|
Speech recep thresh
|
$78.40 |
$78.40 |
$78.40 |
|
|
Speech Therapy Session (one-on-one)
|
$272.00 |
$272.00 |
$283.20 |
|
|
Sperm isolation complex
|
$260.00 |
$260.00 |
$260.00 |
|
|
Sperm isolation simple
|
$200.00 |
$200.00 |
$200.00 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,774.40 |
$1,774.40 |
$1,884.00 |
|
|
Spine X-ray (single view, one level)
|
$154.40 |
$336.80 |
$414.40 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$449.96 |
$449.96 |
$526.40 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$61.35 |
$61.35 |
$64.80 |
|
|
Splint finger fold over sm
|
$34.80 |
$34.80 |
$112.80 |
|
|
Splint finger frog med
|
$4.98 |
$4.98 |
$46.40 |
|
|
Splint func pos polyflex ii med
|
$316.73 |
$316.73 |
$316.73 |
|
|
Splint rstrc wrst/cmc right med
|
$146.04 |
$146.04 |
$209.60 |
|
|
Srs linear based
|
$3,042.40 |
$3,042.40 |
$12,160.00 |
|
|
St analysis behavior qualitative voice/resonance
|
$279.20 |
$279.20 |
$444.00 |
|
|
Staph a dna amp probe
|
$136.80 |
$136.80 |
$136.80 |
|
|
St cognitve performance testing healthcare professional each hour
|
$332.00 |
$332.00 |
$344.00 |
|
|
Stem cells total count
|
$205.60 |
$205.60 |
$205.60 |
|
|
Stent axios caut enh 15x10mm electrocaut
|
$32,911.99 |
$32,911.99 |
$35,903.99 |
|
|
Stent bili dbl pgtl 10fx5cm
|
$2,631.20 |
$2,631.20 |
$10,389.60 |
|
|
Stent bili rx wallflx 10x80 uncvr
|
$27,447.61 |
$27,447.61 |
$29,942.84 |
|
|
Stent placemt retro carotid
|
$8,537.60 |
$8,537.60 |
$8,657.60 |
|
|
Sterile water/saline, 10 ml
|
$2.40 |
$2.40 |
$3.40 |
|
|
Sterile water/saline, 500 ml
|
$26.79 |
$31.60 |
$40.00 |
|
|
St evaluate speech sound production
|
$302.40 |
$302.40 |
$388.80 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$436.80 |
$436.80 |
$479.20 |
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,665.60 |
$1,665.60 |
$2,047.20 |
|
|
Strapping of ankle and/or ft 29540
|
$222.40 |
$222.40 |
$230.40 |
|
|
Strapping of chest
|
$202.40 |
$202.40 |
$212.00 |
|
|
Strapping of elbow or wrist 29260
|
$194.40 |
$200.80 |
$210.40 |
|
|
Strapping of hand or finger
|
$189.60 |
$189.60 |
$191.20 |
|
|
Strapping of hip
|
$187.20 |
$187.20 |
$187.20 |
|
|
Strapping of knee
|
$207.20 |
$207.20 |
$228.80 |
|
|
Strapping of toes 29550
|
$194.40 |
$194.40 |
$197.60 |
|
|
Strep b dna amp probe
|
$195.20 |
$195.20 |
$195.20 |
|
|
Streptomycin injection
|
$35.41 |
$35.41 |
$35.41 |
|
|
Streptozocin injection
|
$726.64 |
$726.64 |
$726.64 |
|
|
Stress test pulmonary
|
$261.60 |
$261.60 |
$357.60 |
|
|
Stress tte complete
|
$1,063.20 |
$1,063.20 |
$2,543.20 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$33.75 |
$59.44 |
$81.20 |
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,782.75 |
$2,782.75 |
$25,358.48 |
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$67.10 |
$67.10 |
$119.96 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$35.05 |
$40.93 |
$578.09 |
|
|
Support clav 29.6-40.5in med
|
$156.84 |
$156.84 |
$225.12 |
|
|
Supprelin la implant
|
$72,648.14 |
$72,648.14 |
$72,648.14 |
|
|
Surg dx exam anorectal
|
$3,645.60 |
$3,645.60 |
$3,645.60 |
|
|
Surgical pathology level 1 gross examination only
|
$30.40 |
$35.20 |
$88.00 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$66.40 |
$68.80 |
$124.80 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$80.00 |
$136.00 |
$156.00 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$105.60 |
$180.80 |
