|
Rp loclzj tum spect w/ct 1
|
$2,645.76 |
$2,645.76 |
$2,689.05 |
$2,573.55
|
|
Rp loclzj tum spect w/ct 2
|
$3,001.09 |
$3,001.09 |
$3,001.09 |
$3,186.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$2,860.36 |
$2,860.36 |
$3,093.35 |
$2,175.36
|
|
Rpl tun-cvad w subq port
|
$5,007.60 |
$5,007.60 |
$5,708.20 |
$4,819.80
|
|
Rpl tun-cvad w subq pump
|
$3,062.40 |
$3,062.40 |
$3,062.40 |
$6,067.30
|
|
Rpl tun cvc wo subq port
|
$5,014.75 |
$5,014.75 |
$5,708.20 |
$3,724.63
|
|
Rpm tx mgmt 1st 20 min
|
$90.40 |
$90.40 |
$90.40 |
$72.60
|
|
Rpm tx mgmt ea addl 20 min
|
$73.60 |
$73.60 |
$73.60 |
$73.60
|
|
Rpr aa hrn 1st > 10 ncr/strn
|
$2,563.20 |
$2,563.20 |
$2,563.20 |
$1,982.40
|
|
Rpr aa hrn 1st > 10 rdc
|
$1,928.80 |
$1,928.80 |
$1,928.80 |
$5,855.00
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$1,865.60 |
$1,865.60 |
$43,190.68 |
$6,904.15
|
|
Rpr aa hrn 1st 3-10 rdc
|
$1,434.40 |
$1,434.40 |
$48,176.21 |
$7,383.87
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$856.00 |
$856.00 |
$28,157.55 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$1,189.60 |
$1,189.60 |
$51,873.40 |
$6,904.15
|
|
Rpr aa hrn rcr > 10 ncr/strn
|
$3,104.80 |
$3,104.80 |
$3,104.80 |
$2,402.40
|
|
Rpr aa hrn rcr > 10 rdc
|
$2,217.60 |
$2,217.60 |
$3,156.00 |
$1,719.20
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$2,148.00 |
$2,148.00 |
$2,148.00 |
$1,663.20
|
|
Rpr aa hrn rcr 3-10 rdc
|
$1,600.80 |
$1,600.80 |
$1,600.80 |
$6,856.20
|
|
Rpr aa hrn rcr < 3 ncr/strn
|
$1,431.20 |
$1,431.20 |
$1,431.20 |
$6,463.42
|
|
Rpr aa hrn rcr < 3 rdc
|
$1,056.80 |
$1,056.80 |
$1,503.00 |
$4,271.28
|
|
Rpr blood ves w/vein graft/up ext 35236
|
$4,923.20 |
$4,923.20 |
$4,923.20 |
$5,983.35
|
|
Rpr blood vsl grf oth vein lo ex
|
$4,564.80 |
$4,564.80 |
$4,564.80 |
$5,907.78
|
|
Rpr blvs gr ot/th vn ntrth w
|
$6,742.40 |
$6,742.40 |
$6,742.40 |
$6,390.80
|
|
Rpr blvsl gr ot/th vn ntr-ab
|
$7,948.80 |
$7,948.80 |
$7,948.80 |
$7,815.60
|
|
Rpr choanal atresia ntranasl
|
$1,745.60 |
$1,745.60 |
$1,745.60 |
$6,839.00
|
|
Rpr choanal atresia trsnpltn
|
$2,387.20 |
$2,387.20 |
$2,387.20 |
$6,553.49
|
|
Rpr csf leak/pseudomeng/laminectomy63709
|
$2,661.60 |
$2,661.60 |
$2,661.60 |
$1,933.20
|
|
Rpr diaphragm hernia/chronic/not neonate 39541
|
$2,301.60 |
$2,301.60 |
$2,301.60 |
$1,705.80
|
|
Rpr diaphragm lac/any approach 39501
|
$2,092.00 |
$2,092.00 |
$2,092.00 |
$1,509.66
|
|
Rpr fem hernia init blocked
|
$3,094.40 |
$3,094.40 |
$3,094.40 |
$4,176.15
|
|
Rpr hern preemie reduc
|
$3,897.60 |
$3,897.60 |
$3,897.60 |
$6,839.00
|
|
Rpr hypopl a-arch w/byp
|
$4,469.60 |
$4,469.60 |
$4,469.60 |
$4,469.60
|
