|
Special radiation dosimetry
|
$556.80 |
$556.80 |
$556.80 |
$392.50
|
|
Special radiation treatment
|
$3,091.80 |
$3,091.80 |
$3,091.80 |
$1,986.00
|
|
Special teletx port plan
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$1,086.99
|
|
Specific gravity body fluid
|
$22.80 |
$22.80 |
$22.80 |
$22.00
|
|
Specimen fat stain
|
$24.00 |
$24.00 |
$24.00 |
$35.10
|
|
Sperm antibody test
|
$86.40 |
$86.40 |
$86.40 |
$57.85
|
|
Spinal bone allograftstructural 20931
|
$51,423.55 |
$51,423.55 |
$51,423.55 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$107,706.23 |
$107,706.23 |
$107,706.23 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,154.00 |
$2,154.00 |
$2,154.00 |
$1,439.40
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$1,652.42 |
$1,652.42 |
$1,652.42 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$214.18 |
$214.18 |
$214.18 |
$68.25
|
|
Splint finger fold over sm
|
$314.95 |
$314.95 |
$314.95 |
$146.88
|
|
Splint finger frog med
|
$320.52 |
$320.52 |
$320.52 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$314.95 |
$314.95 |
$314.95 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$12,050.22 |
$12,050.22 |
$14,935.62 |
$4,619.65
|
|
Srsf2 gene common variants
|
$331.80 |
$331.80 |
$331.80 |
$227.66
|
|
Srs linear based
|
$15,420.00 |
$15,420.00 |
$15,420.00 |
$13,585.00
|
|
Staph a dna amp probe
|
$165.60 |
$165.60 |
$165.60 |
$125.00
|
|
Static or dynami afo pre ots
|
$993.42 |
$993.42 |
$993.42 |
$284.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$71,680.02 |
$71,680.02 |
$71,680.02 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$57,618.36 |
$57,618.36 |
$57,618.36 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$62,585.46 |
$62,585.46 |
$62,585.46 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$1,390.79 |
$1,390.79 |
$1,390.79 |
$4,939.20
|
|
Sterile water/saline, 10 ml
|
$25.20 |
$25.20 |
$34.98 |
$13.32
|
|
Sternal pad
|
$359.50 |
$359.50 |
$359.50 |
$216.89
|
|
Stimulants synthetic
|
$185.40 |
$185.40 |
$185.40 |
$80.08
|
|
Stocking sup grips 4 pre ots
|
$56.03 |
$56.03 |
$56.03 |
$31.58
|
|
Straight knee joint heavy du
|
$526.47 |
$526.47 |
$526.47 |
$317.69
|
|
Strep a ag ia
|
$10.80 |
$10.80 |
$34.20 |
$75.40
|
|
Strep b assay w/optic
|
$6,238.80 |
$6,238.80 |
$6,238.80 |
$80.16
|
|
Strep b dna amp probe
|
$94.80 |
$94.80 |
$94.80 |
$120.90
|
|
Str markers specimen anal
|
$948.00 |
$948.00 |
$948.00 |
$751.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$7.50 |
$7.50 |
$7.50 |
$52.31
|
|
Suction lipectomy trunk
|
$11,608.58 |
$11,608.58 |
$61,508.00 |
$4,332.25
|
|
Sugars single quant
|
$338.40 |
$338.40 |
$338.40 |
$64.28
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$10,243.02 |
$10,243.02 |
$10,422.72 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$67.74 |
$67.74 |
$70.74 |
$82.43
|
|
Support clav 29.6-40.5in med
|
$907.15 |
$907.15 |
$907.15 |
$94.19
|
|
Surg dx exam anorectal
|
$3,625.20 |
$3,625.20 |
$3,625.20 |
$3,245.23
|
|
Surgical pathology level 1 gross examination only
|
$37.20 |
$37.20 |
$37.20 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$52.80 |
$52.80 |
$19,670.76 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$97.80 |
$97.80 |
$97.80 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$11,683.88 |
$11,683.88 |
$14,923.61 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$456.00 |
$456.00 |
$456.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$96.60 |
$96.60 |
$96.60 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$298.20 |
$298.20 |
$298.20 |
$35.70
|
|
Susceptibility mic per plate
|
$321.60 |
$321.60 |
$321.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$63.60 |
$63.60 |
$63.60 |
$59.28
|
|
Suspension of testis
|
$12,746.76 |
$12,746.76 |
$12,746.76 |
$4,061.71
|
|
Suspension sleeve lower ext
|
$380.64 |
$380.64 |
$380.64 |
$251.38
|
|
Svc venogram s&i
|
$2,668.20 |
$2,668.20 |