$216.80 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$494.40 |
$494.40 |
$522.40 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$694.40 |
$694.40 |
$1,214.40 |
|
|
Susceptibility agar dilution per agent
|
$45.60 |
$45.60 |
$45.60 |
|
|
Susceptibility enzyme detection per enzyme
|
$29.60 |
$29.60 |
$29.60 |
|
|
Susceptibility mic per plate
|
$176.00 |
$176.00 |
$176.00 |
|
|
Svc venogram s&i
|
$1,859.20 |
$1,859.20 |
$2,959.20 |
|
|
Swallowing Evaluation (Bedside)
|
$350.40 |
$352.80 |
$366.40 |
|
|
Swallowing Therapy Session
|
$278.40 |
$278.40 |
$307.20 |
|
|
Sweat collection by iontophoresis
|
$36.00 |
$36.00 |
$36.00 |
|
|
Synvisc or synvisc-one
|
$307.91 |
$449.34 |
$504.68 |
|
|
System cardiomems hosp electronics
|
$39,600.00 |
$39,600.00 |
$43,200.00 |
|
|
System pacing micra av
|
$22,264.00 |
$22,264.00 |
$30,542.54 |
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$19,407.52 |
$19,407.52 |
$21,171.84 |
|
|
System recell skin grafting/harvesting
|
$14,400.00 |
$14,400.00 |
$14,400.00 |
|
|
System sealant biosentry tract
|
$1,029.28 |
$1,029.28 |
$1,235.14 |
|
|
T3 (triiodothyronine) free
|
$90.40 |
$90.40 |
$90.40 |
|
|
T3 (triiodothyronine) total
|
$104.80 |
$104.80 |
$104.80 |
|
|
T4 (thyroxine) free
|
$47.20 |
$47.20 |
$47.20 |
|
|
T4 (thyroxine) total
|
$40.80 |
$40.80 |
$40.80 |
|
|
Tacrol envarsus ex rel oral
|
$8.43 |
$8.43 |
$8.43 |
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$3.14 |
$4.48 |
$27.09 |
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$314.39 |
$314.39 |
$692.18 |
|
|
Tacrolimus therapeutic drug level
|
$91.20 |
$91.20 |
$91.20 |
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$160.80 |
$236.00 |
$376.80 |
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$12,807.21 |
$12,807.21 |
$12,807.21 |
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$3,403.24 |
$3,403.24 |
$15,403.51 |
|
|
Tavr perq femoral
|
$17,088.00 |
$17,088.00 |
$21,020.80 |
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$739.75 |
$739.75 |
$739.75 |
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$261.60 |
$261.60 |
$261.60 |
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$250.40 |
$250.40 |
$250.40 |
|
|
Tc-99m exame autol wbc diag per dose
|
$4,508.00 |
$4,508.00 |
$4,508.00 |
|
|
Tc-99m exametazime diag
|
$3,443.20 |
$3,443.20 |
$3,443.20 |
|
|
Tc-99m labeled rbc
|
$428.00 |
$428.00 |
$743.20 |
|
|
Tc-99m maa
|
$936.80 |
$936.80 |
$1,324.00 |
|
|
Tc-99m mebrofenin
|
$106.40 |
$106.40 |
$178.40 |
|
|
Tc-99m medronate
|
$133.60 |
$133.60 |
$240.00 |
|
|
Tc-99m mertiatide
|
$756.00 |
$756.00 |
$1,075.20 |
|
|
Tc-99m oxidronate
|
$168.00 |
$168.00 |
$460.00 |
|
|
Tc-99m pentetate dtpa
|
$388.80 |
$388.80 |
$752.00 |
|
|
Tc-99m pentetate dtpa aerosol
|
$388.80 |
$388.80 |
$752.00 |
|
|
Tc-99m pertechnetate per mci
|
$54.40 |
$54.40 |
$108.00 |
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$186.40 |
$186.40 |
$639.20 |
|
|
Tc-99m sestamibi p study dose
|
$174.40 |
$174.40 |
$352.00 |
|
|
Tc-99m succimer (dmsa)
|
$1,916.80 |
$1,916.80 |
$5,364.80 |
|
|
Tc-99m sulfur colloid
|
$308.00 |
$308.00 |
$1,144.00 |
|
|
Tc-99m tilmanocept diag
|
$1,171.20 |
$1,171.20 |
$1,171.20 |
|
|
Tcd emboli detect without inj
|
$928.00 |
$928.00 |
$928.00 |
|
|
T-cell depletion of harvest
|
$20,656.80 |
$20,656.80 |
$20,656.80 |
|
|
T cells absolute cd4/cd8 including ratio
|
$189.60 |
$189.60 |
$189.60 |
|
|
T cells absolute cd 4 count
|
$97.60 |
$97.60 |
$97.60 |
|
