|
Shoulder prosthesis removal
|
$1,177.20 |
$1,177.20 |
$1,177.20 |
$4,832.80
|
|
Shoulder X-ray
|
$256.77 |
$256.77 |
$256.77 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$24.03 |
$24.03 |
$24.03 |
$349.20
|
|
Sialography s&i
|
$19.17 |
$19.17 |
$19.17 |
$499.20
|
|
Sialolithotomy 42330
|
$224.64 |
$224.64 |
$224.64 |
$3,837.72
|
|
Sickling rbc
|
$8.91 |
$8.91 |
$8.91 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$275.67 |
$275.67 |
$275.67 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$103.68 |
$103.68 |
$103.68 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$107.73 |
$107.73 |
$107.73 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$280.53 |
$280.53 |
$280.53 |
$1,444.83
|
|
Sigmoidoscopy w/ablation
|
$146.34 |
$146.34 |
$146.34 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$96.66 |
$96.66 |
$96.66 |
$1,388.56
|
|
Sigmoidoscopy w/plcmt stent
|
$140.40 |
$140.40 |
$140.40 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$200.34 |
$200.34 |
$200.34 |
$2,564.40
|
|
Sigmoidoscopy w/tumr remove
|
$110.16 |
$110.16 |
$110.16 |
$1,558.80
|
|
Sigmoidoscopy w/ultrasound
|
$113.67 |
$113.67 |
$113.67 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$154.71 |
$154.71 |
$154.71 |
$2,106.60
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$86.40 |
$86.40 |
$86.40 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$71.82 |
$71.82 |
$71.82 |
$1,901.90
|
|
Simple cystometrogram 51725
|
$200.88 |
$200.88 |
$200.88 |
$589.45
|
|
Sinus CT scan (with and without contrast)
|
$1,319.49 |
$1,319.49 |
$1,319.49 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,036.53 |
$1,036.53 |
$1,036.53 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$894.78 |
$894.78 |
$894.78 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$56.16 |
$56.16 |
$56.16 |
$2,489.25
|
|
Sinusotomy maxillary sinus 31020
|
$500.85 |
$500.85 |
$500.85 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$569.16 |
$569.16 |
$569.16 |
$6,177.60
|
|
Skeletal muscle relaxant 1/2
|
$48.06 |
$48.06 |
$48.06 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$1.62 |
$1.62 |
$1.62 |
$16.12
|
|
Skin Biopsy
|
$96.39 |
$96.39 |
$96.39 |
$360.34
|
|
Skin full graft 20sq cm less 15200
|
$633.15 |
$633.15 |
$633.15 |
$2,371.50
|
|
Skin full graft add-on 15241
|
$97.47 |
$97.47 |
$97.47 |
$675.58
|
|
Skin pedicle flap trunk
|
$679.86 |
$679.86 |
$679.86 |
$2,501.86
|
|
Skin split graft addl 100sq cm 15101
|
$100.17 |
$100.17 |
$100.17 |
$1,793.40
|
|
Skyla, 13.5 mg
|
$493.29 |
$493.29 |
$493.29 |
$1,643.47
|
|
Sleep study attended
|
$38.61 |
$38.61 |
$38.61 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$441.72 |
$441.72 |
$441.72 |
$3,607.50
|
|
Sleep study unattended
|
$28.89 |
$28.89 |
$28.89 |
$580.87
|
|
Sling arm deluxe w/pad xs
|
$12.96 |
$12.96 |
$12.96 |
$30.35
|
|
Slitting of prepuce
|
$132.57 |
$132.57 |
$132.57 |
$3,365.50
|
|
Slp pure tone screening
|
$21.06 |
$21.06 |
$21.06 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$67.77 |
$67.77 |
$67.77 |
$296.34
|
|
Small bowel endoscopy
|
$131.22 |
$131.22 |
$131.22 |
$2,463.36
|
|
Small bowel endoscopy
|
$186.03 |
$186.03 |
$186.03 |
$2,244.82
|
|
Small bowel endoscopy
|
$217.89 |
$217.89 |
$217.89 |
$2,638.57
|
|
Small bowel endoscopy
|
$223.29 |
$223.29 |
$223.29 |
$2,389.40
|
|
Small bowel endoscopy
|
$258.12 |
$258.12 |
$258.12 |
$2,638.57
|
|
Small bowel endoscopy
|
$348.30 |
$348.30 |
$348.30 |
$2,842.50
|
|
Small bowel endoscopy
|
$68.58 |
$68.58 |
$68.58 |
$1,620.78
|
|
Small bowel endoscopy
|
$139.05 |
$139.05 |
$139.05 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$174.42 |
$174.42 |
$174.42 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$144.99 |
