|
Sickling rbc
|
$25.81 |
$25.81 |
$25.81 |
$53.40
|
|
Sincalide 5 mcg solution for injection
|
$196.15 |
$196.15 |
$196.15 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$786.90 |
$786.90 |
$786.90 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$741.48 |
$741.48 |
$741.48 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$756.00 |
$756.00 |
$756.00 |
$1,151.00
|
|
Sirolimus, oral
|
$22.20 |
$22.20 |
$22.20 |
$19.16
|
|
Skin test unlisted antigen ea
|
$26.09 |
$26.09 |
$26.09 |
$43.80
|
|
Sling arm deluxe w/pad xs
|
$103.58 |
$103.58 |
$103.58 |
$37.80
|
|
Smear fluorescent and/or acid fast stain
|
$23.13 |
$23.13 |
$23.13 |
$50.70
|
|
Smear gram stain
|
$42.37 |
$42.37 |
$42.37 |
$48.00
|
|
Smear nasal eosinophil
|
$21.65 |
$21.65 |
$21.65 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$52.08 |
$52.08 |
$52.08 |
$60.00
|
|
Smear wet mount
|
$21.74 |
$21.74 |
$21.74 |
$56.13
|
|
Snrpn/ube3a gene
|
$479.34 |
$479.34 |
$479.34 |
$228.80
|
|
Sodium 24 hour urine
|
$47.18 |
$47.18 |
$47.18 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$48.58 |
$48.58 |
$48.58 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$48.71 |
$48.71 |
$48.71 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$24.18 |
$24.18 |
$24.18 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$17.39 |
$17.39 |
$17.39 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$9.45 |
$9.45 |
$9.45 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$24.88 |
$24.88 |
$24.88 |
$42.43
|
|
Somatosensory testing
|
$358.35 |
$358.35 |
$358.35 |
$827.45
|
|
Somatropin injection
|
$339.59 |
$339.59 |
$339.59 |
$339.59
|
|
Specific gravity body fluid
|
$14.99 |
$14.99 |
$14.99 |
$21.55
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$159.01 |
$159.01 |
$159.01 |
$526.80
|
|
Split blood or products
|
$65.12 |
$65.12 |
$65.12 |
$143.64
|
|
St analysis behavior qualitative voice/resonance
|
$64.57 |
$64.57 |
$64.57 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$106.28 |
$106.28 |
$106.28 |
$313.96
|
|
St evaluate speech sound production
|
$68.64 |
$68.64 |
$68.64 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$142.36 |
$142.36 |
$142.36 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$134.59 |
$134.59 |
$134.59 |
$336.00
|
|
St evaluation swallow function
|
$88.43 |
$88.43 |
$88.43 |
$323.72
|
|
Strapping of ankle and/or ft 29540
|
$89.36 |
$89.36 |
$89.36 |
$185.36
|
|
Strapping of chest
|
$111.37 |
$111.37 |
$111.37 |
$196.93
|
|
Strapping of elbow or wrist 29260
|
$176.31 |
$176.31 |
$176.31 |
$176.31
|
|
Strapping of hand or finger
|
$153.74 |
$153.74 |
$153.74 |
$197.63
|
|
Strapping of hip
|
$114.33 |
$114.33 |
$114.33 |
$164.70
|
|
Strapping of knee
|
$93.52 |
$93.52 |
$93.52 |
$216.34
|
|
Strapping of toes 29550
|
$78.90 |
$78.90 |
$78.90 |
$183.30
|
|
Streptomycin injection
|
$26.21 |
$26.21 |
$26.21 |
$26.21
|
|
Streptozocin injection
|
$459.11 |
$459.11 |
$459.11 |
$400.68
|
|
Stress test pulmonary
|
$135.61 |
$135.61 |
$135.61 |
$330.63
|
|
St treatment speech individual
|
$66.05 |
$66.05 |
$66.05 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$87.32 |
$87.32 |
$87.32 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$61.83 |
$61.83 |
$61.83 |
$22.19
|
|
Sugars single quant
|
$92.91 |
$92.91 |
$92.91 |
$64.28
|
|
Supprelin la implant
|
$25,852.66 |
$25,852.66 |
$25,852.66 |
$45,560.39
|
|
Surgical pathology level 1 gross examination only
|
$23.31 |
$23.31 |
$23.31 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$48.56 |
$48.56 |
$48.56 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$50.14 |
$50.14 |
$50.14 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$68.45 |
$68.45 |
$68.45 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$160.30 |
