|
Shoulder MRI (with contrast)
|
$1,416.96 |
$1,743.30 |
$8,487.87 |
|
|
Shoulder MRI (without contrast)
|
$957.27 |
$1,549.08 |
$14,309.07 |
|
|
Shoulder X-ray
|
$268.77 |
$380.30 |
$899.48 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$201.63 |
$343.00 |
$1,009.75 |
|
|
Shunt glaucoma baerveldt 350mm
|
$491.70 |
$3,581.59 |
$3,581.59 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$400.92 |
$400.92 |
$900.00 |
|
|
Shunt subclavian to pulm art
|
$29,988.00 |
$29,988.00 |
$29,988.00 |
|
|
Sialography s&i
|
$376.35 |
$376.35 |
$376.35 |
|
|
Sialolithotomy 42330
|
$1,959.75 |
$1,959.75 |
$11,430.00 |
|
|
Sickling rbc
|
$25.00 |
$65.91 |
$338.37 |
|
|
Sigmoidoscopy and biopsy
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Sigmoidoscopy flex decompression 45337
|
$925.00 |
$925.00 |
$925.00 |
|
|
Sigmoidoscopy for bleeding
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Sigmoidoscopy w/ablation
|
$1,238.00 |
$1,238.00 |
$1,238.00 |
|
|
Sigmoidoscopy w/fb removal 45332
|
$1,374.75 |
$1,374.75 |
$3,011.00 |
|
|
Sigmoidoscopy w/plcmt stent
|
$1,198.00 |
$1,198.00 |
$1,198.00 |
|
|
Sigmoidoscopy w/resection
|
$5,104.00 |
$5,104.00 |
$5,104.00 |
|
|
Sigmoidoscopy w/tumr remove
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Sigmoidoscopy w/ultrasound
|
$1,740.57 |
$1,740.57 |
$3,011.00 |
|
|
Sigmoidoscopy w/us guide bx
|
$4,178.00 |
$4,178.00 |
$4,178.00 |
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Signal avg ecg w or without ecg 93278
|
$37.89 |
$813.93 |
$813.93 |
|
|
Sig w/tndsc balloon dilation
|
$3,011.00 |
$3,011.00 |
$3,011.00 |
|
|
Simple cystometrogram 51725
|
$396.63 |
$396.63 |
$396.63 |
|
|
Sincalide 5 mcg solution for injection
|
$142.54 |
$354.67 |
$547.95 |
|
|
Single energy x-ray study
|
$97.89 |
$97.89 |
$97.89 |
|
|
Sinus CT scan (with and without contrast)
|
$974.14 |
$1,610.70 |
$3,291.94 |
|
|
Sinus CT scan (with contrast)
|
$880.90 |
$1,473.03 |
$8,643.22 |
|
|
Sinus CT scan (without contrast)
|
$667.19 |
$1,319.37 |
$9,334.46 |
|
|
Sinus/juglr venogram s&i
|
$612.72 |
$1,971.06 |
$10,421.00 |
|
|
Sinusotomy maxillary sinus 31020
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
|
|
Sinusotomy sinus remove polyps 31032
|
$15,400.00 |
$15,400.00 |
$15,400.00 |
|
|
Sinus X-ray (complete)
|
$297.19 |
$375.57 |
$552.00 |
|
|
Sinus X-ray (limited)
|
$139.42 |
$417.00 |
$1,212.76 |
|
|
Sirolimus, oral
|
$148.53 |
$148.53 |
$2,170.16 |
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$163.93 |
$163.93 |
$19,722.94 |
|
|
Skeletal muscle relaxant 1/2
|
$41.69 |
$41.69 |
$85.13 |
|
|
Skin Biopsy
|
$258.41 |
$560.04 |
$780.00 |
|
|
Skin full graft 20sq cm less 15200
|
$2,190.24 |
$2,190.24 |
$6,588.00 |
|
|
Skin full graft add-on 15241
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
|
|
Skin pedicle flap arms/legs
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
|
|
Skin split graft addl 100sq cm 15101
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
|
|
Skull X-ray (1 to 3 views)
|
$148.00 |
$293.38 |
$1,557.49 |
|
|
Skull X-ray (complete)
|
$315.24 |
$412.23 |
$1,584.86 |
|
|
Skyla, 13.5 mg
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
|
|
Slco1b1 gene com variants
|
$674.70 |
$674.70 |
$674.70 |
|
|
Sleep study attended
|
$1,237.08 |
$1,237.08 |
