|
Sugars single quant
|
$8.86 |
$8.86 |
$11.16 |
$52.47
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$11.58 |
$11.58 |
$11.58 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$86.72 |
$86.72 |
$109.26 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$120.31 |
$120.31 |
$151.58 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$8.63 |
$8.63 |
$10.87 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$14.08 |
$14.08 |
$17.74 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$20.43 |
$20.43 |
$25.74 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$418.82 |
$418.82 |
$527.67 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$36.32 |
$36.32 |
$45.76 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$94.21 |
$94.21 |
$118.69 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$29.74 |
$29.74 |
$37.47 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$57.44 |
$57.44 |
$72.36 |
$34.48
|
|
Susceptibility mic per plate
|
$225.87 |
$225.87 |
$284.57 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$88.53 |
$88.53 |
$111.54 |
$48.30
|
|
Svc venogram s&i
|
$636.74 |
$636.74 |
$636.74 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$17.03 |
$17.03 |
$21.45 |
$44.85
|
|
System cardiomems hosp electronics
|
$24,003.44 |
$24,003.44 |
$24,003.44 |
$41,639.82
|
|
System pacing micra av
|
$12,317.71 |
$12,317.71 |
$12,317.71 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$9,434.12 |
$9,434.12 |
$9,434.12 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$13.62 |
$13.62 |
$17.16 |
$89.82
|
|
T3 (triiodothyronine) total
|
$12.72 |
$12.72 |
$16.02 |
$94.90
|
|
T4 (thyroxine) free
|
$196.36 |
$196.36 |
$247.39 |
$81.60
|
|
T4 (thyroxine) total
|
$200.90 |
$200.90 |
$253.11 |
$73.64
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.15 |
$1.15 |
$18.85 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$183.87 |
$183.87 |
$183.87 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$62.88 |
$62.88 |
$79.23 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$1,737.92 |
$1,737.92 |
$2,189.62 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,744.05 |
$1,744.05 |
$2,197.34 |
$3,385.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$192.05 |
$192.05 |
$241.96 |
$166.46
|
|
Tc-99m apcitide diag
|
$237.22 |
$237.22 |
$298.87 |
$1,765.30
|
|
Tc-99m arcitumomab
|
$2,085.68 |
$2,085.68 |
$2,627.77 |
$2,159.40
|
|
Tc-99m bicisate
|
$231.77 |
$231.77 |
$292.01 |
$1,969.45
|
|
Tc-99m depreotide
|
$426.76 |
$426.76 |
$537.68 |
$1,937.35
|
|
Tc-99m disofenin
|
$50.63 |
$50.63 |
$63.78 |
$151.32
|
|
Tc-99m exametazime diag
|
$392.26 |
$392.26 |
$494.21 |
$2,166.26
|
|
Tc-99m fanolesomab diag
|
$798.36 |
$798.36 |
$1,005.87 |
$2,860.65
|
|
Tc-99m labeled rbc
|
$78.32 |
$78.32 |
$98.67 |
$323.01
|
|
Tc-99m maa
|
$48.36 |
$48.36 |
$60.92 |
$312.06
|
|
Tc-99m mebrofenin
|
$64.70 |
$64.70 |
$81.51 |
$169.53
|
|
Tc-99m medronate
|
$72.87 |
$72.87 |
$91.81 |
$122.46
|
|
Tc-99m mertiatide
|
$108.74 |
$108.74 |
$137.00 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$59.93 |
$59.93 |
$75.51 |
$245.85
|
|
Tc-99m pertechnetate per mci
|
$36.78 |
$36.78 |
$46.34 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$125.54 |
$125.54 |
$158.16 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$124.40 |
$124.40 |
$156.73 |
$221.60
|
|
Tc-99m sulfur colloid
|
$193.41 |
$193.41 |
$243.68 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$115.77 |
$115.77 |
$145.86 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$392.26 |
$392.26 |
$494.21 |
$930.54
|
|
Tcd emboli detect w/inj
|
$306.23 |
$306.23 |
$385.82 |
$404.68
|
|
Tcd emboli detect without inj
|
$296.92 |
$296.92 |
$374.09 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$39.05 |
$39.05 |
$49.20 |
$186.00
|
|
T cells absolute cd 4 count
