|
Screening Mammogram
|
$413.40 |
$413.40 |
$413.40 |
$312.55
|
|
Screening prostate cancer PSA
|
$508.80 |
$508.80 |
$508.80 |
$100.63
|
|
Screen pap by tech w md supv
|
$93.60 |
$93.60 |
$93.60 |
$52.65
|
|
Sec art mech thrmbc non-intracranial add-on
|
$5,542.20 |
$5,542.20 |
$5,542.20 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$89.40 |
$89.40 |
$89.40 |
$42.00
|
|
Select picture audiometry
|
$145.20 |
$145.20 |
$145.20 |
$105.60
|
|
Set radiation therapy field
|
$1,195.20 |
$1,195.20 |
$1,195.20 |
$762.40
|
|
Set radiation therapy field
|
$2,635.80 |
$2,635.80 |
$2,635.80 |
$1,157.38
|
|
Set radiation therapy field
|
$2,139.60 |
$2,139.60 |
$2,139.60 |
$1,636.36
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$256.20 |
$256.20 |
$256.20 |
$235.13
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$375.60 |
$375.60 |
$375.60 |
$235.13
|
|
Shoe post-op mens m
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$52.20
|
|
Shoulder MRI (with and without contrast)
|
$4,254.00 |
$4,254.00 |
$4,254.00 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$4,363.20 |
$4,363.20 |
$4,363.20 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$3,748.80 |
$3,748.80 |
$3,748.80 |
$2,065.05
|
|
Shoulder X-ray
|
$550.80 |
$550.80 |
$550.80 |
$339.50
|
|
Shrinker prosth above knee
|
$585.60 |
$585.60 |
$585.60 |
$168.89
|
|
Sickling rbc
|
$96.00 |
$96.00 |
$96.00 |
$57.92
|
|
Sinus CT scan (with and without contrast)
|
$2,287.80 |
$2,287.80 |
$2,287.80 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$2,053.20 |
$2,053.20 |
$2,053.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,725.60 |
$1,725.60 |
$1,725.60 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,957.20 |
$1,957.20 |
$1,957.20 |
$2,489.25
|
|
Skin Biopsy
|
$375.60 |
$375.60 |
$375.60 |
$360.34
|
|
Sleep study attended
|
$4,533.60 |
$4,533.60 |
$4,533.60 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$5,131.20 |
$5,131.20 |
$5,131.20 |
$3,607.50
|
|
Sleep study unattended
|
$1,417.20 |
$1,417.20 |
$1,417.20 |
$580.87
|
|
Sleeve fing rolyan med
|
$118.20 |
$118.20 |
$118.20 |
$203.58
|
|
Sling pelv split sam med
|
$307.80 |
$307.80 |
$307.80 |
$150.00
|
|
Slp stdy unatnd w/anal
|
$82.20 |
$82.20 |
$82.20 |
$296.34
|
|
Slp ther svc non-spch gen
|
$330.00 |
$330.00 |
$330.00 |
$188.50
|
|
Smear fluorescent and/or acid fast stain
|
$130.20 |
$130.20 |
$130.20 |
$64.20
|
|
Smear gram stain
|
$66.00 |
$66.00 |
$66.00 |
$55.25
|
|
Smear nasal eosinophil
|
$65.40 |
$65.40 |
$65.40 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$118.20 |
$118.20 |
$118.20 |
$73.15
|
|
Smear wet mount
|
$79.20 |
$79.20 |
$79.20 |
$67.49
|
|
Snrpn/ube3a gene
|
$1,758.00 |
$1,758.00 |
$1,758.00 |
$231.85
|
|
So cap design without jnts cf
|
$514.80 |
$514.80 |
$514.80 |
$606.35
|
|
Sodium 24 hour urine
|
$161.40 |
$161.40 |
$161.40 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$112.20 |
$112.20 |
$112.20 |
$45.60
|
|
Somatosensory testing
|
$1,516.80 |
$1,516.80 |
$1,516.80 |
$816.00
|
|
So neo gsap dna mcrstl ins
|
$8,194.80 |
$8,194.80 |
$8,194.80 |
$2,296.00
|
|
Special physics consult
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$725.00
|
|
Special radiation dosimetry
|
$495.60 |
$495.60 |
$495.60 |
$392.50
|
|
Special radiation treatment
|
$2,245.80 |
$2,245.80 |
$2,245.80 |
$1,986.00
|
|
Special teletx port plan
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$1,086.99
|
|
Specific gravity body fluid
|
$30.00 |
$30.00 |
$30.00 |
$22.00
|
|
Speech audiometry complete
|
$177.00 |
$177.00 |
$177.00 |
$109.20
|
|
Speech recep thresh
|
$160.20 |
$160.20 |
$160.20 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,895.40 |
$1,895.40 |
$1,895.40 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$853.20 |
$853.20 |
