|
Scan duplex extracranial arteries unilateral/limited study
|
$236.40 |
$278.24 |
$652.08 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$291.54 |
$343.14 |
$658.95 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$332.67 |
$338.01 |
$666.98 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$219.62 |
$288.83 |
$663.92 |
$595.35
|
|
Sclerotherapy fluid collection pq w/img
|
$832.35 |
$832.35 |
$1,184.20 |
$2,148.60
|
|
Scope uretscp lithovue dig disp
|
$1,991.97 |
$2,191.54 |
$2,515.00 |
$4,246.72
|
|
Screening hepatitis b non-obstetric high risk
|
$46.23 |
$46.23 |
$46.23 |
$60.00
|
|
Screening Mammogram
|
$241.05 |
$241.05 |
$268.95 |
$310.20
|
|
Screening prostate cancer PSA
|
$58.17 |
$58.17 |
$98.94 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$7,557.00 |
$21,670.86 |
$37,581.54 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$249.19 |
$284.17 |
$511.12 |
$608.90
|
|
Sec art mech thrmbc non-intracranial add-on
|
$2,303.73 |
$2,490.35 |
$5,479.03 |
$4,336.20
|
|
Sedimentation rate erythrocyte automated
|
$1.65 |
$2.03 |
$71.44 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$19.58 |
$29.37 |
$76.40 |
$96.60
|
|
Semen analysis w/count
|
$4.47 |
$4.47 |
$6.73 |
$56.44
|
|
Serpina1 gene
|
$64.70 |
$64.70 |
$96.53 |
$197.00
|
|
Sertraline (zoloft) - sendout
|
$33.28 |
$33.28 |
$33.28 |
$126.43
|
|
Set radiation therapy field
|
$471.39 |
$471.39 |
$535.22 |
$782.61
|
|
Set radiation therapy field
|
$857.46 |
$857.46 |
$857.46 |
$1,159.03
|
|
Set radiation therapy field
|
$955.65 |
$955.65 |
$1,273.97 |
$1,636.36
|
|
Sevelamer carbonate pdr 20mg
|
$19.49 |
$19.49 |
$19.49 |
$21.42
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$302.55 |
$302.55 |
$302.55 |
$286.89
|
|
Sheath gldlight lasr 12fx50cm
|
$2,515.00 |
$2,981.51 |
$2,987.42 |
$6,570.70
|
|
Sheath laser cavaclear 14f
|
$2,981.51 |
$2,981.51 |
$2,981.51 |
$7,143.32
|
|
Shoe heel new rubber standar
|
$82.52 |
$82.52 |
$82.52 |
$63.70
|
|
Shoe lift elev heel/sole neo
|
$157.77 |
$157.77 |
$157.77 |
$175.04
|
|
Shoe outflare wedge
|
$106.96 |
$106.96 |
$106.96 |
$107.24
|
|
Shoe post-op mens m
|
$4.36 |
$4.36 |
$61.12 |
$53.20
|
|
Shot (Injection into Muscle or Under the Skin)
|
$54.25 |
$64.45 |
$156.62 |
$136.80
|
|
Shoulder AC Joint X-ray (both sides)
|
$78.56 |
$84.88 |
$197.50 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$94.74 |
$102.37 |
$226.15 |
$287.25
|
|
Shoulder MRI (with and without contrast)
|
$690.61 |
$701.57 |
$2,899.00 |
$2,821.65
|
|
Shoulder MRI (with contrast)
|
$575.50 |
$584.64 |
$1,314.47 |
$2,483.00
|
|
Shoulder MRI (without contrast)
|
$460.40 |
$467.71 |
$2,457.03 |
$2,088.20
|
|
Shoulder X-ray
|
$101.27 |
$109.42 |
$373.73 |
$341.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$72.82 |
$78.68 |
$258.62 |
$264.00
|
|
Shrinker prosth below knee
|
$304.84 |
$304.84 |
$304.84 |
$105.12
|
|
Shunt glaucoma baerveldt 350mm
|
$1,296.51 |
$1,296.51 |
$1,296.51 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$85.09 |
$91.93 |
$233.36 |
$355.80
|
|
Sialography s&i
|
$179.57 |
$179.57 |
$194.02 |
$499.20
|
|
Sickling rbc
|
$10.25 |
$20.57 |
$37.82 |
$59.40
|
|
Sigmoidoscopy and biopsy
|
$1,390.87 |
$1,390.87 |
$1,390.87 |
$1,446.90
|
|
Signal avg ecg w or without ecg 93278
|
$197.32 |
$197.32 |
$207.23 |
$280.00
|
|
Sincalide 5 mcg solution for injection
|
$153.19 |
$153.19 |
$194.88 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$381.60 |
$397.59 |
$1,300.33 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$317.97 |
$331.30 |
$1,080.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$254.34 |
$265.00 |
$884.33 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$1,069.84 |
$1,155.92 |
$3,349.38 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$88.48 |
