|
Sodium 24 hour urine
|
$40.10 |
$40.10 |
$40.10 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$46.35 |
$46.35 |
$46.35 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$42.25
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$13.67 |
$13.67 |
$13.67 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$64.82 |
$64.82 |
$64.82 |
$42.43
|
|
Specific gravity body fluid
|
$29.67 |
$29.67 |
$29.67 |
$21.55
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$869.79 |
$869.79 |
$869.79 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$536.34 |
$536.34 |
$536.34 |
$526.80
|
|
Sputum specimen collection
|
$101.01 |
$101.01 |
$101.01 |
$180.00
|
|
Staph a dna amp probe
|
$94.53 |
$94.53 |
$94.53 |
$116.39
|
|
St evaluate speech sound production comprehensive/expressive
|
$141.20 |
$141.20 |
$141.20 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$154.22 |
$154.22 |
$154.22 |
$336.00
|
|
St evaluation swallow function
|
$146.93 |
$146.93 |
$146.93 |
$323.72
|
|
Stress test pulmonary
|
$118.40 |
$118.40 |
$118.40 |
$330.63
|
|
St treatment speech individual
|
$73.11 |
$73.11 |
$73.11 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$107.12 |
$107.12 |
$107.12 |
$221.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$5.33 |
$5.33 |
$5.33 |
$22.19
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$23.64 |
$23.64 |
$23.64 |
$52.49
|
|
Surg dx exam anorectal
|
$2,363.76 |
$2,363.76 |
$2,363.76 |
$2,814.85
|
|
Surgical pathology level 1 gross examination only
|
$30.20 |
$30.20 |
$30.20 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$65.42 |
$65.42 |
$65.42 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$104.06 |
$104.06 |
$104.06 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$112.20 |
$112.20 |
$112.20 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$161.76 |
$161.76 |
$161.76 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$368.46 |
$368.46 |
$368.46 |
$720.75
|
|
Susceptibility enzyme detection per enzyme
|
$46.89 |
$46.89 |
$46.89 |
$31.85
|
|
Susceptibility mic per plate
|
$107.91 |
$107.91 |
$107.91 |
$89.70
|
|
Suscept studies macrobroth dilution ea
|
$67.58 |
$67.58 |
$67.58 |
$47.17
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$118.29 |
$118.29 |
$118.29 |
$45.70
|
|
T3 (triiodothyronine) free
|
$82.88 |
$82.88 |
$82.88 |
$91.20
|
|
T3 (triiodothyronine) total
|
$52.46 |
$52.46 |
$52.46 |
$88.00
|
|
T4 (thyroxine) free
|
$161.18 |
$161.18 |
$161.18 |
$65.00
|
|
T4 (thyroxine) total
|
$44.97 |
$44.97 |
$44.97 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$173.70 |
$173.70 |
$173.70 |
$137.15
|
|
Target gsa panel hmtlmph neop
|
$4,117.83 |
$4,117.83 |
$4,117.83 |
$1,928.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1.79 |
$1.79 |
$1.79 |
$760.95
|
|
Tbs techl calculation only
|
$129.47 |
$129.47 |
$129.47 |
$119.66
|
|
Tbs techl prep&transmis data
|
$129.47 |
$129.47 |
$129.47 |
$105.08
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$166.46 |
$166.46 |
$166.46 |
$178.40
|
|
Tc-99m exame autol wbc diag per dose
|
$3,612.03 |
$3,612.03 |
$3,612.03 |
$2,393.40
|
|
Tc-99m labeled rbc
|
$298.40 |
$298.40 |
$298.40 |
$312.70
|
|
Tc-99m maa
|
$267.74 |
$267.74 |
$267.74 |
$306.60
|
|
Tc-99m mebrofenin
|
$99.54 |
$99.54 |
$99.54 |
$169.53
|
|
Tc-99m medronate
|
$39.08 |
$39.08 |
$39.08 |
$120.35
|
|
Tc-99m mertiatide
|
$554.84 |
$554.84 |
$554.84 |
$757.25
|
|
Tc-99m pentetate dtpa
|
$161.51 |
$161.51 |
$161.51 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$181.37 |
$181.37 |
$181.37 |
$231.60
|
|
Tc-99m pertechnetate per mci
|
$49.20 |
$49.20 |
$49.20 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$77.01 |
$77.01 |
$77.01 |
$137.01
|
|
Tc-99m sestamibi p study dose
|
$251.54 |
$251.54 |
$251.54 |
$221.60
|
|
Tc-99m sulfur colloid
