|
Smear wet mount
|
$229.25 |
$229.25 |
$457.43 |
$67.49
|
|
Socket insert without lock mech
|
$10,489.00 |
$10,489.00 |
$10,489.00 |
$1,192.50
|
|
Socket insert w lock mech
|
$6,242.00 |
$6,242.00 |
$6,242.00 |
$1,544.50
|
|
Sock fracture or equal each
|
$935.00 |
$935.00 |
$935.00 |
$74.51
|
|
Sodium 24 hour urine
|
$127.50 |
$127.50 |
$254.91 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$85.85 |
$85.85 |
$91.00 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$87.71 |
$87.71 |
$134.00 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$87.71 |
$87.71 |
$87.71 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$92.48 |
$92.48 |
$92.48 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$51.75 |
$51.75 |
$198.85 |
$45.60
|
|
Special radiation treatment
|
$6,264.56 |
$6,264.56 |
$6,264.56 |
$1,986.00
|
|
Special teletx port plan
|
$19,762.84 |
$19,762.84 |
$19,762.84 |
$1,086.99
|
|
Specific gravity body fluid
|
$215.22 |
$215.22 |
$215.22 |
$22.00
|
|
Specimen fat stain
|
$181.00 |
$181.00 |
$362.23 |
$35.10
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$1,611.15 |
$1,611.15 |
$1,611.15 |
$543.26
|
|
Split blood or products
|
$110.81 |
$110.81 |
$110.81 |
$127.48
|
|
Srs multisource
|
$189,736.70 |
$189,736.70 |
$189,736.70 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$1,112.29 |
$1,112.29 |
$1,112.29 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$666.52 |
$666.52 |
$666.52 |
$286.00
|
|
St evaluate speech sound production
|
$1,112.29 |
$1,112.29 |
$1,112.29 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$1,112.29 |
$1,112.29 |
$1,112.29 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$1,276.25 |
$1,276.25 |
$1,276.25 |
$399.60
|
|
St evaluation swallow function
|
$476.25 |
$476.25 |
$476.25 |
$314.40
|
|
Strapping of elbow or wrist 29260
|
$504.78 |
$504.78 |
$504.78 |
$154.70
|
|
Strapping of knee
|
$496.88 |
$496.88 |
$496.88 |
$205.20
|
|
Strep a ag ia
|
$194.75 |
$194.75 |
$392.90 |
$75.40
|
|
Strep b dna amp probe
|
$162.00 |
$162.00 |
$162.00 |
$120.90
|
|
Streptozocin injection
|
$1,073.98 |
$1,073.98 |
$1,073.98 |
$785.95
|
|
Stress test pulmonary
|
$1,265.81 |
$1,265.81 |
$1,265.81 |
$322.85
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$83.34 |
$83.34 |
$83.34 |
$52.31
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$118.19 |
$118.19 |
$118.19 |
$82.43
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$264.98 |
$264.98 |
$296.80 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$254.91 |
$254.91 |
$254.91 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$797.99 |
$797.99 |
$797.99 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,840.85 |
$1,840.85 |
$1,840.85 |
$181.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$2,439.99 |
$2,439.99 |
$2,439.99 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$3,016.93 |
$3,016.93 |
$3,016.93 |
$718.00
|
|
Suspension sleeve lower ext
|
$1,491.00 |
$1,491.00 |
$1,491.00 |
$251.38
|
|
T3 (triiodothyronine) free
|
$711.00 |
$711.00 |
$1,422.53 |
$99.20
|
|
T3 (triiodothyronine) total
|
$303.00 |
$303.00 |
$604.98 |
$93.52
|
|
T4 (thyroxine) free
|
$79.75 |
$79.75 |
$596.49 |
$85.20
|
|
T4 (thyroxine) total
|
$207.25 |
$207.25 |
$413.55 |
$69.00
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$549.82 |
$549.82 |
$549.82 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$320.75 |
$320.75 |
$643.04 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,391.84 |
$4,391.84 |
$4,391.84 |
$2,762.00
|
|
Target gsa panel organ neop
|
$14,347.14 |
$14,347.14 |
$14,347.14 |
$1,655.52
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$489.75 |
$489.75 |
$1,063.99 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$427.50 |
$427.50 |
$928.08 |
$177.65
|
|
Tc-99m bicisate
|
$5,416.16 |
$5,416.16 |
$5,416.16 |
$1,969.45
|
|
Tc-99m depreotide
|
$470.97 |
$470.97 |
$470.97 |
$1,486.80
