|
Removal cerumen impacted (both sides)
|
$35.21 |
$35.21 |
$35.21 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$107.32 |
$107.32 |
$107.32 |
$255.97
|
|
Removal foreign body foot subcutaneous right
|
$209.75 |
$209.75 |
$209.75 |
$1,260.80
|
|
Removal sutr and stapl no anes
|
$119.24 |
$119.24 |
$119.24 |
$82.05
|
|
Removal sutr or stapl no anes
|
$89.43 |
$89.43 |
$89.43 |
$93.88
|
|
Remove hip foreign body 27086
|
$262.57 |
$262.57 |
$262.57 |
$2,396.00
|
|
Remove renal tube w/fluoro
|
$873.49 |
$873.49 |
$873.49 |
$1,172.80
|
|
Renal function panel
|
$96.10 |
$96.10 |
$96.10 |
$114.37
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$272.63 |
$272.63 |
$272.63 |
$1,055.69
|
|
Repair extns tendon finger without grft ea
|
$618.69 |
$618.69 |
$618.69 |
$2,340.00
|
|
Repair finger/hand tendon
|
$756.01 |
$756.01 |
$756.01 |
$4,350.00
|
|
Repair lac palate<2 cm
|
$192.15 |
$192.15 |
$192.15 |
$780.65
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$218.30 |
$218.30 |
$218.30 |
$954.20
|
|
Repair rpr lip full thickness vermilion only
|
$319.41 |
$319.41 |
$319.41 |
$1,244.09
|
|
Replace duod/jej tube perc
|
$934.46 |
$934.46 |
$934.46 |
$1,357.60
|
|
Replace g/c tube perc
|
$690.57 |
$690.57 |
$690.57 |
$1,366.30
|
|
Replace g-j tube perc
|
$974.17 |
$974.17 |
$974.17 |
$1,568.05
|
|
Reptilase test
|
$18.69 |
$18.69 |
$18.69 |
$72.15
|
|
Resp virus 6-11 targets
|
$437.54 |
$437.54 |
$437.54 |
$479.20
|
|
Resuscitation delivery/birthing room
|
$690.10 |
$690.10 |
$690.10 |
$802.00
|
|
Reticulated platelet assay
|
$67.28 |
$67.28 |
$67.28 |
$75.00
|
|
Reticulocyte direct measurement automated
|
$10.59 |
$10.59 |
$10.59 |
$36.57
|
|
Rheumatoid factor quantitative
|
$40.64 |
$40.64 |
$40.64 |
$57.50
|
|
Rib and Chest X-ray (3 views, left side)
|
$296.14 |
$296.14 |
$296.14 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$372.50 |
$372.50 |
$372.50 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$303.45 |
$303.45 |
$303.45 |
$397.60
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$147.38 |
$147.38 |
$147.38 |
$1,876.00
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$3.68 |
$3.68 |
$3.68 |
$4,820.04
|
|
Rubella antibody igg
|
$41.38 |
$41.38 |
$41.38 |
$77.40
|
|
Rubeola antibody igg
|
$44.34 |
$44.34 |
$44.34 |
$80.00
|
|
Russell viper venom diluted
|
$37.38 |
$37.38 |
$37.38 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$1,739.26 |
$1,739.26 |
$1,739.26 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$349.26 |
$349.26 |
$349.26 |
$314.26
|
|
Salivary gland imaging
|
$521.42 |
$521.42 |
$521.42 |
$585.00
|
|
Salmonella antibody
|
$53.95 |
$53.95 |
$53.95 |
$37.58
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$448.50 |
$448.50 |
$448.50 |
$761.15
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$469.43 |
$469.43 |
$469.43 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$778.60 |
$778.60 |
$778.60 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$577.67 |
$577.67 |
$577.67 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$642.85 |
$642.85 |
$642.85 |
$597.35
|
|
Screening Mammogram
|
$278.26 |
$278.26 |
$278.26 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$70,301.14 |
$70,301.14 |
$70,301.14 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$749.40 |
$749.40 |
$749.40 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$5.61 |
$5.61 |
$5.61 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$67.41 |
$67.41 |
$67.41 |
$96.00
|
|
Semen analysis presence/motility
|
$32.60 |
$32.60 |
$32.60 |
$70.40
|
|
Semen analysis w/count
|
$22.91 |
$22.91 |
$22.91 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$364.03 |
$364.03 |
$364.03 |
$316.68
|
|
Sheath gldlight lasr 12fx50cm
|
$6,905.81 |
$6,905.81 |
$6,905.81 |
$6,570.70
|
|
Shot (Injection into Muscle or Under the Skin)
|
$113.81 |
$113.81 |
