|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$1,085.22 |
$1,085.22 |
$1,085.22 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$15.69 |
$15.69 |
$15.69 |
$188.50
|
|
Rp loclzj tum 2+area 1+d img
|
$745.60 |
$745.60 |
$745.60 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$1,441.60 |
$1,441.60 |
$1,441.60 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$833.28 |
$833.28 |
$833.28 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$2,141.12 |
$2,141.12 |
$2,141.12 |
$4,647.04
|
|
Rpl tun cvc wo subq port
|
$2,984.00 |
$2,984.00 |
$2,984.00 |
$3,687.00
|
|
Rpm tx mgmt 1st 20 min
|
$23.68 |
$23.68 |
$23.68 |
$77.91
|
|
Rpm tx mgmt ea addl 20 min
|
$23.68 |
$23.68 |
$23.68 |
$101.25
|
|
Rpr aa hrn 1st > 10 ncr/strn
|
$777.92 |
$777.92 |
$777.92 |
$1,982.40
|
|
Rpr aa hrn 1st > 10 rdc
|
$585.92 |
$585.92 |
$585.92 |
$5,110.00
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$567.36 |
$567.36 |
$567.36 |
$6,904.15
|
|
Rpr aa hrn 1st 3-10 rdc
|
$436.80 |
$436.80 |
$436.80 |
$6,912.52
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$261.12 |
$261.12 |
$261.12 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$362.88 |
$362.88 |
$362.88 |
$6,904.15
|
|
Rpr aa hrn rcr > 10 rdc
|
$674.24 |
$674.24 |
$674.24 |
$1,719.20
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$652.80 |
$652.80 |
$652.80 |
$1,663.20
|
|
Rpr aa hrn rcr 3-10 rdc
|
$487.04 |
$487.04 |
$487.04 |
$6,819.30
|
|
Rpr aa hrn rcr < 3 rdc
|
$323.20 |
$323.20 |
$323.20 |
$4,176.15
|
|
Rpr diaphragm lac/any approach 39501
|
$313.92 |
$313.92 |
$313.92 |
$1,539.60
|
|
Rpr fem hernia init blocked
|
$497.92 |
$497.92 |
$497.92 |
$4,176.15
|
|
Rpr parastomal hernia rdc 49621
|
$572.16 |
$572.16 |
$572.16 |
$1,450.40
|
|
Rpr parastomal hrna ncr/strn 49622
|
$709.12 |
$709.12 |
$709.12 |
$1,786.40
|
|
Rpr rem hernia init reduce
|
$455.04 |
$455.04 |
$455.04 |
$3,906.18
|
|
Rsv assay w/optic
|
$14.40 |
$14.40 |
$14.40 |
$79.38
|
|
Rubella antibody igg
|
$26.24 |
$26.24 |
$26.24 |
$77.03
|
|
Rubeola antibody igg
|
$117.12 |
$117.12 |
$117.12 |
$80.00
|
|
Russell viper venom diluted
|
$19.20 |
$19.20 |
$19.20 |
$72.54
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$2,116.43 |
$2,116.43 |
$2,116.43 |
$5,174.32
|
|
Salivary gland imaging
|
$298.56 |
$298.56 |
$298.56 |
$585.00
|
|
Salmonella antibody
|
$17.92 |
$17.92 |
$17.92 |
$37.58
|
|
Same day nb discharge 99463
|
$86.08 |
$86.08 |
$86.08 |
$183.07
|
|
Sbsq ic vlbw inf<1,500 gm
|
$103.36 |
$103.36 |
$103.36 |
$248.00
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$60.48 |
$60.48 |
$60.48 |
$109.85
|
|
Sbsq nursing facil care/day new problem 25 min
|
$87.04 |
$87.04 |
$87.04 |
$144.30
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$413.12 |
$413.12 |
$413.12 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$352.64 |
$352.64 |
$352.64 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$382.08 |
$382.08 |
$382.08 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$212.80 |
$212.80 |
$212.80 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$323.20 |
$323.20 |
$323.20 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$258.88 |
$258.88 |
$258.88 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$498.56 |
$498.56 |
$498.56 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$287.36 |
$287.36 |
$287.36 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$252.48 |
$252.48 |
$252.48 |
$595.35
|
|
Scan proc cranial extra
|
$134.72 |
$134.72 |
$134.72 |
$2,366.00
|
|
Scan proc cranial intra 61781
|
$174.72 |
$174.72 |
$174.72 |
$2,067.91
|
|
Scope uretscp lithovue dig disp
|
$3,024.00 |
$3,024.00 |
$3,024.00 |
$4,490.64
|
|
Screening Colonoscopy (average risk)
|
$144.96 |
$144.96 |
$144.96 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$144.96 |
$144.96 |
$144.96 |
