|
Smear fluorescent and/or acid fast stain
|
$75.40 |
$75.40 |
$75.40 |
$50.70
|
|
Smear gram stain
|
$81.25 |
$81.25 |
$81.25 |
$48.00
|
|
Smear special stain inclusion bodies/parasites
|
$106.60 |
$106.60 |
$106.60 |
$60.00
|
|
Smear wet mount
|
$88.40 |
$88.40 |
$88.40 |
$56.13
|
|
Snrpn/ube3a gene
|
$264.55 |
$264.55 |
$264.55 |
$228.80
|
|
Sodium 24 hour urine
|
$80.60 |
$80.60 |
$80.60 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$130.00 |
$130.00 |
$130.00 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$130.00 |
$130.00 |
$130.00 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$130.00 |
$130.00 |
$130.00 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$130.00 |
$130.00 |
$130.00 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$103.35 |
$103.35 |
$103.35 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$78.65 |
$78.65 |
$78.65 |
$42.43
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$9.36 |
$9.36 |
$9.36 |
$8.89
|
|
Special physics consult
|
$57,831.80 |
$57,831.80 |
$57,831.80 |
$688.05
|
|
Special radiation treatment
|
$41,389.40 |
$41,389.40 |
$41,389.40 |
$1,945.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$3,993.27 |
$3,993.27 |
$3,993.27 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$469.30 |
$469.30 |
$469.30 |
$526.80
|
|
Srs linear based
|
$36,631.40 |
$36,631.40 |
$36,631.40 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$157.30 |
$157.30 |
$157.30 |
$295.10
|
|
Staph a dna amp probe
|
$150.15 |
$150.15 |
$150.15 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$278.20 |
$278.20 |
$278.20 |
$313.96
|
|
St evaluate speech sound production
|
$152.10 |
$152.10 |
$152.10 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$313.95 |
$313.95 |
$313.95 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$428.35 |
$428.35 |
$428.35 |
$336.00
|
|
St evaluation swallow function
|
$428.35 |
$428.35 |
$428.35 |
$323.72
|
|
Strep b dna amp probe
|
$65.65 |
$65.65 |
$65.65 |
$124.20
|
|
Stress test pulmonary
|
$454.35 |
$454.35 |
$454.35 |
$330.63
|
|
Stress tte complete
|
$1,964.95 |
$1,964.95 |
$1,964.95 |
$1,989.60
|
|
St treatment speech individual
|
$245.70 |
$245.70 |
$245.70 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$230.75 |
$230.75 |
$230.75 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$22.19
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$40.75 |
$40.75 |
$40.75 |
$0.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$35.75 |
$35.75 |
$35.75 |
$52.49
|
|
Surg dx exam anorectal
|
$12,132.37 |
$12,132.37 |
$12,132.37 |
$2,814.85
|
|
Surgical pathology level 1 gross examination only
|
$9,714.28 |
$9,714.28 |
$9,714.28 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$470.60 |
$470.60 |
$470.60 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$19,100.82 |
$19,100.82 |
$19,100.82 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$6,537.05 |
$6,537.05 |
$6,537.05 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$19,460.62 |
$19,460.62 |
$19,460.62 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$47,161.39 |
$47,161.39 |
$47,161.39 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$48.10 |
$48.10 |
$48.10 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$6.50 |
$6.50 |
$6.50 |
$31.85
|
|
Susceptibility mic per plate
|
$126.75 |
$126.75 |
$126.75 |
$89.70
|
|
Svc venogram s&i
|
$1,672.45 |
$1,672.45 |
$1,672.45 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$202.15 |
$202.15 |
$202.15 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$38.35 |
$38.35 |
$38.35 |
$45.70
|
|
T3 (triiodothyronine) free
|
$303.55 |
$303.55 |
$303.55 |
$91.20
|
|
T3 (triiodothyronine) total
|
$112.45 |
$112.45 |
$112.45 |
$88.00
|
|
T4 (thyroxine) free
|
$228.15 |
$228.15 |
$228.15 |
$65.00
|
|
T4 (thyroxine) total