$113.81 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$250.33 |
$250.33 |
$250.33 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$177.95 |
$177.95 |
$177.95 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$2,085.47 |
$2,085.47 |
$2,085.47 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,737.77 |
$1,737.77 |
$1,737.77 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,390.07 |
$1,390.07 |
$1,390.07 |
$2,096.84
|
|
Shoulder X-ray
|
$294.82 |
$294.82 |
$294.82 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$213.81 |
$213.81 |
$213.81 |
$263.25
|
|
Shunt glaucoma baerveldt 350mm
|
$9,910.88 |
$9,910.88 |
$9,910.88 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$337.31 |
$337.31 |
$337.31 |
$355.80
|
|
Sickling rbc
|
$34.89 |
$34.89 |
$34.89 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$2,092.51 |
$2,092.51 |
$2,092.51 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,743.76 |
$1,743.76 |
$1,743.76 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,395.01 |
$1,395.01 |
$1,395.01 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$288.84 |
$288.84 |
$288.84 |
$346.45
|
|
Sinus X-ray (limited)
|
$183.93 |
$183.93 |
$183.93 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$94.86 |
$94.86 |
$94.86 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$272.90 |
$272.90 |
$272.90 |
$294.45
|
|
Skull X-ray (complete)
|
$313.41 |
$313.41 |
$313.41 |
$417.50
|
|
Slco1b1 gene com variants
|
$331.80 |
$331.80 |
$331.80 |
$241.24
|
|
Sleep study unattended
|
$503.15 |
$503.15 |
$503.15 |
$594.00
|
|
Sling suprapubic suburetheral
|
$9,609.67 |
$9,609.67 |
$9,609.67 |
$9,679.96
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$127.28 |
$127.28 |
$127.28 |
$139.44
|
|
Slp ther svc non-spch gen
|
$62.75 |
$62.75 |
$62.75 |
$188.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$400.39 |
$400.39 |
$400.39 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$45.42 |
$45.42 |
$45.42 |
$64.35
|
|
Smear gram stain
|
$8.68 |
$8.68 |
$8.68 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$12.02 |
$12.02 |
$12.02 |
$73.50
|
|
Smear wet mount
|
$35.40 |
$35.40 |
$35.40 |
$67.55
|
|
Snrpn/ube3a gene
|
$184.54 |
$184.54 |
$184.54 |
$230.63
|
|
Sodium 24 hour urine
|
$44.35 |
$44.35 |
$44.35 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$27.72 |
$27.72 |
$27.72 |
$46.26
|
|
Specific gravity body fluid
|
$6.16 |
$6.16 |
$6.16 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$236.80 |
$236.80 |
$236.80 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$114.26 |
$114.26 |
$114.26 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$776.35 |
$776.35 |
$776.35 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$219.12 |
$219.12 |
$219.12 |
$251.00
|
|
Sputum specimen collection
|
$303.06 |
$303.06 |
$303.06 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$224.96 |
$224.96 |
$224.96 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$151.55 |
$151.55 |
$151.55 |
$286.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$23,435.14 |
$23,435.14 |
$23,435.14 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$4,956.78 |
$4,956.78 |
$4,956.78 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$18,748.54 |
$18,748.54 |
$18,748.54 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$4,956.78 |
$4,956.78 |
$4,956.78 |
$4,631.82
|
|
St evaluate speech sound production
|
$165.17 |
$165.17 |
$165.17 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$178.92 |
$178.92 |
$178.92 |
$400.00
|
|
Stimulants synthetic
|
$98.56 |
$98.56 |
$98.56 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,245.84 |
$1,245.84 |
$1,245.84 |
$1,345.40
|
|
Strep b dna amp probe
|
$70.81 |
$70.81 |
$70.81 |
$124.15
|
|
Stress test pulmonary
|
$364.14 |
$364.14 |
$364.14 |
$324.00
|
|
Str markers specimen anal
|
$901.86 |
$901.86 |
$901.86 |
$756.60
|