|
Sodium chloride 0.9 % intravenous solution
|
$18.20 |
$18.20 |
$18.20 |
$48.11
|
|
Sodium serum/plasma/whole blood
|
$25.60 |
$25.60 |
$25.60 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$316.80 |
$316.80 |
$316.80 |
$177.52
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,758.40 |
$1,758.40 |
$1,758.40 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$841.60 |
$841.60 |
$841.60 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$552.00 |
$552.00 |
$552.00 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$67.20 |
$67.20 |
$67.20 |
$68.25
|
|
Splint finger frog med
|
$79.20 |
$79.20 |
$79.20 |
$38.08
|
|
Splint func pos polyflex ii med
|
$13.60 |
$13.60 |
$13.60 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$102.40 |
$102.40 |
$102.40 |
$99.04
|
|
Split blood or products
|
$653.60 |
$653.60 |
$653.60 |
$127.48
|
|
Srs linear based
|
$2,193.60 |
$2,193.60 |
$2,193.60 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$383.20 |
$383.20 |
$383.20 |
$297.60
|
|
Staph a dna amp probe
|
$175.20 |
$175.20 |
$175.20 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$424.80 |
$424.80 |
$424.80 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$12,508.65 |
$12,508.65 |
$12,508.65 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$488.32 |
$488.32 |
$488.32 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$20,962.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$15,972.00 |
$15,972.00 |
$15,972.00 |
$14,356.50
|
|
Sterile water/saline, 10 ml
|
$36.80 |
$36.80 |
$36.80 |
$13.32
|
|
St evaluate speech sound production
|
$380.00 |
$380.00 |
$380.00 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$380.00 |
$380.00 |
$380.00 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$429.60 |
$429.60 |
$429.60 |
$399.60
|
|
St evaluation swallow function
|
$380.00 |
$380.00 |
$380.00 |
$314.40
|
|
Strapping of toes 29550
|
$116.80 |
$116.80 |
$116.80 |
$164.70
|
|
Stress test pulmonary
|
$455.20 |
$455.20 |
$455.20 |
$322.85
|
|
St treatment speech individual
|
$304.80 |
$304.80 |
$304.80 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$296.80 |
$296.80 |
$296.80 |
$240.31
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$25.20 |
$25.20 |
$25.20 |
$82.43
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$5.60 |
$5.60 |
$5.60 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$126.40 |
$126.40 |
$126.40 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$126.40 |
$126.40 |
$126.40 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$252.80 |
$252.80 |
$252.80 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$218.40 |
$218.40 |
$218.40 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$718.00
|
|
Susceptibility enzyme detection per enzyme
|
$20.00 |
$20.00 |
$20.00 |
$35.70
|
|
Susceptibility mic per plate
|
$52.80 |
$52.80 |
$52.80 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$27.20 |
$27.20 |
$27.20 |
$59.28
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$18.40 |
$18.40 |
$18.40 |
$41.60
|
|
System pacing micra av
|
$16,130.40 |
$16,130.40 |
$16,130.40 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$4,620.00 |
$4,620.00 |
$4,620.00 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$70.40 |
$70.40 |
$70.40 |
$99.20
|
|
T3 (triiodothyronine) total
|
$59.20 |
$59.20 |
$59.20 |
$93.52
|
|
T4 (thyroxine) free
|
$35.00 |
$35.00 |
$35.00 |
$85.20
|
|
T4 (thyroxine) total
|
$28.00 |
$28.00 |
$28.00 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$2.20 |
$2.20 |
$2.20 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$50.00 |
$50.00 |
$50.00 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$2,246.30
|
|
Target gsa panel organ neop
|
$2,392.00 |
$2,392.00 |
$2,392.00 |
$1,655.52
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$327.60 |