|
$30.65 |
$30.65 |
$38.61 |
$120.25
|
|
T cells total count
|
$39.05 |
$39.05 |
$49.20 |
$124.11
|
|
Telehealth original site facility fee
|
$18.39 |
$18.39 |
$23.17 |
$60.80
|
|
Telethx isodose plan cplx
|
$108.97 |
$108.97 |
$108.97 |
$1,617.00
|
|
Temozolomide
|
$287.61 |
$287.61 |
$287.61 |
$374.66
|
|
Temozolomide 100 mg intravenous solution
|
$829.69 |
$829.69 |
$829.69 |
$3,129.70
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$1,019.23 |
$1,019.23 |
$1,019.23 |
$3,957.79
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$3,105.36 |
$3,105.36 |
$3,912.48 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$27.75 |
$27.75 |
$32.01 |
$46.10
|
|
Test stress cardiovascular tracing only
|
$656.03 |
$656.03 |
$656.03 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$461.95 |
$461.95 |
$461.95 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$83.31 |
$83.31 |
$104.97 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$22.93 |
$22.93 |
$22.93 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$19.53 |
$19.53 |
$19.53 |
$50.40
|
|
Ther/proph/diag inj ia
|
$106.11 |
$106.11 |
$106.11 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$12.72 |
$12.72 |
$16.02 |
$35.72
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,557.00 |
$1,557.00 |
$1,961.68 |
$1,804.00
|
|
Throat x-ray & fluoroscopy
|
$191.91 |
$191.91 |
$191.91 |
$188.00
|
|
Thrombectmy crnry perq mechanical
|
$1,898.18 |
$1,898.18 |
$1,898.18 |
$3,580.00
|
|
Thrombectomy/inf pq dialysis circuit
|
$3,475.60 |
$3,475.60 |
$3,475.60 |
$7,828.60
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$7,092.85 |
$7,092.85 |
$7,092.85 |
$15,185.00
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$10,781.14 |
$10,781.14 |
$10,781.14 |
$24,605.30
|
|
Thrombin time
|
$44.95 |
$44.95 |
$56.63 |
$48.75
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$10.22 |
$10.22 |
$12.87 |
$56.93
|
|
Thromboxane urine
|
$29.51 |
$29.51 |
$37.18 |
$52.22
|
|
Thyroglobulin antibody
|
$13.62 |
$13.62 |
$17.16 |
$84.00
|
|
Thyroid mets imag whole body
|
$972.93 |
$972.93 |
$972.93 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$284.66 |
$284.66 |
$358.65 |
$120.00
|
|
Thyroid Ultrasound
|
$752.06 |
$752.06 |
$947.52 |
$589.96
|
|
Thyrotropin alfa 0.9 mg intramuscular solution
|
$1,019.23 |
$1,019.23 |
$1,019.23 |
$4,319.71
|
|
Thyroxine binding globulin (tbg)
|
$11.35 |
$11.35 |
$14.30 |
$63.60
|
|
Tib/per revasc stent & ather 37231
|
$10,058.15 |
$10,058.15 |
$10,058.15 |
$21,900.00
|
|
Tib/per revasc w/ather add-on 37233
|
$4,300.29 |
$4,300.29 |
$4,300.29 |
$10,406.14
|
|
Tigecycline injection
|
$119.18 |
$119.18 |
$138.43 |
$277.31
|
|
Tilt table study
|
$901.19 |
$901.19 |
$901.19 |
$1,495.00
|
|
Tissue amnio epifix inj 100mg
|
$3,301.95 |
$3,301.95 |
$3,301.95 |
$3,846.61
|
|
Tissue culture placenta
|
$204.30 |
$204.30 |
$257.40 |
$520.91
|
|
Tissue culture skin/biopsy
|
$190.68 |
$190.68 |
$240.24 |
$558.87
|
|
Tissue exam koh skin/hair/nails
|
$23.39 |
$23.39 |
$89.81 |
$47.40
|
|
Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm
|
$4,293.26 |
$4,293.26 |
$4,293.26 |
$2,516.07
|
|
Tissue transglutaminase iga
|
$14.99 |
$14.99 |
$18.88 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$34.96 |
$34.96 |
$44.05 |
$77.22
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.44 |
$7.44 |
$326.20 |
$141.75
|
|
Tobramycin peak therapeutic drug level
|
$41.77 |
$41.77 |
$52.63 |
$121.55
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$365.25 |
$365.25 |
$365.25 |
$404.20
|
|
Total tau
|
$340.50 |
$340.50 |
$429.00 |
$293.00
|
|
Toxoplasma antibody igg
|
$35.87 |
$35.87 |
$45.19 |
$84.35
|
|
Toxoplasma antibody igm
|
$43.36 |
$43.36 |
$54.63 |
$83.20
|
|
Tp53 gene full gene sequence
|
$128.03 |
$128.03 |
$161.31 |
$706.04
|
