|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$47,921.90 |
$47,921.90 |
$47,921.90 |
$26,561.92
|
|
Rmvl icd pulse gen only
|
$7,976.69 |
$7,976.69 |
$7,976.69 |
$4,114.00
|
|
Rmvl ndwellg tun pleural cath
|
$4,594.78 |
$4,594.78 |
$4,594.78 |
$1,217.97
|
|
Rmvl perm pm pulse gen
|
$7,864.99 |
$7,864.99 |
$7,864.99 |
$6,608.00
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$21,606.41 |
$21,606.41 |
$21,606.41 |
$17,475.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$20,526.17 |
$20,526.17 |
$20,526.17 |
$10,427.04
|
|
Rmvl pq iabp
|
$265.63 |
$265.63 |
$265.63 |
$1,082.40
|
|
Rmvl pq vad left hrt vein sep session
|
$5,022.85 |
$5,022.85 |
$5,022.85 |
$2,722.30
|
|
Rmvl subq card rhythm mntr
|
$4,189.07 |
$4,189.07 |
$4,189.07 |
$1,991.00
|
|
Rmvl tv pm lead dual
|
$7,976.69 |
$7,976.69 |
$7,976.69 |
$4,069.52
|
|
Rmvl tv pm lead sgl
|
$21,396.52 |
$21,396.52 |
$21,396.52 |
$4,195.80
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$62,797.94 |
$62,797.94 |
$62,797.94 |
$7,269.05
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$4,150.52 |
$4,150.52 |
$4,150.52 |
$180.55
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$9,436.88 |
$9,436.88 |
$9,436.88 |
$2,331.08
|
|
Rpl tun-cvad w subq port
|
$7,262.34 |
$7,262.34 |
$7,262.34 |
$4,738.00
|
|
Rpl tun cvc wo subq port
|
$13,143.82 |
$13,143.82 |
$13,143.82 |
$4,201.80
|
|
Rubella antibody igg
|
$285.57 |
$285.57 |
$285.57 |
$73.10
|
|
Rubeola antibody igg
|
$347.18 |
$347.18 |
$347.18 |
$79.68
|
|
Russell viper venom diluted
|
$99.60 |
$99.60 |
$99.60 |
$70.16
|
|
Salmonella antibody
|
$261.75 |
$261.75 |
$261.75 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,177.04 |
$1,177.04 |
$1,177.04 |
$670.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$910.14 |
$910.14 |
$910.14 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,160.34 |
$1,160.34 |
$1,160.34 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$754.41 |
$754.41 |
$754.41 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$754.41 |
$754.41 |
$754.41 |
$601.70
|
|
Screening Mammogram
|
$535.14 |
$535.14 |
$535.14 |
$303.55
|
|
Sedimentation rate erythrocyte automated
|
$405.66 |
$405.66 |
$405.66 |
$44.20
|
|
Serpina1 gene
|
$866.24 |
$866.24 |
$866.24 |
$191.73
|
|
Sho arthrs srg lmtd dbrdmt
|
$22,578.76 |
$22,578.76 |
$22,578.76 |
$3,839.54
|
|
Sho arthrs srg lss&rescj ads
|
$22,578.76 |
$22,578.76 |
$22,578.76 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$39,749.27 |
$39,749.27 |
$39,749.27 |
$5,419.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$22,578.76 |
$22,578.76 |
$22,578.76 |
$3,839.54
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$39,749.27 |
$39,749.27 |
$39,749.27 |
$6,839.00
|
|
Shoulder MRI (with and without contrast)
|
$3,302.52 |
$3,302.52 |
$3,302.52 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$2,420.05 |
$2,420.05 |
$2,420.05 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$2,277.93 |
$2,277.93 |
$2,277.93 |
$2,051.28
|
|
Shoulder X-ray
|
$711.93 |
$711.93 |
$711.93 |
$367.02
|
|
Sickling rbc
|
$90.53 |
$90.53 |
$90.53 |
$53.55
|
|
Sinus CT scan (with and without contrast)
|
$1,376.92 |
$1,376.92 |
$1,376.92 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$3,683.91 |
$3,683.91 |
$3,683.91 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$3,297.83 |
$3,297.83 |
$3,297.83 |
$1,279.50
|
|
Sleep Study (Polysomnography)
|
$8,280.74 |
$8,280.74 |
$8,280.74 |
$3,936.80
|
|
Slp ther svc non-spch gen
|
$428.36 |
$428.36 |
$428.36 |
$186.40
|
|
Smear fluorescent and/or acid fast stain
|
$106.96 |
$106.96 |
$106.96 |
$64.20
|
|
Smear gram stain
|
$303.31 |
$303.31 |
$303.31 |
$57.85
|
|
Smear special stain inclusion bodies/parasites
|
$328.91 |
$328.91 |
$328.91 |
$64.35
|
|
Smear wet mount
|
$316.46 |
$316.46 |
$316.46 |
$68.63
|
|
Sodium 24 hour urine
|
$283.32 |
$283.32 |
$283.32 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$75.07 |
$75.07 |
$75.07 |
$46.43
|
|
Sodium chloride 3 % ivpb
|
$218.76 |
$218.76 |
