|
Slp eval for nonspeech dev ea addl 30 mins
|
$75.20 |
$75.20 |
$75.20 |
$139.44
|
|
Slp eval non-spch gen comm dev
|
$211.20 |
$211.20 |
$211.20 |
$285.09
|
|
Slp pure tone screening
|
$24.80 |
$24.80 |
$24.80 |
$64.50
|
|
Slp stdy unatnd w/anal
|
$770.52 |
$770.52 |
$770.52 |
$285.00
|
|
Slp ther svc non-spch gen
|
$186.40 |
$186.40 |
$186.40 |
$188.00
|
|
Small animal inoculation
|
$42.40 |
$42.40 |
$42.40 |
$23.24
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$490.07 |
$490.07 |
$490.07 |
$557.70
|
|
Small bowel endoscopy
|
$363.20 |
$363.20 |
$363.20 |
$2,596.41
|
|
Small bowel endoscopy
|
$517.60 |
$517.60 |
$517.60 |
$2,244.82
|
|
Small bowel endoscopy
|
$608.00 |
$608.00 |
$608.00 |
$2,638.57
|
|
Small bowel endoscopy
|
$623.20 |
$623.20 |
$623.20 |
$2,518.10
|
|
Small bowel endoscopy
|
$720.00 |
$720.00 |
$720.00 |
$2,638.57
|
|
Small bowel endoscopy
|
$975.20 |
$975.20 |
$975.20 |
$3,265.60
|
|
Small bowel endoscopy
|
$698.40 |
$698.40 |
$698.40 |
$2,088.00
|
|
Small bowel endoscopy
|
$388.00 |
$388.00 |
$388.00 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$484.80 |
$484.80 |
$484.80 |
$2,590.33
|
|
Small bowel endoscopy 44365
|
$460.00 |
$460.00 |
$460.00 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$400.80 |
$400.80 |
$400.80 |
$2,490.15
|
|
Small bowel endoscopy/biopsy
|
$756.80 |
$756.80 |
$756.80 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$447.20 |
$447.20 |
$447.20 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$2,381.60 |
$2,381.60 |
$2,381.60 |
$2,406.40
|
|
Small bowel endoscopy/stent 44370
|
$673.60 |
$673.60 |
$673.60 |
$4,992.00
|
|
Smear fluorescent and/or acid fast stain
|
$38.58 |
$38.58 |
$38.58 |
$64.00
|
|
Smear gram stain
|
$38.58 |
$38.58 |
$38.58 |
$54.03
|
|
Smear nasal eosinophil
|
$56.44 |
$56.44 |
$56.44 |
$45.50
|
|
Smear special stain inclusion bodies/parasites
|
$38.58 |
$38.58 |
$38.58 |
$71.81
|
|
Smear wet mount
|
$38.58 |
$38.58 |
$38.58 |
$66.30
|
|
Smn1 gene full gene sequence
|
$289.30 |
$289.30 |
$289.30 |
$495.69
|
|
Smn1 gen nown famil seq vrnt
|
$177.80 |
$177.80 |
$177.80 |
$255.58
|
|
Smpd1 gene common variants
|
$127.86 |
$127.86 |
$127.86 |
$133.84
|
|
Snrpn/ube3a gene
|
$127.86 |
$127.86 |
$127.86 |
$228.80
|
|
Sock fracture or equal each
|
$72.80 |
$72.80 |
$72.80 |
$74.51
|
|
Sodium 24 hour urine
|
$33.57 |
$33.57 |
$33.57 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$47.84 |
$47.84 |
$47.84 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$48.00 |
$48.00 |
$48.00 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$48.00 |
$48.00 |
$48.00 |
$37.64
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.84 |
$14.84 |
$14.84 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$172.00 |
$172.00 |
$172.00 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$33.57 |
$33.57 |
$33.57 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$1.52 |
$1.52 |
$1.52 |
$177.52
|
|
Soft interface below knee se
|
$196.00 |
$196.00 |
$196.00 |
$179.08
|
|
So gsap cl fr cpy nmbr&mcrst
|
$323.55 |
$323.55 |
$323.55 |
$1,345.31
|
|
Somatosensory testing
|
$357.60 |
$357.60 |
$357.60 |
$816.00
|
|
So neo gsap dna/dna&rna
|
$2,869.97 |
$2,869.97 |
$2,869.97 |
$2,989.55
|
|
So neo gsap dna mcrstl ins
|
$861.00 |
$861.00 |
$861.00 |
$2,175.00
|
|
Sp bone agrft morsel add-on
|
$406.40 |
$406.40 |
$406.40 |
$406.40
|
|
Sp bone agrft struct add-on
|
$442.40 |
$442.40 |
$442.40 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$291.20 |
$291.20 |
$291.20 |
$498.55
|
|
Special casting material
|
$47.20 |
$47.20 |
$47.20 |
$47.45
|
|
Special physics consult
|
$999.56 |
$999.56 |
$999.56 |
