|
Sodium chloride 0.9 % IV bolus
|
$20.00 |
$20.00 |
$20.00 |
$43.45
|
|
Sodium chloride 0.9 % IV bolus
|
$20.50 |
$20.50 |
$20.50 |
$37.19
|
|
Sodium chloride 3 % ivpb
|
$12.00 |
$12.00 |
$12.00 |
$37.80
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.42 |
$14.42 |
$14.42 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$371.98 |
$371.98 |
$371.98 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$72.50 |
$72.50 |
$72.50 |
$45.50
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$184.30 |
$184.30 |
$184.30 |
$177.52
|
|
Special physics consult
|
$303.00 |
$303.00 |
$303.00 |
$709.00
|
|
Special radiation dosimetry
|
$303.00 |
$303.00 |
$303.00 |
$393.25
|
|
Special radiation treatment
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$1,945.00
|
|
Special teletx port plan
|
$790.50 |
$790.50 |
$790.50 |
$1,056.31
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,394.00 |
$1,394.00 |
$1,394.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$387.00 |
$387.00 |
$387.00 |
$543.26
|
|
Sr-89 stront chlor ther / mci
|
$9,059.50 |
$9,059.50 |
$9,059.50 |
$2,617.05
|
|
St analysis behavior qualitative voice/resonance
|
$188.50 |
$188.50 |
$188.50 |
$295.10
|
|
Staph a dna amp probe
|
$234.50 |
$234.50 |
$234.50 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$217.50 |
$217.50 |
$217.50 |
$281.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$29,237.45 |
$29,237.45 |
$29,237.45 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,376.00 |
$3,376.00 |
$3,376.00 |
$2,301.33
|
|
Stent bili rx wallflx 10x80 uncvr
|
$20,164.93 |
$20,164.93 |
$20,164.93 |
$20,300.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$16,270.00 |
$16,270.00 |
$16,270.00 |
$14,356.50
|
|
St evaluate speech sound production
|
$188.50 |
$188.50 |
$188.50 |
$289.20
|
|
St evaluate speech sound production comprehensive/expressive
|
$385.00 |
$385.00 |
$385.00 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$188.50 |
$188.50 |
$188.50 |
$370.50
|
|
St evaluation swallow function
|
$159.00 |
$159.00 |
$159.00 |
$309.60
|
|
Streptomycin injection
|
$132.77 |
$132.77 |
$132.77 |
$143.00
|
|
Streptozocin injection
|
$496.36 |
$496.36 |
$496.36 |
$785.95
|
|
Stress test pulmonary
|
$161.00 |
$161.00 |
$161.00 |
$322.85
|
|
Stress tte complete
|
$777.50 |
$777.50 |
$777.50 |
$1,797.59
|
|
St treatment speech individual
|
$167.00 |
$167.00 |
$167.00 |
$249.00
|
|
St treatment swallow dysfunction/oral
|
$181.00 |
$181.00 |
$181.00 |
$243.99
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$12.00 |
$12.00 |
$12.00 |
$54.55
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$12,849.20 |
$12,849.20 |
$12,849.20 |
$7,487.55
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$7.14 |
$7.14 |
$7.14 |
$122.16
|
|
Surgical pathology level 1 gross examination only
|
$39.00 |
$39.00 |
$39.00 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$61.50 |
$61.50 |
$61.50 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$129.00 |
$129.00 |
$129.00 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$301.50 |
$301.50 |
$301.50 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$453.50 |
$453.50 |
$453.50 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$633.00 |
$633.00 |
$633.00 |
$720.75
|
|
Susceptibility mic per plate
|
$68.50 |
$68.50 |
$68.50 |
$104.58
|
|
Synvisc or synvisc-one
|
$247.68 |
$247.68 |
$247.68 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$28.50 |
$28.50 |
$28.50 |
$40.00
|
|
System cardiomems hosp electronics
|
$58,750.00 |
$58,750.00 |
$58,750.00 |
$38,226.50
|
|
System pacing micra av
|
$35,112.50 |
$35,112.50 |
$35,112.50 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$11,785.25 |
$11,785.25 |
$11,785.25 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$68.00 |
$68.00 |
$68.00 |
$99.00
|
|
T3 (triiodothyronine) total
|
$59.50 |
$59.50 |
$59.50 |
