|
Sperm antibody test
|
$621.15 |
$621.15 |
$621.15 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,234.80 |
$1,234.80 |
$5,817.00 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$833.35 |
$3,159.00 |
$4,255.02 |
$559.96
|
|
Spleen imaging
|
$539.70 |
$539.70 |
$539.70 |
$539.70
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$857.00 |
$857.00 |
$857.00 |
$380.00
|
|
Splint extn xsm w sof-stretch rolyan
|
$18.90 |
$18.90 |
$18.90 |
$52.65
|
|
Splint finger frog med
|
$37.23 |
$37.23 |
$37.23 |
$27.95
|
|
Split blood or products
|
$92.75 |
$92.75 |
$357.43 |
$148.98
|
|
Sr-89 stront chlor ther / mci
|
$8,479.80 |
$8,479.80 |
$8,479.80 |
$4,588.65
|
|
Srs linear based
|
$10,761.00 |
$23,033.50 |
$23,033.50 |
$14,124.25
|
|
Srs multisource
|
$42,976.15 |
$42,976.15 |
$42,976.15 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$372.05 |
$372.05 |
$1,935.00 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$191.80 |
$191.80 |
$656.48 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$19,250.00 |
$19,250.00 |
$68,862.00 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$80,850.00 |
$80,850.00 |
$80,850.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,452.30 |
$3,452.30 |
$3,452.30 |
$1,322.36
|
|
Stent bili rx wallflx 10x80 uncvr
|
$71,644.13 |
$71,644.13 |
$71,644.13 |
$18,714.49
|
|
Stent bronch dumon sil 10x40mm
|
$3,307.50 |
$3,307.50 |
$3,307.50 |
$5,943.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$12,390.35 |
$12,390.35 |
$12,390.35 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$4,956.35 |
$4,956.35 |
$4,956.35 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$7,073.15 |
$7,073.15 |
$43,358.00 |
$19,765.20
|
|
St evaluate speech sound production
|
$194.60 |
$194.60 |
$194.60 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$284.90 |
$284.90 |
$284.90 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$400.40 |
$400.40 |
$400.40 |
$406.40
|
|
St evaluation swallow function
|
$298.20 |
$298.20 |
$298.20 |
$336.60
|
|
Strapping of elbow or wrist 29260
|
$86.80 |
$86.80 |
$86.80 |
$171.00
|
|
Strep b assay w/optic
|
$367.00 |
$367.00 |
$701.60 |
$32.00
|
|
Strep b dna amp probe
|
$422.80 |
$422.80 |
$422.80 |
$139.20
|
|
Streptomycin injection
|
$50.02 |
$50.02 |
$494.62 |
$138.30
|
|
Streptozocin injection
|
$954.71 |
$954.71 |
$954.71 |
$943.23
|
|
Stress test pulmonary
|
$211.05 |
$211.05 |
$487.91 |
$327.20
|
|
Stress tte complete
|
$2,513.00 |
$2,513.00 |
$3,379.24 |
$1,964.95
|
|
St treatment speech individual
|
$216.30 |
$216.30 |
$216.30 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$141.40 |
$141.40 |
$141.40 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$94.93 |
$94.93 |
$94.93 |
$49.13
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$291.52 |
$1,946.00 |
$2,172.32 |
$151.29
|
|
Support clav 29.6-40.5in med
|
$15.73 |
$15.73 |
$15.73 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$122.50 |
$122.50 |
$484.00 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$273.70 |
$273.70 |
$827.00 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$322.70 |
$322.70 |
$1,167.00 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$408.10 |
$408.10 |
$408.10 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$534.80 |
$534.80 |
$1,836.00 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,093.75 |
$1,093.75 |
$3,780.00 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$42.70 |
$42.70 |
$42.70 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$36.40 |
$50.89 |
$669.95 |
$34.48
|
|
Susceptibility mic per plate
|
$172.20 |
$172.20 |
$172.20 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$43.05 |
$282.87 |
$1,328.00 |
$48.30
|
|
Svc venogram s&i
|
$1,691.55 |
$1,691.55 |
$1,691.55 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$11,720.43 |
$11,720.43 |
$11,720.43 |
$1,232.66
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$46.90 |
$46.90 |
