|
Red blood cells leukocytes reduced irradiated each unit
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$528.45
|
|
Refill/maint pump/resvr syst
|
$642.60 |
$642.60 |
$642.60 |
$397.60
|
|
Relocation skin pocket aicd
|
$2,792.40 |
$2,792.40 |
$2,792.40 |
$2,761.55
|
|
Relocation skin pocket pm
|
$2,784.00 |
$2,784.00 |
$2,784.00 |
$2,585.00
|
|
Rem/biv cast full arm/leg
|
$505.20 |
$505.20 |
$505.20 |
$320.79
|
|
Rem endovas vena cava filter
|
$5,257.80 |
$5,257.80 |
$5,257.80 |
$5,509.05
|
|
Removal central venous catheter tunneled without port/pump
|
$3,156.60 |
$3,156.60 |
$3,156.60 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$3,789.00 |
$3,789.00 |
$3,789.00 |
$2,356.71
|
|
Removal cerumen impacted (both sides)
|
$952.20 |
$952.20 |
$952.20 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$281.40 |
$281.40 |
$281.40 |
$249.60
|
|
Removal embedded foreign body vestibule mouth smpl
|
$774.00 |
$774.00 |
$774.00 |
$783.75
|
|
Removal foreign body foot subcutaneous right
|
$1,149.60 |
$1,149.60 |
$1,149.60 |
$1,256.00
|
|
Removal/replacement ppm generator dual lead system
|
$6,550.80 |
$6,550.80 |
$6,550.80 |
$12,384.25
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$238.80 |
$238.80 |
$238.80 |
$292.50
|
|
Renal function panel
|
$89.40 |
$89.40 |
$89.40 |
$113.52
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$877.20 |
$877.20 |
$877.20 |
$1,025.95
|
|
Repair finger/hand tendon
|
$2,044.20 |
$2,044.20 |
$2,044.20 |
$4,150.20
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$280.20 |
$280.20 |
$280.20 |
$1,006.50
|
|
Replace g/c tube perc
|
$1,275.60 |
$1,275.60 |
$1,275.60 |
$1,341.50
|
|
Replace/revise brain shunt
|
$8,247.60 |
$8,247.60 |
$8,247.60 |
$8,043.00
|
|
Reposition pm/icd lead
|
$2,379.60 |
$2,379.60 |
$2,379.60 |
$3,790.00
|
|
Repos lv lead pm/icd
|
$3,633.00 |
$3,633.00 |
$3,633.00 |
$3,724.63
|
|
Reptilase test
|
$103.20 |
$103.20 |
$103.20 |
$72.00
|
|
Respirator motion mgmt simul
|
$1.80 |
$1.80 |
$1.80 |
$1,197.50
|
|
Resuscitation cardiopulmonary
|
$531.60 |
$531.60 |
$531.60 |
$764.40
|
|
Resuscitation delivery/birthing room
|
$779.40 |
$779.40 |
$779.40 |
$780.42
|
|
Reticulocyte automated
|
$41.40 |
$41.40 |
$41.40 |
$52.57
|
|
Revasc evasc fpvt angio cplx 1st
|
$18,081.00 |
$18,081.00 |
$18,081.00 |
$10,094.56
|
|
Revasc evasc fpvt angio sf 1st
|
$13,345.80 |
$13,345.80 |
$13,345.80 |
$10,094.56
|
|
Revasc evasc fpvt athrec cplx 1st
|
$60,319.80 |
$60,319.80 |
$60,319.80 |
$29,423.20
|
|
Revasc evasc fpvt athrec sf 1st
|
$42,983.40 |
$42,983.40 |
$42,983.40 |
$25,206.69
|
|
Revasc evasc fpvt stent cplx 1st
|
$45,627.60 |
$45,627.60 |
$45,627.60 |
$20,474.72
|
|
Revasc evasc fpvt stent sf 1st
|
$27,067.20 |
$27,067.20 |
$27,067.20 |
$20,474.72
|
|
Revasc evasc imvt angio cplx 1st
|
$33,711.60 |
$33,711.60 |
$33,711.60 |
$19,149.11
|
|
Revasc evasc imvt angio sf 1st
|
$27,067.20 |
$27,067.20 |
$27,067.20 |
$17,691.50
|
|
Revasc evasc ivt angio cplx 1st
|
$19,653.00 |
$19,653.00 |
$19,653.00 |
$10,094.56
|
|
Revasc evasc ivt stent cplx 1st
|
$39,255.00 |
$39,255.00 |
$39,255.00 |
$20,474.72
|
|
Revasc evasc ivt stent sf 1st
|
$27,067.20 |
$27,067.20 |
$27,067.20 |
$20,474.72
|
|
Revasc evasc tpvt angio cplx 1st
|
$33,999.60 |
$33,999.60 |
$33,999.60 |
$20,474.72
|
|
Revasc evasc tpvt angio sf 1st
|
$27,067.20 |
$27,067.20 |
$27,067.20 |
$16,491.68
|
|
Revasc intra lithotrip-ather
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$19,624.54
|
|
Revasc intra lithotrip-stent
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$20,329.50
|
|
Revasc intravasc lithotripsy
|
$14,986.20 |
$14,986.20 |
$14,986.20 |
$11,320.00
|
|
Revasc lithotr-ather tib/per
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$19,875.58
|
|
Revasc lithotrip-stent-ather
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$21,249.26
|
|
Revasc lithotrip tibi/perone
|
$14,041.80 |
$14,041.80 |
$14,041.80 |
$13,925.00
|
|
Revasc lithotr-stent tib/per
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$20,329.50
|
|
Revasc lith-sten-ath tib/per
|
$22,723.20 |
$22,723.20 |
$22,723.20 |
