|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$22.28 |
$61.34 |
$140.52 |
|
|
Support clav 29.6-40.5in med
|
$99.90 |
$99.90 |
$99.90 |
|
|
Surgical opening of throat
|
$2,432.15 |
$2,432.15 |
$2,432.15 |
|
|
Surgical pathology level 1 gross examination only
|
$58.05 |
$78.15 |
$656.35 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$139.00 |
$168.55 |
$330.70 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$165.00 |
$210.55 |
$919.90 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$256.80 |
$276.70 |
$1,434.35 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$330.00 |
$429.35 |
$2,810.60 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$447.20 |
$791.85 |
$1,110.10 |
|
|
Surgical trays
|
$96.00 |
$96.00 |
$96.00 |
|
|
Susceptibility agar dilution per agent
|
$14.15 |
$54.00 |
$167.65 |
|
|
Susceptibility enzyme detection per enzyme
|
$8.65 |
$11.55 |
$66.40 |
|
|
Susceptibility mic per plate
|
$94.50 |
$129.60 |
$167.65 |
|
|
Svc venogram s&i
|
$142.00 |
$2,859.80 |
$2,859.80 |
|
|
Swallowing Evaluation (Bedside)
|
$118.10 |
$479.90 |
$754.45 |
|
|
Swallowing Therapy Session
|
$170.90 |
$341.45 |
$547.15 |
|
|
Sweat collection by iontophoresis
|
$51.70 |
$51.70 |
$258.15 |
|
|
Synch audio-only est high 40
|
$189.40 |
$241.75 |
$317.50 |
|
|
Synch audio-only est low 20
|
$86.90 |
$110.95 |
$145.30 |
|
|
Synch audio-only est mod 30
|
$128.10 |
$163.50 |
$215.05 |
|
|
Synch audio-only est sf 10
|
$47.60 |
$60.75 |
$79.80 |
|
|
Synch audio-only new high 60
|
$232.80 |
$287.45 |
$324.80 |
|
|
Synch audio-only new low 30
|
$112.50 |
$143.60 |
$188.15 |
|
|
Synch audio-only new mod 45
|
$176.70 |
$225.55 |
$296.50 |
|
|
Synch audio-only new sf 15
|
$64.90 |
$82.85 |
$108.35 |
|
|
Synvisc or synvisc-one
|
$3,270.38 |
$3,270.38 |
$4,165.57 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$31.10 |
$31.20 |
$91.80 |
|
|
System pacing micra av
|
$3,100.00 |
$3,100.00 |
$3,100.00 |
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$3,900.00 |
$3,900.00 |
$5,893.00 |
|
|
T3 (triiodothyronine) free
|
$186.00 |
$199.80 |
$452.45 |
|
|
T3 (triiodothyronine) total
|
$140.35 |
$175.50 |
$304.70 |
|
|
T4 (thyroxine) free
|
$26.75 |
$95.80 |
$156.35 |
|
|
T4 (thyroxine) total
|
$78.15 |
$86.70 |
$148.45 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.13 |
$2.83 |
$9.98 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,862.34 |
$1,862.34 |
$1,862.34 |
|
|
Tacrolimus therapeutic drug level
|
$82.25 |
$232.70 |
$448.45 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$3,674.21 |
$3,674.21 |
$6,078.88 |
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$253.35 |
$473.75 |
$741.25 |
|
|
Target gsa panel hmtlmph neop
|
$997.20 |
$2,256.65 |
$6,417.75 |
|
|
Target gsa panel organ neop
|
$1,073.00 |
$1,671.50 |
$4,575.20 |
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$45,657.50 |
$45,657.50 |
$45,657.50 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,368.23 |
$2,150.15 |
$2,770.33 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$64.25 |
$172.10 |
$386.50 |
|
|
Tc-99m disofenin
|
$188.95 |
$267.45 |
$511.00 |
|
|
Tc-99m exame autol wbc diag per dose
|
$34.80 |
$2,303.90 |
$3,169.95 |
|
|
Tc-99m labeled rbc
|
$170.05 |
$432.85 |
$528.10 |
|
|
Tc-99m maa
|
$67.45 |
$172.50 |
$629.80 |
|
|
Tc-99m mebrofenin
|
$80.25 |
$102.60 |
$274.30 |
|
|
Tc-99m medronate
|
$35.10 |
$160.95 |
$300.55 |
|
|
Tc-99m mertiatide
|
$877.15 |
$1,291.35 |
$2,509.45 |
|
|
Tc-99m oxidronate
|
$138.70 |
$142.90 |
