|
Subtalar arthro w/deb
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Subtalar arthro w/exc
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Subtalar arthro w/fb rmvl
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Subtalar arthro w/fusion
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
|
|
Subtemporal cranial dcmprn
|
$2,208.33 |
$2,208.33 |
$2,208.33 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$4.13 |
$4.13 |
$9.87 |
|
|
Suction lipectomy head&neck
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
|
|
Suction lipectomy lwr extrem
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
|
|
Suction lipectomy trunk
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
|
|
Suction lipectomy upr extrem
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
|
|
Suction socket
|
$1,165.12 |
$1,165.12 |
$1,165.12 |
|
|
Suction susp ak/knee disart
|
$736.58 |
$736.58 |
$736.58 |
|
|
Sugars multiple quant
|
$15.91 |
$15.91 |
$15.91 |
|
|
Sugars single quant
|
$13.44 |
$15.91 |
$410.40 |
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.05 |
$0.05 |
$0.05 |
|
|
Sulfonylurea screen qn-sendout
|
$96.12 |
$162.00 |
$162.00 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$27.34 |
$27.41 |
$48.72 |
|
|
Sup/ext non-ins inf pump syr
|
$4.79 |
$4.79 |
$4.79 |
|
|
Sup of prep of antigen # of vials 95144
|
$64.39 |
$64.39 |
$64.39 |
|
|
Supply of digital device
|
$183.07 |
$183.07 |
$183.07 |
|
|
Supp non-insulin inf cath/wk
|
$35.70 |
$35.70 |
$35.70 |
|
|
Support clav 29.6-40.5in med
|
$58.40 |
$111.23 |
$111.23 |
|
|
Supprelin la implant
|
$23,946.72 |
$59,595.77 |
$59,595.77 |
|
|
Surg dx exam anorectal
|
$3,816.64 |
$3,816.64 |
$3,816.64 |
|
|
Surg ect salp-oophorectomy 59120
|
$1,129.75 |
$1,129.75 |
$1,129.75 |
|
|
Surg ect without salp-oophorectomy 59121
|
$1,131.31 |
$1,131.31 |
$1,131.31 |
|
|
Surgery for urethra pouch
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
|
|
Surgery of pancreatic cyst
|
$1,640.14 |
$1,640.14 |
$1,640.14 |
|
|
Surgery to stop leg growth
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Surgery to stop leg growth
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Surgery to stop leg growth
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Surgery to stop leg growth
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
|
|
Surgical exposure prostate 55860
|
$7,372.68 |
$7,372.68 |
$7,372.68 |
|
|
Surgical opening esophagus
|
$1,913.16 |
$1,913.16 |
$1,913.16 |
|
|
Surgical opening esophagus
|
$1,550.00 |
$1,550.00 |
$1,550.00 |
|
|
Surgical opening of stomach
|
$1,358.04 |
$1,358.04 |
$1,358.04 |
|
|
Surgical opening of stomach 43500
|
$1,129.36 |
$1,129.36 |
$1,129.36 |
|
|
Surgical opening of throat
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
|
|
Surgical pathology level 1 gross examination only
|
$15.12 |
$75.00 |
$147.20 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$31.92 |
$140.00 |
$339.20 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$38.64 |
$167.00 |
$414.40 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$46.53 |
$208.00 |
$1,696.38 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$96.88 |
$489.00 |
$654.40 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$140.56 |
$859.00 |
$1,423.20 |
|
|
Surgical repair stomach bleedin ulcer 43501
|
$1,918.66 |
$1,918.66 |
$1,918.66 |
|
|
Surgical repair stomach gastric lac 43502
|
$2,158.03 |
$2,158.03 |
$2,158.03 |
|
|
Surgical revision intestine
|
$1,528.29 |
$1,528.29 |
$1,528.29 |
|
|
Surgical trays
|
$21.28 |
$21.28 |
$21.28 |
|
|
Surgigraft, 1 sq cm
