|
Scan duplex lower extremity arteries unilateral/limited study left
|
$626.60 |
$626.60 |
$626.60 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$626.60 |
$626.60 |
$626.60 |
$597.35
|
|
Scan proc cranial extra
|
$909.35 |
$909.35 |
$909.35 |
$2,248.40
|
|
Scan proc cranial intra 61781
|
$975.00 |
$975.00 |
$975.00 |
$1,015.00
|
|
Scan proc spinal
|
$975.00 |
$975.00 |
$975.00 |
$2,544.58
|
|
Sclerotherapy fluid collection pq w/img
|
$6,055.40 |
$6,055.40 |
$6,055.40 |
$2,148.60
|
|
Scr c/v cyto,autosys and md
|
$74.10 |
$74.10 |
$74.10 |
$55.20
|
|
Screen cerv/vag thin layer
|
$58.50 |
$58.50 |
$58.50 |
$86.56
|
|
Screen c/v thin layer by md
|
$74.10 |
$74.10 |
$74.10 |
$55.20
|
|
Screening Colonoscopy (average risk)
|
$2,963.35 |
$2,963.35 |
$2,963.35 |
$1,800.00
|
|
Screening Colonoscopy (high risk)
|
$2,963.35 |
$2,963.35 |
$2,963.35 |
$2,000.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$260.00 |
$260.00 |
$260.00 |
$57.60
|
|
Screening hepatitis c antibody high risk
|
$190.45 |
$190.45 |
$190.45 |
$93.60
|
|
Screening Mammogram
|
$637.00 |
$637.00 |
$793.00 |
$311.50
|
|
Screening prostate cancer PSA
|
$82.55 |
$82.55 |
$834.00 |
$101.60
|
|
Screen pap by tech w md supv
|
$69.55 |
$69.55 |
$69.55 |
$53.46
|
|
Screen/visual acuity/bilat/quant 99173
|
$146.25 |
$146.25 |
$146.25 |
$28.86
|
|
Scrotal (Testicle) Ultrasound
|
$763.10 |
$763.10 |
$763.10 |
$611.91
|
|
Sc ther infusion reset pump
|
$126.75 |
$126.75 |
$126.75 |
$140.15
|
|
Sec abd wall suture evisceration/dehsn 49900
|
$3,226.60 |
$3,226.60 |
$3,226.60 |
$2,005.60
|
|
Sec art mech thrmbc non-intracranial add-on
|
$5,712.85 |
$5,712.85 |
$5,712.85 |
$4,380.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$569.40 |
$569.40 |
$569.40 |
$223.89
|
|
Sedimentation rate erythrocyte automated
|
$44.20 |
$44.20 |
$44.20 |
$42.00
|
|
Segmentectomy 32484
|
$6,598.80 |
$6,598.80 |
$6,598.80 |
$2,915.40
|
|
Select picture audiometry
|
$193.70 |
$193.70 |
$193.70 |
$105.60
|
|
Self-adher band w>=3" <5"/yd
|
$16.25 |
$16.25 |
$16.25 |
$2.07
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$222.95 |
$222.95 |
$222.95 |
$96.85
|
|
Self-meas bp 2 readg bid 30d
|
$46.80 |
$46.80 |
$46.80 |
$11.30
|
|
Self-meas bp pt educaj/train
|
$137.15 |
$137.15 |
$137.15 |
$29.55
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$77.35 |
$77.35 |
$77.35 |
$51.98
|
|
Self-mgmt educ/train 5-8 pt 30min
|
$68.25 |
$68.25 |
$68.25 |
$33.04
|
|
Semen analysis
|
$40.30 |
$40.30 |
$40.30 |
$13.60
|
|
Semen analysis presence/motility
|
$157.95 |
$157.95 |
$157.95 |
$70.40
|
|
Semen analysis w/count
|
$122.20 |
$122.20 |
$122.20 |
$56.44
|
|
Sensorineural acuity lvl tst
|
$55.90 |
$55.90 |
$55.90 |
$129.36
|
|
Sept9 promoter methylation analysis
|
$241.15 |
$241.15 |
$241.15 |
$316.68
|
|
Serpina1 gene
|
$243.10 |
$243.10 |
$243.10 |
$197.00
|
|
Set radiation therapy field
|
$944.45 |
$944.45 |
$944.45 |
$787.50
|
|
Set radiation therapy field
|
$2,353.00 |
$2,353.00 |
$2,353.00 |
$1,180.38
|
|
Set radiation therapy field
|
$2,498.60 |
$2,498.60 |
$8,412.00 |
$1,641.90
|
|
Sex chromatin identification
|
$25.35 |
$25.35 |
$25.35 |
$45.60
|
|
Sf3b1 gene common variants
|
$1,491.10 |
$1,491.10 |
$1,491.10 |
$248.10
|
|
Sgmdsc w/band ligation
|
$4,407.00 |
$4,407.00 |
$4,407.00 |
$2,288.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$484.25 |
$484.25 |
$484.25 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$484.25 |
$484.25 |
$484.25 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$974.35 |
$974.35 |
$974.35 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$974.35 |
$974.35 |
$974.35 |
$472.79
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$484.25 |
$484.25 |
$484.25 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$484.25 |
$484.25 |
$484.25 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$484.25 |
$484.25 |
$484.25 |
$269.50
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$974.35 |
$974.35 |
$974.35 |
$400.40
