|
Semen analysis presence/motility
|
$36.00 |
$36.00 |
$36.00 |
$70.40
|
|
Serial casting application 97139app
|
$159.00 |
$159.00 |
$159.00 |
$78.39
|
|
Sertraline (zoloft) - sendout
|
$208.20 |
$208.20 |
$208.20 |
$126.43
|
|
Sgmdsc w/band ligation
|
$1,275.60 |
$1,275.60 |
$1,275.60 |
$2,288.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$163.20 |
$163.20 |
$163.20 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$204.00 |
$204.00 |
$204.00 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$236.40 |
$236.40 |
$236.40 |
$436.64
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$294.00 |
$294.00 |
$294.00 |
$472.79
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$134.40 |
$134.40 |
$134.40 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$183.00 |
$183.00 |
$183.00 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$214.20 |
$214.20 |
$214.20 |
$268.47
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$238.80 |
$238.80 |
$238.80 |
$400.40
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$133.20 |
$133.20 |
$133.20 |
$311.40
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$178.20 |
$178.20 |
$178.20 |
$234.00
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$213.00 |
$213.00 |
$213.00 |
$286.89
|
|
Sheath gldlight lasr 12fx50cm
|
$7,481.40 |
$7,481.40 |
$7,481.40 |
$6,570.70
|
|
Shoe heel pad & depress for
|
$4.80 |
$4.80 |
$4.80 |
$149.60
|
|
Shoe post-op mens m
|
$21.00 |
$21.00 |
$21.00 |
$53.20
|
|
Sho heel count plast reinfor
|
$16.20 |
$16.20 |
$16.20 |
$346.47
|
|
Shot (Injection into Muscle or Under the Skin)
|
$73.20 |
$73.20 |
$73.20 |
$136.80
|
|
Shoulder AC Joint X-ray (both sides)
|
$175.20 |
$175.20 |
$175.20 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$238.20 |
$238.20 |
$238.20 |
$287.25
|
|
Shoulder MRI (with and without contrast)
|
$3,769.80 |
$3,769.80 |
$3,769.80 |
$2,821.65
|
|
Shoulder MRI (with contrast)
|
$2,408.40 |
$2,408.40 |
$2,408.40 |
$2,483.00
|
|
Shoulder MRI (without contrast)
|
$2,193.60 |
$2,193.60 |
$2,193.60 |
$2,088.20
|
|
Shoulder X-ray
|
$300.60 |
$300.60 |
$300.60 |
$341.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$165.60 |
$165.60 |
$165.60 |
$264.00
|
|
Shunt glaucoma baerveldt 350mm
|
$4,781.40 |
$4,781.40 |
$4,781.40 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$219.60 |
$219.60 |
$219.60 |
$355.80
|
|
Sialography s&i
|
$288.60 |
$288.60 |
$288.60 |
$499.20
|
|
Sialolithotomy 42330
|
$454.80 |
$454.80 |
$454.80 |
$3,837.72
|
|
Sickling rbc
|
$28.20 |
$28.20 |
$28.20 |
$59.40
|
|
Sigmoidoscopy and biopsy
|
$105.60 |
$105.60 |
$105.60 |
$1,446.90
|
|
Sigmoidoscopy flex decompression 45337
|
$291.00 |
$291.00 |
$291.00 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$741.00 |
$741.00 |
$741.00 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$541.80 |
$541.80 |
$541.80 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$1,464.00 |
$1,464.00 |
$1,464.00 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$565.80 |
$565.80 |
$565.80 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$318.00 |
$318.00 |
$318.00 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$301.80 |
$301.80 |
$301.80 |
$2,997.10
|
|
Sigmoidoscopy w/tumr remove
|
$622.20 |
$622.20 |
$622.20 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$283.80 |
$283.80 |
$283.80 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$257.40 |
$257.40 |
$257.40 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$574.80 |
$574.80 |
$574.80 |
$1,976.25
|
|
Signal avg ecg w or without ecg 93278
|
$123.60 |
$123.60 |
$123.60 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$928.20 |
$928.20 |
$928.20 |
$2,288.00
|
|
Simple cystometrogram 51725
|
$381.60 |
$381.60 |
$381.60 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$243.50 |
$243.50 |
