|
Snrpn/ube3a gene
|
$169.80 |
$169.80 |
$169.80 |
$231.85
|
|
So airplane w/wo joint cf
|
$3,838.93 |
$3,838.93 |
$3,838.93 |
$1,276.80
|
|
So cap design without jnts cf
|
$2,926.39 |
$2,926.39 |
$2,926.39 |
$606.35
|
|
Socket insert without lock mech
|
$1,939.65 |
$1,939.65 |
$1,939.65 |
$1,192.50
|
|
Sock fracture or equal each
|
$108.53 |
$108.53 |
$108.53 |
$74.51
|
|
Sodium 24 hour urine
|
$19.80 |
$19.80 |
$19.80 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$36.00 |
$36.00 |
$36.00 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$36.00 |
$36.00 |
$36.00 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$45.90 |
$45.90 |
$45.90 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$36.00 |
$36.00 |
$36.00 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$129.74 |
$129.74 |
$129.74 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$19.80 |
$19.80 |
$19.80 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$7.58 |
$7.58 |
$7.58 |
$177.52
|
|
Soft interface below knee se
|
$270.09 |
$270.09 |
$270.09 |
$179.08
|
|
So neo gsap dna/dna&rna
|
$3,954.00 |
$3,954.00 |
$3,954.00 |
$2,989.55
|
|
So vest canvas/web pre ots
|
$570.05 |
$570.05 |
$570.05 |
$256.54
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$283.20 |
$283.20 |
$283.20 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$1,645.85 |
$1,645.85 |
$1,645.85 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$213.33 |
$213.33 |
$213.33 |
$68.25
|
|
Splint finger fold over sm
|
$313.70 |
$313.70 |
$313.70 |
$146.88
|
|
Splint finger frog med
|
$319.24 |
$319.24 |
$319.24 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$313.70 |
$313.70 |
$313.70 |
$99.04
|
|
Sputum specimen collection
|
$139.20 |
$139.20 |
$139.20 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$221.40 |
$221.40 |
$221.40 |
$297.60
|
|
Static or dynami afo pre ots
|
$989.48 |
$989.48 |
$989.48 |
$284.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$71,395.37 |
$71,395.37 |
$71,395.37 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$57,389.55 |
$57,389.55 |
$57,389.55 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$62,336.93 |
$62,336.93 |
$62,336.93 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$1,385.27 |
$1,385.27 |
$1,385.27 |
$4,939.20
|
|
Sterile water/saline, 10 ml
|
$36.00 |
$36.00 |
$36.00 |
$13.32
|
|
Sternal pad
|
$358.07 |
$358.07 |
$358.07 |
$216.89
|
|
St evaluate speech sound production
|
$90.60 |
$90.60 |
$90.60 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$561.60 |
$561.60 |
$561.60 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$211.20 |
$211.20 |
$211.20 |
$399.60
|
|
St evaluation swallow function
|
$211.20 |
$211.20 |
$211.20 |
$314.40
|
|
Stocking sup grips 4 pre ots
|
$55.81 |
$55.81 |
$55.81 |
$31.58
|
|
Straight knee joint heavy du
|
$524.38 |
$524.38 |
$524.38 |
$317.69
|
|
Strapping of ankle and/or ft 29540
|
$105.00 |
$105.00 |
$105.00 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$41.40 |
$41.40 |
$41.40 |
$154.70
|
|
Strapping of hand or finger
|
$41.40 |
$41.40 |
$41.40 |
$174.82
|
|
Strapping of knee
|
$84.00 |
$84.00 |
$84.00 |
$205.20
|
|
Strep a ag ia
|
$50.40 |
$50.40 |
$50.40 |
$75.40
|
|
Stress tte complete
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$1,870.50
|
|
Str markers specimen anal
|
$699.00 |
$699.00 |
$699.00 |
$751.50
|
|
St treatment speech individual
|
$144.60 |
$144.60 |
$144.60 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$136.20 |
$136.20 |
$136.20 |
$240.31
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$4.80 |
$4.80 |
$4.80 |
$52.31
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$2,734.56 |
$2,734.56 |
$2,734.56 |
$7,345.98
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$49.61 |
$49.61 |
$49.61 |
$82.43
|
|
Support clav 29.6-40.5in med
|
$903.55 |
$903.55 |