|
$40.95 |
$40.95 |
$40.95 |
$62.40
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Tacrolimus therapeutic drug level
|
$160.55 |
$160.55 |
$160.55 |
$137.15
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$35.75 |
$35.75 |
$35.75 |
$35.75
|
|
Target gsa panel hmtlmph neop
|
$1,508.00 |
$1,508.00 |
$1,508.00 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,630.20 |
$1,630.20 |
$1,630.20 |
$3,567.96
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$930.34 |
$930.34 |
$930.34 |
$760.95
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$89.05 |
$89.05 |
$89.05 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$147.55 |
$147.55 |
$147.55 |
$178.40
|
|
Tc-99m exame autol wbc diag per dose
|
$6,486.35 |
$6,486.35 |
$6,486.35 |
$2,393.40
|
|
Tc-99m labeled rbc
|
$487.50 |
$487.50 |
$487.50 |
$312.70
|
|
Tc-99m maa
|
$714.35 |
$714.35 |
$714.35 |
$306.60
|
|
Tc-99m mebrofenin
|
$741.65 |
$741.65 |
$741.65 |
$169.53
|
|
Tc-99m medronate
|
$111.15 |
$111.15 |
$111.15 |
$120.35
|
|
Tc-99m pertechnetate per mci
|
$50.05 |
$50.05 |
$50.05 |
$22.10
|
|
Tc-99m sulfur colloid
|
$468.00 |
$468.00 |
$468.00 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$1,620.45 |
$1,620.45 |
$1,620.45 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$373.10 |
$373.10 |
$373.10 |
$189.60
|
|
T cells absolute cd 4 count
|
$210.60 |
$210.60 |
$210.60 |
$120.25
|
|
T cells total count
|
$217.10 |
$217.10 |
$217.10 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$6,998.55 |
$6,998.55 |
$6,998.55 |
$217.09
|
|
Telehealth original site facility fee
|
$38.35 |
$38.35 |
$38.35 |
$55.65
|
|
Telethx isodose plan cplx
|
$14,041.30 |
$14,041.30 |
$14,041.30 |
$1,526.85
|
|
Temozolomide
|
$66.62 |
$66.62 |
$66.62 |
$632.98
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$16,665.05 |
$16,665.05 |
$16,665.05 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$13.00 |
$13.00 |
$13.00 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,144.65 |
$1,144.65 |
$1,144.65 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$2,130.89 |
$2,130.89 |
$2,130.89 |
$1,073.02
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$7,462.34 |
$7,462.34 |
$7,462.34 |
$6,935.61
|
|
Theophylline therapeutic drug level
|
$220.35 |
$220.35 |
$220.35 |
$101.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$40.30 |
$40.30 |
$40.30 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$40.30 |
$40.30 |
$40.30 |
$47.50
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,466.10 |
$2,466.10 |
$2,466.10 |
$1,658.70
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$28,412.46 |
$28,412.46 |
$28,412.46 |
$15,640.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$61,480.50 |
$61,480.50 |
$61,480.50 |
$25,597.40
|
|
Thrombin time
|
$70.20 |
$70.20 |
$70.20 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$92.30 |
$92.30 |
$92.30 |
$56.93
|
|
Thyroglobulin antibody
|
$227.50 |
$227.50 |
$227.50 |
$86.40
|
|
Thyroid imaging
|
$497.90 |
$497.90 |
$497.90 |
$577.80
|
|
Thyroid met imaging
|
$876.20 |
$876.20 |
$876.20 |
$509.60
|
|
Thyroid mets imag whole body
|
$1,561.95 |
$1,561.95 |
$1,561.95 |
$1,320.00
|
|
Thyroid (TSH) Test
|
$189.80 |
$189.80 |
$189.80 |
$101.40
|
|
Thyroid Ultrasound
|
$791.70 |
$791.70 |
$791.70 |
$553.80
|
|
Thyroid uptake measurement
|
$767.00 |
$767.00 |
$767.00 |
$580.20
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$3,359.48 |
$3,359.48 |
$3,359.48 |
$3,167.70
|
|
Thyroxine binding globulin (tbg)
|
$126.10 |
$126.10 |
$126.10 |
$75.00
|
|
Tigecycline injection
|
$268.12 |
$268.12 |
$268.12 |
$7.44
|
|
Tilt table study
|
$1,840.15 |
$1,840.15 |
$1,840.15 |
$1,488.24
|
|
Tissue culture placenta
|
$360.75 |
$360.75 |
$360.75 |
$470.00
|
|
Tissue exam koh skin/hair/nails
|
$9.75 |
$9.75 |
$9.75 |
$45.23
|