|
$171.12 |
$171.12 |
$4,696.24 |
|
|
Surg tx anal fistula 2nd stage 46285
|
$3,816.64 |
$3,816.64 |
$3,816.64 |
|
|
Susceptibility agar dilution per agent
|
$2.35 |
$17.00 |
$85.60 |
|
|
Susceptibility enzyme detection per enzyme
|
$2.35 |
$22.00 |
$53.60 |
|
|
Susceptibility mic per plate
|
$11.94 |
$58.00 |
$92.00 |
|
|
Suscept studies macrobroth dilution ea
|
$9.16 |
$9.16 |
$9.16 |
|
|
Suspend bowel w/prosthesis
|
$1,351.05 |
$1,351.05 |
$1,351.05 |
|
|
Suspension of testis
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
|
|
Suspension of uterus
|
$1,059.58 |
$1,059.58 |
$1,059.58 |
|
|
Suspension of uterus 58400
|
$602.56 |
$602.56 |
$602.56 |
|
|
Suspension sleeve lower ext
|
$76.02 |
$207.00 |
$207.00 |
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$1,468.40 |
$1,468.40 |
$1,468.40 |
|
|
Suture bile duct injury 47900
|
$1,958.21 |
$1,958.21 |
$1,958.21 |
|
|
Svc venogram s&i
|
$830.34 |
$2,164.52 |
$5,157.60 |
|
|
Swallowing Evaluation (Bedside)
|
$79.38 |
$365.00 |
$439.00 |
|
|
Swallowing Therapy Session
|
$106.40 |
$281.00 |
$552.00 |
|
|
Sweat collection by iontophoresis
|
$37.20 |
$106.00 |
$135.00 |
|
|
Symes ankle without (sach) foot
|
$4,287.00 |
$4,287.00 |
$4,287.00 |
|
|
Symes met fr leath socket ar
|
$5,739.64 |
$5,739.64 |
$5,739.64 |
|
|
Symes type medial opening so
|
$437.34 |
$437.34 |
$437.34 |
|
|
Symes type poster opening so
|
$572.18 |
$572.18 |
$572.18 |
|
|
Symes type ptb brim design s
|
$457.53 |
$457.53 |
$457.53 |
|
|
Syme typ expandabl wall sckt
|
$932.89 |
$932.89 |
$932.89 |
|
|
Sympathectomy cervical
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
|
|
Sympathectomy digital artery
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
|
|
Sympathectomy lumbar
|
$1,053.93 |
$1,053.93 |
$1,053.93 |
|
|
Sympathectomy supfc palmar
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Sympathectomy thoracolumbar
|
$1,681.03 |
$1,681.03 |
$1,681.03 |
|
|
Synojoynt, inj., 1 mg
|
$4.30 |
$4.30 |
$4.30 |
|
|
Synthetic sentence id test
|
$51.36 |
$51.36 |
$51.36 |
|
|
Synvisc or synvisc-one
|
$10.43 |
$10.43 |
$1,053.54 |
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$6.07 |
$46.00 |
$104.00 |
|
|
System cardiomems hosp electronics
|
$25,200.00 |
$41,360.00 |
$48,109.04 |
|
|
System pacing micra av
|
$13,720.00 |
$13,720.00 |
$15,400.00 |
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$4,480.00 |
$4,480.00 |
$6,996.08 |
|
|
T3 (triiodothyronine) free
|
$16.92 |
$68.00 |
$247.20 |
|
|
T3 (triiodothyronine) total
|
$19.57 |
$42.84 |
$195.20 |
|
|
T4 (thyroxine) free
|
$12.45 |
$37.20 |
$132.80 |
|
|
T4 (thyroxine) total
|
$9.48 |
$19.74 |
$132.80 |
|
|
Tacrol astagraf ex rel oral
|
$0.50 |
$0.81 |
$0.81 |
|
|
Tacrol envarsus ex rel oral
|
$1.21 |
$2.58 |
$2.58 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.27 |
$0.27 |
$10.76 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$362.18 |
$362.18 |
$362.18 |
|
|
Tacrolimus therapeutic drug level
|
$5.32 |
$87.00 |
$452.00 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$19.65 |
$19.65 |
$19.65 |
|
|
Tah rad debulk/lymph remove 58954
|
$2,975.29 |
$2,975.29 |
$2,975.29 |
|
|
Tah rad dissect for debulk 58953
|
$2,751.82 |
$2,751.82 |
$2,751.82 |
|
|
Tah w/mmk 58152
|
$1,610.50 |
$1,610.50 |
$1,610.50 |
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$54.88 |
$302.00 |
$448.80 |
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$102.04 |
$102.04 |
$102.04 |
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$103.38 |
$103.38 |
$103.38 |
|
|
Talymed
|
$171.12 |
$171.12 |
$171.12 |
|
