|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$4.68 |
$4.68 |
$4.68 |
$177.52
|
|
Somatropin injection
|
$2,770.40 |
$2,770.40 |
$2,770.40 |
$2,111.40
|
|
Sotalol hydrochloride IV
|
$771.26 |
$771.26 |
$771.26 |
$5,761.57
|
|
Specific gravity body fluid
|
$14.95 |
$14.95 |
$14.95 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$651.30 |
$651.30 |
$651.30 |
$384.80
|
|
Speech audiometry complete
|
$154.70 |
$154.70 |
$154.70 |
$109.20
|
|
Speech recep thresh
|
$154.70 |
$154.70 |
$154.70 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$307.45 |
$307.45 |
$307.45 |
$246.87
|
|
Sperm antibody test
|
$136.50 |
$136.50 |
$136.50 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$3,105.70 |
$3,105.70 |
$3,105.70 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$395.20 |
$395.20 |
$395.20 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$491.40 |
$491.40 |
$491.40 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$18.20 |
$18.20 |
$18.20 |
$71.44
|
|
Splint finger 4 prong foam sm
|
$20.80 |
$20.80 |
$20.80 |
$34.00
|
|
Splint finger frog med
|
$5.20 |
$5.20 |
$5.20 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$38.35 |
$38.35 |
$38.35 |
$99.04
|
|
Split blood or products
|
$768.30 |
$768.30 |
$768.30 |
$127.80
|
|
Sprchoroidal spc njx rx agt
|
$991.90 |
$991.90 |
$991.90 |
$454.19
|
|
St analysis behavior qualitative voice/resonance
|
$353.60 |
$353.60 |
$353.60 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$430.30 |
$430.30 |
$430.30 |
$286.00
|
|
Stent bili rx wallflx 10x80 uncvr
|
$36,014.55 |
$36,014.55 |
$36,014.55 |
$20,962.50
|
|
St evaluate speech sound production
|
$372.45 |
$372.45 |
$372.45 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$538.85 |
$538.85 |
$538.85 |
$400.00
|
|
Strep a ag ia
|
$75.40 |
$75.40 |
$75.40 |
$75.40
|
|
Strep b dna amp probe
|
$157.30 |
$157.30 |
$157.30 |
$124.15
|
|
Streptomycin injection
|
$175.50 |
$175.50 |
$175.50 |
$138.30
|
|
Stress test pulmonary
|
$385.45 |
$385.45 |
$385.45 |
$324.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$4.54 |
$4.54 |
$4.54 |
$54.80
|
|
Sugars single quant
|
$52.00 |
$52.00 |
$52.00 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,164,968.00 |
$2,164,968.00 |
$2,164,968.00 |
$7,487.55
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$2.96 |
$2.96 |
$2.96 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,129.07 |
$1,129.07 |
$1,129.07 |
$129.89
|
|
Support clav 29.6-40.5in med
|
$31.20 |
$31.20 |
$31.20 |
$94.08
|
|
Supprelin la implant
|
$117,424.98 |
$117,424.98 |
$117,424.98 |
$80,935.72
|
|
Surgical pathology level 1 gross examination only
|
$109.85 |
$109.85 |
$109.85 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$176.15 |
$176.15 |
$176.15 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$239.85 |
$239.85 |
$239.85 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$239.85 |
$239.85 |
$239.85 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,613.30 |
$1,613.30 |
$1,613.30 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$3,664.05 |
$3,664.05 |
$3,664.05 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$21.45 |
$21.45 |
$21.45 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$21.45 |
$21.45 |
$21.45 |
$35.89
|
|
Susceptibility mic per plate
|
$39.00 |
$39.00 |
$39.00 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$29.90 |
$29.90 |
$29.90 |
$59.28
|
|
Swallowing Evaluation (Bedside)
|
$370.50 |
$370.50 |
$370.50 |
$316.80
|
|
Swallowing Therapy Session
|
$431.60 |
$431.60 |
$431.60 |
$232.56
|
|
Synvisc or synvisc-one
|
$534.14 |
$534.14 |
$534.14 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$19.50 |
$19.50 |
$19.50 |
$42.24
|
|
T3 (triiodothyronine) free
|
$76.05 |
$76.05 |
$76.05 |
$100.32
|
|
T3 (triiodothyronine) total
|
$63.70 |
$63.70 |
$63.70 |
$93.52
|
|
T4 (thyroxine) free
|
$40.30 |