$1,951.46
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$28.80 |
$28.80 |
$28.80 |
$57.60
|
|
Screening Mammogram
|
$162.24 |
$162.24 |
$162.24 |
$312.55
|
|
Screening prostate cancer PSA
|
$33.60 |
$33.60 |
$33.60 |
$100.63
|
|
Screen/visual acuity/bilat/quant 99173
|
$25.60 |
$25.60 |
$25.60 |
$28.86
|
|
Screw cortex 2.0 x 10mm
|
$16,648.64 |
$16,648.64 |
$16,648.64 |
$29,055.00
|
|
Sec art mech thrmbc non-intracranial add-on
|
$814.08 |
$814.08 |
$814.08 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$15.04 |
$15.04 |
$15.04 |
$42.00
|
|
Segmentectomy 32484
|
$511.68 |
$511.68 |
$511.68 |
$3,491.20
|
|
Semen analysis presence/motility
|
$2.28 |
$2.28 |
$2.28 |
$71.05
|
|
Set radiation therapy field
|
$455.68 |
$455.68 |
$455.68 |
$762.40
|
|
Set radiation therapy field
|
$754.24 |
$754.24 |
$754.24 |
$1,636.36
|
|
Sevelamer carbonate pdr 20mg
|
$6.52 |
$6.52 |
$6.52 |
$21.96
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$112.96 |
$112.96 |
$112.96 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$112.96 |
$112.96 |
$112.96 |
$284.88
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$77.12 |
$77.12 |
$77.12 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$77.12 |
$77.12 |
$77.12 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$87.36 |
$87.36 |
$87.36 |
$269.50
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$155.20 |
$155.20 |
$155.20 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$77.12 |
$77.12 |
$77.12 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$88.64 |
$88.64 |
$88.64 |
$289.30
|
|
Sho arthrs srg bicp tenodsis
|
$739.84 |
$739.84 |
$739.84 |
$4,950.40
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$862.72 |
$862.72 |
$862.72 |
$7,807.24
|
|
Shoulder MRI (with and without contrast)
|
$1,148.48 |
$1,148.48 |
$1,148.48 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$1,102.08 |
$1,102.08 |
$1,102.08 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$1,382.08 |
$1,382.08 |
$1,382.08 |
$2,065.05
|
|
Shoulder prosthesis removal
|
$786.88 |
$786.88 |
$786.88 |
$3,870.38
|
|
Shoulder X-ray
|
$188.80 |
$188.80 |
$188.80 |
$339.50
|
|
Shunt glaucoma baerveldt 350mm
|
$3,456.00 |
$3,456.00 |
$3,456.00 |
$4,636.80
|
|
Sialography s&i
|
$203.52 |
$203.52 |
$203.52 |
$499.20
|
|
Sialolithotomy 42330
|
$128.32 |
$128.32 |
$128.32 |
$3,837.72
|
|
Sickling rbc
|
$15.04 |
$15.04 |
$15.04 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$352.00 |
$352.00 |
$352.00 |
$1,351.63
|
|
Sigmoidoscopy for bleeding
|
$72.96 |
$72.96 |
$72.96 |
$1,890.00
|
|
Sigmoidoscopy/submucosal injection 45335
|
$53.76 |
$53.76 |
$53.76 |
$1,444.83
|
|
Sigmoidoscopy w/fb removal 45332
|
$82.88 |
$82.88 |
$82.88 |
$1,388.56
|
|
Sigmoidoscopy w/tumr remove
|
$95.04 |
$95.04 |
$95.04 |
$1,558.80
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$73.92 |
$73.92 |
$73.92 |
$1,664.40
|
|
Sincalide 5 mcg solution for injection
|
$133.47 |
$133.47 |
$133.47 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$991.68 |
$991.68 |
$991.68 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$671.36 |
$671.36 |
$671.36 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$503.68 |
$503.68 |
$503.68 |
$1,292.04
|
|
Sipuleucel-t - su
|
$39,843.84 |
$39,843.84 |
$39,843.84 |
$100,990.51
|
|
Skel musc relaxant 3 or more
|
$1.92 |
$1.92 |
$1.92 |
$16.12
|
|
Skin Biopsy
|
$112.96 |
$112.96 |
$112.96 |
$360.34
|
|
Skyla, 13.5 mg
|
$776.32 |
$776.32 |
$776.32 |
$1,643.47
|
|
Sling suprapubic suburetheral
|
$5,487.68 |
$5,487.68 |
$5,487.68 |
$9,679.96
|
|
Slitting of prepuce
|
$97.28 |
$97.28 |
$97.28 |
$3,365.50
|
|
Slp pure tone screening
|
$5.44 |
$5.44 |
$5.44 |
$60.48
|
|
Slp ther svc non-spch gen
|
$42.56 |
$42.56 |
$42.56 |
$188.50
|
|
Sm-153 lexidron ther
|
$6,115.20 |
$6,115.20 |
$6,115.20 |
$7,320.12
|
