|
Rp loclzj tum 2+area 1+d img
|
$646.15 |
$646.15 |
$646.15 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$1,435.56 |
$1,435.56 |
$1,435.56 |
$2,556.60
|
|
Rp loclzj tum spect w/ct 2
|
$1,887.08 |
$1,887.08 |
$1,887.08 |
$3,176.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$1,324.01 |
$1,324.01 |
$1,324.01 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$2,628.36 |
$2,628.36 |
$2,628.36 |
$4,738.00
|
|
Rpl tun-cvad w subq pump
|
$3,724.85 |
$3,724.85 |
$3,724.85 |
$5,988.54
|
|
Rpl tun cvc wo subq port
|
$1,765.65 |
$1,765.65 |
$1,765.65 |
$3,724.63
|
|
Rsv assay w/optic
|
$11.16 |
$11.16 |
$11.16 |
$76.32
|
|
Rubella antibody igg
|
$14.95 |
$14.95 |
$14.95 |
$77.40
|
|
Rubeola antibody igg
|
$16.02 |
$16.02 |
$16.02 |
$80.00
|
|
Russell viper venom diluted
|
$16.92 |
$16.92 |
$16.92 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$1,188.86 |
$1,188.86 |
$1,188.86 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$64.42 |
$64.42 |
$64.42 |
$314.26
|
|
Salivary gland imaging
|
$374.45 |
$374.45 |
$374.45 |
$585.00
|
|
Salmonella antibody
|
$19.49 |
$19.49 |
$19.49 |
$37.58
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$279.55 |
$279.55 |
$279.55 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$170.66 |
$170.66 |
$170.66 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$341.95 |
$341.95 |
$341.95 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$294.22 |
$294.22 |
$294.22 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$218.71 |
$218.71 |
$218.71 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$181.58 |
$181.58 |
$181.58 |
$597.35
|
|
Sclerotherapy fluid collection pq w/img
|
$1,374.97 |
$1,374.97 |
$1,374.97 |
$2,144.48
|
|
Scope uretscp lithovue dig disp
|
$2,733.17 |
$2,733.17 |
$2,733.17 |
$4,246.72
|
|
Screening Mammogram
|
$163.10 |
$163.10 |
$163.10 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$48,750.88 |
$48,750.88 |
$48,750.88 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$204.61 |
$204.61 |
$204.61 |
$611.91
|
|
Sec art mech thrmbc non-intracranial add-on
|
$2,454.03 |
$2,454.03 |
$2,454.03 |
$4,332.68
|
|
Sedimentation rate erythrocyte automated
|
$2.54 |
$2.54 |
$2.54 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$60.45 |
$60.45 |
$60.45 |
$96.00
|
|
Semen analysis presence/motility
|
$15.65 |
$15.65 |
$15.65 |
$70.40
|
|
Semen analysis w/count
|
$11.00 |
$11.00 |
$11.00 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$248.83 |
$248.83 |
$248.83 |
$316.68
|
|
Serpina1 gene
|
$149.47 |
$149.47 |
$149.47 |
$197.00
|
|
Set radiation therapy field
|
$730.57 |
$730.57 |
$730.57 |
$782.61
|
|
Set radiation therapy field
|
$876.29 |
$876.29 |
$876.29 |
$1,159.03
|
|
Set radiation therapy field
|
$1,403.92 |
$1,403.92 |
$1,403.92 |
$1,636.36
|
|
Sf3b1 gene common variants
|
$250.56 |
$250.56 |
$250.56 |
$248.10
|
|
Sheath gldlight lasr 12fx50cm
|
$4,099.02 |
$4,099.02 |
$4,099.02 |
$6,570.70
|
|
Shot (Injection into Muscle or Under the Skin)
|
$51.32 |
$51.32 |
$51.32 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$87.30 |
$87.30 |
$87.30 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$66.18 |
$66.18 |
$66.18 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$617.99 |
$617.99 |
$617.99 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$514.92 |
$514.92 |
$514.92 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$411.86 |
$411.86 |
$411.86 |
$2,096.84
|
|
Shoulder X-ray
|
$57.73 |
$57.73 |
$57.73 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$52.45 |
$52.45 |
$52.45 |
$263.25
|
|
Shunt glaucoma baerveldt 350mm
|
$5,155.04 |
$5,155.04 |
$5,155.04 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$241.12 |
$241.12 |
$241.12 |
$355.80
|
|
Sialography s&i
|
$205.22 |
$205.22 |
$205.22 |
$499.20
|
|
Sickling rbc
|
$15.79 |
$15.79 |