$19,385.85
|
|
Rheumatoid factor quantitative
|
$104.40 |
$104.40 |
$104.40 |
$57.00
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$14,463.60 |
$14,463.60 |
$14,463.60 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$20,616.00 |
$20,616.00 |
$20,616.00 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$3,446.40 |
$3,446.40 |
$3,446.40 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$2,326.20 |
$2,326.20 |
$2,326.20 |
$3,977.32
|
|
Rmvl perm pm pulse gen
|
$2,127.60 |
$2,127.60 |
$2,127.60 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$3,388.20 |
$3,388.20 |
$3,388.20 |
$10,542.00
|
|
Rmvl subq card rhythm mntr
|
$1,933.20 |
$1,933.20 |
$1,933.20 |
$1,734.00
|
|
Rmvl tv pm lead dual
|
$2,326.20 |
$2,326.20 |
$2,326.20 |
$4,028.20
|
|
Rmvl tv pm lead sgl
|
$2,542.20 |
$2,542.20 |
$2,542.20 |
$4,031.69
|
|
Rp loclzj tum spect w/ct 1
|
$2,542.20 |
$2,542.20 |
$2,542.20 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$3,814.20 |
$3,814.20 |
$3,814.20 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$3,175.20 |
$3,175.20 |
$3,175.20 |
$2,173.60
|
|
Rsv assay w/optic
|
$221.40 |
$221.40 |
$221.40 |
$79.38
|
|
Rtm 1st set-up&pt educaj eqp
|
$235.20 |
$235.20 |
$235.20 |
$177.66
|
|
Rtm dev sply mscskl 16-30 d
|
$67.80 |
$67.80 |
$67.80 |
$90.40
|
|
Rtm dev sply resp sys 16-30d
|
$67.80 |
$67.80 |
$67.80 |
$67.80
|
|
Rubella antibody igg
|
$199.80 |
$199.80 |
$199.80 |
$77.03
|
|
Rubeola antibody igg
|
$220.20 |
$220.20 |
$220.20 |
$80.00
|
|
Russell viper venom diluted
|
$219.60 |
$219.60 |
$219.60 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$2,430.00 |
$2,430.00 |
$2,430.00 |
$1,008.79
|
|
Sarscov coronavirus ag ia
|
$57.60 |
$57.60 |
$57.60 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$289.80 |
$289.80 |
$289.80 |
$104.00
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,270.80 |
$1,270.80 |
$1,270.80 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$618.60 |
$618.60 |
$618.60 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$834.00 |
$834.00 |
$834.00 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$445.20 |
$445.20 |
$445.20 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$846.00 |
$846.00 |
$846.00 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$810.00 |
$810.00 |
$810.00 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,550.40 |
$1,550.40 |
$1,550.40 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$598.80 |
$598.80 |
$598.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$544.80 |
$544.80 |
$544.80 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$198.60 |
$198.60 |
$198.60 |
$85.15
|
|
Screening Mammogram
|
$413.40 |
$413.40 |
$413.40 |
$312.55
|
|
Screening prostate cancer PSA
|
$108.00 |
$108.00 |
$108.00 |
$100.63
|
|
Sec art mech thrmbc non-intracranial add-on
|
$4,937.40 |
$4,937.40 |
$4,937.40 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$47.40 |
$47.40 |
$47.40 |
$42.00
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$60.00 |
$60.00 |
$60.00 |
$51.98
|
|
Self-mgmt educ/train 5-8 pt 30min
|
$60.00 |
$60.00 |
$60.00 |
$33.04
|
|
Set radiation therapy field
|
$898.20 |
$898.20 |
$898.20 |
$762.40
|
|
Set radiation therapy field
|
$3,027.00 |
$3,027.00 |
$3,027.00 |
$1,157.38
|
|
Set radiation therapy field
|
$2,417.40 |
$2,417.40 |
$2,417.40 |
$1,636.36
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$252.00 |
$252.00 |
$252.00 |
$314.00
|
|
Shoe post-op mens m
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$52.20
|
|
Shoulder MRI (with and without contrast)
|
$3,714.00 |
$3,714.00 |
$3,714.00 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$3,580.20 |
$3,580.20 |
$3,580.20 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$5,037.00 |
$5,037.00 |
$5,037.00 |
$2,065.05
|
|
Shoulder X-ray
|
$475.20 |
$475.20 |
$475.20 |
$339.50
|
|
Shrinker prosth above knee
|
$585.60 |
$585.60 |
$585.60 |
$168.89
|
|
Sialography s&i
|
$571.20 |
$571.20 |
$571.20 |
$499.20
|
|
Sickling rbc
|
$76.20 |
$76.20 |
$76.20 |
$57.92
|
|
Simple cystometrogram 51725
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$589.45
|