$95.60 |
$208.58 |
$347.10
|
|
Sinus X-ray (limited)
|
$74.39 |
$80.37 |
$166.94 |
$215.75
|
|
Sipuleucel-t - su
|
$71,819.82 |
$71,819.82 |
$71,819.82 |
$100,990.51
|
|
Sirolimus, oral
|
$56.92 |
$56.92 |
$56.92 |
$41.70
|
|
Skeletal muscle relaxant 1/2
|
$24.33 |
$24.33 |
$24.64 |
$83.85
|
|
Skin Biopsy
|
$205.13 |
$205.13 |
$303.31 |
$361.20
|
|
Skin split graft addl 100sq cm 15101
|
$1,681.43 |
$1,681.43 |
$1,681.43 |
$1,793.40
|
|
Skull X-ray (1 to 3 views)
|
$88.22 |
$95.32 |
$226.53 |
$294.66
|
|
Skull X-ray (complete)
|
$112.23 |
$121.26 |
$285.74 |
$423.15
|
|
Slco1b1 gene com variants
|
$98.17 |
$98.17 |
$146.48 |
$235.20
|
|
Sleep study attended
|
$1,147.18 |
$1,147.18 |
$1,147.18 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,588.34 |
$2,588.34 |
$2,588.34 |
$3,734.50
|
|
Sleep study unattended
|
$518.83 |
$518.83 |
$518.83 |
$594.00
|
|
Sling suprapubic suburetheral
|
$1,462.86 |
$6,551.30 |
$8,769.90 |
$9,679.96
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$46.99 |
$46.99 |
$46.99 |
$139.44
|
|
Slp eval non-spch gen comm dev
|
$164.26 |
$164.26 |
$164.26 |
$285.09
|
|
Slp ther svc non-spch gen
|
$63.20 |
$63.20 |
$962.64 |
$188.00
|
|
Sm-153 lexidron ther
|
$5,745.00 |
$5,745.00 |
$8,207.97 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$143.29 |
$154.82 |
$314.39 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$15.03 |
$18.43 |
$82.90 |
$64.20
|
|
Smear gram stain
|
$28.07 |
$34.42 |
$73.35 |
$55.42
|
|
Smear nasal eosinophil
|
$22.90 |
$22.90 |
$37.44 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$15.91 |
$19.51 |
$105.44 |
$73.15
|
|
Smear wet mount
|
$11.71 |
$14.36 |
$80.22 |
$67.49
|
|
Smpd1 gene common variants
|
$427.08 |
$427.08 |
$427.08 |
$133.84
|
|
Snrpn/ube3a gene
|
$54.60 |
$132.52 |
$442.36 |
$228.80
|
|
Socket insert without lock mech
|
$1,604.40 |
$1,604.40 |
$1,604.40 |
$1,192.50
|
|
Sock fracture or equal each
|
$233.79 |
$233.79 |
$233.79 |
$74.51
|
|
Sock wool above knee
|
$61.12 |
$61.12 |
$61.12 |
$51.18
|
|
Sodium 24 hour urine
|
$11.38 |
$11.52 |
$75.64 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$22.54 |
$22.54 |
$80.15 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$22.54 |
$22.54 |
$80.15 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$22.54 |
$22.54 |
$80.15 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$22.54 |
$22.54 |
$80.15 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$58.45 |
$58.45 |
$74.20 |
$80.73
|
|
Sodium serum/plasma/whole blood
|
$15.17 |
$16.32 |
$55.78 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$163.50 |
$163.50 |
$163.50 |
$177.52
|
|
Soft interface below knee se
|
$515.70 |
$515.70 |
$515.70 |
$179.08
|
|
Somatropin injection
|
$836.97 |
$836.97 |
$836.97 |
$2,111.40
|
|
Special physics consult
|
$542.60 |
$542.60 |
$731.15 |
$725.00
|
|
Special radiation dosimetry
|
$241.05 |
$241.05 |
$276.60 |
$392.50
|
|
Special radiation treatment
|
$1,551.27 |
$1,551.27 |
$2,936.44 |
$2,052.00
|
|
Special teletx port plan
|
$850.08 |
$850.08 |
$1,093.67 |
$1,095.05
|
|
Specific gravity body fluid
|
$1.58 |
$1.60 |
$27.51 |
$22.00
|
|
Specimen fat stain
|
$3.10 |
$3.10 |
$4.66 |
$35.10
|
|
Speech and Language Evaluation (comprehensive)
|
$63.25 |
$94.88 |
$458.02 |
$385.00
|
|
Speech evaluation complex
|
$194.97 |
$194.97 |
$210.65 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$43.01 |
$64.52 |
$154.33 |
$248.30
|
|
Sperm antibody test
|
$13.42 |
$13.42 |
$13.42 |
$57.85
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$708.98 |
$1,388.19 |
$1,562.17 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$63.42 |
$68.53 |
$221.56 |
$251.00
|
|
Spleen imaging
|
$215.01 |
$215.01 |
$404.54 |
$679.00
|