$1,237.08 |
|
|
Sleep Study (Polysomnography)
|
$2,195.14 |
$3,068.13 |
$9,509.00 |
|
|
Sleep study unattended
|
$254.56 |
$430.95 |
$4,112.99 |
|
|
Sleeve fing rolyan med
|
$210.38 |
$210.38 |
$210.38 |
|
|
Sling suprapubic suburetheral
|
$3,115.75 |
$15,381.89 |
$15,381.89 |
|
|
Slitting of prepuce
|
$4,451.07 |
$4,451.07 |
$7,452.00 |
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$142.35 |
$142.35 |
$288.00 |
|
|
Slp eval non-spch gen comm dev
|
$285.09 |
$285.09 |
$533.00 |
|
|
Slp pure tone screening
|
$70.20 |
$70.20 |
$261.00 |
|
|
Slp stdy unatnd w/anal
|
$63.64 |
$63.64 |
$63.64 |
|
|
Slp ther svc non-spch gen
|
$106.08 |
$106.08 |
$106.08 |
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$307.55 |
$557.70 |
$2,994.22 |
|
|
Small bowel endoscopy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy
|
$1,788.14 |
$5,544.00 |
$5,544.00 |
|
|
Small bowel endoscopy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy
|
$4,894.00 |
$4,894.00 |
$4,894.00 |
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$3,153.00 |
$3,153.00 |
$3,153.00 |
|
|
Small bowel endoscopy 44365
|
$3,153.00 |
$3,153.00 |
$3,153.00 |
|
|
Small bowel endoscopy/biopsy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy/biopsy
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Small bowel endoscopy br/wa
|
$4,894.00 |
$4,894.00 |
$4,894.00 |
|
|
Small bowel endoscopy br/wa
|
$4,894.00 |
$4,894.00 |
$4,894.00 |
|
|
Small bowel endoscopy/stent 44370
|
$7,331.00 |
$7,331.00 |
$7,331.00 |
|
|
Smallpox&monkeypox vac 0.5ml
|
$0.08 |
$0.08 |
$0.08 |
|
|
Smear fluorescent and/or acid fast stain
|
$25.00 |
$120.51 |
$288.88 |
|
|
Smear gram stain
|
$20.00 |
$80.34 |
$467.92 |
|
|
Smear nasal eosinophil
|
$27.00 |
$94.77 |
$160.00 |
|
|
Smear special stain inclusion bodies/parasites
|
$8.00 |
$102.57 |
$321.03 |
|
|
Smear wet mount
|
$27.00 |
$70.59 |
$601.34 |
|
|
Smn1 gene full gene sequence
|
$495.69 |
$495.69 |
$495.69 |
|
|
Smn1 gen nown famil seq vrnt
|
$304.59 |
$304.59 |
$304.59 |
|
|
Snrpn/ube3a gene
|
$69.81 |
$69.81 |
$235.00 |
|
|
Sodium 24 hour urine
|
$13.03 |
$74.49 |
$193.25 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$6.22 |
$429.51 |
$429.51 |
|
|
Sodium chloride 0.9 % IV bolus
|
$6.16 |
$18.24 |
$18.24 |
|
|
Sodium chloride 0.9 % IV bolus
|
$5.45 |
$8.07 |
$70.04 |
|
|
Sodium chloride 3 % ivpb
|
$7.77 |
$57.14 |
$278.66 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$27.52 |
$27.52 |
$1,001.49 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$2,652.02 |
$2,652.02 |
$3,070.53 |
|
|
Sodium serum/plasma/whole blood
|
$8.29 |
$67.86 |
$162.90 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$127.08 |
$330.63 |
$330.63 |
|
|
Somatosensory testing
|
$668.00 |
$1,316.25 |
$1,316.25 |
|
|
Somatropin injection
|
$330.29 |
$330.29 |
$1,688.16 |
|
|
So neo gsap dna mcrstl ins
|
$4,563.00 |
$4,563.00 |
$4,563.00 |
|
|
Sotalol hydrochloride IV
|
$15,216.60 |
$15,216.60 |
$15,216.60 |
|
|
Sp bone algrft morsel add-on
|
$803.40 |
$803.40 |
$803.40 |
|
|
Special physics consult
|
$228.52 |
$477.75 |
$1,256.00 |
|
|
Special radiation dosimetry
|
$249.83 |
$353.34 |
$731.34 |
|
|
Special radiation treatment
|
$358.76 |
$1,515.93 |
$5,476.66 |
|
|
Special supplies phys/qhp
|
$231.22 |
$231.22 |
$231.22 |
|