$40.30 |
$40.30 |
$89.60
|
|
T4 (thyroxine) total
|
$30.55 |
$30.55 |
$30.55 |
$70.20
|
|
Tacrol astagraf ex rel oral
|
$9.01 |
$9.01 |
$9.01 |
$62.32
|
|
Tacrol envarsus ex rel oral
|
$44.58 |
$44.58 |
$44.58 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$28.99 |
$28.99 |
$28.99 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$596.76 |
$596.76 |
$596.76 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$61.75 |
$61.75 |
$61.75 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$4,355.10 |
$4,355.10 |
$4,355.10 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$395.20 |
$395.20 |
$395.20 |
$289.20
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$21,795.67 |
$21,795.67 |
$21,795.67 |
$1,223.36
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$36,045.46 |
$36,045.46 |
$36,045.46 |
$21,745.13
|
|
Target gsa panel hmtlmph neop
|
$3,406.65 |
$3,406.65 |
$3,406.65 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,667.90 |
$1,667.90 |
$1,667.90 |
$3,746.70
|
|
Target gsa panel organ neop
|
$2,992.60 |
$2,992.60 |
$2,992.60 |
$1,701.91
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$46,800.00 |
$46,800.00 |
$46,800.00 |
$24,217.20
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,169.67 |
$1,169.67 |
$1,169.67 |
$937.50
|
|
Tbs dxa cal w/i&r fx risk
|
$200.85 |
$200.85 |
$200.85 |
$127.12
|
|
Tbs techl calculation only
|
$395.20 |
$395.20 |
$395.20 |
$153.60
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$278.20 |
$278.20 |
$278.20 |
$179.95
|
|
Tc-99m bicisate
|
$2,447.90 |
$2,447.90 |
$2,447.90 |
$2,070.00
|
|
Tc-99m exametazime diag
|
$2,033.20 |
$2,033.20 |
$2,033.20 |
$2,135.70
|
|
Tc-99m labeled rbc
|
$227.50 |
$227.50 |
$227.50 |
$306.00
|
|
Tc-99m maa
|
$709.80 |
$709.80 |
$709.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$40.30 |
$40.30 |
$40.30 |
$157.65
|
|
Tc-99m medronate
|
$36.40 |
$36.40 |
$36.40 |
$111.01
|
|
Tc-99m mertiatide
|
$369.20 |
$369.20 |
$369.20 |
$756.00
|
|
Tc-99m oxidronate
|
$53.30 |
$53.30 |
$53.30 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$276.90 |
$276.90 |
$276.90 |
$222.60
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$76.70 |
$76.70 |
$76.70 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$42.90 |
$42.90 |
$42.90 |
$287.20
|
|
Tc-99m sulfur colloid
|
$130.00 |
$130.00 |
$130.00 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$40.30 |
$40.30 |
$40.30 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$773.50 |
$773.50 |
$773.50 |
$985.60
|
|
T cells absolute cd4/cd8 including ratio
|
$210.60 |
$210.60 |
$210.60 |
$184.00
|
|
T cells absolute cd 4 count
|
$120.25 |
$120.25 |
$120.25 |
$111.20
|
|
T cells total count
|
$169.00 |
$169.00 |
$169.00 |
$130.20
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$130,977.60 |
$130,977.60 |
$130,977.60 |
$40,114.80
|
|
Telehealth original site facility fee
|
$29.25 |
$29.25 |
$29.25 |
$51.00
|
|
Temozolomide
|
$673.36 |
$673.36 |
$673.36 |
$540.06
|
|
Temozolomide 100 mg intravenous solution
|
$3,129.70 |
$3,129.70 |
$3,129.70 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$4,914.80 |
$4,914.80 |
$4,914.80 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$19,998.07 |
$19,998.07 |
$19,998.07 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$46.10 |
$46.10 |
$46.10 |
$39.33
|
|
Test for porphobilinogen
|
$26.00 |
$26.00 |
$26.00 |
$33.57
|
|
Testosterone undecanoate 1mg
|
$1,694.94 |
$1,694.94 |
$1,694.94 |
$3,528.08
|
|
Test stress cardiovascular tracing only
|
$1,164.15 |
$1,164.15 |
$1,164.15 |
$953.40
|
|
Test urine for porphyrins
|
$59.80 |
$59.80 |
$59.80 |
$49.98
|
|
Tetanus immune globulin inj
|
$1,534.24 |
$1,534.24 |
$1,534.24 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$5,727.70 |
$5,727.70 |
$5,727.70 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$63.70 |
$63.70 |
$63.70 |
$108.00
|
