|
Shoulder MRI (with contrast)
|
$2,238.76 |
$2,238.76 |
$5,309.20 |
$2,449.85
|
|
Shoulder MRI (without contrast)
|
$1,639.52 |
$1,639.52 |
$4,516.85 |
$2,060.00
|
|
Shoulder prosthesis removal
|
$5,259.20 |
$5,259.20 |
$5,259.20 |
$3,870.38
|
|
Shoulder X-ray
|
$222.80 |
$222.80 |
$436.15 |
$340.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$203.69 |
$203.69 |
$42,541.71 |
$260.40
|
|
Shrinker prosth above knee
|
$230.16 |
$230.16 |
$230.16 |
$168.89
|
|
Shrinker prosth below knee
|
$178.39 |
$178.39 |
$178.39 |
$109.00
|
|
Shunt glaucoma baerveldt 350mm
|
$3,209.23 |
$3,209.23 |
$4,659.72 |
$4,427.72
|
|
Shuntogram nonvascular supervision & interpretation
|
$167.70 |
$167.70 |
$216.80 |
$359.55
|
|
Sialidase enzyme assay
|
$38.58 |
$38.58 |
$38.58 |
$54.99
|
|
Sialography s&i
|
$215.20 |
$215.20 |
$215.20 |
$512.40
|
|
Sialolithotomy 42330
|
$572.00 |
$572.00 |
$572.00 |
$3,864.00
|
|
Sickling rbc
|
$33.57 |
$33.57 |
$85.80 |
$56.99
|
|
Sigmoidoscopy and biopsy
|
$672.00 |
$672.00 |
$3,261.31 |
$1,550.40
|
|
Sigmoidoscopy flex decompression 45337
|
$291.20 |
$291.20 |
$291.20 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$649.60 |
$649.60 |
$649.60 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$6,681.60 |
$6,681.60 |
$6,681.60 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$2,126.74 |
$2,126.74 |
$2,126.74 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$388.80 |
$388.80 |
$388.80 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$501.60 |
$501.60 |
$501.60 |
$2,997.10
|
|
Sigmoidoscopy w/tumr remove
|
$694.40 |
$694.40 |
$6,528.94 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$312.00 |
$312.00 |
$312.00 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$428.80 |
$428.80 |
$428.80 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$764.00 |
$764.00 |
$764.00 |
$1,976.25
|
|
Signal avg ecg w or without ecg 93278
|
$70.40 |
$70.40 |
$70.40 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$1,105.60 |
$1,105.60 |
$1,105.60 |
$2,288.00
|
|
Simple cystometrogram 51725
|
$522.40 |
$522.40 |
$522.40 |
$614.00
|
|
Sincalide 5 mcg solution for injection
|
$149.35 |
$149.35 |
$651.10 |
$309.14
|
|
Single energy x-ray study
|
$76.80 |
$76.80 |
$76.80 |
$125.84
|
|
Sinus CT scan (with and without contrast)
|
$1,593.80 |
$1,593.80 |
$1,620.43 |
$1,788.60
|
|
Sinus CT scan (with contrast)
|
$1,614.05 |
$1,614.05 |
$1,660.10 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,124.84 |
$1,124.84 |
$1,281.80 |
$1,283.87
|
|
Sinus/juglr venogram s&i
|
$474.40 |
$474.40 |
$474.40 |
$2,537.60
|
|
Sinusotomy maxillary sinus 31020
|
$2,321.60 |
$2,321.60 |
$2,321.60 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$2,859.20 |
$2,859.20 |
$2,859.20 |
$6,465.11
|
|
Sinusotomy sphenoid w/wo bx 31050
|
$2,446.40 |
$2,446.40 |
$2,446.40 |
$6,465.11
|
|
Sinus X-ray (complete)
|
$341.92 |
$341.92 |
$347.10 |
