|
Sulfonylurea screen qn-sendout
|
$96.00 |
$96.00 |
$713.40 |
$160.05
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$19.00 |
$91.25 |
$1,840.28 |
$126.63
|
|
Support clav 29.6-40.5in med
|
$124.85 |
$124.85 |
$175.89 |
$94.08
|
|
Supprelin la implant
|
$93,838.08 |
$93,838.08 |
$93,838.08 |
$80,935.72
|
|
Surgical pathology level 1 gross examination only
|
$94.50 |
$110.02 |
$593.77 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$107.85 |
$124.00 |
$1,113.33 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$97.05 |
$154.50 |
$1,260.15 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$185.00 |
$474.00 |
$1,958.81 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$214.50 |
$330.45 |
$2,986.61 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$244.00 |
$490.20 |
$3,396.44 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$54.62 |
$177.75 |
$188.00 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$46.05 |
$88.04 |
$188.00 |
$35.75
|
|
Susceptibility mic per plate
|
$146.66 |
$188.00 |
$856.79 |
$105.75
|
|
Suscept studies macrobroth dilution ea
|
$35.50 |
$35.50 |
$203.31 |
$59.28
|
|
Svc venogram s&i
|
$1,633.50 |
$1,749.50 |
$5,125.51 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$324.00 |
$324.00 |
$1,672.05 |
$316.55
|
|
Swallowing Therapy Session
|
$216.50 |
$216.50 |
$812.40 |
$240.31
|
|
Sweat collection by iontophoresis
|
$1,413.44 |
$1,413.44 |
$1,413.44 |
$123.78
|
|
Synvisc or synvisc-one
|
$1,232.66 |
$1,232.66 |
$2,711.85 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$69.79 |
$97.00 |
$136.35 |
$41.60
|
|
System cardiomems hosp electronics
|
$30,006.00 |
$30,006.00 |
$45,886.50 |
$38,234.70
|
|
System pacing micra av
|
$32,426.46 |
$32,426.46 |
$34,155.00 |
$24,293.25
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$8,861.20 |
$8,861.20 |
$12,003.00 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$4,640.62 |
$4,640.62 |
$14,020.88 |
$11,183.00
|
|
System sealant biosentry tract
|
$300.00 |
$300.00 |
$1,023.33 |
$889.35
|
|
T3 (triiodothyronine) free
|
$175.79 |
$188.00 |
$2,115.31 |
$100.32
|
|
T3 (triiodothyronine) total
|
$141.20 |
$208.00 |
$1,292.42 |
$93.52
|
|
T4 (thyroxine) free
|
$128.73 |
$188.00 |
$1,266.60 |
$88.44
|
|
T4 (thyroxine) total
|
$102.22 |
$206.73 |
$1,131.08 |
$69.58
|
|
Tacrol envarsus ex rel oral
|
$10.86 |
$32.80 |
$60.12 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$7.00 |
$9.78 |
$43.10 |
$9.93
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$534.82 |
$668.52 |
$2,813.12 |
$596.76
|
|
Tacrolimus therapeutic drug level
|
$209.24 |
$479.00 |
$1,932.98 |
$122.50
|
|
Tafasitamab-cxix 200 mg intravenous solution
|
$2,456.76 |
$2,456.76 |
$2,456.76 |
$2,762.00
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$278.57 |
$353.00 |
$877.92 |
$289.90
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$87.66 |
$87.66 |
$87.66 |
$14.62
|
|
Target gsa panel hmtlmph neop
|
$2,014.80 |
$2,014.80 |
$8,967.00 |
$2,246.30
|
|
Target gsa panel organ/hmtlmph neop
|
$1,496.50 |
$1,496.50 |
$7,560.00 |
$3,746.70
|
|
Target gsa panel organ neop
|
$1,376.50 |
$1,376.50 |
$5,238.75 |
$1,681.28
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$27,030.00 |
$27,030.00 |
$27,030.00 |
$24,217.20
|
|
Tas congenital car anomal
|
$7,684.33 |
$7,684.33 |
$36,085.59 |
$6,003.27
|
|
Tavr perq femoral
|
$14,593.50 |
$32,560.45 |
$74,639.72 |
$15,454.40
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$743.87 |
$743.87 |
$863.75 |
$937.50
|
|
Tbs techl calculation only
|
$89.50 |
$89.50 |
$99.13 |
$153.60
|
|
Tbs techl prep&transmis data
|
$99.13 |
$99.13 |
$99.13 |
$119.66
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$45.00 |
$184.80 |
$1,185.92 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$139.00 |
$220.37 |
$1,871.67 |
$180.80
|
|
Tc-99m bicisate
|
$2,270.12 |
$2,270.12 |
$2,270.12 |
$2,070.00
|
|
Tc-99m exame autol wbc diag per dose