$160.30 |
$160.30 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$208.22 |
$208.22 |
$208.22 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$20.72 |
$20.72 |
$20.72 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$13.97 |
$13.97 |
$13.97 |
$31.85
|
|
Susceptibility mic per plate
|
$163.98 |
$163.98 |
$163.98 |
$89.70
|
|
Sweat collection by iontophoresis
|
$50.14 |
$50.14 |
$50.14 |
$100.20
|
|
Synvisc or synvisc-one
|
$1,242.63 |
$1,242.63 |
$1,242.63 |
$1,053.54
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$45.70 |
$45.70 |
$45.70 |
$45.70
|
|
T3 (triiodothyronine) free
|
$89.82 |
$89.82 |
$89.82 |
$91.20
|
|
T3 (triiodothyronine) total
|
$59.02 |
$59.02 |
$59.02 |
$88.00
|
|
T4 (thyroxine) free
|
$61.33 |
$61.33 |
$61.33 |
$65.00
|
|
T4 (thyroxine) total
|
$41.26 |
$41.26 |
$41.26 |
$62.40
|
|
Tacrol envarsus ex rel oral
|
$2.74 |
$2.74 |
$2.74 |
$3.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$1.36 |
$1.36 |
$1.36 |
$4.87
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$176.77 |
$176.77 |
$176.77 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$96.66 |
$96.66 |
$96.66 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$925.19 |
$925.19 |
$925.19 |
$1,928.40
|
|
Target gsa panel organ/hmtlmph neop
|
$1,259.70 |
$1,259.70 |
$1,259.70 |
$3,567.96
|
|
Target gsa panel organ neop
|
$1,426.07 |
$1,426.07 |
$1,426.07 |
$1,913.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$332.56 |
$332.56 |
$332.56 |
$760.95
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$85.93 |
$85.93 |
$85.93 |
$221.65
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$77.52 |
$77.52 |
$77.52 |
$178.40
|
|
T cells absolute cd4/cd8 including ratio
|
$185.28 |
$185.28 |
$185.28 |
$189.60
|
|
T cells absolute cd 4 count
|
$110.72 |
$110.72 |
$110.72 |
$120.25
|
|
T cells total count
|
$68.92 |
$68.92 |
$68.92 |
$126.90
|
|
Telavancin injection
|
$464.05 |
$464.05 |
$464.05 |
$2,428.05
|
|
Temozolomide
|
$427.46 |
$427.46 |
$427.46 |
$632.98
|
|
Temozolomide 100 mg intravenous solution
|
$29.19 |
$29.19 |
$29.19 |
$601.80
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$116.48 |
$116.48 |
$116.48 |
$116.48
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$7,570.16 |
$7,570.16 |
$7,570.16 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$9.71 |
$9.71 |
$9.71 |
$39.33
|
|
Test for urine cystines
|
$18.50 |
$18.50 |
$18.50 |
$23.20
|
|
Test stress cardiovascular tracing only
|
$365.84 |
$365.84 |
$365.84 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$404.61 |
$404.61 |
$404.61 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$60.77 |
$60.77 |
$60.77 |
$101.40
|
|
Therapeutic procd strg endur
|
$35.71 |
$35.71 |
$35.71 |
$72.39
|
|
Therapy activity per session >= 45 minutes
|
$210.44 |
$210.44 |
$210.44 |
$210.44
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$48.29 |
$48.29 |
$48.29 |
$50.40
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$26.64 |
$26.64 |
$26.64 |
$47.50
|
|
Ther nma rdctj intus/obstrcj
|
$254.19 |
$254.19 |
$254.19 |
$524.80
|
|
Ther/proph/diag inj ia
|
$221.54 |
$221.54 |
$221.54 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$11.68 |
$11.68 |
$11.68 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$967.18 |
$967.18 |
$967.18 |
$1,658.70
|
|
Thoracotomy with cardiac massage
|
$921.49 |
$921.49 |
$921.49 |
$2,313.88
|
|
Thrombin time
|
$42.83 |
$42.83 |
$42.83 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$34.60 |
$34.60 |
$34.60 |
$56.93
|
|
Thyroglobulin antibody
|
$56.89 |
$56.89 |
$56.89 |
$86.40
|
|
Thyroid (TSH) Test
|
$83.07 |
$83.07 |
$83.07 |
$101.40
|
|
Thyroid Ultrasound
|
$408.02 |
$408.02 |
$408.02 |
$553.80
|