$46.90 |
$44.85
|
|
System cardiomems hosp electronics
|
$68,860.05 |
$68,860.05 |
$68,860.05 |
$41,639.82
|
|
System pacing micra av
|
$89,302.50 |
$89,302.50 |
$89,302.50 |
$24,469.57
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$75,466.13 |
$75,466.13 |
$75,466.13 |
$10,980.00
|
|
T3 (triiodothyronine) free
|
$40.95 |
$40.95 |
$40.95 |
$89.82
|
|
T3 (triiodothyronine) total
|
$130.20 |
$130.20 |
$130.20 |
$94.90
|
|
T4 (thyroxine) free
|
$62.65 |
$62.65 |
$62.65 |
$81.60
|
|
T4 (thyroxine) total
|
$83.30 |
$83.30 |
$83.30 |
$73.64
|
|
Tacrol envarsus ex rel oral
|
$1.93 |
$1.93 |
$432.00 |
$15.60
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.25 |
$12.25 |
$12.25 |
$12.25
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$373.01 |
$373.01 |
$373.01 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$233.10 |
$233.10 |
$675.00 |
$122.40
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$26,747.47 |
$26,747.47 |
$26,747.47 |
$31,080.00
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$50.00 |
$79.87 |
$86.85 |
$32.40
|
|
Tap block bilat cont infusion 64489
|
$520.80 |
$520.80 |
$520.80 |
$914.55
|
|
Tap block uni by cont infusion 64487
|
$390.60 |
$390.60 |
$390.60 |
$638.65
|
|
Target gsa panel hmtlmph neop
|
$1,305.50 |
$1,305.50 |
$1,305.50 |
$1,928.40
|
|
Tas congenital car anomal
|
$3,578.75 |
$3,578.75 |
$3,578.75 |
$6,003.27
|
|
Tavr perq femoral
|
$12,190.85 |
$12,190.85 |
$123,061.64 |
$16,357.00
|
|
Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe
|
$1,149.99 |
$1,149.99 |
$1,149.99 |
$959.55
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$173.95 |
$652.55 |
$789.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$32.90 |
$32.90 |
$750.00 |
$166.46
|
|
Tc-99m bicisate
|
$1,969.45 |
$1,969.45 |
$3,372.43 |
$1,969.45
|
|
Tc-99m disofenin
|
$63.70 |
$63.70 |
$63.70 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,081.41 |
$3,177.30 |
$3,177.30 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,135.70 |
$2,135.70 |
$2,135.70 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$381.15 |
$381.15 |
$4,440.00 |
$323.01
|
|
Tc-99m maa
|
$386.05 |
$386.05 |
$1,099.56 |
$312.06
|
|
Tc-99m mebrofenin
|
$103.60 |
$103.60 |
$103.60 |
$169.53
|
|
Tc-99m medronate
|
$61.25 |
$61.25 |
$1,099.56 |
$122.46
|
|
Tc-99m mertiatide
|
$944.65 |
$944.65 |
$944.65 |
$757.25
|
|
Tc-99m oxidronate
|
$63.70 |
$63.70 |
$556.03 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$426.65 |
$426.65 |
$4,662.00 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$634.90 |
$634.90 |
$634.90 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$9.10 |
$9.10 |
$9.10 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$109.90 |
$109.90 |
$1,129.55 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$199.85 |
$199.85 |
$5,135.81 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$306.95 |
$306.95 |
$1,720.26 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$313.60 |
$313.60 |
$313.60 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$96.00 |
$119.00 |
$119.00 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,279.60 |
$1,279.60 |
$3,976.40 |
$930.54
|
|
Tcd emboli detect w/inj
|
$315.70 |
$315.70 |
$315.70 |
$404.68
|
|
Tcd emboli detect without inj
|
$309.75 |
$309.75 |
$309.75 |
$397.15
|
|
T cells absolute cd4/cd8 including ratio
|
$376.25 |
$376.25 |
$789.00 |
$186.00
|
|
T cells absolute cd 4 count
|
$197.05 |
$197.05 |
$789.00 |
$120.25
|
|
T cells total count
|
$199.50 |
$210.68 |
$487.00 |
$124.11
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$10,547.78 |
$10,547.78 |
$10,547.78 |
$40,985.00
|
|
Tee w or without fol w/cont, mon
|
$591.50 |
$591.50 |
$591.50 |
$1,077.92
|
|
Telavancin injection
|
$693.04 |
$693.04 |
$693.04 |
$1,216.45
|
|
Telehealth original site facility fee
|
$22.75 |
$22.75 |
$22.75 |
$60.80
|
|
Telethx isodose plan cplx
|
$2,987.25 |
$2,987.25 |
$33,936.00 |
$1,617.00
|