$853.20 |
$543.26
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$280.80 |
$280.80 |
$280.80 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$85.20 |
$85.20 |
$85.20 |
$68.25
|
|
Splint finger frog med
|
$24.00 |
$24.00 |
$24.00 |
$38.08
|
|
Splint func pos polyflex ii med
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$585.60 |
$585.60 |
$585.60 |
$99.04
|
|
Srs linear based
|
$17,914.20 |
$17,914.20 |
$17,914.20 |
$13,585.00
|
|
Srs multisource
|
$37,210.80 |
$37,210.80 |
$37,210.80 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$358.20 |
$358.20 |
$358.20 |
$297.60
|
|
Staph a dna amp probe
|
$201.60 |
$201.60 |
$201.60 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$280.20 |
$280.20 |
$280.20 |
$286.00
|
|
Stenger test pure tone
|
$145.20 |
$145.20 |
$145.20 |
$77.84
|
|
Stent placemt retro carotid
|
$4,759.80 |
$4,759.80 |
$4,759.80 |
$5,328.00
|
|
Stereotactic radiation trmt
|
$1,092.60 |
$1,092.60 |
$1,092.60 |
$845.60
|
|
St evaluate speech sound production
|
$293.40 |
$293.40 |
$293.40 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$406.20 |
$406.20 |
$406.20 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$410.40 |
$410.40 |
$410.40 |
$399.60
|
|
St evaluation swallow function
|
$309.60 |
$309.60 |
$309.60 |
$314.40
|
|
Stress test pulmonary
|
$592.20 |
$592.20 |
$592.20 |
$322.85
|
|
Stress tte complete
|
$3,042.60 |
$3,042.60 |
$3,042.60 |
$1,870.50
|
|
Str markers spec anal addl
|
$511.80 |
$511.80 |
$511.80 |
$479.17
|
|
Str markers specimen anal
|
$1,152.60 |
$1,152.60 |
$1,152.60 |
$751.50
|
|
St treatment speech individual
|
$256.80 |
$256.80 |
$256.80 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$216.00 |
$216.00 |
$216.00 |
$240.31
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$753.60 |
$753.60 |
$753.60 |
$717.60
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$236.40 |
$236.40 |
$236.40 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$228.60 |
$228.60 |
$228.60 |
$216.00
|
|
Sugars single quant
|
$339.60 |
$339.60 |
$339.60 |
$64.28
|
|
Support clav 29.6-40.5in med
|
$169.20 |
$169.20 |
$169.20 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$156.00 |
$156.00 |
$156.00 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$279.60 |
$279.60 |
$279.60 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$345.60 |
$345.60 |
$345.60 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$408.00 |
$408.00 |
$408.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$711.00 |
$711.00 |
$711.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,274.40 |
$1,274.40 |
$1,274.40 |
$718.00
|
|
Susceptibility agar dilution per agent
|
$122.40 |
$122.40 |
$122.40 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$39.60 |
$39.60 |
$39.60 |
$35.70
|
|
Susceptibility mic per plate
|
$70.80 |
$70.80 |
$70.80 |
$106.00
|
|
Svc venogram s&i
|
$2,624.40 |
$2,624.40 |
$2,624.40 |
$1,934.62
|
|
Sweat collection by iontophoresis
|
$135.00 |
$135.00 |
$135.00 |
$125.40
|
|
Synch audio-only est high 40
|
$160.20 |
$160.20 |
$160.20 |
$189.40
|
|
Synch audio-only est low 20
|
$73.20 |
$73.20 |
$73.20 |
$90.60
|
|
Synch audio-only est mod 30
|
$108.60 |
$108.60 |
$108.60 |
$136.64
|
|
Synch audio-only est sf 10
|
$40.20 |
$40.20 |
$40.20 |
$53.20
|
|
Synch audio-only new high 60
|
$196.20 |
$196.20 |
$196.20 |
$200.30
|
|
Synch audio-only new low 30
|
$94.80 |
$94.80 |
$94.80 |
$117.00
|
|
Synch audio-only new mod 45
|
$150.00 |
$150.00 |
$150.00 |
$163.38
|
|
Synch audio-only new sf 15
|
$54.60 |
$54.60 |
$54.60 |
$67.80
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$96.00 |
$96.00 |
$96.00 |
$41.60
|
|
T3 (triiodothyronine) free
|
$96.00 |
$96.00 |
$96.00 |
$99.20
|
|
T3 (triiodothyronine) total
|
$80.40 |
$80.40 |
$80.40 |
$93.52
|
