|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$7,914.03 |
$7,914.03 |
$7,914.03 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$145.50 |
$145.50 |
$145.50 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$139.24 |
$139.24 |
$139.24 |
$126.63
|
|
Support clav 29.6-40.5in med
|
$99.90 |
$99.90 |
$99.90 |
$94.08
|
|
Surgical opening of throat
|
$2,432.15 |
$2,432.15 |
$2,432.15 |
$2,133.48
|
|
Surgical pathology level 1 gross examination only
|
$656.35 |
$656.35 |
$656.35 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$245.65 |
$245.65 |
$245.65 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$919.90 |
$919.90 |
$919.90 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,434.35 |
$1,434.35 |
$1,434.35 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$2,810.60 |
$2,810.60 |
$2,810.60 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$791.85 |
$791.85 |
$791.85 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$14.15 |
$14.15 |
$14.15 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$8.65 |
$8.65 |
$8.65 |
$35.75
|
|
Susceptibility mic per plate
|
$164.55 |
$164.55 |
$164.55 |
$105.75
|
|
Svc venogram s&i
|
$2,859.80 |
$2,859.80 |
$2,859.80 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$754.45 |
$754.45 |
$754.45 |
$316.55
|
|
Swallowing Therapy Session
|
$483.20 |
$483.20 |
$483.20 |
$240.31
|
|
Synch audio-only est high 40
|
$189.40 |
$189.40 |
$189.40 |
$190.77
|
|
Synch audio-only est low 20
|
$86.90 |
$86.90 |
$86.90 |
$90.60
|
|
Synch audio-only est mod 30
|
$128.10 |
$128.10 |
$128.10 |
$136.64
|
|
Synch audio-only est sf 10
|
$47.60 |
$47.60 |
$47.60 |
$53.20
|
|
Synch audio-only new high 60
|
$232.80 |
$232.80 |
$232.80 |
$207.64
|
|
Synch audio-only new low 30
|
$112.50 |
$112.50 |
$112.50 |
$117.00
|
|
Synch audio-only new mod 45
|
$176.70 |
$176.70 |
$176.70 |
$166.70
|
|
Synch audio-only new sf 15
|
$64.90 |
$64.90 |
$64.90 |
$67.80
|
|
Synvisc or synvisc-one
|
$3,270.38 |
$3,270.38 |
$3,270.38 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$31.20 |
$31.20 |
$31.20 |
$41.60
|
|
System pacing micra av
|
$3,100.00 |
$3,100.00 |
$3,100.00 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$3,900.00 |
$3,900.00 |
$3,900.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$214.45 |
$214.45 |
$214.45 |
$100.32
|
|
T3 (triiodothyronine) total
|
$179.35 |
$179.35 |
$179.35 |
$93.52
|
|
T4 (thyroxine) free
|
$26.75 |
$26.75 |
$26.75 |
$88.44
|
|
T4 (thyroxine) total
|
$86.70 |
$86.70 |
$86.70 |
$69.58
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.83 |
$2.83 |
$2.83 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,862.34 |
$1,862.34 |
$1,862.34 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$232.70 |
$232.70 |
$232.70 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$663.00 |
$663.00 |
$663.00 |
$289.90
|
|
Target gsa panel hmtlmph neop
|
$2,256.65 |
$2,256.65 |
$2,256.65 |
$2,246.30
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,187.83 |
$2,187.83 |
$2,187.83 |
$937.50
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$172.10 |
$172.10 |
$172.10 |
$180.80
|
|
Tc-99m disofenin
|
$511.00 |
$511.00 |
$511.00 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$3,169.95 |
$3,169.95 |
$3,169.95 |
$2,503.15
|
|
Tc-99m labeled rbc
|
$432.85 |
$432.85 |
$432.85 |
$306.00
|
|
Tc-99m maa
|
$629.80 |
$629.80 |
$629.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$274.30 |
$274.30 |
$274.30 |
$157.65
|
|
Tc-99m medronate
|
$160.95 |
$160.95 |
$160.95 |
$111.01
|
|
Tc-99m mertiatide
|
$2,509.45 |
$2,509.45 |
$2,509.45 |
$756.00
|
|
Tc-99m oxidronate
|
$142.90 |
$142.90 |
$142.90 |
$108.00
|
|
Tc-99m pentetate dtpa aerosol
|
$512.05 |
$512.05 |
$512.05 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$143.00 |
$143.00 |
$143.00 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$144.30 |
$144.30 |
