|
Smear nasal eosinophil
|
$14.19 |
$68.40 |
$182.40 |
|
|
Smear special stain inclusion bodies/parasites
|
$22.50 |
$71.40 |
$228.00 |
|
|
Smear wet mount
|
$12.54 |
$74.16 |
$222.40 |
|
|
Smn1 gene full gene sequence
|
$289.30 |
$289.30 |
$289.30 |
|
|
Smn1 gen nown famil seq vrnt
|
$177.80 |
$177.80 |
$177.80 |
|
|
Smpd1 gene common variants
|
$50.49 |
$140.00 |
$693.00 |
|
|
Snrpn/ube3a gene
|
$127.86 |
$668.80 |
$2,261.60 |
|
|
So cap design without jnts cf
|
$514.80 |
$596.40 |
$1,110.00 |
|
|
Sock fracture or equal each
|
$31.19 |
$72.80 |
$74.20 |
|
|
Sodium 24 hour urine
|
$14.19 |
$56.00 |
$167.40 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$21.60 |
$82.11 |
$279.65 |
|
|
Sodium chloride 0.9 % IV bolus
|
$14.70 |
$60.57 |
$1,155.87 |
|
|
Sodium chloride 0.9 % IV bolus
|
$15.57 |
$56.95 |
$279.65 |
|
|
Sodium chloride 3 % ivpb
|
$0.06 |
$26.60 |
$309.05 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.84 |
$67.32 |
$418.25 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$172.00 |
$210.68 |
$737.80 |
|
|
Sodium serum/plasma/whole blood
|
$6.60 |
$56.65 |
$122.40 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$1.52 |
$15.92 |
$170.35 |
|
|
Soft interface below knee se
|
$160.30 |
$196.00 |
$289.44 |
|
|
So gsap cl fr cpy nmbr&mcrst
|
$323.55 |
$323.55 |
$323.55 |
|
|
So gsap dna cpy nmbr&mcrstl
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
|
|
Somatosensory testing
|
$145.53 |
$857.40 |
$2,845.80 |
|
|
Somatropin injection
|
$2,111.06 |
$2,111.06 |
$2,111.06 |
|
|
So neo gsap dna/dna&rna
|
$2,869.97 |
$2,869.97 |
$3,767.04 |
|
|
So neo gsap dna mcrstl ins
|
$861.00 |
$8,194.80 |
$10,926.40 |
|
|
Sotalol hydrochloride IV
|
$12,733.00 |
$17,313.80 |
$22,937.60 |
|
|
So vest canvas/web pre ots
|
$289.44 |
$289.44 |
$289.44 |
|
|
Spacer bag/reservoir
|
$6.60 |
$6.60 |
$6.60 |
|
|
Sp bone agrft morsel add-on
|
$406.40 |
$406.40 |
$406.40 |
|
|
Sp bone agrft struct add-on
|
$442.40 |
$442.40 |
$442.40 |
|
|
Sp bone algrft morsel add-on
|
$147.60 |
$147.60 |
$291.20 |
|
|
Special casting material
|
$36.60 |
$36.60 |
$47.20 |
|
|
Special physics consult
|
$275.00 |
$876.24 |
$49,199.50 |
|
|
Special pump services
|
$838.80 |
$838.80 |
$928.00 |
|
|
Special pump services
|
$587.40 |
$587.40 |
$649.60 |
|
|
Special pump services
|
$336.60 |
$336.60 |
$464.80 |
|
|
Special radiation dosimetry
|
$222.50 |
$525.00 |
$32,309.20 |
|
|
Special radiation treatment
|
$525.00 |
$2,347.20 |
$50,960.70 |
|
|
Special supplies phys/qhp
|
$8.40 |
$90.40 |
$103.80 |
|
|
Special teletx port plan
|
$350.00 |
$1,205.00 |
$28,321.82 |
|
|
Specific gravity body fluid
|
$11.22 |
$34.20 |
$432.00 |
|
|
Specimen fat stain
|
$40.00 |
$40.00 |
$124.00 |
|
|
Speech and Language Evaluation (comprehensive)
|
$95.00 |
$457.50 |
$797.04 |
|
|
Speech audiometry complete
|
$43.20 |
$89.60 |
$181.80 |
|
|
Speech evaluation complex
|
$173.25 |
$624.00 |
$988.20 |
|
|
Speech recep thresh
|
$30.69 |
$77.50 |
$160.20 |
|
|
Speech Therapy Session (one-on-one)
|
$85.00 |
$256.80 |
$477.00 |
|
|
Sperm antibody test
|
$32.50 |
$262.50 |
$262.50 |
|
|
Sperm evaluation test
|
$49.60 |
$49.60 |
$49.60 |
|
|
Sperm identification
|
$109.60 |
$109.60 |
$685.44 |
|
|
Sperm isolation complex
|
$140.80 |
$140.80 |
$140.80 |
|
|
Sperm isolation simple
|
$52.47 |
$52.47 |
$104.80 |