$2,668.20 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$85.20 |
$85.20 |
$85.20 |
$125.40
|
|
Synvisc or synvisc-one
|
$7,149.42 |
$7,149.42 |
$7,149.42 |
$1,274.94
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$49.80 |
$49.80 |
$49.80 |
$41.60
|
|
System cardiomems hosp electronics
|
$75,499.92 |
$75,499.92 |
$75,499.92 |
$39,037.95
|
|
System pacing micra av
|
$66,360.46 |
$66,360.46 |
$66,360.46 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$32,063.62 |
$32,063.62 |
$32,063.62 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$18,041.51 |
$18,041.51 |
$18,041.51 |
$11,183.00
|
|
T3 (triiodothyronine) free
|
$37.20 |
$37.20 |
$37.20 |
$99.20
|
|
T3 (triiodothyronine) total
|
$36.00 |
$36.00 |
$36.00 |
$93.52
|
|
T4 (thyroxine) free
|
$65.40 |
$65.40 |
$65.40 |
$85.20
|
|
T4 (thyroxine) total
|
$88.80 |
$88.80 |
$88.80 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.50 |
$4.50 |
$9.84 |
$9.84
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,377.18 |
$1,377.18 |
$1,438.38 |
$601.95
|
|
Tacrolimus therapeutic drug level
|
$48.60 |
$48.60 |
$48.60 |
$122.40
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$7,118.94 |
$7,118.94 |
$7,118.94 |
$2,762.00
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$58,920.48 |
$58,920.48 |
$58,920.48 |
$21,745.13
|
|
Talymed
|
$3,411.49 |
$3,411.49 |
$3,411.49 |
$3,411.49
|
|
Tap block bilat cont infusion 64489
|
$1,639.80 |
$1,639.80 |
$1,639.80 |
$1,407.60
|
|
Tap block uni by cont infusion 64487
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$869.40
|
|
Target gsa panel hmtlmph neop
|
$2,570.40 |
$2,570.40 |
$2,570.40 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$4,598.40 |
$4,598.40 |
$4,598.40 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$1,655.52
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$76,500.00 |
$76,500.00 |
$76,500.00 |
$24,217.20
|
|
Tavr perq femoral
|
$21,976.80 |
$21,976.80 |
$21,976.80 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$2,051.46 |
$2,051.46 |
$2,087.40 |
$937.50
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$130.20 |
$130.20 |
$130.20 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$181.80 |
$181.80 |
$181.80 |
$177.65
|
|
Tc-99m bicisate
|
$30.00 |
$30.00 |
$30.00 |
$1,969.45
|
|
Tc-99m mebrofenin
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$157.65
|
|
Tc-99m medronate
|
$190.20 |
$190.20 |
$190.20 |
$111.01
|
|
Tc-99m mertiatide
|
$1,371.60 |
$1,371.60 |
$1,371.60 |
$756.00
|
|
Tc-99m oxidronate
|
$1,031.10 |
$1,031.10 |
$1,031.10 |
$105.60
|
|
Tc-99m sestamibi p study dose
|
$1,032.30 |
$1,032.30 |
$1,032.30 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$2,608.20 |
$2,608.20 |
$2,608.20 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$1,623.00 |
$1,623.00 |
$1,623.00 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$649.20 |
$649.20 |
$649.20 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$1,122.48 |
$1,122.48 |
$1,122.48 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$68.40 |
$68.40 |
$68.40 |
$176.40
|
|
T cells absolute cd 4 count
|
$88.20 |
$88.20 |
$88.20 |
$111.20
|
|
T cells total count
|
$68.40 |
$68.40 |
$68.40 |
$126.90
|
|
Telethx isodose plan cplx
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$1,526.85
|
|
Telethx isodose plan simple
|
$807.00 |
$807.00 |
$807.00 |
$873.62
|
|
Temozolomide 100 mg intravenous solution
|
$5,115.90 |
$5,115.90 |
$5,115.90 |
$1,867.28
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$10,201.68 |
$10,201.68 |
$10,201.68 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$42,564.96 |
$42,564.96 |
$43,311.72 |
$15,245.38
|
|
Tenosynovectomy radic 26145
|
$8,908.26 |
$8,908.26 |
$8,908.26 |
$1,893.86
|
|
Tenotomy open tndn flxr toe sgl tndn spx
|
$17,457.72 |
$17,457.72 |
$17,457.72 |
$2,139.67
|
|
Tension based scoliosis orth
|
$7,573.03 |
$7,573.03 |
$7,573.03 |
$3,528.00
|