$725.00
|
|
Special pump services
|
$928.00 |
$928.00 |
$928.00 |
$901.60
|
|
Special pump services
|
$649.60 |
$649.60 |
$649.60 |
$548.80
|
|
Special pump services
|
$464.80 |
$464.80 |
$464.80 |
$392.00
|
|
Special radiation dosimetry
|
$999.56 |
$999.56 |
$999.56 |
$392.73
|
|
Special radiation treatment
|
$2,357.19 |
$2,357.19 |
$2,357.19 |
$2,045.50
|
|
Special supplies phys/qhp
|
$90.40 |
$90.40 |
$90.40 |
$60.00
|
|
Special teletx port plan
|
$2,498.88 |
$2,498.88 |
$2,498.88 |
$1,086.99
|
|
Specific gravity body fluid
|
$33.57 |
$33.57 |
$33.57 |
$22.00
|
|
Specimen fat stain
|
$56.44 |
$56.44 |
$56.44 |
$35.10
|
|
Speech and Language Evaluation (comprehensive)
|
$450.28 |
$450.28 |
$450.28 |
$380.00
|
|
Speech audiometry complete
|
$83.20 |
$83.20 |
$83.20 |
$109.20
|
|
Speech evaluation complex
|
$228.00 |
$228.00 |
$228.00 |
$527.06
|
|
Speech recep thresh
|
$53.60 |
$53.60 |
$53.60 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$209.61 |
$209.61 |
$209.61 |
$248.84
|
|
Sperm antibody test
|
$56.44 |
$56.44 |
$56.44 |
$57.85
|
|
Sperm evaluation test
|
$49.60 |
$49.60 |
$49.60 |
$27.03
|
|
Sperm identification
|
$109.60 |
$109.60 |
$109.60 |
$101.55
|
|
Sperm isolation complex
|
$140.80 |
$140.80 |
$140.80 |
$176.28
|
|
Sperm isolation simple
|
$104.80 |
$104.80 |
$104.80 |
$126.05
|
|
Sperm washing 58323
|
$38.40 |
$38.40 |
$38.40 |
$238.06
|
|
Sphenoid sinus surgery
|
$3,276.80 |
$3,276.80 |
$3,276.80 |
$6,547.81
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$1,876.80 |
$1,876.80 |
$1,876.80 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$266.40 |
$266.40 |
$266.40 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$309.60 |
$309.60 |
$309.60 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,387.82 |
$1,387.82 |
$1,387.82 |
$1,474.00
|
|
Spine X-ray (single view, one level)
|
$159.16 |
$159.16 |
$159.16 |
$251.40
|
|
Spirmtry w/brnchdil inf-2 yr
|
$316.00 |
$316.00 |
$316.00 |
$368.50
|
|
Spirometry up to 2 yrs old
|
$194.40 |
$194.40 |
$194.40 |
$242.25
|
|
Spleen imaging
|
$1,204.32 |
$1,204.32 |
$1,204.32 |
$679.00
|
|
Splenectomy total open 38100
|
$2,828.80 |
$2,828.80 |
$2,828.80 |
$2,166.00
|
|
Splint arm vnyl coated padded lft med
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$881.60 |
$881.60 |
$881.60 |
$392.09
|
|
Splint finger 4 prong foam sm
|
$20.80 |
$20.80 |
$20.80 |
$34.00
|
|
Splint fing stax assort 1-7in
|
$5.60 |
$5.60 |
$5.60 |
$5.60
|
|
Splint rstrc wrst/cmc right med
|
$196.00 |
$196.00 |
$196.00 |
$100.00
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$6,005.04 |
$6,005.04 |
$6,005.04 |
$4,687.20
|
|
Split blood or products
|
$164.99 |
$164.99 |
$164.99 |
$129.50
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$516.00 |
$516.00 |
$516.00 |
$1,612.78
|
|
Spontaneous nystagmus study
|
$52.80 |
$52.80 |
$52.80 |
$130.65
|
|
Sprchoroidal spc njx rx agt
|
$313.60 |
$313.60 |
$313.60 |
$454.19
|
|
Sputum specimen collection
|
$180.00 |
$180.00 |
$180.00 |
$180.00
|
|
Srs cranial lesion complex
|
$3,244.00 |
$3,244.00 |
$3,244.00 |
$3,244.00
|
|
Srs cranial lesion simple
|
$2,384.00 |
$2,384.00 |
$2,384.00 |
$3,145.05
|
|
Srs cran les complex addl
|
$711.20 |
$711.20 |
$711.20 |
$711.20
|
|
Srs cran les simple addl
|
$719.20 |
$719.20 |
$719.20 |
$719.20
|
|
Srs linear based
|
$16,473.10 |
$16,473.10 |
$16,473.10 |
$14,124.25
|
|
Srs multisource
|
$2,114.40 |
$2,114.40 |
$2,114.40 |
$35,192.81
|
|
Srs spinal lesion
|
$2,631.20 |
$2,631.20 |
$2,631.20 |
$2,631.20
|
|
Srs spinal lesion addl
|
$591.20 |
$591.20 |
$591.20 |
$591.20
|
|
Staggered spondaic word test
|
$100.80 |
$100.80 |
$100.80 |
$253.00
|