|
Smear special stain inclusion bodies/parasites
|
$44.45 |
$44.45 |
$44.45 |
$64.35
|
|
Smear wet mount
|
$82.60 |
$82.60 |
$82.60 |
$68.63
|
|
Sodium 24 hour urine
|
$44.10 |
$44.10 |
$1,103.08 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$7.35 |
$7.35 |
$7.35 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$18.82 |
$18.82 |
$176.52 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$7.21 |
$7.21 |
$7.21 |
$46.35
|
|
Sodium chloride 3 % ivpb
|
$24.14 |
$24.14 |
$24.14 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$62.61 |
$62.61 |
$1,158.58 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$269.10 |
$269.10 |
$269.10 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$39.20 |
$39.20 |
$1,048.58 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$150.27 |
$150.27 |
$684.55 |
$223.86
|
|
Somatosensory testing
|
$173.95 |
$173.95 |
$173.95 |
$583.80
|
|
Somatropin injection
|
$112.60 |
$112.60 |
$112.60 |
$339.59
|
|
Special physics consult
|
$2,781.10 |
$2,781.10 |
$2,781.10 |
$700.74
|
|
Special radiation dosimetry
|
$112.00 |
$112.00 |
$112.00 |
$445.50
|
|
Special radiation treatment
|
$3,141.95 |
$3,141.95 |
$3,141.95 |
$1,934.03
|
|
Special teletx port plan
|
$1,542.45 |
$1,542.45 |
$1,542.45 |
$1,046.65
|
|
Specific gravity body fluid
|
$22.40 |
$22.40 |
$22.40 |
$23.63
|
|
Specimen fat stain
|
$28.70 |
$28.70 |
$28.70 |
$32.76
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,234.80 |
$1,234.80 |
$1,234.80 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$833.35 |
$833.35 |
$4,845.85 |
$559.96
|
|
Spleen imaging
|
$539.70 |
$539.70 |
$539.70 |
$539.70
|
|
Splint extn xsm w sof-stretch rolyan
|
$18.90 |
$18.90 |
$18.90 |
$41.58
|
|
Splint finger frog med
|
$37.23 |
$37.23 |
$37.23 |
$21.50
|
|
Split blood or products
|
$92.75 |
$92.75 |
$92.75 |
$148.98
|
|
Sr-89 stront chlor ther / mci
|
$8,479.80 |
$8,479.80 |
$8,479.80 |
$4,588.65
|
|
Srs linear based
|
$23,033.50 |
$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 |
$372.05 |
$300.00
|
|
St cognitve performance testing healthcare professional each hour
|
$191.80 |
$191.80 |
$667.08 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$19,250.00 |
$19,250.00 |
$19,250.00 |
$23,387.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$80,850.00 |
$80,850.00 |
$80,850.00 |
$39,270.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,452.30 |
$3,452.30 |
$3,452.30 |
$1,206.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$71,644.13 |
$71,644.13 |
$71,644.13 |
$18,472.24
|
|
Stent bronch dumon sil 10x40mm
|
$3,307.50 |
$3,307.50 |
$3,307.50 |
$6,285.56
|
|
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 |
$7,073.15 |
$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
|
$605.91 |
$605.91 |
$605.91 |
$32.00
|
|
Strep b dna amp probe
|
$422.80 |
$422.80 |
$422.80 |
$139.20
|
|
Streptomycin injection
|
$50.02 |
$50.02 |
$50.02 |
$100.00
|
|
Streptozocin injection
|
$954.71 |
$954.71 |
$954.71 |
$954.71
|
|
Stress test pulmonary
|
$211.05 |
$211.05 |
$211.05 |
$327.20
|
|
Stress tte complete
|
$2,513.00 |
$2,513.00 |
$2,513.00 |
$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
|
|
Sulfonylurea screen qn-sendout
|
$313.85 |
$313.85 |
$313.85 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$291.52 |
$291.52 |
$2,150.97 |
$91.67
|
|
Support clav 29.6-40.5in med
|
$15.73 |
$15.73 |
$15.73 |
$68.54
|
|
Surgical pathology level 1 gross examination only
|
$122.50 |
$122.50 |
$533.25 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$273.70 |
$273.70 |
$1,249.60 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$322.70 |
$322.70 |
$1,249.60 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$408.10 |
$408.10 |
$2,246.37 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$534.80 |
$534.80 |
$3,141.43 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,093.75 |
$1,093.75 |
$4,717.96 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$42.70 |
$42.70 |
$42.70 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$36.40 |
$36.40 |
$950.00 |
$34.48
|
|
Susceptibility mic per plate
|
$172.20 |
$172.20 |
$172.20 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$43.05 |
$43.05 |
$1,447.52 |
$48.30
|
|
Svc venogram s&i
|
$1,691.55 |
$1,691.55 |
$14,992.85 |
$1,908.00
|
|
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 |
$41,360.00
|
|
System pacing micra av
|
$89,302.50 |
$89,302.50 |
$89,302.50 |
$22,733.55
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$75,466.13 |
$75,466.13 |
$75,466.13 |
$9,363.28
|
|
T3 (triiodothyronine) free
|
$40.95 |
$40.95 |
$844.22 |
$89.82
|
|
T3 (triiodothyronine) total
|
$130.20 |
$130.20 |
$3,091.24 |
$94.90
|
|
T4 (thyroxine) free
|
$62.65 |
$62.65 |
$1,966.36 |
$81.60
|
|
T4 (thyroxine) total
|
$83.30 |
$83.30 |
$1,497.66 |
$73.64
|
|
Tacrol envarsus ex rel oral
|
$1.93 |
$1.93 |
$1.93 |
$3.20
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$12.25 |
$12.25 |
$12.25 |
$9.99
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$373.01 |
$373.01 |
$373.01 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$233.10 |
$233.10 |
$632.07 |
$122.40
|
|
Talquetamab-tgvs 2 mg/ml subcutaneous solution
|
$26,747.47 |
$26,747.47 |
$26,747.47 |
$26,095.32
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$81.25 |
$81.25 |
$81.25 |
$35.75
|
|
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 |
$4,221.50 |
$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 |
$12,190.85 |
$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 |
$173.95 |
$173.95 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$32.90 |
$32.90 |
$1,338.24 |
$166.46
|
|
Tc-99m bicisate
|
$1,969.45 |
$1,969.45 |
$1,969.45 |
$1,969.45
|
|
Tc-99m disofenin
|
$63.70 |
$63.70 |
$63.70 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$1,305.67 |
$1,305.67 |
$3,177.30 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$2,135.70 |
$2,135.70 |
$6,745.24 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$381.15 |
$381.15 |
$2,682.67 |
$323.01
|
|
Tc-99m maa
|
$386.05 |
$386.05 |
$1,328.96 |
$312.06
|
|
Tc-99m mebrofenin
|
$103.60 |
$103.60 |
$1,328.96 |
$169.53
|
|
Tc-99m medronate
|
$61.25 |
$61.25 |
$1,328.96 |
$122.46
|
|
Tc-99m mertiatide
|
$944.65 |
$944.65 |
$2,611.33 |
$757.25
|
|
Tc-99m oxidronate
|
$63.70 |
$63.70 |
$63.70 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$426.65 |
$426.65 |
$1,617.17 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$634.90 |
$634.90 |
$634.90 |
$244.02
|
