|
Red blood cells each unit
|
$760.80 |
$760.80 |
$760.80 |
$387.36
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$1,027.80 |
$1,027.80 |
$1,027.80 |
$577.71
|
|
Red blood cells leukocytes reduced each unit
|
$871.20 |
$871.20 |
$871.20 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$528.45
|
|
Red blood cells washed each unit
|
$949.20 |
$949.20 |
$949.20 |
$572.46
|
|
Refill/maint pump/resvr syst
|
$287.40 |
$287.40 |
$287.40 |
$397.60
|
|
Removal central venous catheter tunneled without port/pump
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$2,356.71
|
|
Removal cerumen impacted (both sides)
|
$205.80 |
$205.80 |
$205.80 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$290.40 |
$290.40 |
$290.40 |
$249.60
|
|
Removal foreign body foot subcutaneous right
|
$887.40 |
$887.40 |
$887.40 |
$1,256.00
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$241.20 |
$241.20 |
$241.20 |
$292.50
|
|
Renal function panel
|
$254.40 |
$254.40 |
$254.40 |
$113.52
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$709.20 |
$709.20 |
$709.20 |
$1,025.95
|
|
Repair extns tendon finger without grft ea
|
$6,487.80 |
$6,487.80 |
$6,487.80 |
$2,224.00
|
|
Repair finger/hand tendon
|
$9,828.00 |
$9,828.00 |
$9,828.00 |
$4,150.20
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$295.80 |
$295.80 |
$295.80 |
$1,006.50
|
|
Replace duod/jej tube perc
|
$1,953.00 |
$1,953.00 |
$1,953.00 |
$1,354.54
|
|
Replace g/c tube perc
|
$1,117.80 |
$1,117.80 |
$1,117.80 |
$1,341.50
|
|
Replace g-j tube perc
|
$2,280.00 |
$2,280.00 |
$2,280.00 |
$1,498.53
|
|
Replace/revise brain shunt
|
$8,214.60 |
$8,214.60 |
$8,214.60 |
$8,043.00
|
|
Reptilase test
|
$107.40 |
$107.40 |
$107.40 |
$72.00
|
|
Respirator motion mgmt simul
|
$1,046.40 |
$1,046.40 |
$1,046.40 |
$1,197.50
|
|
Resuscitation cardiopulmonary
|
$1,947.60 |
$1,947.60 |
$1,947.60 |
$764.40
|
|
Reticulocyte automated
|
$84.00 |
$84.00 |
$84.00 |
$52.57
|
|
Reticulocyte direct measurement automated
|
$273.60 |
$273.60 |
$273.60 |
$36.57
|
|
Rheumatoid factor qualitative
|
$88.80 |
$88.80 |
$88.80 |
$57.20
|
|
Rheumatoid factor quantitative
|
$91.20 |
$91.20 |
$91.20 |
$57.00
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$16,410.60 |
$16,410.60 |
$16,410.60 |
$24,844.79
|
|
Rmvl perm pm pulse gen
|
$5,806.20 |
$5,806.20 |
$5,806.20 |
$6,094.40
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$13,282.20 |
$13,282.20 |
$13,282.20 |
$14,929.60
|
|
Rp loclzj tum 2+area 1+d img
|
$3,597.00 |
$3,597.00 |
$3,597.00 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 2
|
$4,182.60 |
$4,182.60 |
$4,182.60 |
$3,139.20
|
|
Rpl tun-cvad w subq port
|
$9,226.80 |
$9,226.80 |
$9,226.80 |
$4,647.04
|
|
Rsv assay w/optic
|
$242.40 |
$242.40 |
$242.40 |
$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
|
$172.20 |
$172.20 |
$172.20 |
$77.03
|
|
Rubeola antibody igg
|
$184.80 |
$184.80 |
$184.80 |
$80.00
|
|
Russell viper venom diluted
|
$228.60 |
$228.60 |
$228.60 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$2,420.40 |
$2,420.40 |
$2,420.40 |
$1,008.79
|
|
Sarscov coronavirus ag ia
|
$58.80 |
$58.80 |
$58.80 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$298.80 |
$298.80 |
$298.80 |
$104.00
|
|
Sbrt management
|
$9,210.00 |
$9,210.00 |
$9,210.00 |
$1,189.60
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$877.20 |
$877.20 |
$877.20 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$463.80 |
$463.80 |
$463.80 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$775.20 |
$775.20 |
$775.20 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$693.60 |
$693.60 |