|
|
Sperm washing 58323
|
$38.40 |
$39.60 |
$39.60 |
|
|
Sphenoid sinus surgery
|
$3,276.80 |
$3,276.80 |
$3,276.80 |
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$1,456.20 |
$1,876.80 |
$27,067.75 |
|
|
Spinal bone allograftstructural 20931
|
$243.00 |
$243.00 |
$266.40 |
|
|
Spinal bone autograftlocal 20936
|
$309.60 |
$424.20 |
$424.20 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$435.00 |
$1,485.00 |
$11,258.10 |
|
|
Spine X-ray (single view, one level)
|
$87.50 |
$324.00 |
$565.92 |
|
|
Spirmtry w/brnchdil inf-2 yr
|
$316.00 |
$316.00 |
$316.00 |
|
|
Spirometry up to 2 yrs old
|
$194.40 |
$194.40 |
$194.40 |
|
|
Spleen imaging
|
$529.65 |
$882.60 |
$1,204.32 |
|
|
Splenectomy total open 38100
|
$2,166.00 |
$2,166.00 |
$2,828.80 |
|
|
Splint arm vnyl coated padded lft med
|
$48.00 |
$48.00 |
$48.00 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$280.80 |
$388.80 |
$881.60 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$36.00 |
$85.20 |
$127.20 |
|
|
Splint finger 4 prong foam sm
|
$16.80 |
$16.80 |
$110.16 |
|
|
Splint finger fold over sm
|
$20.00 |
$158.20 |
$158.20 |
|
|
Splint finger frog med
|
$3.00 |
$35.00 |
$105.00 |
|
|
Splint fing stax assort 1-7in
|
$3.60 |
$3.60 |
$5.60 |
|
|
Splint func pos polyflex ii med
|
$4.80 |
$1,143.00 |
$1,524.00 |
|
|
Splint rstrc wrst/cmc right med
|
$16.20 |
$369.60 |
$780.80 |
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$1,651.80 |
$4,440.00 |
$7,907.76 |
|
|
Split blood or products
|
$62.50 |
$165.00 |
$321.84 |
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$516.00 |
$2,966.40 |
$4,533.60 |
|
|
Spontaneous nystagmus study
|
$52.20 |
$52.20 |
$52.80 |
|
|
Sprchoroidal spc njx rx agt
|
$313.60 |
$313.60 |
$313.60 |
|
|
Sputum specimen collection
|
$58.40 |
$83.16 |
$370.08 |
|
|
Sr-89 stront chlor ther / mci
|
$805.80 |
$805.80 |
$1,250.70 |
|
|
Srs cranial lesion complex
|
$3,244.00 |
$9,470.30 |
$9,470.30 |
|
|
Srs cranial lesion simple
|
$2,384.00 |
$6,274.10 |
$6,274.10 |
|
|
Srs cran les complex addl
|
$711.20 |
$711.20 |
$711.20 |
|
|
Srs cran les simple addl
|
$719.20 |
$1,498.70 |
$1,498.70 |
|
|
Srs linear based
|
$11,228.25 |
$17,736.00 |
$48,428.10 |
|
|
Srs multisource
|
$2,114.40 |
$56,264.40 |
$65,189.60 |
|
|
Srs spinal lesion
|
$2,631.20 |
$2,631.20 |
$2,631.20 |
|
|
Srs spinal lesion addl
|
$591.20 |
$591.20 |
$591.20 |
|
|
Staggered spondaic word test
|
$100.80 |
$100.80 |
$100.80 |
|
|
Staging lapro hodgkins disease/lymphoma 49220
|
$1,826.40 |
$1,826.40 |
$1,826.40 |
|
|
St analysis behavior qualitative voice/resonance
|
$187.92 |
$358.20 |
$797.04 |
|
|
Staph a dna amp probe
|
$30.75 |
$162.40 |
$270.00 |
|
|
Static or dynami afo pre ots
|
$291.20 |
$291.20 |
$291.20 |
|
|
St cognitve performance testing healthcare professional each hour
|
$78.60 |
$280.20 |
$392.70 |
|
|
Stem cells total count
|
$156.00 |
$212.50 |
$442.40 |
|
|
Stenger test pure tone
|
$25.74 |
$77.50 |
$527.40 |
|
|
Stenger test speech
|
$40.80 |
$358.20 |
$590.00 |
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$1,219.80 |
$21,568.80 |
$146,158.30 |
|
|
Stent axios caut enh 15x10mm electrocaut
|
$1,628.38 |
$23,203.40 |
$135,494.55 |
|
|
Stent bili dbl pgtl 10fx5cm
|
$204.80 |
$530.04 |
$144,548.20 |
|
|
Stent bili rx wallflx 10x80 uncvr
|
$162.00 |
$6,264.00 |
$135,036.44 |
|