$93.52
|
|
T4 (thyroxine) free
|
$43.50 |
$43.50 |
$43.50 |
$84.15
|
|
T4 (thyroxine) total
|
$36.00 |
$36.00 |
$36.00 |
$67.10
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$0.50 |
$0.50 |
$0.50 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$388.27 |
$388.27 |
$388.27 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$44.50 |
$44.50 |
$44.50 |
$120.60
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$1,752.66 |
$1,752.66 |
$1,752.66 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$10,185.66 |
$10,185.66 |
$10,185.66 |
$19,613.80
|
|
Target gsa panel hmtlmph neop
|
$4,410.00 |
$4,410.00 |
$4,410.00 |
$2,160.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$255.50 |
$255.50 |
$255.50 |
$175.92
|
|
Tc-99m bicisate
|
$563.56 |
$563.56 |
$563.56 |
$1,984.80
|
|
Tc-99m exametazime diag
|
$1,716.36 |
$1,716.36 |
$1,716.36 |
$2,033.20
|
|
Tc-99m labeled rbc
|
$129.45 |
$129.45 |
$129.45 |
$302.40
|
|
Tc-99m maa
|
$29.32 |
$29.32 |
$29.32 |
$288.75
|
|
Tc-99m mebrofenin
|
$105.00 |
$105.00 |
$105.00 |
$157.65
|
|
Tc-99m medronate
|
$57.65 |
$57.65 |
$57.65 |
$111.01
|
|
Tc-99m mertiatide
|
$491.28 |
$491.28 |
$491.28 |
$756.00
|
|
Tc-99m oxidronate
|
$57.76 |
$57.76 |
$57.76 |
$105.30
|
|
Tc-99m pentetate dtpa
|
$607.41 |
$607.41 |
$607.41 |
$224.40
|
|
Tc-99m pentetate dtpa aerosol
|
$594.26 |
$594.26 |
$594.26 |
$190.80
|
|
Tc-99m pertechnetate per mci
|
$40.74 |
$40.74 |
$40.74 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$147.22 |
$147.22 |
$147.22 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$76.00 |
$76.00 |
$76.00 |
$289.80
|
|
Tc-99m succimer (dmsa)
|
$796.09 |
$796.09 |
$796.09 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$181.50 |
$181.50 |
$181.50 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$76.00 |
$76.00 |
$76.00 |
$188.50
|
|
Tc-99m tilmanocept diag
|
$735.96 |
$735.96 |
$735.96 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$199.00 |
$199.00 |
$199.00 |
$175.00
|
|
T cells absolute cd 4 count
|
$113.50 |
$113.50 |
$113.50 |
$110.72
|
|
T cells total count
|
$171.00 |
$171.00 |
$171.00 |
$123.00
|
|
Telehealth original site facility fee
|
$35.00 |
$35.00 |
$35.00 |
$51.85
|
|
Telethx isodose plan cplx
|
$790.50 |
$790.50 |
$790.50 |
$1,522.19
|
|
Temozolomide
|
$10.24 |
$10.24 |
$10.24 |
$540.06
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$894.77 |
$894.77 |
$894.77 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,480.88 |
$9,480.88 |
$9,480.88 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$2.34 |
$2.34 |
$2.34 |
$37.76
|
|
Test stress cardiovascular tracing only
|
$581.00 |
$581.00 |
$581.00 |
$949.92
|
|
Tetanus immune globulin inj
|
$777.19 |
$777.19 |
$777.19 |
$1,210.21
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$5,408.64 |
$5,408.64 |
$5,408.64 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$44.50 |
$44.50 |
$44.50 |
$108.00
|
|
Therapeutic procd strg endur
|
$45.00 |
$45.00 |
$45.00 |
$83.16
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$32.50 |
$32.50 |
$32.50 |
$55.98
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$28.00 |
$28.00 |
$28.00 |
$50.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$5.30 |
$5.30 |
$5.30 |
$25.54
|
|
Thiotepa injection
|
$302.21 |
$302.21 |
$302.21 |
$1,485.00
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$1,083.00 |
$1,083.00 |
$1,083.00 |
$1,687.50
|
|
Thrombin time
|
$40.00 |
$40.00 |
$40.00 |
$53.76
|
|
Thromboplastin inhibition
|
$51.50 |
$51.50 |
$51.50 |
$55.20
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$40.00 |
$40.00 |
$40.00 |
$61.50
|
|
Thyroglobulin antibody
|
$76.50 |
$76.50 |
$76.50 |
$81.90
|
|
Thyroid mets imag whole body
|
$1,173.50 |
$1,173.50 |
$1,173.50 |
$1,544.00
|
|
Thyroid (TSH) Test
|
$68.00 |
$68.00 |
$68.00 |
$112.00
|
|
Thyroid Ultrasound
|
$513.00 |
$513.00 |
$513.00 |
$588.50
|