$144.99 |
$144.99 |
$2,413.20
|
|
Small bowel endoscopy/biopsy
|
$270.54 |
$270.54 |
$270.54 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$53.73 |
$53.73 |
$53.73 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$77.76 |
$77.76 |
$77.76 |
$2,381.60
|
|
Smear fluorescent and/or acid fast stain
|
$6.21 |
$6.21 |
$6.21 |
$64.20
|
|
Smear gram stain
|
$57.51 |
$57.51 |
$57.51 |
$55.25
|
|
Smear nasal eosinophil
|
$1.25 |
$1.25 |
$1.25 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$29.70 |
$29.70 |
$29.70 |
$73.15
|
|
Smear wet mount
|
$57.51 |
$57.51 |
$57.51 |
$67.49
|
|
Smpd1 gene common variants
|
$12.69 |
$12.69 |
$12.69 |
$133.84
|
|
Snrpn/ube3a gene
|
$90.45 |
$90.45 |
$90.45 |
$231.85
|
|
Sodium 24 hour urine
|
$52.92 |
$52.92 |
$52.92 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$38.96 |
$38.96 |
$38.96 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$18.23 |
$18.23 |
$18.23 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$47.52 |
$47.52 |
$47.52 |
$37.50
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$59.13 |
$59.13 |
$59.13 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$38.61 |
$38.61 |
$38.61 |
$45.60
|
|
Sp bone agrft morsel add-on
|
$147.96 |
$147.96 |
$147.96 |
$406.40
|
|
Sp bone agrft struct add-on
|
$160.92 |
$160.92 |
$160.92 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$198.45 |
$198.45 |
$198.45 |
$498.55
|
|
Special radiation dosimetry
|
$49.95 |
$49.95 |
$49.95 |
$392.50
|
|
Special radiation treatment
|
$116.37 |
$116.37 |
$116.37 |
$1,986.00
|
|
Special supplies phys/qhp
|
$910.17 |
$910.17 |
$910.17 |
$60.00
|
|
Special teletx port plan
|
$54.27 |
$54.27 |
$54.27 |
$1,086.99
|
|
Specific gravity body fluid
|
$0.71 |
$0.71 |
$0.71 |
$22.00
|
|
Speech recep thresh
|
$21.60 |
$21.60 |
$21.60 |
$82.88
|
|
Sperm antibody test
|
$13.03 |
$13.03 |
$13.03 |
$57.85
|
|
Sphenoid sinus surgery
|
$989.82 |
$989.82 |
$989.82 |
$6,547.81
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$691.74 |
$691.74 |
$691.74 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$97.20 |
$97.20 |
$97.20 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$217.89 |
$217.89 |
$217.89 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$212.49 |
$212.49 |
$212.49 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$274.32 |
$274.32 |
$274.32 |
$543.26
|
|
Splenectomy total open 38100
|
$1,034.10 |
$1,034.10 |
$1,034.10 |
$2,166.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$392.04 |
$392.04 |
$392.04 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$47.52 |
$47.52 |
$47.52 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$45.90 |
$45.90 |
$45.90 |
$34.00
|
|
Splint finger frog med
|
$25.38 |
$25.38 |
$25.38 |
$38.08
|
|
Splint func pos polyflex ii med
|
$11.34 |
$11.34 |
$11.34 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$64.80 |
$64.80 |
$64.80 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$646.38 |
$646.38 |
$646.38 |
$4,619.65
|
|
Split blood or products
|
$28.89 |
$28.89 |
$28.89 |
$127.48
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$119.61 |
$119.61 |
$119.61 |
$1,612.78
|
|
St analysis behavior qualitative voice/resonance
|
$41.85 |
$41.85 |
$41.85 |
$297.60
|
|
Staph a dna amp probe
|
$30.24 |
$30.24 |
$30.24 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$137.16 |
$137.16 |
$137.16 |
$286.00
|
|
Stenger test speech
|
$21.06 |
$21.06 |
$21.06 |
$404.25
|
|
Stent axios caut enh 15x10mm electrocaut
|
$2,991.33 |
$2,991.33 |
$2,991.33 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$734.67 |
$734.67 |
$734.67 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$3,338.28 |
$3,338.28 |
$3,338.28 |
$20,962.50
|