|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$854.41 |
$854.41 |
$854.41 |
$243.11
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$883.73 |
$883.73 |
$883.73 |
$455.01
|
|
Ring ostmy barr adapt 48mm
|
$19.00 |
$19.00 |
$19.00 |
$9.40
|
|
Rotavirus antibody
|
$1,702.97 |
$1,702.97 |
$1,702.97 |
$125.01
|
|
Rp loclzj tum 2+area 1+d img
|
$2,791.61 |
$2,791.61 |
$2,791.61 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$7,024.09 |
$7,024.09 |
$7,024.09 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$7,968.06 |
$7,968.06 |
$7,968.06 |
$3,139.20
|
|
Rsv assay w/optic
|
$430.23 |
$430.23 |
$430.23 |
$79.38
|
|
Russell viper venom diluted
|
$854.45 |
$854.45 |
$854.45 |
$72.54
|
|
Salmonella antibody
|
$832.14 |
$832.14 |
$832.14 |
$37.58
|
|
Saquinavir, 200 mg
|
$176.93 |
$176.93 |
$176.93 |
$14.00
|
|
Sarscov coronavirus ag ia
|
$30.49 |
$30.49 |
$30.49 |
$59.25
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$5,007.98 |
$5,007.98 |
$5,007.98 |
$750.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$4,361.58 |
$4,361.58 |
$4,361.58 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$4,345.74 |
$4,345.74 |
$4,345.74 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$4,345.74 |
$4,345.74 |
$4,345.74 |
$985.20
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$3,781.73 |
$3,781.73 |
$3,781.73 |
$595.35
|
|
Screening Mammogram
|
$653.09 |
$653.09 |
$653.09 |
$312.55
|
|
Screening prostate cancer PSA
|
$1,049.49 |
$1,049.49 |
$1,049.49 |
$100.63
|
|
Sedimentation rate erythrocyte automated
|
$529.95 |
$529.95 |
$529.95 |
$42.00
|
|
Sevelamer carbonate 800 mg tablet
|
$23.77 |
$23.77 |
$23.77 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$21.96 |
$21.96 |
$21.96 |
$21.96
|
|
Shoe lift elev heel/sole neo
|
$654.00 |
$654.00 |
$654.00 |
$175.04
|
|
Shuntogram nonvascular supervision & interpretation
|
$226.89 |
$226.89 |
$226.89 |
$349.20
|
|
Sialography s&i
|
$853.78 |
$853.78 |
$853.78 |
$499.20
|
|
Sickling rbc
|
$477.84 |
$477.84 |
$477.84 |
$57.92
|
|
Sildenafil citrate, 25 mg
|
$33.56 |
$33.56 |
$33.56 |
$182.99
|
|
Sincalide 5 mcg solution for injection
|
$1,242.11 |
$1,242.11 |
$1,242.11 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$8,270.73 |
$8,270.73 |
$8,270.73 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$6,280.20 |
$6,280.20 |
$6,280.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,959.89 |
$2,959.89 |
$2,959.89 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$8,622.19 |
$8,622.19 |
$8,622.19 |
$2,489.25
|
|
Skin barrier with flange
|
$57.00 |
$57.00 |
$57.00 |
$1.65
|
|
Smear nasal eosinophil
|
$409.38 |
$409.38 |
$409.38 |
$46.20
|
|
Socket insert without lock mech
|
$5,291.00 |
$5,291.00 |
$5,291.00 |
$1,192.50
|
|
Sodium 24 hour urine
|
$282.86 |
$282.86 |
$282.86 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$238.58 |
$238.58 |
$238.58 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$272.89 |
$272.89 |
$272.89 |
$46.00
|
|
Sodium chloride 3 % ivpb
|
$311.54 |
$311.54 |
$311.54 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$349.11 |
$349.11 |
$349.11 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$291.79 |
$291.79 |
$291.79 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$796.52 |
$796.52 |
$796.52 |
$177.52
|
|
Specific gravity body fluid
|
$150.34 |
$150.34 |
$150.34 |
$22.00
|
|
Speech evaluation complex
|
$1,769.47 |
$1,769.47 |
$1,769.47 |
$527.06
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$2,389.42 |
$2,389.42 |
$2,389.42 |
$543.26
|
|
Spleen imaging
|
$4,102.14 |
$4,102.14 |
$4,102.14 |
$679.00
|
|
St cognitve performance testing healthcare professional each hour
|
$1,312.64 |
$1,312.64 |
$1,312.64 |
$286.00
|
|
Strep b assay w/optic
|
$567.15 |
$567.15 |
$567.15 |
$80.16
|
|
Stress test pulmonary
|
$1,500.69 |
$1,500.69 |
$1,500.69 |
$322.85
|
|
Stress tte complete
|
$9,082.74 |
$9,082.74 |
$9,082.74 |
$1,870.50