$693.60 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$697.80 |
$697.80 |
$697.80 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$956.40 |
$956.40 |
$956.40 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$742.80 |
$742.80 |
$742.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,018.20 |
$1,018.20 |
$1,018.20 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$139.80 |
$139.80 |
$139.80 |
$85.15
|
|
Scr c/v cyto,thinlayer,rescr
|
$139.80 |
$139.80 |
$139.80 |
$54.40
|
|
Screening Mammogram
|
$413.40 |
$413.40 |
$413.40 |
$312.55
|
|
Screening prostate cancer PSA
|
$251.40 |
$251.40 |
$251.40 |
$100.63
|
|
Screen pap by tech w md supv
|
$79.20 |
$79.20 |
$79.20 |
$52.65
|
|
Sedimentation rate erythrocyte automated
|
$76.80 |
$76.80 |
$76.80 |
$42.00
|
|
Set radiation therapy field
|
$905.40 |
$905.40 |
$905.40 |
$762.40
|
|
Set radiation therapy field
|
$1,417.80 |
$1,417.80 |
$1,417.80 |
$1,157.38
|
|
Set radiation therapy field
|
$2,107.80 |
$2,107.80 |
$2,107.80 |
$1,636.36
|
|
Shoe post-op mens m
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$52.20
|
|
Shoulder MRI (with and without contrast)
|
$4,199.40 |
$4,199.40 |
$4,199.40 |
$2,713.80
|
|
Shoulder MRI (without contrast)
|
$6,179.40 |
$6,179.40 |
$6,179.40 |
$2,065.05
|
|
Shoulder X-ray
|
$604.20 |
$604.20 |
$604.20 |
$339.50
|
|
Shrinker prosth above knee
|
$585.60 |
$585.60 |
$585.60 |
$168.89
|
|
Sickling rbc
|
$94.80 |
$94.80 |
$94.80 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$172.80 |
$172.80 |
$172.80 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$2,446.80 |
$2,446.80 |
$2,446.80 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$2,446.80 |
$2,446.80 |
$2,446.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,446.80 |
$2,446.80 |
$2,446.80 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$1,959.60 |
$1,959.60 |
$1,959.60 |
$2,489.25
|
|
Skin Biopsy
|
$519.60 |
$519.60 |
$519.60 |
$360.34
|
|
Sleep Study (Polysomnography)
|
$4,524.60 |
$4,524.60 |
$4,524.60 |
$3,607.50
|
|
Sleep study unattended
|
$723.00 |
$723.00 |
$723.00 |
$580.87
|
|
Sling pelv split sam med
|
$307.80 |
$307.80 |
$307.80 |
$150.00
|
|
Slp stdy unatnd w/anal
|
$81.00 |
$81.00 |
$81.00 |
$296.34
|
|
Smear fluorescent and/or acid fast stain
|
$106.80 |
$106.80 |
$106.80 |
$64.20
|
|
Smear gram stain
|
$88.20 |
$88.20 |
$88.20 |
$55.25
|
|
Smear nasal eosinophil
|
$70.80 |
$70.80 |
$70.80 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$124.20 |
$124.20 |
$124.20 |
$73.15
|
|
Smear wet mount
|
$107.40 |
$107.40 |
$107.40 |
$67.49
|
|
Snrpn/ube3a gene
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$231.85
|
|
Sodium 24 hour urine
|
$84.60 |
$84.60 |
$84.60 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$72.60 |
$72.60 |
$72.60 |
$45.60
|
|
So neo gsap dna mcrstl ins
|
$8,194.80 |
$8,194.80 |
$8,194.80 |
$2,296.00
|
|
Special physics consult
|
$927.00 |
$927.00 |
$927.00 |
$725.00
|
|
Special radiation dosimetry
|
$536.40 |
$536.40 |
$536.40 |
$392.50
|
|
Special radiation treatment
|
$2,347.20 |
$2,347.20 |
$2,347.20 |
$1,986.00
|
|
Special teletx port plan
|
$1,158.00 |
$1,158.00 |
$1,158.00 |
$1,086.99
|
|
Specific gravity body fluid
|
$72.60 |
$72.60 |
$72.60 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,444.40 |
$2,444.40 |
$2,444.40 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$872.40 |
$872.40 |
$872.40 |
$543.26
|
|
Splint extn xsm w sof-stretch rolyan
|
$85.20 |
$85.20 |
$85.20 |
$68.25
|
|
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
|
$17,736.00 |
$17,736.00 |
$17,736.00 |
$13,585.00
|
|
Srs multisource
|
$36,840.00 |
$36,840.00 |
$36,840.00 |
$34,165.20
|
