|
Pt application of modality traction mechanical
|
$91.20 |
$91.20 |
$91.20 |
$87.19
|
|
Pt evaluation high complexity patient/family
|
$235.20 |
$235.20 |
$235.20 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$152.40 |
$152.40 |
$152.40 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$193.20 |
$193.20 |
$193.20 |
$247.20
|
|
Pt re-evaluation patient/family
|
$140.40 |
$140.40 |
$140.40 |
$141.93
|
|
Pt repositioning canalith procedure(s) per day
|
$81.60 |
$81.60 |
$81.60 |
$140.80
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$74.40 |
$74.40 |
$74.40 |
$83.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$95.40 |
$95.40 |
$95.40 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$61.20 |
$61.20 |
$61.20 |
$84.90
|
|
Pulmonary vent imaging
|
$1,828.20 |
$1,828.20 |
$1,828.20 |
$828.73
|
|
Pulse ox continuous overnight monitoring
|
$510.00 |
$510.00 |
$510.00 |
$351.20
|
|
Pulse ox multiple
|
$182.40 |
$182.40 |
$182.40 |
$190.25
|
|
Pulse ox single
|
$136.20 |
$136.20 |
$136.20 |
$78.99
|
|
Puncture arterial withdrawal blood for diagnosis
|
$187.20 |
$187.20 |
$187.20 |
$113.75
|
|
Pyruvate
|
$154.20 |
$154.20 |
$154.20 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$3,371.40 |
$3,371.40 |
$3,371.40 |
$1,507.40
|
|
Quant diff pulm perf w/imaging
|
$2,359.20 |
$2,359.20 |
$2,359.20 |
$1,228.80
|
|
Quest t3 uptake
|
$123.60 |
$123.60 |
$123.60 |
$55.00
|
|
Rabies ig ht&sol human im/sc
|
$5,401.91 |
$5,401.91 |
$5,401.91 |
$5,401.91
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$5,401.91 |
$5,401.91 |
$5,401.91 |
$1,624.21
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$2,707.80 |
$2,707.80 |
$2,707.80 |
$1,646.00
|
|
Radphm lcl tmr plnr bdy two day img
|
$3,421.80 |
$3,421.80 |
$3,421.80 |
$2,582.32
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$2,893.20 |
$2,893.20 |
$2,893.20 |
$2,683.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$2,494.80 |
$2,494.80 |
$2,494.80 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$880.20 |
$880.20 |
$880.20 |
$1,075.78
|
|
Rapid Strep Test
|
$124.80 |
$124.80 |
$124.80 |
$67.80
|
|
Rbc count only automated
|
$35.40 |
$35.40 |
$35.40 |
$20.00
|
|
Rbc deglycerolized each unit
|
$1,122.60 |
$1,122.60 |
$1,122.60 |
$785.20
|
|
Red blood cells each unit
|
$551.40 |
$551.40 |
$551.40 |
$380.25
|
|
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit
|
$2,587.20 |
$2,587.20 |
$2,587.20 |
$537.70
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$607.80 |
$607.80 |
$607.80 |
$624.65
|
|
Red blood cells leukocytes reduced each unit
|
$546.00 |
$546.00 |
$546.00 |
$519.35
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$751.20 |
$751.20 |
$751.20 |
$645.45
|
|
Red blood cells washed each unit
|
$494.40 |
$494.40 |
$494.40 |
$561.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$626.62 |
$626.62 |
$626.62 |
$115.07
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$340.80 |
$340.80 |
$340.80 |
$236.64
|
|
Remove esophagus obstruction
|
$315.00 |
$315.00 |
$315.00 |
$340.60
|
|
Renal function panel
|
$222.60 |
$222.60 |
$222.60 |
$95.76
|
|
Resuscitation cardiopulmonary
|
$1,297.20 |
$1,297.20 |
$1,297.20 |
$895.44
|
|
Reticulocyte automated
|
$79.80 |
$79.80 |
$79.80 |
$54.27
|
|
Reticulocyte direct measurement automated
|
$17.40 |
$17.40 |
$17.40 |
$32.50
|
|
Rheumatoid factor qualitative
|
$96.60 |
$96.60 |
$96.60 |
$54.60
|
|
Rheumatoid factor quantitative
|
$97.20 |
$97.20 |
$97.20 |
$59.80
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$511.80 |
$511.80 |
$511.80 |
$345.07
|
|
Rho d immune globulin inj
|
$355.78 |
$355.78 |
$355.78 |
$232.72
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$44.69 |
$44.69 |
$44.69 |
$60.40
|
|
Rp loclzj tum 2+area 1+d img
|
$2,479.80 |
$2,479.80 |
$2,479.80 |
$1,283.66
|
|
Rsv assay w/optic
|
$288.60 |
$288.60 |
$288.60 |
$64.13
|
|
Rubella antibody igg
