|
Sickling rbc
|
$449.25 |
$449.25 |
$449.25 |
$53.55
|
|
Sildenafil citrate, 25 mg
|
$126.09 |
$126.09 |
$126.09 |
$4.87
|
|
Sincalide 5 mcg solution for injection
|
$6,239.53 |
$6,239.53 |
$6,239.53 |
$354.67
|
|
Sinus/juglr venogram s&i
|
$8,676.01 |
$8,676.01 |
$8,676.01 |
$2,489.25
|
|
Sodium 24 hour urine
|
$211.58 |
$211.58 |
$211.58 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$334.58 |
$334.58 |
$334.58 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$334.58 |
$334.58 |
$334.58 |
$47.27
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$314.38 |
$314.38 |
$314.38 |
$84.80
|
|
Sodium serum/plasma/whole blood
|
$209.62 |
$209.62 |
$209.62 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$246.47 |
$246.47 |
$246.47 |
$195.48
|
|
Special physics consult
|
$1,783.35 |
$1,783.35 |
$1,783.35 |
$700.74
|
|
Special radiation dosimetry
|
$737.89 |
$737.89 |
$737.89 |
$445.50
|
|
Special radiation treatment
|
$11,355.76 |
$11,355.76 |
$11,355.76 |
$1,934.03
|
|
Special teletx port plan
|
$2,376.74 |
$2,376.74 |
$2,376.74 |
$1,046.65
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$378.51 |
$378.51 |
$378.51 |
$559.96
|
|
Split blood or products
|
$670.38 |
$670.38 |
$670.38 |
$148.98
|
|
Srs linear based
|
$15,552.79 |
$15,552.79 |
$15,552.79 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$941.33 |
$941.33 |
$941.33 |
$300.00
|
|
Strep a ag ia
|
$516.99 |
$516.99 |
$516.99 |
$75.40
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$29.93 |
$29.93 |
$29.93 |
$49.13
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$132.00 |
$132.00 |
$132.00 |
$74.79
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$962.94 |
$962.94 |
$962.94 |
$151.29
|
|
Surgical pathology level 1 gross examination only
|
$246.47 |
$246.47 |
$246.47 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$586.28 |
$586.28 |
$586.28 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$1,151.58 |
$1,151.58 |
$1,151.58 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,349.88 |
$1,349.88 |
$1,349.88 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,596.07 |
$1,596.07 |
$1,596.07 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,233.20 |
$2,233.20 |
$2,233.20 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$249.92 |
$249.92 |
$249.92 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$243.10 |
$243.10 |
$243.10 |
$34.48
|
|
Suscept studies macrobroth dilution ea
|
$197.26 |
$197.26 |
$197.26 |
$48.30
|
|
Svc venogram s&i
|
$8,676.01 |
$8,676.01 |
$8,676.01 |
$1,908.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$156.48 |
$156.48 |
$156.48 |
$44.85
|
|
T3 (triiodothyronine) free
|
$274.60 |
$274.60 |
$274.60 |
$89.82
|
|
T3 (triiodothyronine) total
|
$228.59 |
$228.59 |
$228.59 |
$94.90
|
|
T4 (thyroxine) free
|
$573.91 |
$573.91 |
$573.91 |
$81.60
|
|
T4 (thyroxine) total
|
$194.55 |
$194.55 |
$194.55 |
$73.64
|
|
Tacrolimus 5 mg/ml intravenous solution
|
$1,605.79 |
$1,605.79 |
$1,605.79 |
$612.11
|
|
Tacrolimus therapeutic drug level
|
$1,097.58 |
$1,097.58 |
$1,097.58 |
$122.40
|
|
Tamoxifen 10 mg tabs 60 each bottle
|
$31.06 |
$31.06 |
$31.06 |
$32.40
|
|
Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells
|
$533.00 |
$533.00 |
$533.00 |
$200.00
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$1,775.68 |
$1,775.68 |
$1,775.68 |
$166.46
|
|
Tc-99m bicisate
|
$3,615.80 |
$3,615.80 |
$3,615.80 |
$1,969.45
|
|
Tc-99m disofenin
|
$145.90 |
$145.90 |
$145.90 |
$151.32
|
|
Tc-99m exame autol wbc diag per dose
|
$5,129.37 |
$5,129.37 |
$5,129.37 |
$2,393.40
|
|
Tc-99m exametazime diag
|
$4,749.24 |
$4,749.24 |
$4,749.24 |
$2,166.26
|
|
Tc-99m labeled rbc
|
$3,883.78 |
$3,883.78 |
$3,883.78 |
$323.01
|
|
Tc-99m maa
|
$551.46 |
$551.46 |
$551.46 |
$312.06
|
|
Tc-99m mebrofenin
|
$861.36 |
$861.36 |
$861.36 |
$169.53
|
|
Tc-99m medronate
|
$284.47 |
$284.47 |
$284.47 |
$122.46
|
|
Tc-99m mertiatide
|
$3,327.84 |
$3,327.84 |
$3,327.84 |
$757.25
|
|
