|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$609.60 |
$609.60 |
$1,785.00 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$564.60 |
$564.60 |
$1,014.60 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$424.80 |
$424.80 |
$756.00 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$532.20 |
$532.20 |
$1,297.80 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$746.40 |
$746.40 |
$1,878.00 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$472.80 |
$472.80 |
$940.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$466.20 |
$466.20 |
$955.80 |
$595.35
|
|
Sclerotherapy fluid collection pq w/img
|
$3,881.40 |
$3,881.40 |
$3,881.40 |
$2,114.45
|
|
Scr c/v cyto,thinlayer,rescr
|
$195.60 |
$195.60 |
$195.60 |
$85.15
|
|
Scr c/v cyto,thinlayer,rescr
|
$195.60 |
$195.60 |
$195.60 |
$54.40
|
|
Screening Mammogram
|
$487.20 |
$487.20 |
$487.20 |
$312.55
|
|
Screening prostate cancer PSA
|
$471.00 |
$471.00 |
$471.00 |
$100.63
|
|
Screen pap by tech w md supv
|
$103.80 |
$103.80 |
$103.80 |
$52.65
|
|
Screen/visual acuity/bilat/quant 99173
|
$79.80 |
$79.80 |
$79.80 |
$28.86
|
|
Sec art mech thrmbc non-intracranial add-on
|
$5,604.60 |
$5,604.60 |
$5,604.60 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$3.60 |
$3.60 |
$103.80 |
$42.00
|
|
Select picture audiometry
|
$310.80 |
$310.80 |
$310.80 |
$105.60
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$51.60 |
$51.60 |
$51.60 |
$51.98
|
|
Self-mgmt educ/train 5-8 pt 30min
|
$43.80 |
$43.80 |
$43.80 |
$33.04
|
|
Sensorimotor examination
|
$115.80 |
$115.80 |
$115.80 |
$109.50
|
|
Set radiation therapy field
|
$1,480.20 |
$1,480.20 |
$1,480.20 |
$762.40
|
|
Set radiation therapy field
|
$2,664.60 |
$2,664.60 |
$2,664.60 |
$1,157.38
|
|
Set radiation therapy field
|
$3,736.20 |
$3,736.20 |
$3,736.20 |
$1,636.36
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$145.20 |
$145.20 |
$145.20 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$172.80 |
$172.80 |
$172.80 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$177.00 |
$177.00 |
$177.00 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$287.40 |
$287.40 |
$287.40 |
$472.79
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$145.20 |
$145.20 |
$145.20 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$158.40 |
$158.40 |
$158.40 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$172.80 |
$172.80 |
$172.80 |
$269.50
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$287.40 |
$287.40 |
$287.40 |
$400.65
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$218.40 |
$218.40 |
$218.40 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$163.20 |
$163.20 |
$163.20 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$172.20 |
$172.20 |
$172.20 |
$289.30
|
|
Shoe post-op mens m
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$52.20
|
|
Shoulder MRI (with and without contrast)
|
$3,999.00 |
$3,999.00 |
$5,420.40 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$3,672.60 |
$3,672.60 |
$5,069.40 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$3,672.60 |
$3,672.60 |
$5,069.40 |
$2,065.05
|
|
Shoulder X-ray
|
$223.80 |
$223.80 |
$781.80 |
$339.50
|
|
Shrinker prosth above knee
|
$585.60 |
$585.60 |
$585.60 |
$168.89
|
|
Shuntogram nonvascular supervision & interpretation
|
$253.20 |
$253.20 |
$2,260.20 |
$349.20
|
|
Sialography s&i
|
$4,133.40 |
$4,133.40 |
$4,133.40 |
$499.20
|
|
Sickling rbc
|
$124.80 |
$124.80 |
$124.80 |
$57.92
|
|
Signal avg ecg w or without ecg 93278
|
$298.80 |
$298.80 |
$298.80 |
$280.00
|
|
Simple cystometrogram 51725
|
$1,537.80 |
$1,537.80 |
$1,537.80 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$157.80 |