|
$2,431.95 |
$2,431.95 |
$4,920.00 |
$2,503.15
|
|
Tc-99m exametazime diag
|
$3,619.50 |
$3,619.50 |
$3,910.39 |
$2,135.70
|
|
Tc-99m fanolesomab diag
|
$21,150.06 |
$21,150.06 |
$21,150.06 |
$2,115.12
|
|
Tc-99m gluceptate
|
$201.84 |
$201.84 |
$201.84 |
$31.35
|
|
Tc-99m graphite crucible
|
$698.87 |
$698.87 |
$698.87 |
$742.50
|
|
Tc-99m labeled rbc
|
$306.00 |
$453.87 |
$866.13 |
$306.00
|
|
Tc-99m maa
|
$74.55 |
$430.00 |
$477.82 |
$312.06
|
|
Tc-99m mebrofenin
|
$202.80 |
$232.87 |
$594.03 |
$157.65
|
|
Tc-99m medronate
|
$41.70 |
$202.87 |
$259.32 |
$111.01
|
|
Tc-99m mertiatide
|
$315.55 |
$776.75 |
$776.75 |
$756.00
|
|
Tc-99m oxidronate
|
$74.55 |
$74.55 |
$199.75 |
$108.00
|
|
Tc-99m pentetate dtpa
|
$327.87 |
$327.87 |
$1,047.54 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$139.65 |
$139.65 |
$1,047.54 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$33.21 |
$33.21 |
$176.87 |
$18.67
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$178.50 |
$178.50 |
$186.51 |
$141.00
|
|
Tc-99m sestamibi p study dose
|
$109.62 |
$249.75 |
$1,406.51 |
$287.20
|
|
Tc-99m succimer (dmsa)
|
$1,475.50 |
$1,475.50 |
$2,970.00 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$186.51 |
$205.55 |
$347.10 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$214.37 |
$366.60 |
$788.20 |
$193.28
|
|
Tc-99m tilmanocept diag
|
$1,166.70 |
$1,166.70 |
$1,257.12 |
$985.60
|
|
Tcd emboli detect w/inj
|
$122.00 |
$122.00 |
$640.22 |
$475.80
|
|
Tcd emboli detect without inj
|
$122.00 |
$363.60 |
$765.87 |
$475.28
|
|
Tcd vasoreactivity study
|
$566.88 |
$566.88 |
$566.88 |
$566.88
|
|
T cells absolute cd4/cd8 including ratio
|
$75.00 |
$228.43 |
$1,126.24 |
$185.28
|
|
T cells absolute cd 4 count
|
$26.50 |
$107.10 |
$613.14 |
$111.20
|
|
T cells total count
|
$45.00 |
$123.00 |
$1,778.08 |
$130.35
|
|
Teaec w/wo patch graft iliofemoral
|
$1,344.96 |
$1,344.96 |
$1,344.96 |
$6,120.00
|
|
Team conf without pat by hc pro
|
$141.89 |
$141.89 |
$141.89 |
$110.62
|
|
Team conf w/pat by hc prof
|
$113.83 |
$113.83 |
$113.83 |
$104.59
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$40,114.80 |
$40,114.80 |
$40,114.80 |
$40,114.80
|
|
Tee w or without fol w/cont, mon
|
$7,790.70 |
$7,790.70 |
$7,790.70 |
$1,692.44
|
|
Telavancin injection
|
$1,191.80 |
$1,191.80 |
$3,787.98 |
$1,191.80
|
|
Telehealth original site facility fee
|
$46.35 |
$111.80 |
$465.99 |
$51.00
|
|
Telethx isodose plan cplx
|
$759.37 |
$1,679.31 |
$2,335.50 |
$1,526.85
|
|
Telethx isodose plan simple
|
$620.10 |
$759.37 |
$1,606.50 |
$877.09
|
|
Temozolomide
|
$64.37 |
$647.64 |
$775.00 |
$540.06
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$4,950.80 |
$9,031.44 |
$27,862.04 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$9,028.34 |
$10,454.62 |
$14,951.87 |
$14,951.87
|
|
Teniposide, 50 mg
|
$20,834.91 |
$20,834.91 |
$20,834.91 |
$849.48
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$10.95 |
$73.32 |
$659.89 |
$39.33
|
|
Teriparatide injection
|
$17,418.66 |
$17,418.66 |
$17,418.66 |
$7,403.20
|
|
Tert gene targeted seq alys
|
$186.00 |
$186.00 |
$1,650.00 |
$335.00
|
|
Test for urine cystines
|
$17.00 |
$17.00 |
$17.00 |
$26.00
|
|
Testicular imaging w/vasc flow
|
$449.57 |
$837.50 |
$2,768.30 |
$842.56
|
|
Test pathogen(s) for platelets reference
|
$29.90 |
$45.00 |
$45.00 |
$70.00
|
|
Test stress cardiovascular tracing only
|
$818.10 |
$1,439.00 |
$2,079.16 |
$953.40
|
|
Tetanus immune globulin inj
|
$826.25 |
$1,172.11 |
$4,053.50 |
$1,285.36
|
|
Tgsap hl neo 5-50 rna alys
|
$3,450.00 |
$3,450.00 |
$5,106.47 |
$879.20
|
|
Tgsap so/hl 51/< rna alys
|
$5,025.00 |
$5,025.00 |
$5,025.00 |
$4,563.00
|
|
Tgsap so neo 5-50 rna alys
|
$5,106.47 |
$5,106.47 |
$5,536.50 |
$1,019.60
|
|
Thaw preserved stem cells
|
$3,042.99 |
$3,042.99 |
$3,042.99 |
$1,136.85
|
|
Theophylline therapeutic drug level
|
$9.50 |
$141.91 |
$1,208.52 |
$108.00
|