Tc-99m oxidronate
|
$843.88 |
$843.88 |
$843.88 |
$124.23
|
|
Tc-99m pentetate dtpa
|
$551.46 |
$551.46 |
$551.46 |
$245.85
|
|
Tc-99m pentetate dtpa aerosol
|
$551.46 |
$551.46 |
$551.46 |
$244.02
|
|
Tc-99m pertechnetate per mci
|
$38.15 |
$38.15 |
$38.15 |
$28.08
|
|
Tc-99m pyroph diag per dose up to 25 mci
|
$671.60 |
$671.60 |
$671.60 |
$147.24
|
|
Tc-99m sestamibi p study dose
|
$1,207.18 |
$1,207.18 |
$1,207.18 |
$221.60
|
|
Tc-99m succimer (dmsa)
|
$1,560.30 |
$1,560.30 |
$1,560.30 |
$1,578.33
|
|
Tc-99m sulfur colloid
|
$1,419.17 |
$1,419.17 |
$1,419.17 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$829.58 |
$829.58 |
$829.58 |
$198.05
|
|
Tc-99m tilmanocept diag
|
$1,841.51 |
$1,841.51 |
$1,841.51 |
$930.54
|
|
T cells absolute cd4/cd8 including ratio
|
$1,189.08 |
$1,189.08 |
$1,189.08 |
$186.00
|
|
T cells absolute cd 4 count
|
$987.12 |
$987.12 |
$987.12 |
$120.25
|
|
T cells total count
|
$801.90 |
$801.90 |
$801.90 |
$124.11
|
|
Telethx isodose plan cplx
|
$3,703.64 |
$3,703.64 |
$3,703.64 |
$1,617.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$21,617.89 |
$21,617.89 |
$21,617.89 |
$16,531.64
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$175.29 |
$175.29 |
$175.29 |
$46.10
|
|
Test pathogen(s) for platelets reference
|
$186.45 |
$186.45 |
$186.45 |
$73.45
|
|
Test stress cardiovascular tracing only
|
$3,102.33 |
$3,102.33 |
$3,102.33 |
$1,001.55
|
|
Tetanus immune globulin inj
|
$1,061.64 |
$1,061.64 |
$1,061.64 |
$1,204.50
|
|
Theophylline therapeutic drug level
|
$493.12 |
$493.12 |
$493.12 |
$108.00
|
|
Therapy nutrition individual initial f2f w/patient each 15 minutes
|
$111.44 |
$111.44 |
$111.44 |
$55.00
|
|
Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes
|
$57.21 |
$57.21 |
$57.21 |
$50.40
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$89.06 |
$89.06 |
$89.06 |
$35.72
|
|
Thrombin time
|
$676.26 |
$676.26 |
$676.26 |
$48.75
|
|
Thyroglobulin antibody
|
$676.26 |
$676.26 |
$676.26 |
$84.00
|
|
Thyroid met uptake
|
$51.61 |
$51.61 |
$51.61 |
$380.00
|
|
Thyroid (TSH) Test
|
$1,051.70 |
$1,051.70 |
$1,051.70 |
$120.00
|
|
Tigecycline injection
|
$1,096.59 |
$1,096.59 |
$1,096.59 |
$277.31
|
|
Tilt table study
|
$4,643.24 |
$4,643.24 |
$4,643.24 |
$1,495.00
|
|
Tirofiban 12.5 mg/50 ml
|
$1,484.95 |
$1,484.95 |
$1,484.95 |
$384.17
|
|
Tissue culture skin/biopsy
|
$642.10 |
$642.10 |
$642.10 |
$558.87
|
|
Tl-201 thallium diag per mci
|
$533.66 |
$533.66 |
$533.66 |
$77.22
|
|
Tomosynthesis breast diagnostic left
|
$71.18 |
$71.18 |
$71.18 |
$78.80
|
|
Tomosynthesis breast screen bilateral
|
$65.62 |
$65.62 |
$65.62 |
$73.45
|
|
Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution
|
$2,455.57 |
$2,455.57 |
$2,455.57 |
$404.20
|
|
Toxoplasma antibody igg
|
$651.64 |
$651.64 |
$651.64 |
$84.35
|
|
Toxoplasma antibody igm
|
$551.73 |
$551.73 |
$551.73 |
$83.20
|
|
Training self management diabetes individual outpatient department per 30 minutes
|
$212.58 |
$212.58 |
$212.58 |
$104.50
|
|
Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution
|
$636.08 |
$636.08 |
$636.08 |
$77.65
|
|
Transcatheter bx s&i
|
$8,341.37 |
$8,341.37 |
$8,341.37 |
$1,875.96
|
|
Transferrin
|
$353.01 |
$353.01 |
$353.01 |
$87.30
|
|
Trastuzumab 150 mg intravenous solution
|
$12,989.61 |
$12,989.61 |
$12,989.61 |
$3,900.04
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour
|
$411.79 |
$411.79 |
$411.79 |
$241.15
|
|
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour
|
$325.63 |
$325.63 |
$325.63 |
$149.00
|
|
Treatment inhalation pressurized/nonpressurized acute airway obstruction
|
$245.68 |
$245.68 |
$245.68 |
$210.00
|
|
Treponema pallidum antibody
|
$141.06 |
$141.06 |
$141.06 |
$72.80
|
|
Triamcinolone acetonide 40 mg/ml suspension for injection
|
$194.72 |
$194.72 |
$194.72 |
$55.80
|
|
Tx atrial fib pulm vein isol
|
$41,161.39 |
$41,161.39 |
$41,161.39 |
$32,426.20
|
|
Tx l/r atrial fib addl
|
$4,075.17 |
$4,075.17 |
$4,075.17 |
$7,717.80
|