|
$100.80 |
$100.80 |
$100.80 |
$73.05
|
|
Rubeola antibody igg
|
$157.80 |
$157.80 |
$157.80 |
$80.00
|
|
Russell viper venom diluted
|
$154.20 |
$154.20 |
$154.20 |
$73.03
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,425.60 |
$1,425.60 |
$1,425.60 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$1,170.60 |
$1,170.60 |
$1,170.60 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$788.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,231.20 |
$1,231.20 |
$1,231.20 |
$507.18
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$711.00 |
$711.00 |
$711.00 |
$586.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,342.20 |
$1,342.20 |
$1,342.20 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$836.40 |
$836.40 |
$836.40 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,072.20 |
$1,072.20 |
$1,072.20 |
$527.80
|
|
Screen cerv/vag thin layer
|
$151.20 |
$151.20 |
$151.20 |
$61.20
|
|
Screening Mammogram
|
$255.60 |
$255.60 |
$255.60 |
$287.12
|
|
Screening prostate cancer PSA
|
$178.80 |
$178.80 |
$178.80 |
$96.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$324.00 |
$324.00 |
$324.00 |
$194.35
|
|
Sedimentation rate erythrocyte automated
|
$90.00 |
$90.00 |
$90.00 |
$37.80
|
|
Semen analysis presence/motility
|
$80.40 |
$80.40 |
$80.40 |
$79.92
|
|
Serial casting application 97139app
|
$58.80 |
$58.80 |
$58.80 |
$67.42
|
|
Shoe post-op mens m
|
$22.20 |
$22.20 |
$22.20 |
$29.76
|
|
Shoulder MRI (with and without contrast)
|
$5,319.60 |
$5,319.60 |
$5,319.60 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$4,594.80 |
$4,594.80 |
$4,594.80 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$3,675.60 |
$3,675.60 |
$3,675.60 |
$1,938.28
|
|
Shoulder X-ray
|
$492.00 |
$492.00 |
$492.00 |
$307.20
|
|
Sialidase enzyme assay
|
$59.40 |
$59.40 |
$59.40 |
$54.60
|
|
Sincalide 5 mcg solution for injection
|
$199.80 |
$199.80 |
$199.80 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,690.20 |
$1,690.20 |
$1,690.20 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,291.80 |
$1,291.80 |
$1,291.80 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$1,033.20 |
$1,033.20 |
$1,033.20 |
$1,151.00
|
|
Skin Biopsy
|
$489.00 |
$489.00 |
$489.00 |
$362.40
|
|
Slp pure tone screening
|
$66.60 |
$66.60 |
$66.60 |
$64.50
|
|
Smear fluorescent and/or acid fast stain
|
$97.20 |
$97.20 |
$97.20 |
$50.70
|
|
Smear gram stain
|
$73.80 |
$73.80 |
$73.80 |
$48.00
|
|
Smear nasal eosinophil
|
$81.60 |
$81.60 |
$81.60 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$142.20 |
$142.20 |
$142.20 |
$60.00
|
|
Smear wet mount
|
$83.40 |
$83.40 |
$83.40 |
$56.13
|
|
Sodium 24 hour urine
|
$49.80 |
$49.80 |
$49.80 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$49.07 |
$49.07 |
$49.07 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$49.63 |
$49.63 |
$49.63 |
$42.25
|
|
Sodium chloride 0.9 % IV bolus
|
$49.00 |
$49.00 |
$49.00 |
$42.25
|
|
Sodium chloride 3 % ivpb
|
$79.30 |
$79.30 |
$79.30 |
$37.50
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$104.98 |
$104.98 |
$104.98 |
$28.46
|
|
Sodium serum/plasma/whole blood
|
$57.60 |
$57.60 |
$57.60 |
$42.43
|
|
Specific gravity body fluid
|
$45.60 |
$45.60 |
$45.60 |
$21.55
|
|
Speech audiometry complete
|
$90.00 |
$90.00 |
$90.00 |
$112.45
|
|
Speech recep thresh
|
$90.00 |
$90.00 |
$90.00 |
$90.60
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,654.20 |
$1,654.20 |
$1,654.20 |
$1,416.00
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$835.80 |
$835.80 |
$835.80 |
$526.80
|
|
St analysis behavior qualitative voice/resonance
|
$142.80 |
$142.80 |
$142.80 |
$295.10
|
|
Staph a dna amp probe
|
$107.40 |
$107.40 |
$107.40 |
$116.39
|
|
St cognitve performance testing healthcare professional each hour
|
$164.40 |
$164.40 |
$164.40 |
$313.96
|
|
Stenger test pure tone
|
$91.20 |
$91.20 |
$91.20 |
$75.60
|