$218.76 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$833.41 |
$833.41 |
$833.41 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$4,430.26 |
$4,430.26 |
$4,430.26 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$299.81 |
$299.81 |
$299.81 |
$42.70
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,843.45 |
$1,843.45 |
$1,843.45 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$902.95 |
$902.95 |
$902.95 |
$559.96
|
|
Split blood or products
|
$1,211.95 |
$1,211.95 |
$1,211.95 |
$148.98
|
|
Srs multisource
|
$33,978.12 |
$33,978.12 |
$33,978.12 |
$31,800.00
|
|
St analysis behavior qualitative voice/resonance
|
$562.47 |
$562.47 |
$562.47 |
$300.00
|
|
Staph a dna amp probe
|
$696.36 |
$696.36 |
$696.36 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$1,013.28 |
$1,013.28 |
$1,013.28 |
$313.96
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$121,550.61 |
$121,550.61 |
$121,550.61 |
$23,387.00
|
|
Stent iliac/open or perc/uni/init 37221
|
$43,233.19 |
$43,233.19 |
$43,233.19 |
$17,281.80
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$49,164.40 |
$49,164.40 |
$49,164.40 |
$9,276.80
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$73,062.21 |
$73,062.21 |
$73,062.21 |
$19,765.20
|
|
St evaluate speech sound production
|
$562.54 |
$562.54 |
$562.54 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$670.39 |
$670.39 |
$670.39 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$480.42 |
$480.42 |
$480.42 |
$406.40
|
|
St evaluation swallow function
|
$1,153.56 |
$1,153.56 |
$1,153.56 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$1,330.26 |
$1,330.26 |
$1,330.26 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$487.48 |
$487.48 |
$487.48 |
$171.00
|
|
Strapping of hand or finger
|
$487.48 |
$487.48 |
$487.48 |
$194.40
|
|
Strapping of knee
|
$956.11 |
$956.11 |
$956.11 |
$224.80
|
|
Strapping of toes 29550
|
$511.85 |
$511.85 |
$511.85 |
$185.36
|
|
Strep b dna amp probe
|
$130.08 |
$130.08 |
$130.08 |
$139.20
|
|
Stress test pulmonary
|
$910.58 |
$910.58 |
$910.58 |
$327.20
|
|
Stress tte complete
|
$4,311.57 |
$4,311.57 |
$4,311.57 |
$1,964.95
|
|
St treatment speech individual
|
$312.15 |
$312.15 |
$312.15 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$291.18 |
$291.18 |
$291.18 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$490.21 |
$490.21 |
$490.21 |
$49.13
|
|
Sulfonylurea screen qn-sendout
|
$252.99 |
$252.99 |
$252.99 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$289.74 |
$289.74 |
$289.74 |
$91.67
|
|
Surgical pathology level 1 gross examination only
|
$238.14 |
$238.14 |
$238.14 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$382.90 |
$382.90 |
$382.90 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$460.74 |
$460.74 |
$460.74 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$1,466.37 |
$1,466.37 |
$1,466.37 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,019.94 |
$1,019.94 |
$1,019.94 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$2,675.35 |
$2,675.35 |
$2,675.35 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$94.27 |
$94.27 |
$94.27 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$94.27 |
$94.27 |
$94.27 |
$34.48
|
|
Susceptibility mic per plate
|
$4,327.40 |
$4,327.40 |
$4,327.40 |
$94.38
|
|
Suscept studies macrobroth dilution ea
|
$131.78 |
$131.78 |
$131.78 |
$48.30
|
|
Svc venogram s&i
|
$9,436.88 |
$9,436.88 |
$9,436.88 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$5,324.48 |
$5,324.48 |
$5,324.48 |
$1,415.99
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$87.32 |
$87.32 |
$87.32 |
$44.85
|
|
T3 (triiodothyronine) free
|
$51.67 |
$51.67 |
$51.67 |
$89.82
|
|
T3 (triiodothyronine) total
|
$411.09 |
$411.09 |
$411.09 |
$94.90
|
|
T4 (thyroxine) free
|
$471.65 |
$471.65 |
$471.65 |
$81.60
|
|
T4 (thyroxine) total
|
$522.45 |
$522.45 |
$522.45 |
$73.64
|
|
Tacrolimus therapeutic drug level
|
$114.87 |
$114.87 |
$114.87 |
$122.40
|
|
Target gsa panel hmtlmph neop
|
$2,930.84 |
$2,930.84 |
$2,930.84 |
$1,928.40
|