|
$229.62 |
$229.62 |
$229.62 |
$240.50
|
|
Tc-99m tilmanocept diag
|
$1,108.52 |
$1,108.52 |
$1,108.52 |
$1,007.79
|
|
T cells absolute cd4/cd8 including ratio
|
$255.24 |
$255.24 |
$255.24 |
$189.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$213.27 |
$213.27 |
$213.27 |
$16,233.59
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$8.60 |
$8.60 |
$8.60 |
$39.33
|
|
Test for chlorohydrocarbons
|
$254.81 |
$254.81 |
$254.81 |
$71.04
|
|
Testicular imaging w/vasc flow
|
$329.15 |
$329.15 |
$329.15 |
$586.96
|
|
Test pathogen(s) for platelets reference
|
$146.37 |
$146.37 |
$146.37 |
$52.00
|
|
Test stress cardiovascular tracing only
|
$713.27 |
$713.27 |
$713.27 |
$1,016.00
|
|
Tetanus immune globulin inj
|
$1,395.20 |
$1,395.20 |
$1,395.20 |
$1,073.02
|
|
Theophylline therapeutic drug level
|
$107.94 |
$107.94 |
$107.94 |
$101.40
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$28.62 |
$28.62 |
$28.62 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$9.54 |
$9.54 |
$9.54 |
$25.80
|
|
Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides)
|
$633.65 |
$633.65 |
$633.65 |
$1,658.70
|
|
Thrombin time
|
$58.52 |
$58.52 |
$58.52 |
$53.50
|
|
Thromboplastin time partial (ptt) substitution fractions each
|
$61.52 |
$61.52 |
$61.52 |
$56.93
|
|
Thyroglobulin antibody
|
$69.42 |
$69.42 |
$69.42 |
$86.40
|
|
Thyroid imaging
|
$370.16 |
$370.16 |
$370.16 |
$577.80
|
|
Thyroid (TSH) Test
|
$74.27 |
$74.27 |
$74.27 |
$101.40
|
|
Thyroid Ultrasound
|
$289.52 |
$289.52 |
$289.52 |
$553.80
|
|
Thyroxine binding globulin (tbg)
|
$90.36 |
$90.36 |
$90.36 |
$75.00
|
|
Tissue exam koh skin/hair/nails
|
$45.23 |
$45.23 |
$45.23 |
$45.23
|
|
Tissue transglutaminase iga
|
$21.09 |
$21.09 |
$21.09 |
$48.57
|
|
Tl-201 thallium diag per mci
|
$209.88 |
$209.88 |
$209.88 |
$78.40
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$7.08 |
$7.08 |
$7.08 |
$72.00
|
|
Tobramycin peak therapeutic drug level
|
$149.93 |
$149.93 |
$149.93 |
$117.00
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$14.28 |
$14.28 |
$14.28 |
$2,743.02
|
|
Tomosynthesis breast diagnostic left
|
$34.07 |
$34.07 |
$34.07 |
$53.92
|
|
Tomosynthesis breast screen bilateral
|
$32.45 |
$32.45 |
$32.45 |
$77.46
|
|
Toxoplasma antibody igg
|
$51.12 |
$51.12 |
$51.12 |
$83.20
|
|
Toxoplasma antibody igm
|
$71.34 |
$71.34 |
$71.34 |
$85.80
|
|
Transabdom amnioinfus w/us
|
$496.26 |
$496.26 |
$496.26 |
$672.00
|
|
Transferrin
|
$92.46 |
$92.46 |
$92.46 |
$83.07
|
|
Transfusion blood/blood component(s)
|
$375.00 |
$375.00 |
$375.00 |
$988.24
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$114.54 |
$114.54 |
$114.54 |
$224.90
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$50.79 |
$50.79 |
$50.79 |
$140.04
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$128.94 |
$128.94 |
$128.94 |
$197.60
|
|
Treponema pallidum antibody
|
$119.52 |
$119.52 |
$119.52 |
$74.40
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$4.56 |
$4.56 |
$4.56 |
$28.90
|
|
Triglycerides
|
$42.81 |
$42.81 |
$42.81 |
$48.75
|
|
Troponin quantitative
|
$74.66 |
$74.66 |
$74.66 |
$112.80
|
|
Ultrasound abdomen aorta screening study aaa
|
$170.31 |
$170.31 |
$170.31 |
$394.20
|
|
Ultrasound breast complete
|
$346.94 |
$346.94 |
$346.94 |
$519.20
|
|
Ultrasound breast unilateral limited (both sides)
|
$330.39 |
$330.39 |
$330.39 |
$427.00
|
|
Ultrasound chest
|
$207.68 |
$207.68 |
$207.68 |
$430.10
|
|
Ultrasound doppler velocimetry fetal umbilical artery
|
$228.42 |
$228.42 |
$228.42 |
$340.03
|
|
Ultrasound elastography ea l target les
|
$178.70 |
$178.70 |
$178.70 |
$136.11
|
|
Ultrasound encephalogram
|
$190.37 |
$190.37 |
$190.37 |
$463.50
|
|
Ultrasound fetal biophysical profile without non-stress testing
|
$125.04 |
$125.04 |
$125.04 |
$428.68
|