$157.80 |
$157.80 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$1,788.60 |
$1,788.60 |
$2,424.60 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,632.60 |
$1,632.60 |
$2,253.00 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,632.60 |
$1,632.60 |
$2,253.00 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$2,098.20 |
$2,098.20 |
$2,098.20 |
$2,489.25
|
|
Skin Biopsy
|
$365.40 |
$365.40 |
$365.40 |
$360.34
|
|
Sleep study attended
|
$1,495.80 |
$1,495.80 |
$5,422.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,358.00 |
$2,358.00 |
$5,285.40 |
$3,607.50
|
|
Sleep study unattended
|
$484.80 |
$484.80 |
$1,389.60 |
$580.87
|
|
Sleeve fing rolyan med
|
$194.40 |
$194.40 |
$194.40 |
$203.58
|
|
Sling pelv split sam med
|
$307.80 |
$307.80 |
$307.80 |
$150.00
|
|
Slp pure tone screening
|
$99.60 |
$99.60 |
$99.60 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$873.00 |
$873.00 |
$873.00 |
$296.34
|
|
Slp ther svc non-spch gen
|
$330.00 |
$330.00 |
$330.00 |
$188.50
|
|
Small bowel endoscopy br/wa
|
$2,905.80 |
$2,905.80 |
$2,905.80 |
$1,924.00
|
|
Smear fluorescent and/or acid fast stain
|
$148.80 |
$148.80 |
$185.40 |
$64.20
|
|
Smear gram stain
|
$33.60 |
$33.60 |
$152.40 |
$55.25
|
|
Smear nasal eosinophil
|
$182.40 |
$182.40 |
$182.40 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$160.20 |
$160.20 |
$160.20 |
$73.15
|
|
Smear wet mount
|
$159.60 |
$159.60 |
$159.60 |
$67.49
|
|
Snrpn/ube3a gene
|
$1,669.80 |
$1,669.80 |
$1,669.80 |
$231.85
|
|
So cap design without jnts cf
|
$864.00 |
$864.00 |
$864.00 |
$606.35
|
|
Sodium 24 hour urine
|
$30.60 |
$30.60 |
$167.40 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$6.60 |
$6.60 |
$85.80 |
$45.60
|
|
Somatosensory testing
|
$2,845.80 |
$2,845.80 |
$2,845.80 |
$816.00
|
|
So neo gsap dna mcrstl ins
|
$7,956.00 |
$7,956.00 |
$8,353.80 |
$2,296.00
|
|
Special physics consult
|
$1,584.60 |
$1,584.60 |
$1,584.60 |
$725.00
|
|
Special radiation dosimetry
|
$372.60 |
$372.60 |
$372.60 |
$392.50
|
|
Special radiation treatment
|
$4,687.20 |
$4,687.20 |
$4,687.20 |
$1,986.00
|
|
Special teletx port plan
|
$1,750.20 |
$1,750.20 |
$1,750.20 |
$1,086.99
|
|
Specific gravity body fluid
|
$15.00 |
$15.00 |
$80.40 |
$22.00
|
|
Speech audiometry complete
|
$181.80 |
$181.80 |
$181.80 |
$109.20
|
|
Speech evaluation complex
|
$624.00 |
$624.00 |
$624.00 |
$527.06
|
|
Speech recep thresh
|
$151.80 |
$151.80 |
$151.80 |
$82.88
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$3,007.80 |
$3,007.80 |
$3,007.80 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$523.80 |
$523.80 |
$523.80 |
$543.26
|
|
Spleen imaging
|
$882.60 |
$882.60 |
$882.60 |
$679.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$460.80 |
$460.80 |
$460.80 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$127.20 |
$127.20 |
$127.20 |
$68.25
|
|
Splint finger frog med
|
$65.40 |
$65.40 |
$65.40 |
$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
|
$21,586.20 |
$21,586.20 |
$21,586.20 |
$13,585.00
|
|
Srs multisource
|
$44,838.00 |
$44,838.00 |
$44,838.00 |
$34,165.20
|
|
St analysis behavior qualitative voice/resonance
|
$358.20 |
$358.20 |
$358.20 |
$297.60
|
|
Staph a dna amp probe
|
$124.20 |
$124.20 |
$270.00 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$280.20 |
$280.20 |
$280.20 |
$286.00
|
|
Stenger test pure tone
|
$527.40 |
$527.40 |
$527.40 |
$77.84
|
|
Stenger test speech
|
$372.60 |
$372.60 |
$372.60 |
$404.25
|
|
Stent placemt retro carotid
|
$27,052.80 |
$27,052.80 |
$27,052.80 |
$5,328.00
|
|
Stereotactic radiation trmt
|
$3,639.00 |
$3,639.00 |
$3,639.00 |
$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
|
