|
Sigmoidoscopy for bleeding
|
$79.80 |
$79.80 |
$79.80 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$207.80 |
$207.80 |
$207.80 |
$1,444.83
|
|
Sigmoidoscopy w/ablation
|
$108.40 |
$108.40 |
$108.40 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$71.60 |
$71.60 |
$71.60 |
$1,388.56
|
|
Sigmoidoscopy w/plcmt stent
|
$104.00 |
$104.00 |
$104.00 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$148.40 |
$148.40 |
$148.40 |
$2,564.40
|
|
Sigmoidoscopy w/tumr remove
|
$81.60 |
$81.60 |
$81.60 |
$1,558.80
|
|
Sigmoidoscopy w/ultrasound
|
$84.20 |
$84.20 |
$84.20 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$114.60 |
$114.60 |
$114.60 |
$2,106.60
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$64.00 |
$64.00 |
$64.00 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$53.20 |
$53.20 |
$53.20 |
$1,901.90
|
|
Simple cystometrogram 51725
|
$148.80 |
$148.80 |
$148.80 |
$589.45
|
|
Sinus CT scan (with and without contrast)
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$774.20 |
$774.20 |
$774.20 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$41.60 |
$41.60 |
$41.60 |
$2,489.25
|
|
Sinusotomy maxillary sinus 31020
|
$371.00 |
$371.00 |
$371.00 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$421.60 |
$421.60 |
$421.60 |
$6,177.60
|
|
Skeletal muscle relaxant 1/2
|
$35.60 |
$35.60 |
$35.60 |
$83.85
|
|
Skel musc relaxant 3 or more
|
$1.20 |
$1.20 |
$1.20 |
$16.12
|
|
Skin Biopsy
|
$145.00 |
$145.00 |
$145.00 |
$360.34
|
|
Skin full graft 20sq cm less 15200
|
$469.00 |
$469.00 |
$469.00 |
$2,371.50
|
|
Skin full graft add-on 15241
|
$72.20 |
$72.20 |
$72.20 |
$675.58
|
|
Skin pedicle flap trunk
|
$503.60 |
$503.60 |
$503.60 |
$2,501.86
|
|
Skin split graft addl 100sq cm 15101
|
$728.00 |
$728.00 |
$728.00 |
$1,793.40
|
|
Skyla, 13.5 mg
|
$365.40 |
$365.40 |
$365.40 |
$1,643.47
|
|
Sleep study attended
|
$28.60 |
$28.60 |
$28.60 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$327.20 |
$327.20 |
$327.20 |
$3,607.50
|
|
Sleep study unattended
|
$476.20 |
$476.20 |
$476.20 |
$580.87
|
|
Sleeve fing rolyan med
|
$74.20 |
$74.20 |
$74.20 |
$203.58
|
|
Sling arm deluxe w/pad xs
|
$8.20 |
$8.20 |
$8.20 |
$30.35
|
|
Sling suprapubic suburetheral
|
$2,424.40 |
$2,424.40 |
$2,424.40 |
$9,679.96
|
|
Slitting of prepuce
|
$98.20 |
$98.20 |
$98.20 |
$3,365.50
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$25.40 |
$25.40 |
$25.40 |
$129.20
|
|
Slp eval non-spch gen comm dev
|
$71.40 |
$71.40 |
$71.40 |
$285.09
|
|
Slp pure tone screening
|
$15.60 |
$15.60 |
$15.60 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$50.20 |
$50.20 |
$50.20 |
$296.34
|
|
Slp ther svc non-spch gen
|
$71.00 |
$71.00 |
$71.00 |
$188.50
|
|
Sm-153 lexidron ther
|
$13,323.80 |
$13,323.80 |
$13,323.80 |
$7,320.12
|
|
Small bowel endoscopy
|
$97.20 |
$97.20 |
$97.20 |
$2,463.36
|
|
Small bowel endoscopy
|
$137.80 |
$137.80 |
$137.80 |
$2,244.82
|
|
Small bowel endoscopy
|
$161.40 |
$161.40 |
$161.40 |
$2,638.57
|
|
Small bowel endoscopy
|
$165.40 |
$165.40 |
$165.40 |
$2,389.40
|
|
Small bowel endoscopy
|
$191.20 |
$191.20 |
$191.20 |
$2,638.57
|
|
Small bowel endoscopy
|
$258.00 |
$258.00 |
$258.00 |
$2,842.50
|
|
Small bowel endoscopy
|
$50.80 |
$50.80 |
$50.80 |
$1,620.78
|
|
Small bowel endoscopy
|
$103.00 |
$103.00 |
$103.00 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$129.20 |
$129.20 |
$129.20 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$107.40 |
$107.40 |
$107.40 |
$2,413.20
|
|
Small bowel endoscopy/biopsy
|
$200.40 |
$200.40 |
$200.40 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$39.80 |
$39.80 |
$39.80 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$57.60 |