$15.79 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$445.18 |
$445.18 |
$445.18 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$370.98 |
$370.98 |
$370.98 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$296.78 |
$296.78 |
$296.78 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$1,320.70 |
$1,320.70 |
$1,320.70 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$63.01 |
$63.01 |
$63.01 |
$346.45
|
|
Sinus X-ray (limited)
|
$46.82 |
$46.82 |
$46.82 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$35.42 |
$35.42 |
$35.42 |
$83.85
|
|
Skin Biopsy
|
$121.50 |
$121.50 |
$121.50 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$66.18 |
$66.18 |
$66.18 |
$294.45
|
|
Skull X-ray (complete)
|
$76.03 |
$76.03 |
$76.03 |
$417.50
|
|
Slco1b1 gene com variants
|
$226.80 |
$226.80 |
$226.80 |
$241.24
|
|
Sleep study attended
|
$1,223.11 |
$1,223.11 |
$1,223.11 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,759.67 |
$2,759.67 |
$2,759.67 |
$3,734.50
|
|
Sleep study unattended
|
$505.99 |
$505.99 |
$505.99 |
$594.00
|
|
Sling suprapubic suburetheral
|
$9,751.36 |
$9,751.36 |
$9,751.36 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$142.60 |
$142.60 |
$142.60 |
$285.09
|
|
Slp ther svc non-spch gen
|
$85.60 |
$85.60 |
$85.60 |
$188.50
|
|
Sm-153 lexidron ther
|
$8,659.14 |
$8,659.14 |
$8,659.14 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$127.42 |
$127.42 |
$127.42 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$18.97 |
$18.97 |
$18.97 |
$64.35
|
|
Smear gram stain
|
$3.63 |
$3.63 |
$3.63 |
$55.55
|
|
Smear special stain inclusion bodies/parasites
|
$17.86 |
$17.86 |
$17.86 |
$73.50
|
|
Smear wet mount
|
$14.79 |
$14.79 |
$14.79 |
$67.55
|
|
Snrpn/ube3a gene
|
$126.14 |
$126.14 |
$126.14 |
$230.63
|
|
Sodium 24 hour urine
|
$16.56 |
$16.56 |
$16.56 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$3.45 |
$3.45 |
$3.45 |
$46.26
|
|
Special physics consult
|
$700.74 |
$700.74 |
$700.74 |
$725.00
|
|
Special radiation dosimetry
|
$368.22 |
$368.22 |
$368.22 |
$392.50
|
|
Special radiation treatment
|
$1,719.32 |
$1,719.32 |
$1,719.32 |
$2,052.00
|
|
Special teletx port plan
|
$802.45 |
$802.45 |
$802.45 |
$1,095.05
|
|
Specific gravity body fluid
|
$2.30 |
$2.30 |
$2.30 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$233.69 |
$233.69 |
$233.69 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$122.84 |
$122.84 |
$122.84 |
$246.87
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$2,492.47 |
$2,492.47 |
$2,492.47 |
$3,245.23
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$690.62 |
$690.62 |
$690.62 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$52.80 |
$52.80 |
$52.80 |
$251.00
|
|
Split blood or products
|
$145.51 |
$145.51 |
$145.51 |
$127.80
|
|
Sprchoroidal spc njx rx agt
|
$296.81 |
$296.81 |
$296.81 |
$454.19
|
|
Sputum specimen collection
|
$145.51 |
$145.51 |
$145.51 |
$180.00
|
|
Srsf2 gene common variants
|
$227.66 |
$227.66 |
$227.66 |
$192.94
|
|
Srs linear based
|
$13,241.63 |
$13,241.63 |
$13,241.63 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$161.78 |
$161.78 |
$161.78 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$212.77 |
$212.77 |
$212.77 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$19,154.84 |
$19,154.84 |
$19,154.84 |
$21,249.26
|
|
Stent axios caut enh 15x10mm electrocaut
|
$21,126.22 |
$21,126.22 |
$21,126.22 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$3,437.32 |
$3,437.32 |
$3,437.32 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$13,001.32 |
$13,001.32 |
$13,001.32 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$3,437.32 |
$3,437.32 |
$3,437.32 |
$4,631.82
|
|
Stent iliac/open or perc/uni/init 37221
|
$14,050.55 |
$14,050.55 |
$14,050.55 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$6,599.96 |
$6,599.96 |
$6,599.96 |
$8,925.76
|