$327.60 |
$327.60 |
$937.50
|
|
Tbs techl calculation only
|
$398.40 |
$398.40 |
$398.40 |
$153.60
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$309.60 |
$309.60 |
$309.60 |
$177.65
|
|
Tc-99m labeled rbc
|
$363.20 |
$363.20 |
$363.20 |
$302.40
|
|
Tc-99m maa
|
$320.80 |
$320.80 |
$320.80 |
$292.80
|
|
Tc-99m mebrofenin
|
$94.40 |
$94.40 |
$94.40 |
$157.65
|
|
Tc-99m medronate
|
$52.80 |
$52.80 |
$52.80 |
$111.01
|
|
Tc-99m mertiatide
|
$824.80 |
$824.80 |
$824.80 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$17.60 |
$17.60 |
$17.60 |
$6.60
|
|
Tc-99m oxidronate
|
$115.20 |
$115.20 |
$115.20 |
$105.60
|
|
Tc-99m pentetate dtpa
|
$273.60 |
$273.60 |
$273.60 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$321.60 |
$321.60 |
$321.60 |
$190.80
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$294.40 |
$294.40 |
$294.40 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$94.40 |
$94.40 |
$94.40 |
$274.45
|
|
Tc-99m sulfur colloid
|
$324.80 |
$324.80 |
$324.80 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$739.20 |
$739.20 |
$739.20 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$3,187.20 |
$3,187.20 |
$3,187.20 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$195.20 |
$195.20 |
$195.20 |
$176.40
|
|
T cells absolute cd 4 count
|
$111.20 |
$111.20 |
$111.20 |
$111.20
|
|
T cells total count
|
$157.60 |
$157.60 |
$157.60 |
$126.90
|
|
Telehealth original site facility fee
|
$42.40 |
$42.40 |
$42.40 |
$51.00
|
|
Telethx isodose plan cplx
|
$1,484.00 |
$1,484.00 |
$1,484.00 |
$1,526.85
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$26,651.20 |
$26,651.20 |
$26,651.20 |
$15,245.38
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$5.20 |
$5.20 |
$5.20 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,102.40 |
$1,102.40 |
$1,102.40 |
$949.70
|
|
Tetanus immune globulin inj
|
$1,468.40 |
$1,468.40 |
$1,468.40 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$59.20 |
$59.20 |
$59.20 |
$108.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$31.80 |
$31.80 |
$31.80 |
$25.54
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$2,428.00 |
$2,428.00 |
$2,428.00 |
$1,687.50
|
|
Thrombectomy/inf pq dialysis circuit
|
$10,528.00 |
$10,528.00 |
$10,528.00 |
$8,084.00
|
|
Thrombectomy/inf pq dialysis circuit w/pta
|
$47,355.20 |
$47,355.20 |
$47,355.20 |
$14,277.20
|
|
Thrombectomy/inf pq dialysis circuit w/stent plcmnt
|
$33,167.20 |
$33,167.20 |
$33,167.20 |
$21,413.60
|
|
Thrombin time
|
$40.80 |
$40.80 |
$40.80 |
$53.76
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$30.40 |
$30.40 |
$30.40 |
$61.52
|
|
Thyroglobulin antibody
|
$66.40 |
$66.40 |
$66.40 |
$82.00
|
|
Thyroid mets imag whole body
|
$2,225.60 |
$2,225.60 |
$2,225.60 |
$1,524.99
|
|
Thyroid (TSH) Test
|
$40.00 |
$40.00 |
$40.00 |
$111.00
|
|
Thyroid Ultrasound
|
$635.20 |
$635.20 |
$635.20 |
$588.50
|
|
Thyroxine binding globulin (tbg)
|
$61.60 |
$61.60 |
$61.60 |
$64.35
|
|
Tissue culture skin/biopsy
|
$591.20 |
$591.20 |
$591.20 |
$484.00
|
|
Tissue exam koh skin/hair/nails
|
$17.60 |
$17.60 |
$17.60 |
$47.20
|
|
Tissue transglutaminase iga
|
$57.60 |
$57.60 |
$57.60 |
$44.16
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$174.00 |
$174.00 |
$174.00 |
$152.36
|
|
Tobramycin peak therapeutic drug level
|
$67.20 |
$67.20 |
$67.20 |
$120.60
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$6,214.80 |
$6,214.80 |
$6,214.80 |
$5,258.52
|
|
Tomosynthesis breast screen bilateral
|
$157.60 |
$157.60 |
$157.60 |
$72.68
|
|
Total tau
|
$1,120.80 |
$1,120.80 |
$1,120.80 |
$312.50
|
|
Toxoplasma antibody igg
|
$60.00 |
$60.00 |
$60.00 |
$89.40
|
|
Toxoplasma antibody igm
|
$60.00 |
$60.00 |
$60.00 |
$87.00
|
|
Tracheobrnchsc thru est trachs incisn
|
$1,532.00 |
$1,532.00 |
$1,532.00 |
$1,420.44
|