$345.24
|
|
Sinus X-ray (limited)
|
$193.69 |
$193.69 |
$193.69 |
$214.50
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$42,938.50 |
$42,938.50 |
$42,938.50 |
$14,361.10
|
|
Skeletal muscle relaxant 1/2
|
$72.14 |
$72.14 |
$72.14 |
$80.10
|
|
Skel musc relaxant 3 or more
|
$13.60 |
$13.60 |
$13.60 |
$16.12
|
|
Skin and muscle repair face
|
$2,522.40 |
$2,522.40 |
$2,522.40 |
$4,332.25
|
|
Skin Biopsy
|
$326.45 |
$326.45 |
$326.45 |
$362.40
|
|
Skin full graft 20sq cm less 15200
|
$2,052.80 |
$2,052.80 |
$2,052.80 |
$2,379.00
|
|
Skin full graft add-on 15241
|
$445.60 |
$445.60 |
$445.60 |
$560.01
|
|
Skin pedicle flap arms/legs
|
$2,168.80 |
$2,168.80 |
$2,168.80 |
$4,332.25
|
|
Skin pedicle flap trunk
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$2,501.86
|
|
Skin split graft addl 100sq cm 15101
|
$460.00 |
$460.00 |
$460.00 |
$1,793.40
|
|
Skin test unlisted antigen ea
|
$48.57 |
$48.57 |
$48.57 |
$48.57
|
|
Skull X-ray (1 to 3 views)
|
$183.30 |
$183.30 |
$232.98 |
$297.00
|
|
Skull X-ray (complete)
|
$232.98 |
$232.98 |
$274.30 |
$417.50
|
|
Skyla, 13.5 mg
|
$1,324.80 |
$1,324.80 |
$1,324.80 |
$1,643.47
|
|
Slco1b1 gene com variants
|
$350.40 |
$350.40 |
$350.40 |
$235.20
|
|
Sleep study attended
|
$931.20 |
$931.20 |
$931.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$1,945.04 |
$1,945.04 |
$3,244.80 |
$3,721.41
|
|
Sleep study unattended
|
$1,296.70 |
$1,296.70 |
$1,296.70 |
$594.00
|
|
Sleeve fing rolyan med
|
$37.65 |
$37.65 |
$37.65 |
$204.60
|
|
Sleeve irr assura 1pc disp
|
$0.65 |
$0.65 |
$0.65 |
$0.65
|
|
Sling arm deluxe w/pad xs
|
$21.60 |
$21.60 |
$529.06 |
$30.35
|
|
Sling pelv split sam med
|
$165.55 |
$165.55 |
$165.55 |
$150.00
|
|
Sling suprapubic suburetheral
|
$3,328.77 |
$3,328.77 |
$9,679.96 |
$9,679.96
|
|
Slitting of prepuce
|
$388.80 |
$388.80 |
$388.80 |
$4,061.71
|
|
Slitting of prepuce
|
$480.80 |
$480.80 |
$480.80 |
$3,376.23
|
|
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
|
$196.00 |
$196.00 |
$196.00 |
$285.00
|
|
Slp ther svc non-spch gen
|
$186.40 |
$186.40 |
$186.40 |
$188.00
|
|
Sm-153 lexidron ther
|
$57,456.00 |
$57,456.00 |
$57,456.00 |
$7,320.12
|
|
Small animal inoculation
|
$42.40 |
$42.40 |
$42.40 |
$23.24
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$574.60 |
$574.60 |
$774.76 |
$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 |
$61.75 |
$64.00
|
|
Smear gram stain
|
$38.58 |
$38.58 |
$40.95 |
$54.03
|
|
Smear nasal eosinophil
|
$27.30 |
$27.30 |
$56.44 |
$45.50
|
|
Smear special stain inclusion bodies/parasites
|
$38.58 |
$38.58 |
$44.20 |
$71.81
|
|
Smear wet mount
|
$38.58 |
$38.58 |
$1,496.30 |
$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
|
|
Sock wool above knee
|
$158.68 |
$158.68 |
$158.68 |
$51.18
|
|
Sodium 24 hour urine
|
$28.60 |
$28.60 |
$33.57 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$46.65 |
$46.65 |
$17,456.75 |
$48.58
|