$144.30 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$430.90 |
$430.90 |
$430.90 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$4,043.85 |
$4,043.85 |
$4,043.85 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$972.75 |
$972.75 |
$972.75 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$523.85 |
$523.85 |
$523.85 |
$193.28
|
|
T cells absolute cd4/cd8 including ratio
|
$67.20 |
$67.20 |
$67.20 |
$185.28
|
|
T cells total count
|
$62.55 |
$62.55 |
$62.55 |
$130.35
|
|
Team conf w/pat by hc prof
|
$193.15 |
$193.15 |
$193.15 |
$104.59
|
|
Tee w or without fol w/cont,cong
|
$1,657.35 |
$1,657.35 |
$1,657.35 |
$2,101.65
|
|
Telehealth original site facility fee
|
$198.45 |
$198.45 |
$198.45 |
$51.00
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$14,329.09 |
$14,329.09 |
$14,329.09 |
$3,723.60
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$228.58 |
$228.58 |
$228.58 |
$39.33
|
|
Testicular imaging w/vasc flow
|
$1,816.65 |
$1,816.65 |
$1,816.65 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$661.35 |
$661.35 |
$661.35 |
$953.40
|
|
Tetanus immune globulin inj
|
$1,550.09 |
$1,550.09 |
$1,550.09 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$10,923.78 |
$10,923.78 |
$10,923.78 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$283.20 |
$283.20 |
$283.20 |
$108.00
|
|
Therapeutic procd strg endur
|
$133.65 |
$133.65 |
$133.65 |
$85.68
|
|
Therapy Activity Training (each 15 minutes)
|
$167.35 |
$167.35 |
$167.35 |
$101.85
|
|
Therapy Exercise Session (each 15 minutes)
|
$172.70 |
$172.70 |
$172.70 |
$98.58
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$115.75 |
$115.75 |
$115.75 |
$57.50
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$113.40 |
$113.40 |
$113.40 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$28.86 |
$28.86 |
$28.86 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$487.25 |
$487.25 |
$487.25 |
$314.50
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,841.90 |
$1,841.90 |
$1,841.90 |
$1,733.65
|
|
Thoracotomy w/expl
|
$7,575.45 |
$7,575.45 |
$7,575.45 |
$2,045.17
|
|
Thoracotomy with cardiac massage
|
$7,227.60 |
$7,227.60 |
$7,227.60 |
$2,138.76
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$3,836.80 |
$3,836.80 |
$3,836.80 |
$1,684.80
|
|
Thrombin time
|
$101.75 |
$101.75 |
$101.75 |
$54.18
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$247.80 |
$247.80 |
$247.80 |
$61.52
|
|
Thyroglobulin antibody
|
$62.55 |
$62.55 |
$62.55 |
$82.73
|
|
Thyroid imaging
|
$1,292.15 |
$1,292.15 |
$1,292.15 |
$696.75
|
|
Thyroid (TSH) Test
|
$214.55 |
$214.55 |
$214.55 |
$112.67
|
|
Thyroid Ultrasound
|
$1,015.05 |
$1,015.05 |
$1,015.05 |
$588.50
|
|
Thyroid uptake measurement
|
$535.70 |
$535.70 |
$535.70 |
$591.25
|
|
Thyroxine binding globulin (tbg)
|
$73.05 |
$73.05 |
$73.05 |
$64.51
|
|
Tilt table study
|
$1,729.85 |
$1,729.85 |
$1,729.85 |
$1,561.82
|
|
Tissue culture placenta
|
$390.80 |
$390.80 |
$390.80 |
$440.50
|
|
Tissue culture skin/biopsy
|
$1,353.70 |
$1,353.70 |
$1,353.70 |
$484.00
|
|
Tissue transglutaminase iga
|
$34.25 |
$34.25 |
$34.25 |
$44.80
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$780.78 |
$780.78 |
$780.78 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$143.35 |
$143.35 |
$143.35 |
$119.40
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$1,268.30 |
$1,268.30 |
$1,268.30 |
$5,258.52
|
|
Toe X-ray (both feet)
|
$318.50 |
$318.50 |
$318.50 |
$258.65
|
|
Tomosynthesis breast screen bilateral
|
$143.00 |
$143.00 |
$143.00 |
$74.10
|
|
Tone decay hearing test
|
$102.60 |
$102.60 |
$102.60 |
$90.37
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$676.16 |
$676.16 |
$676.16 |
$316.84
|
|
Total tau
|
$149.40 |
$149.40 |
$149.40 |
$312.50
|
|
Toxoplasma antibody igg
|
$21.90 |
$21.90 |
$21.90 |
$91.65
|
|
Toxoplasma antibody igm
|
$21.90 |
$21.90 |
$21.90 |
$88.00
|