$152.60 |
|
|
Tc-99m pentetate dtpa
|
$67.45 |
$102.45 |
$255.35 |
|
|
Tc-99m pentetate dtpa aerosol
|
$137.65 |
$255.35 |
$512.05 |
|
|
Tc-99m pertechnetate per mci
|
$15.50 |
$85.00 |
$143.00 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$14.75 |
$144.30 |
$258.00 |
|
|
Tc-99m sestamibi p study dose
|
$171.30 |
$430.90 |
$817.65 |
|
|
Tc-99m succimer (dmsa)
|
$720.75 |
$4,043.85 |
$4,043.85 |
|
|
Tc-99m sulfur colloid
|
$178.15 |
$295.20 |
$972.75 |
|
|
Tc-99m tetrofosmin p study dose
|
$113.60 |
$490.70 |
$533.10 |
|
|
T cells absolute cd4/cd8 including ratio
|
$67.20 |
$169.35 |
$282.45 |
|
|
T cells total count
|
$62.55 |
$126.90 |
$277.80 |
|
|
Team conf without pat by phys
|
$139.05 |
$139.05 |
$139.05 |
|
|
Team conf w/pat by hc prof
|
$193.15 |
$193.15 |
$562.80 |
|
|
Tee w or without fol w/cont,cong
|
$1,657.35 |
$1,657.35 |
$1,657.35 |
|
|
Telehealth original site facility fee
|
$76.95 |
$84.25 |
$234.90 |
|
|
Temozolomide 100 mg intravenous solution
|
$4,368.45 |
$4,368.45 |
$4,368.45 |
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$14,329.09 |
$14,329.09 |
$24,391.51 |
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$10,174.93 |
$10,174.93 |
$10,251.27 |
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$12.15 |
$70.84 |
$228.58 |
|
|
Testicular imaging w/vasc flow
|
$1,215.90 |
$1,284.90 |
$2,411.90 |
|
|
Test stress cardiovascular tracing only
|
$535.70 |
$661.35 |
$1,605.50 |
|
|
Tetanus immune globulin inj
|
$796.08 |
$1,974.39 |
$3,015.53 |
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$5,610.12 |
$10,923.78 |
$14,610.18 |
|
|
Theophylline therapeutic drug level
|
$155.05 |
$175.50 |
$304.70 |
|
|
Therapeutic procd strg endur
|
$75.70 |
$98.40 |
$133.65 |
|
|
Therapy activity per session >= 45 minutes
|
$259.70 |
$259.70 |
$259.70 |
|
|
Therapy Activity Training (each 15 minutes)
|
$105.20 |
$167.35 |
$198.15 |
|
|
Therapy Exercise Session (each 15 minutes)
|
$61.85 |
$159.45 |
$199.50 |
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$54.05 |
$75.60 |
$124.35 |
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$49.85 |
$62.05 |
$113.40 |
|
|
Ther nma rdctj intus/obstrcj
|
$1,004.15 |
$1,004.15 |
$1,044.65 |
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$8.98 |
$25.93 |
$81.21 |
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$200.25 |
$332.00 |
$487.25 |
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$223.25 |
$1,733.65 |
$3,048.95 |
|
|
Thoracotomy w/expl
|
$7,575.45 |
$7,575.45 |
$7,575.45 |
|
|
Thoracotomy with cardiac massage
|
$7,227.60 |
$7,227.60 |
$7,227.60 |
|
|
Three-Phase Bone Scan (Nuclear Medicine)
|
$1,807.70 |
$2,186.50 |
$3,836.80 |
|
|
Thrombin time
|
$66.10 |
$101.75 |
$190.25 |
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$54.10 |
$210.35 |
$247.80 |
|
|
Thyroglobulin antibody
|
$62.55 |
$142.55 |
$189.05 |
|
|
Thyroid imaging
|
$707.70 |
$903.00 |
$1,292.15 |
|
|
Thyroid met imaging
|
$1,228.10 |
$1,228.10 |
$1,228.10 |
|
|
Thyroid (TSH) Test
|
$183.25 |
$197.05 |
$276.85 |
|
|
Thyroid Ultrasound
|
$603.90 |
$706.65 |
$1,015.05 |
|
|
Thyroid uptake measurement
|
$535.70 |
$535.70 |
$1,147.20 |
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,074.85 |
$5,322.66 |
$8,219.15 |
|
|
Thyroxine binding globulin (tbg)
|
$48.40 |
$73.05 |
$425.35 |
|
|
Tilt table study
|
$909.75 |
$1,729.85 |
$1,729.85 |
|
|
Tirofiban 12.5 mg/50 ml
|
$1,077.11 |
$1,077.11 |
$1,077.11 |
|
|
Tissue culture placenta
|
$248.50 |
$390.80 |
$937.85 |
|