.15 |
$232.56
|
|
Sweat collection by iontophoresis
|
$258.15 |
$258.15 |
$258.15 |
$123.78
|
|
Synch audio-only est high 40
|
$317.50 |
$317.50 |
$317.50 |
$196.80
|
|
Synch audio-only est low 20
|
$145.30 |
$145.30 |
$145.30 |
$93.60
|
|
Synch audio-only est mod 30
|
$215.05 |
$215.05 |
$215.05 |
$136.64
|
|
Synch audio-only est sf 10
|
$79.80 |
$79.80 |
$79.80 |
$53.20
|
|
Synch audio-only new high 60
|
$287.45 |
$287.45 |
$287.45 |
$207.64
|
|
Synch audio-only new low 30
|
$188.15 |
$188.15 |
$188.15 |
$120.80
|
|
Synch audio-only new mod 45
|
$296.50 |
$296.50 |
$296.50 |
$176.70
|
|
Synch audio-only new sf 15
|
$108.35 |
$108.35 |
$108.35 |
$71.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$91.80 |
$91.80 |
$91.80 |
$42.24
|
|
T3 (triiodothyronine) free
|
$452.45 |
$452.45 |
$452.45 |
$100.32
|
|
T3 (triiodothyronine) total
|
$304.70 |
$304.70 |
$304.70 |
$93.52
|
|
T4 (thyroxine) free
|
$95.80 |
$95.80 |
$95.80 |
$89.60
|
|
T4 (thyroxine) total
|
$147.75 |
$147.75 |
$147.75 |
$70.20
|
|
Tacrolimus therapeutic drug level
|
$448.45 |
$448.45 |
$448.45 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$741.25 |
$741.25 |
$741.25 |
$289.20
|
|
Target gsa panel hmtlmph neop
|
$997.20 |
$997.20 |
$997.20 |
$2,246.30
|
|
Target gsa panel organ neop
|
$1,671.50 |
$1,671.50 |
$1,671.50 |
$1,701.91
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,150.15 |
$2,150.15 |
$2,150.15 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$109.25 |
$109.25 |
$109.25 |
$179.95
|
|
Tc-99m disofenin
|
$267.45 |
$267.45 |
$267.45 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$34.80 |
$34.80 |
$34.80 |
$2,503.15
|
|
Tc-99m labeled rbc
|
$528.10 |
$528.10 |
$528.10 |
$306.00
|
|
Tc-99m maa
|
$172.50 |
$172.50 |
$172.50 |
$312.06
|
|
Tc-99m mebrofenin
|
$80.25 |
$80.25 |
$80.25 |
$157.65
|
|
Tc-99m medronate
|
$172.50 |
$172.50 |
$172.50 |
$111.01
|
|
Tc-99m mertiatide
|
$877.15 |
$877.15 |
$877.15 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$255.35 |
$255.35 |
$255.35 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$255.35 |
$255.35 |
$255.35 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$105.65 |
$105.65 |
$105.65 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$258.00 |
$258.00 |
$258.00 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$817.65 |
$817.65 |
$817.65 |
$287.20
|
|
Tc-99m sulfur colloid
|
$370.45 |
$370.45 |
$370.45 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$113.60 |
$113.60 |
$113.60 |
$193.28
|
|
T cells absolute cd4/cd8 including ratio
|
$193.95 |
$193.95 |
$193.95 |
$184.00
|
|
T cells total count
|
$130.20 |
$130.20 |
$130.20 |
$130.20
|
|
Telehealth original site facility fee
|
$84.25 |
$84.25 |
$84.25 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$10,174.93 |
$10,174.93 |
$10,174.93 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$125.57 |
$125.57 |
$125.57 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$1,284.90 |
$1,284.90 |
$1,284.90 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$582.95 |
$582.95 |
$582.95 |
$953.40
|
|
Tetanus immune globulin inj
|
$796.08 |
$796.08 |
$796.08 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$5,610.12 |
$5,610.12 |
$5,610.12 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$304.70 |
$304.70 |