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$974.35 |
$974.35 |
$974.35 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$484.25 |
$484.25 |
$484.25 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$484.25 |
$484.25 |
$484.25 |
$289.30
|
|
Sho arthrs srg bicp tenodsis
|
$3,763.50 |
$3,763.50 |
$3,763.50 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$3,936.40 |
$3,936.40 |
$3,936.40 |
$7,166.67
|
|
Sho arthrs srg lmtd dbrdmt
|
$2,010.45 |
$2,010.45 |
$2,010.45 |
$4,807.00
|
|
Sho arthrs srg lss&rescj ads
|
$2,025.40 |
$2,025.40 |
$2,025.40 |
$3,839.54
|
|
Sho arthrs srg prtl synvct
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
$5,886.74
|
|
Sho arthrs srg rpr slap les
|
$3,814.20 |
$3,814.20 |
$3,814.20 |
$6,740.20
|
|
Sho arthrs srg xtnsv dbrdmt
|
$2,282.15 |
$2,282.15 |
$2,282.15 |
$5,148.00
|
|
Shoe post-op mens m
|
$31.85 |
$31.85 |
$31.85 |
$53.20
|
|
Shot (Injection into Muscle or Under the Skin)
|
$399.10 |
$399.10 |
$399.10 |
$138.00
|
|
Shoulder AC Joint X-ray (both sides)
|
$545.35 |
$545.35 |
$545.35 |
$270.69
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$4,053.40 |
$4,053.40 |
$4,053.40 |
$7,907.11
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$645.45 |
$645.45 |
$645.45 |
$288.75
|
|
Shoulder MRI (with and without contrast)
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,825.55
|
|
Shoulder MRI (with contrast)
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$2,511.20
|
|
Shoulder MRI (without contrast)
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$2,102.80
|
|
Shoulder X-ray
|
$545.35 |
$545.35 |
$545.35 |
$343.70
|
|
Shoulder X-ray (single view, both shoulders)
|
$536.90 |
$536.90 |
$536.90 |
$264.00
|
|
Shuntogram nonvascular supervision & interpretation
|
$731.25 |
$731.25 |
$731.25 |
$359.55
|
|
Sialography s&i
|
$98.80 |
$98.80 |
$98.80 |
$513.60
|
|
Sialolithotomy 42330
|
$12,121.20 |
$12,121.20 |
$12,121.20 |
$3,864.00
|
|
Sickling rbc
|
$70.85 |
$70.85 |
$70.85 |
$59.15
|
|
Sigmoidoscopy and biopsy
|
$3,407.95 |
$3,407.95 |
$3,407.95 |
$1,459.20
|
|
Sigmoidoscopy flex decompression 45337
|
$3,407.95 |
$3,407.95 |
$3,407.95 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$4,407.00 |
$4,407.00 |
$4,407.00 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,407.95 |
$3,407.95 |
$3,407.95 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$803.40 |
$803.40 |
$803.40 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$503.10 |
$503.10 |
$503.10 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$778.05 |
$778.05 |
$778.05 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$1,006.85 |
$1,006.85 |
$1,006.85 |
$2,997.10
|
|
Sigmoidoscopy w/tumr remove
|
$4,407.00 |
$4,407.00 |
$4,407.00 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$3,407.95 |
$3,407.95 |
$3,407.95 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$852.15 |
$852.15 |
$852.15 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,407.95 |
$3,407.95 |
$3,407.95 |
$1,976.25
|
|
Signal avg ecg w or without ecg 93278
|
$343.20 |
$343.20 |
$1,388.00 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$4,407.00 |
$4,407.00 |
$4,407.00 |
$2,288.00
|
|
Simple cystometrogram 51725
|
$909.35 |
$909.35 |
$3,163.00 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$305.29 |
$305.29 |
$971.00 |
$309.14
|
|
Single energy x-ray study
|
$63.05 |
$63.05 |
$63.05 |
$125.84
|
|
Sinus CT scan (with and without contrast)
|
$997.75 |
$997.75 |
$997.75 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$997.75 |
$997.75 |
$997.75 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$596.70 |
$596.70 |
$596.70 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$17,646.20 |
$17,646.20 |
$17,646.20 |
$2,565.12
|
|
Sinus X-ray (complete)
|
$557.05 |
$557.05 |
$557.05 |
$347.31
|
|
Sinus X-ray (limited)
|
$538.20 |
$538.20 |
$538.20 |
$216.00
|
|
Sipuleucel-t - su
|
$109,596.50 |
$109,596.50 |
$109,596.50 |
$100,990.51
|
|
Sirolimus, oral
|
$56.88 |
$56.88 |
$56.88 |
$41.70
|