|
Rpr hypspad comp dsj & urtp
|
$2,556.80 |
$2,556.80 |
$2,556.80 |
$5,631.74
|
|
Rpr hypspad comp simple
|
$1,436.00 |
$1,436.00 |
$1,436.00 |
$4,350.00
|
|
Rpr ing hernia baby blocked
|
$3,006.40 |
$3,006.40 |
$3,006.40 |
$4,156.03
|
|
Rpr ing hernia baby reduc
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$4,176.15
|
|
Rpr ing hernia init blocked
|
$2,963.20 |
$2,963.20 |
$2,963.20 |
$4,176.15
|
|
Rpr ing hernia init reduce
|
$2,017.60 |
$2,017.60 |
$2,017.60 |
$5,411.37
|
|
Rpr ing hern premie blocked
|
$4,691.20 |
$4,691.20 |
$4,691.20 |
$4,691.20
|
|
Rpr nsl vlv collapse w/implt
|
$7,606.40 |
$7,606.40 |
$7,606.40 |
$8,139.99
|
|
Rpr parastomal hernia rdc 49621
|
$1,872.00 |
$1,872.00 |
$2,663.00 |
$1,450.40
|
|
Rpr parastomal hrna ncr/strn 49622
|
$2,311.20 |
$2,311.20 |
$2,311.20 |
$1,786.40
|
|
Rpr&refit spct prsth aphakia
|
$25.60 |
$25.60 |
$25.60 |
$81.12
|
|
Rpr rem hernia init reduce
|
$2,825.60 |
$2,825.60 |
$2,825.60 |
$3,906.18
|
|
Rpr xtnsr tndn leg prim without grft ea tndn
|
$893.60 |
$893.60 |
$893.60 |
$5,959.65
|
|
Rrp hypspad comp moblj&urtp
|
$2,390.40 |
$2,390.40 |
$2,390.40 |
$10,106.03
|
|
Rsv assay w/optic
|
$38.58 |
$38.58 |
$112.45 |
$75.45
|
|
Rubella antibody igg
|
$48.57 |
$48.57 |
$131.30 |
$77.80
|
|
Rubeola ag if
|
$121.60 |
$121.60 |
$121.60 |
$83.90
|
|
Rubeola antibody igg
|
$48.57 |
$48.57 |
$128.70 |
$80.00
|
|
Runx1 gene targeted seq alys
|
$659.20 |
$659.20 |
$659.20 |
$454.72
|
|
Russell viper venom diluted
|
$32.85 |
$32.85 |
$111.80 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$1,834.40 |
$1,834.40 |
$1,834.40 |
$1,008.79
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$55.40 |
$55.40 |
$7,844.35 |
$5,174.32
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$199.55 |
$199.55 |
$288.73 |
$313.66
|
|
Salivary gland function exam
|
$228.00 |
$228.00 |
$228.00 |
$719.16
|
|
Salivary gland imaging
|
$378.40 |
$378.40 |
$378.40 |
$585.00
|
|
Salivary glnd img serial img
|
$282.40 |
$282.40 |
$282.40 |
$701.73
|
|
Salmonella antibody
|
$48.57 |
$48.57 |
$48.57 |
$37.58
|
|
Salpingostomy 58770
|
$4,304.00 |
$4,304.00 |
$4,304.00 |
$4,304.00
|
|
Same day nb discharge 99463
|
$199.20 |
$199.20 |
$265.00 |
$183.07
|
|
Sarscov coronavirus ag ia
|
$71.20 |
$71.20 |
$71.20 |
$59.40
|
|
Sarscov & inf vir a&b ag ia
|
$168.80 |
$168.80 |
$168.80 |
$104.00
|
|
S bowel endoscope w/stent
|
$1,034.40 |
$1,034.40 |
$1,034.40 |
$4,379.25
|
|
Sbrt management
|
$1,189.60 |
$1,189.60 |
$2,068.00 |
$1,156.00
|
|
Sbsq ic vlbw inf<1,500 gm
|
$248.00 |
$248.00 |
$346.00 |
$248.00
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$281.60 |
$281.60 |