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$27.60 |
$27.60 |
$27.60 |
$52.31
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$1,646.65 |
$1,646.65 |
$1,646.65 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$507.61 |
$507.61 |
$507.61 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$934.83 |
$934.83 |
$934.83 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,074.79 |
$1,074.79 |
$1,074.79 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,225.12 |
$1,225.12 |
$1,225.12 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,376.97 |
$1,376.97 |
$1,376.97 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,668.74 |
$1,668.74 |
$1,668.74 |
$718.00
|
|
Susceptibility enzyme detection per enzyme
|
$139.94 |
$139.94 |
$139.94 |
$35.70
|
|
Suscept studies macrobroth dilution ea
|
$177.15 |
$177.15 |
$177.15 |
$59.28
|
|
Svc venogram s&i
|
$3,268.46 |
$3,268.46 |
$3,268.46 |
$1,934.62
|
|
T3 (triiodothyronine) free
|
$588.00 |
$588.00 |
$588.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$1,135.81 |
$1,135.81 |
$1,135.81 |
$93.52
|
|
T4 (thyroxine) free
|
$537.40 |
$537.40 |
$537.40 |
$85.20
|
|
T4 (thyroxine) total
|
$464.46 |
$464.46 |
$464.46 |
$69.00
|
|
Tacrolimus therapeutic drug level
|
$1,393.35 |
$1,393.35 |
$1,393.35 |
$122.40
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$60.38 |
$60.38 |
$60.38 |
$14.62
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$163.75 |
$163.75 |
$163.75 |
$194.35
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$791.96 |
$791.96 |
$791.96 |
$177.65
|
|
Tc-99m disofenin
|
$622.13 |
$622.13 |
$622.13 |
$124.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,631.06 |
$1,631.06 |
$1,631.06 |
$2,435.36
|
|
Tc-99m exametazime diag
|
$26,430.14 |
$26,430.14 |
$26,430.14 |
$2,033.20
|
|
Tc-99m fanolesomab diag
|
$13,166.59 |
$13,166.59 |
$13,166.59 |
$2,115.12
|
|
Tc-99m labeled rbc
|
$1,157.14 |
$1,157.14 |
$1,157.14 |
$302.40
|
|
Tc-99m maa
|
$467.51 |
$467.51 |
$467.51 |
$292.80
|
|
Tc-99m mebrofenin
|
$663.85 |
$663.85 |
$663.85 |
$157.65
|
|
Tc-99m medronate
|
$404.40 |
$404.40 |
$404.40 |
$111.01
|
|
Tc-99m mertiatide
|
$3,252.99 |
$3,252.99 |
$3,252.99 |
$756.00
|
|
Tc-99m pentetate dtpa
|
$944.85 |
$944.85 |
$944.85 |
$222.60
|
|
Tc-99m pertechnetate per mci
|
$438.07 |
$438.07 |
$438.07 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$472.38 |
$472.38 |
$472.38 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$1,935.11 |
$1,935.11 |
$1,935.11 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$3,637.07 |
$3,637.07 |
$3,637.07 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$1,711.78 |
$1,711.78 |
$1,711.78 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$1,935.11 |
$1,935.11 |
$1,935.11 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$870.70 |
$870.70 |
$870.70 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$1,228.12 |
$1,228.12 |
$1,228.12 |
$176.40
|
|
T cells absolute cd 4 count
|
$577.58 |
$577.58 |
$577.58 |
$111.20
|
|
T cells total count
|
$1,228.12 |
$1,228.12 |
$1,228.12 |
$126.90
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$135.21 |
$135.21 |
$135.21 |
$39.33
|
|
Test for chlorohydrocarbons
|
$1,228.12 |
$1,228.12 |
$1,228.12 |
$65.00
|
|
Testicular imaging w/vasc flow
|
$3,433.37 |
$3,433.37 |
$3,433.37 |
$842.56
|
|
Test stress cardiovascular tracing only
|
$5,399.43 |
$5,399.43 |
$5,399.43 |
$949.70
|
|
Test urine for porphyrins
|
$282.86 |
$282.86 |
$282.86 |
$49.98
|
|
Tetanus immune globulin inj
|
$3,832.41 |
$3,832.41 |
$3,832.41 |
$1,285.36
|
|
Theophylline therapeutic drug level
|
$544.84 |
$544.84 |
$544.84 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$199.19 |
$199.19 |
$199.19 |
$57.31
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$167.81 |
$167.81 |
$167.81 |
$50.00
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$121.27 |
$121.27 |
$121.27 |
$25.54
|
|
Thrombin time
|
$413.83 |
$413.83 |
$413.83 |
$53.76
|
