|
Sodium chloride 3 % ivpb
|
$26.40 |
$26.40 |
$26.40 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$147.60 |
$147.60 |
$147.60 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$39.60 |
$39.60 |
$39.60 |
$46.26
|
|
Specific gravity body fluid
|
$42.60 |
$42.60 |
$42.60 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$310.20 |
$310.20 |
$310.20 |
$384.80
|
|
Speech evaluation complex
|
$971.40 |
$971.40 |
$971.40 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$180.00 |
$180.00 |
$180.00 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$309.60 |
$309.60 |
$309.60 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$542.40 |
$542.40 |
$542.40 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$108.00 |
$108.00 |
$108.00 |
$71.44
|
|
Splint rstrc wrst/cmc right med
|
$122.40 |
$122.40 |
$122.40 |
$99.04
|
|
Sr-89 stront chlor ther / mci
|
$2,293.20 |
$2,293.20 |
$2,293.20 |
$2,515.15
|
|
St analysis behavior qualitative voice/resonance
|
$310.20 |
$310.20 |
$310.20 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$392.40 |
$392.40 |
$392.40 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$8,935.20 |
$8,935.20 |
$8,935.20 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$477.60 |
$477.60 |
$477.60 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$6,513.00 |
$6,513.00 |
$6,513.00 |
$20,962.50
|
|
Sterile needle
|
$394.20 |
$394.20 |
$394.20 |
$190.13
|
|
Sterile water/saline, 10 ml
|
$51.20 |
$51.20 |
$51.20 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$3.60 |
$3.60 |
$3.60 |
$28.11
|
|
St evaluate speech sound production
|
$310.20 |
$310.20 |
$310.20 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$249.60 |
$249.60 |
$249.60 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,510.20 |
$1,510.20 |
$1,510.20 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$315.60 |
$315.60 |
$315.60 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$471.00 |
$471.00 |
$471.00 |
$157.46
|
|
Strapping of knee
|
$243.60 |
$243.60 |
$243.60 |
$205.20
|
|
Strep a ag ia
|
$76.80 |
$76.80 |
$76.80 |
$75.40
|
|
Strep b dna amp probe
|
$107.40 |
$107.40 |
$107.40 |
$124.15
|
|
Stress tte complete
|
$1,989.60 |
$1,989.60 |
$1,989.60 |
$1,900.96
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$73.20 |
$73.20 |
$73.20 |
$54.80
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.40 |
$0.40 |
$0.40 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$148.00 |
$148.00 |
$148.00 |
$129.89
|
|
Supp non-insulin inf cath/wk
|
$55.20 |
$55.20 |
$55.20 |
$8.45
|
|
Support clav 29.6-40.5in med
|
$180.60 |
$180.60 |
$180.60 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$48.00 |
$48.00 |
$48.00 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$189.00 |
$189.00 |
$189.00 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$212.40 |
$212.40 |
$212.40 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$250.20 |
$250.20 |
$250.20 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$408.00 |
$408.00 |
$408.00 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$619.20 |
$619.20 |
$619.20 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$91.80 |
$91.80 |
$91.80 |
$45.60
|
|
Susceptibility enzyme detection per enzyme
|
$16.80 |
$16.80 |
$16.80 |
$35.89
|
|
Susceptibility mic per plate
|
$187.80 |
$187.80 |
$187.80 |
$106.00
|
|
Swallowing Evaluation (Bedside)
|
$249.60 |
$249.60 |
$249.60 |
$316.80
|
|
Swallowing Therapy Session
|
$179.40 |
$179.40 |
$179.40 |
$232.56
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$76.80 |
$76.80 |
$76.80 |
$42.24
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$6,970.20 |
$6,970.20 |
$6,970.20 |
$12,003.00
|
|
T3 (triiodothyronine) free
|
$137.40 |
$137.40 |
$137.40 |
$100.32
|
|
T3 (triiodothyronine) total
|
$222.60 |
$222.60 |