$57.60 |
$57.60 |
$2,381.60
|
|
Smear fluorescent and/or acid fast stain
|
$34.40 |
$34.40 |
$34.40 |
$64.20
|
|
Smear gram stain
|
$14.20 |
$14.20 |
$14.20 |
$55.25
|
|
Smear nasal eosinophil
|
$16.60 |
$16.60 |
$16.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$32.20 |
$32.20 |
$32.20 |
$73.15
|
|
Smear wet mount
|
$14.20 |
$14.20 |
$14.20 |
$67.49
|
|
Snrpn/ube3a gene
|
$67.00 |
$67.00 |
$67.00 |
$231.85
|
|
Sodium 24 hour urine
|
$28.00 |
$28.00 |
$28.00 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$14.29 |
$14.29 |
$14.29 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$9.00 |
$9.00 |
$9.00 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$8.94 |
$8.94 |
$8.94 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$17.72 |
$17.72 |
$17.72 |
$40.61
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$46.60 |
$46.60 |
$46.60 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$22.20 |
$22.20 |
$22.20 |
$45.60
|
|
Sp bone agrft morsel add-on
|
$109.60 |
$109.60 |
$109.60 |
$406.40
|
|
Sp bone agrft struct add-on
|
$119.20 |
$119.20 |
$119.20 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$147.00 |
$147.00 |
$147.00 |
$498.55
|
|
Special radiation dosimetry
|
$37.00 |
$37.00 |
$37.00 |
$392.50
|
|
Special radiation treatment
|
$86.20 |
$86.20 |
$86.20 |
$1,986.00
|
|
Special supplies phys/qhp
|
$488.56 |
$488.56 |
$488.56 |
$60.00
|
|
Special teletx port plan
|
$40.20 |
$40.20 |
$40.20 |
$1,086.99
|
|
Specific gravity body fluid
|
$14.00 |
$14.00 |
$14.00 |
$22.00
|
|
Speech recep thresh
|
$16.00 |
$16.00 |
$16.00 |
$82.88
|
|
Sphenoid sinus surgery
|
$733.20 |
$733.20 |
$733.20 |
$6,547.81
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$512.40 |
$512.40 |
$512.40 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$72.00 |
$72.00 |
$72.00 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$161.40 |
$161.40 |
$161.40 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$654.20 |
$654.20 |
$654.20 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$323.00 |
$323.00 |
$323.00 |
$543.26
|
|
Splenectomy total open 38100
|
$766.00 |
$766.00 |
$766.00 |
$2,166.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$290.40 |
$290.40 |
$290.40 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$35.20 |
$35.20 |
$35.20 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$34.00 |
$34.00 |
$34.00 |
$34.00
|
|
Splint finger frog med
|
$18.80 |
$18.80 |
$18.80 |
$38.08
|
|
Splint func pos polyflex ii med
|
$13.00 |
$13.00 |
$13.00 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$48.00 |
$48.00 |
$48.00 |
$99.04
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$478.80 |
$478.80 |
$478.80 |
$4,619.65
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$88.60 |
$88.60 |
$88.60 |
$1,612.78
|
|
Sr-89 stront chlor ther / mci
|
$1,698.60 |
$1,698.60 |
$1,698.60 |
$2,667.94
|
|
St analysis behavior qualitative voice/resonance
|
$214.60 |
$214.60 |
$214.60 |
$297.60
|
|
Staph a dna amp probe
|
$91.00 |
$91.00 |
$91.00 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$83.00 |
$83.00 |
$83.00 |
$286.00
|
|
Stenger test speech
|
$15.60 |
$15.60 |
$15.60 |
$404.25
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,827.00 |
$6,827.00 |
$6,827.00 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$5,332.20 |
$5,332.20 |
$5,332.20 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$2,472.80 |
$2,472.80 |
$2,472.80 |
$20,962.50
|
|
Stereotactic radiation trmt
|
$339.40 |
$339.40 |
$339.40 |
$845.60
|
|
Sterile water/saline, 10 ml
|
$8.42 |
$8.42 |
$8.42 |
$13.32
|
|
Sternal debridement
|
$379.20 |
$379.20 |
$379.20 |
$1,318.40
|