$903.55 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$42.00 |
$42.00 |
$42.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$83.40 |
$83.40 |
$83.40 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$105.00 |
$105.00 |
$105.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$165.00 |
$165.00 |
$165.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$242.40 |
$242.40 |
$242.40 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$41.40 |
$41.40 |
$41.40 |
$45.45
|
|
Susceptibility mic per plate
|
$171.60 |
$171.60 |
$171.60 |
$106.00
|
|
Suscept studies macrobroth dilution ea
|
$24.60 |
$24.60 |
$24.60 |
$59.28
|
|
Suspension sleeve lower ext
|
$379.13 |
$379.13 |
$379.13 |
$251.38
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$18.00 |
$18.00 |
$18.00 |
$41.60
|
|
System cardiomems hosp electronics
|
$75,200.10 |
$75,200.10 |
$75,200.10 |
$39,037.95
|
|
System pacing micra av
|
$66,096.93 |
$66,096.93 |
$66,096.93 |
$24,577.07
|
|
System pcmkr dual chamber leadless micra av2 intrdcr cath
|
$31,936.30 |
$31,936.30 |
$31,936.30 |
$12,003.00
|
|
System recell skin grafting/harvesting
|
$27,210.56 |
$27,210.56 |
$27,210.56 |
$11,183.00
|
|
T3 (triiodothyronine) free
|
$66.60 |
$66.60 |
$66.60 |
$99.20
|
|
T3 (triiodothyronine) total
|
$79.20 |
$79.20 |
$79.20 |
$93.52
|
|
T4 (thyroxine) free
|
$35.40 |
$35.40 |
$35.40 |
$85.20
|
|
T4 (thyroxine) total
|
$40.80 |
$40.80 |
$40.80 |
$69.00
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$4.80 |
$4.80 |
$4.80 |
$9.84
|
|
Tacrolimus therapeutic drug level
|
$51.60 |
$51.60 |
$51.60 |
$122.40
|
|
Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection
|
$12,574.42 |
$12,574.42 |
$12,574.42 |
$2,369.70
|
|
Talymed
|
$5,145.27 |
$5,145.27 |
$5,145.27 |
$3,411.49
|
|
Tap block bilat cont infusion 64489
|
$1,216.20 |
$1,216.20 |
$1,216.20 |
$1,407.60
|
|
Tap block uni by cont infusion 64487
|
$653.40 |
$653.40 |
$653.40 |
$869.40
|
|
Target gsa panel organ/hmtlmph neop
|
$8,758.80 |
$8,758.80 |
$8,758.80 |
$3,746.70
|
|
Tarlatamab-dlle 10 mg intravenous solution
|
$27,000.00 |
$27,000.00 |
$27,000.00 |
$24,217.20
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$201.00 |
$201.00 |
$201.00 |
$177.65
|
|
Tc-99m bicisate
|
$8,799.18 |
$8,799.18 |
$8,799.18 |
$1,969.45
|
|
Tc-99m exame autol wbc diag per dose
|
$5,141.90 |
$5,141.90 |
$5,141.90 |
$2,435.36
|
|
Tc-99m labeled rbc
|
$97.20 |
$97.20 |
$97.20 |
$302.40
|
|
Tc-99m maa
|
$81.60 |
$81.60 |
$81.60 |
$292.80
|
|
Tc-99m mebrofenin
|
$190.20 |
$190.20 |
$190.20 |
$157.65
|
|
Tc-99m medronate
|
$99.00 |
$99.00 |
$99.00 |
$111.01
|
|
Tc-99m mertiatide
|
$285.03 |
$285.03 |
$285.03 |
$756.00
|
|
Tc-99m oxidronate
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$105.60
|
|
Tc-99m pertechnetate per mci
|
$225.60 |
$225.60 |
$225.60 |
$22.10
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$147.58 |
$147.58 |
$147.58 |
$136.40
|
|
Tc-99m sestamibi p study dose
|
$289.80 |
$289.80 |
$289.80 |
$274.45
|
|
Tc-99m succimer (dmsa)
|
$1,438.61 |
$1,438.61 |
$1,438.61 |
$1,128.40
|
|
Tc-99m sulfur colloid
|
$167.40 |
$167.40 |
$167.40 |
$240.50
|
|
Tc-99m tetrofosmin p study dose
|
$244.20 |
$244.20 |
$244.20 |
$190.80
|
|
Tc-99m tilmanocept diag
|
$7,938.86 |
$7,938.86 |
$7,938.86 |
$955.60
|
|
T cells absolute cd4/cd8 including ratio
|
$348.00 |
$348.00 |
$348.00 |
$176.40
|
|
T cells absolute cd 4 count
|
$99.00 |
$99.00 |
$99.00 |
$111.20
|
|
T cells total count
|
$139.80 |
$139.80 |
$139.80 |
$126.90
|
|
Tebentafusp-tebn 100 mcg/0.5 ml intravenous solution
|
$37,782.00 |
$37,782.00 |
$37,782.00 |
$40,114.80
|
|
Telehealth original site facility fee
|
$121.20 |
$121.20 |
$121.20 |
$51.00
|
|
Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln
|
$3,600.58 |
$3,600.58 |
$3,600.58 |
$3,723.60
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$13,441.57 |
$13,441.57 |
$13,441.57 |
$15,245.38
|