$222.60 |
$93.52
|
|
T4 (thyroxine) free
|
$300.00 |
$300.00 |
$300.00 |
$89.60
|
|
T4 (thyroxine) total
|
$82.80 |
$82.80 |
$82.80 |
$70.20
|
|
Tacrol envarsus ex rel oral
|
$3.40 |
$3.40 |
$3.40 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$27.60 |
$27.60 |
$27.60 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,588.00 |
$1,588.00 |
$1,588.00 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$276.00 |
$276.00 |
$276.00 |
$122.50
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$387.60 |
$387.60 |
$387.60 |
$289.20
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$14.80 |
$14.80 |
$14.80 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$2,947.80 |
$2,947.80 |
$2,947.80 |
$2,246.30
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$797.40 |
$797.40 |
$797.40 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$209.40 |
$209.40 |
$209.40 |
$179.95
|
|
Tc-99m apcitide diag
|
$1,761.60 |
$1,761.60 |
$1,761.60 |
$1,181.70
|
|
Tc-99m arcitumomab
|
$2,781.60 |
$2,781.60 |
$2,781.60 |
$2,085.68
|
|
Tc-99m bicisate
|
$697.80 |
$697.80 |
$697.80 |
$2,070.00
|
|
Tc-99m depreotide
|
$209.40 |
$209.40 |
$209.40 |
$1,486.80
|
|
Tc-99m disofenin
|
$59.40 |
$59.40 |
$59.40 |
$124.32
|
|
Tc-99m fanolesomab diag
|
$3,894.60 |
$3,894.60 |
$3,894.60 |
$2,115.12
|
|
Tc-99m labeled rbc
|
$147.00 |
$147.00 |
$147.00 |
$306.00
|
|
Tc-99m maa
|
$133.80 |
$133.80 |
$133.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$292.20 |
$292.20 |
$292.20 |
$157.65
|
|
Tc-99m medronate
|
$39.60 |
$39.60 |
$39.60 |
$111.01
|
|
Tc-99m mertiatide
|
$709.20 |
$709.20 |
$709.20 |
$756.00
|
|
Tc-99m non-heu per study dose
|
$19.20 |
$19.20 |
$19.20 |
$8.00
|
|
Tc-99m oxidronate
|
$44.40 |
$44.40 |
$44.40 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$55.80 |
$55.80 |
$55.80 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$196.20 |
$196.20 |
$196.20 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$59.40 |
$59.40 |
$59.40 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$126.00 |
$126.00 |
$126.00 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$237.60 |
$237.60 |
$237.60 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$556.20 |
$556.20 |
$556.20 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$158.40 |
$158.40 |
$158.40 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$511.20 |
$511.20 |
$511.20 |
$193.28
|
|
T cells absolute cd4/cd8 including ratio
|
$112.80 |
$112.80 |
$112.80 |
$184.00
|
|
T cells absolute cd 4 count
|
$144.00 |
$144.00 |
$144.00 |
$111.20
|
|
T cells total count
|
$112.80 |
$112.80 |
$112.80 |
$130.20
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$8,196.60 |
$8,196.60 |
$8,196.60 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$27,148.20 |
$27,148.20 |
$27,148.20 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$111.20 |
$111.20 |
$111.20 |
$39.33
|
|
Test for chlorohydrocarbons
|
$85.20 |
$85.20 |
$85.20 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$1,618.20 |
$1,618.20 |
$1,618.20 |
$953.40
|
|
Tetanus immune globulin inj
|
$2,306.40 |
$2,306.40 |
$2,306.40 |
$1,285.36
|
|
Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe
|
$48.80 |
$48.80 |
$48.80 |
$8,737.05
|
|
Theophylline therapeutic drug level
|
$163.80 |
$163.80 |
$163.80 |
$108.00
|
|
Therapy Activity Training (each 15 minutes)
|
$130.20 |
$130.20 |
$130.20 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$130.20 |
$130.20 |
$130.20 |
$98.58
|
|
Ther nma rdctj intus/obstrcj
|
$1,384.80 |
$1,384.80 |
$1,384.80 |
$538.88
|
|
Ther/proph/diag inj ia
|
$378.00 |
$378.00 |
$378.00 |
$247.33
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$42.60 |
$42.60 |
$42.60 |
$25.54
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$599.40 |
$599.40 |
$599.40 |
$313.60
|