$321.00 |
$198.31
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$136.80 |
$136.80 |
$165.00 |
$106.38
|
|
Sbsq nursing facil care/day new problem 25 min
|
$197.60 |
$197.60 |
$221.00 |
$144.30
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$79.20 |
$79.20 |
$105.00 |
$67.60
|
|
Sbsq psyc collab care mgmt
|
$251.20 |
$251.20 |
$251.20 |
$109.46
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$406.40 |
$406.40 |
$2,082.00 |
$767.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$325.00 |
$325.00 |
$453.05 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$386.96 |
$386.96 |
$453.70 |
$582.50
|
|
Scan duplex extremity veins unilateral/limited study
|
$614.74 |
$614.74 |
$841.10 |
$721.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$453.05 |
$453.05 |
$765.32 |
$651.60
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$453.05 |
$453.05 |
$616.64 |
$595.35
|
|
Scan proc cranial extra
|
$434.40 |
$434.40 |
$434.40 |
$2,248.40
|
|
Scan proc cranial intra 61781
|
$552.80 |
$552.80 |
$552.80 |
$1,015.00
|
|
Scan proc spinal
|
$552.80 |
$552.80 |
$552.80 |
$2,544.58
|
|
Sclerotherapy fluid collection pq w/img
|
$1,320.15 |
$1,320.15 |
$2,860.00 |
$2,148.60
|
|
Scope plantar fasciotomy
|
$3,185.60 |
$3,185.60 |
$24,123.06 |
$3,839.54
|
|
Scope uretscp lithovue dig disp
|
$2,514.76 |
$2,514.76 |
$2,514.76 |
$4,246.72
|
|
Scr c/v cyto, automated sys
|
$36.80 |
$36.80 |
$36.80 |
$36.80
|
|
Scr c/v cyto,autosys and md
|
$55.20 |
$55.20 |
$55.20 |
$55.20
|
|
Scr c/v cyto, autosys, rescr
|
$64.00 |
$64.00 |
$64.00 |
$59.28
|
|
Scr c/v cyto,thinlayer,rescr
|
$88.00 |
$88.00 |
$88.00 |
$88.00
|
|
Scr c/v cyto,thinlayer,rescr
|
$55.00 |
$55.00 |
$191.10 |
$85.15
|
|
Scr c/v cyto,thinlayer,rescr
|
$54.40 |
$54.40 |
$54.40 |
$54.40
|
|
Screen cerv/vag thin layer
|
$55.00 |
$55.00 |
$120.25 |
$86.56
|
|
Screen c/v thin layer by md
|
$55.20 |
$55.20 |
$55.20 |
$55.20
|
|
Screening Colonoscopy (average risk)
|
$813.60 |
$813.60 |
$4,541.75 |
$1,800.00
|
|
Screening Colonoscopy (high risk)
|
$813.60 |
$813.60 |
$5,431.75 |
$2,000.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$20.80 |
$20.80 |
$64.28 |
$57.60
|
|
Screening hepatitis b non-obstetric high risk
|
$110.00 |
$110.00 |
$110.00 |
$60.00
|
|
Screening hepatitis c antibody high risk
|
$45.50 |
$45.50 |
$110.00 |
$93.60
|
|
Screening HIV antigen/antibody combination assay
|
$48.80 |
$48.80 |
$2,022.00 |
$42.30
|
|
Screening Mammogram
|
$245.35 |
$245.35 |
$394.55 |
$310.20
|
|
Screening pap smear by phys
|
$55.20 |
$55.20 |
$67.00 |
$41.00
|
|
Screening prostate cancer PSA
|
$64.28 |
$64.28 |
$1,076.00 |
$101.60
|