$304.70 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$188.00 |
$188.00 |
$188.00 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$193.30 |
$193.30 |
$193.30 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$124.35 |
$124.35 |
$124.35 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$74.90 |
$74.90 |
$74.90 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$8.98 |
$8.98 |
$8.98 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$384.60 |
$384.60 |
$384.60 |
$313.60
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$223.25 |
$223.25 |
$223.25 |
$1,724.25
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$2,537.80 |
$2,537.80 |
$2,537.80 |
$1,703.45
|
|
Thrombin time
|
$113.05 |
$113.05 |
$113.05 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$54.10 |
$54.10 |
$54.10 |
$62.01
|
|
Thyroglobulin antibody
|
$189.05 |
$189.05 |
$189.05 |
$82.50
|
|
Thyroid (TSH) Test
|
$276.85 |
$276.85 |
$276.85 |
$112.70
|
|
Thyroid Ultrasound
|
$706.65 |
$706.65 |
$706.65 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$425.35 |
$425.35 |
$425.35 |
$64.51
|
|
Tirofiban 12.5 mg/50 ml
|
$1,077.11 |
$1,077.11 |
$1,077.11 |
$458.85
|
|
Tissue culture placenta
|
$390.80 |
$390.80 |
$390.80 |
$453.00
|
|
Tissue culture skin/biopsy
|
$175.50 |
$175.50 |
$175.50 |
$488.74
|
|
Tissue transglutaminase iga
|
$15.25 |
$15.25 |
$15.25 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$463.55 |
$463.55 |
$463.55 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$304.70 |
$304.70 |
$304.70 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$3,256.84 |
$3,256.84 |
$3,256.84 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$330.00 |
$330.00 |
$330.00 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$266.20 |
$266.20 |
$266.20 |
$74.10
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$630.94 |
$630.94 |
$630.94 |
$316.84
|
|
Total tau
|
$120.90 |
$120.90 |
$120.90 |
$312.50
|
|
Toxoplasma antibody igg
|
$228.55 |
$228.55 |
$228.55 |
$91.65
|
|
Toxoplasma antibody igm
|
$135.50 |
$135.50 |
$135.50 |
$87.75
|
|
Tp53 gene full gene sequence
|
$1,604.65 |
$1,604.65 |
$1,604.65 |
$706.04
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$184.50 |
$184.50 |
$184.50 |
$102.27
|
|
Transferrin
|
$93.15 |
$93.15 |
$93.15 |
$82.00
|
|
Transvaginal Pelvic Ultrasound (not pregnancy)
|
$757.20 |
$757.20 |
$757.20 |
$561.60
|
|
Transvaginal Pregnancy Ultrasound
|
$573.50 |
$573.50 |
$573.50 |
$499.20
|
|
Trastuzumab 150 mg intravenous solution
|
$288,956.88 |
$288,956.88 |
$288,956.88 |
$3,141.85
|
|
Trastuzumab-anns 150 mg intravenous solution
|
$1,681.20 |
$1,681.20 |
$1,681.20 |
$7,540.20
|
|
Treat ankle dislocation
|
$442.55 |
$442.55 |
$442.55 |
$2,360.00
|
|
Treat big toe fracture
|
$887.80 |
$887.80 |
$887.80 |
$4,485.60
|
|
Treat elbow dislocation
|
$429.20 |
$429.20 |
$429.20 |
$2,272.50
|
|
Treat elbow fracture
|
$732.80 |
$732.80 |
$732.80 |
$2,026.50
|
|
Treat finger fracture each
|
$528.55 |
$528.55 |
$528.55 |
$1,592.00
|
|
Treat fracture of radius
|
$630.70 |
$630.70 |
$630.70 |
$1,790.00
|
|
Treat fracture of ulna
|
$600.65 |
$600.65 |
$600.65 |
$731.04
|
|
Treat hip dislocation
|
$680.60 |
$680.60 |
$680.60 |
$2,211.05
|
|
Treat hip dislocation
|
$299.50 |
$299.50 |
$299.50 |
$2,641.60
|