|
|
Tc-99m exame autol wbc diag per dose
|
$8,748.28 |
$8,748.28 |
$8,748.28 |
$2,435.36
|
|
Tc-99m maa
|
$197.28 |
$197.28 |
$197.28 |
$292.80
|
|
Tc-99m mertiatide
|
$2,237.12 |
$2,237.12 |
$2,237.12 |
$756.00
|
|
Tc-99m oxidronate
|
$150.11 |
$150.11 |
$150.11 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$197.28 |
$197.28 |
$197.28 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$568.58 |
$568.58 |
$568.58 |
$190.80
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$46.80 |
$46.80 |
$46.80 |
$136.40
|
|
Tc-99m tetrofosmin p study dose
|
$1,916.63 |
$1,916.63 |
$1,916.63 |
$190.80
|
|
T cells absolute cd4/cd8 including ratio
|
$209.00 |
$209.00 |
$1,314.71 |
$176.40
|
|
Telavancin injection
|
$465.00 |
$465.00 |
$465.00 |
$1,191.80
|
|
Telethx isodose plan cplx
|
$29,601.97 |
$29,601.97 |
$29,601.97 |
$1,526.85
|
|
Telethx isodose plan simple
|
$17,873.67 |
$17,873.67 |
$17,873.67 |
$873.62
|
|
Temozolomide 100 mg intravenous solution
|
$3,566.77 |
$3,566.77 |
$3,566.77 |
$1,867.28
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$23,035.43 |
$23,035.43 |
$23,035.43 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$103.50 |
$103.50 |
$169.50 |
$39.33
|
|
Test for chlorohydrocarbons
|
$751.45 |
$751.45 |
$751.45 |
$65.00
|
|
Test pathogen(s) for platelets reference
|
$3,204.82 |
$3,204.82 |
$3,204.82 |
$70.00
|
|
Tetanus immune globulin inj
|
$1,573.18 |
$1,573.18 |
$1,573.18 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$181.00 |
$181.00 |
$547.34 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$93.44 |
$93.44 |
$93.44 |
$25.54
|
|
Thiotepa injection
|
$565.71 |
$565.71 |
$565.71 |
$1,485.00
|
|
Throat x-ray & fluoroscopy
|
$2,261.44 |
$2,261.44 |
$2,261.44 |
$259.60
|
|
Thrombin time
|
$215.25 |
$215.25 |
$483.86 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$207.25 |
$207.25 |
$413.55 |
$61.52
|
|
Thromboxane urine
|
$329.75 |
$329.75 |
$720.79 |
$95.00
|
|
Thyroglobulin antibody
|
$402.50 |
$402.50 |
$806.46 |
$82.00
|
|
Thyroid imaging
|
$1,963.00 |
$1,963.00 |
$7,604.14 |
$695.02
|
|
Thyroid mets imag whole body
|
$15,266.73 |
$15,266.73 |
$15,266.73 |
$1,524.99
|
|
Thyroid Ultrasound
|
$2,770.25 |
$2,770.25 |
$2,770.25 |
$588.50
|
|
Thyroid uptake measurement
|
$1,264.25 |
$1,264.25 |
$4,897.58 |
$591.25
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$6,751.54 |
$6,751.54 |
$6,751.54 |
$4,112.43
|
|
Thyroxine binding globulin (tbg)
|
$290.75 |
$290.75 |
$588.57 |
$64.35
|
|
Tibial length sock fx or equ
|
$452.00 |
$452.00 |
$452.00 |
$88.92
|
|
Tigecycline injection
|
$158.00 |
$158.00 |
$158.00 |
$234.00
|
|
Tilt table study
|
$14,008.81 |
$14,008.81 |
$14,008.81 |
$1,507.01
|
|
Tissue culture skin/biopsy
|
$2,802.74 |
$2,802.74 |
$2,802.74 |
$484.00
|
|
Tissue culture tumor
|
$1,402.42 |
$1,402.42 |
$1,402.42 |
$483.36
|
|
Tl-201 thallium diag per mci
|
$1,045.65 |
$1,045.65 |
$1,045.65 |
$78.40
|
|
Tlso 2mod symphis-xipho pre
|
$7,579.00 |
$7,579.00 |
$7,579.00 |
$1,874.66
|
|
Tlso 2 shl symphys-stern cst
|
$8,885.00 |
$8,885.00 |
$8,885.00 |
$1,808.59
|
|
Tlso 3mod sacro-scap pre
|
$8,958.00 |
$8,958.00 |
$8,958.00 |
$2,117.57
|
|
Tlso rigid plastic cust fab
|
$11,692.00 |
$11,692.00 |
$11,692.00 |
$2,347.16
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$128.50 |
$128.50 |
$128.50 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$313.00 |
$313.00 |
$631.43 |
$120.60
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$342.17 |
$342.17 |
$342.17 |
$325.00
|
|
Toxoplasma antibody igg
|
$646.22 |
$646.22 |
$1,592.25 |
$89.40
|
|
Toxoplasma antibody igm
|
$470.00 |
$470.00 |
$941.28 |
$87.00
|
|
Tpmt gene com vrnts
|
$877.88 |
$877.88 |
$877.88 |
$371.80
|
|
Trabectedin 1 mg intravenous solution
|
$11,057.31 |
$11,057.31 |
$11,057.31 |
$6,827.00
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$104.45 |
$104.45 |
$104.45 |
$56.38
|