$243.50 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,351.80 |
$1,351.80 |
$1,351.80 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$1,342.80 |
$1,342.80 |
$1,342.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,021.80 |
$1,021.80 |
$1,021.80 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$919.80 |
$919.80 |
$919.80 |
$2,517.48
|
|
Sinusotomy maxillary sinus 31020
|
$937.20 |
$937.20 |
$937.20 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$6,465.11
|
|
Sinusotomy sphenoid w/wo bx 31050
|
$947.40 |
$947.40 |
$947.40 |
$6,465.11
|
|
Sinus X-ray (complete)
|
$250.20 |
$250.20 |
$250.20 |
$347.10
|
|
Sinus X-ray (limited)
|
$207.60 |
$207.60 |
$207.60 |
$215.75
|
|
Sipuleucel-t - su
|
$98,900.28 |
$98,900.28 |
$98,900.28 |
$100,990.51
|
|
Sirolimus, oral
|
$60.62 |
$60.62 |
$60.62 |
$41.70
|
|
Skin Biopsy
|
$160.80 |
$160.80 |
$160.80 |
$361.20
|
|
Skin full graft 20sq cm less 15200
|
$1,573.20 |
$1,573.20 |
$1,573.20 |
$2,379.00
|
|
Skin full graft add-on 15241
|
$268.20 |
$268.20 |
$268.20 |
$560.01
|
|
Skin split graft addl 100sq cm 15101
|
$354.00 |
$354.00 |
$354.00 |
$1,793.40
|
|
Skin test unlisted antigen ea
|
$43.80 |
$43.80 |
$43.80 |
$48.57
|
|
Skull X-ray (1 to 3 views)
|
$165.00 |
$165.00 |
$165.00 |
$294.66
|
|
Skull X-ray (complete)
|
$273.00 |
$273.00 |
$273.00 |
$423.15
|
|
Skyla, 13.5 mg
|
$1,801.20 |
$1,801.20 |
$1,801.20 |
$1,643.47
|
|
Sleep study attended
|
$1,168.20 |
$1,168.20 |
$1,168.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,588.40 |
$2,588.40 |
$2,588.40 |
$3,734.50
|
|
Sleep study unattended
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$594.00
|
|
Sling arm deluxe w/pad xs
|
$16.80 |
$16.80 |
$16.80 |
$30.35
|
|
Sling pelv split sam med
|
$23.40 |
$23.40 |
$23.40 |
$150.00
|
|
Sling suprapubic suburetheral
|
$3,130.80 |
$3,130.80 |
$3,130.80 |
$9,679.96
|
|
Slp pure tone screening
|
$24.00 |
$24.00 |
$24.00 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$352.80 |
$352.80 |
$352.80 |
$557.70
|
|
Small bowel endoscopy
|
$325.80 |
$325.80 |
$325.80 |
$2,596.41
|
|
Small bowel endoscopy
|
$310.20 |
$310.20 |
$310.20 |
$2,244.82
|
|
Small bowel endoscopy
|
$369.00 |
$369.00 |
$369.00 |
$2,638.57
|
|
Small bowel endoscopy
|
$372.00 |
$372.00 |
$372.00 |
$2,518.10
|
|
Small bowel endoscopy
|
$589.20 |
$589.20 |
$589.20 |
$2,638.57
|
|
Small bowel endoscopy
|
$307.20 |
$307.20 |
$307.20 |
$2,088.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$411.60 |
$411.60 |
$411.60 |
$2,590.33
|
|
Small bowel endoscopy 44365
|
$378.00 |
$378.00 |
$378.00 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$312.00 |
$312.00 |
$312.00 |
$2,490.15
|
|
Small bowel endoscopy br/wa
|
$253.80 |
$253.80 |
$253.80 |
$1,924.00
|
|
Small bowel endoscopy/stent 44370
|
$405.00 |
$405.00 |
$405.00 |
$4,992.00
|
|
Smear fluorescent and/or acid fast stain
|
$150.00 |
$150.00 |
$150.00 |
$64.20
|
|
Smear gram stain
|
$48.00 |
$48.00 |
$48.00 |
$55.42
|
|
Smear nasal eosinophil
|
$41.40 |
$41.40 |
$41.40 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$34.20 |
$34.20 |
$34.20 |
$73.15
|
|
Smear wet mount
|
$48.00 |
$48.00 |
$48.00 |
$67.49
|
|
Sodium 24 hour urine
|
$45.60 |
$45.60 |
$45.60 |
$48.75
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$68.74 |
$68.74 |
$68.74 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$432.56 |
$432.56 |
$432.56 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$46.80 |
$46.80 |
$46.80 |
$46.26
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$170.35 |
$170.35 |
$170.35 |
$177.52
|
|
Spacer bag/reservoir
|
$6.60 |
$6.60 |
$6.60 |
$26.00
|
|
Special casting material
|
$36.60 |
$36.60 |
$36.60 |
$47.45
|
|
Special supplies phys/qhp
|
$103.80 |
$103.80 |
$103.80 |
$60.00
|
|
Specific gravity body fluid
|
$34.20 |
$34.20 |
$34.20 |
$22.00
|