|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$789.68 |
$789.68 |
$789.68 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$480.31 |
$480.31 |
$480.31 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$469.60 |
$469.60 |
$469.60 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$795.75 |
$795.75 |
$795.75 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$477.45 |
$477.45 |
$477.45 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$493.51 |
$493.51 |
$493.51 |
$601.70
|
|
Scope uretscp lithovue dig disp
|
$535.26 |
$535.26 |
$535.26 |
$4,079.62
|
|
Screening Mammogram
|
$211.61 |
$211.61 |
$211.61 |
$303.55
|
|
Screening prostate cancer PSA
|
$100.63 |
$100.63 |
$100.63 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$5,552.60 |
$5,552.60 |
$5,552.60 |
$28,750.65
|
|
Sc ther infusion reset pump
|
$36.40 |
$36.40 |
$36.40 |
$126.75
|
|
Sedimentation rate erythrocyte automated
|
$34.62 |
$34.62 |
$34.62 |
$44.20
|
|
Semen analysis presence/motility
|
$31.05 |
$31.05 |
$31.05 |
$70.85
|
|
Semen analysis w/count
|
$26.41 |
$26.41 |
$26.41 |
$56.44
|
|
Serpina1 gene
|
$114.19 |
$114.19 |
$114.19 |
$191.73
|
|
Sertraline (zoloft) - sendout
|
$50.32 |
$50.32 |
$50.32 |
$173.16
|
|
Set radiation therapy field
|
$205.19 |
$205.19 |
$205.19 |
$731.50
|
|
Set radiation therapy field
|
$487.44 |
$487.44 |
$487.44 |
$1,102.40
|
|
Set radiation therapy field
|
$513.13 |
$513.13 |
$513.13 |
$1,636.36
|
|
Shoulder MRI (with and without contrast)
|
$1,218.95 |
$1,218.95 |
$1,218.95 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$1,083.36 |
$1,083.36 |
$1,083.36 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,128.68 |
$1,128.68 |
$1,128.68 |
$2,051.28
|
|
Shoulder X-ray
|
$599.49 |
$599.49 |
$599.49 |
$367.02
|
|
Shunt glaucoma baerveldt 350mm
|
$713.68 |
$713.68 |
$713.68 |
$4,709.25
|
|
Sickling rbc
|
$2.50 |
$2.50 |
$2.50 |
$53.55
|
|
Sincalide 5 mcg solution for injection
|
$171.83 |
$171.83 |
$171.83 |
$355.41
|
|
Sinus CT scan (with and without contrast)
|
$1,132.24 |
$1,132.24 |
$1,132.24 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,100.84 |
$1,100.84 |
$1,100.84 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,038.75 |
$1,038.75 |
$1,038.75 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$1,200.40 |
$1,200.40 |
$1,200.40 |
$2,489.25
|
|
Skin Biopsy
|
$317.59 |
$317.59 |
$317.59 |
$382.80
|
|
Skin full graft 20sq cm less 15200
|
$1,607.19 |
$1,607.19 |
$1,607.19 |
$2,190.24
|
|
Sleep Study (Polysomnography)
|
$1,982.58 |
$1,982.58 |
$1,982.58 |
$3,936.80
|
|
Sleep study unattended
|
$322.94 |
$322.94 |
$322.94 |
$595.50
|
|
Sleeve fing rolyan med
|
$96.71 |
$96.71 |
$96.71 |
$167.31
|
|
Sling suprapubic suburetheral
|
$2,499.42 |
$2,499.42 |
$2,499.42 |
$10,439.00
|
|
Slp pure tone screening
|
$147.73 |
$147.73 |
$147.73 |
$67.60
|
|
Small bowel endoscopy
|
$1,524.05 |
$1,524.05 |
$1,524.05 |
$2,466.10
|
|
Small bowel endoscopy
|
$1,598.98 |
$1,598.98 |
$1,598.98 |
$2,244.82
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$1,524.05 |
$1,524.05 |
$1,524.05 |
$2,244.82
|
|
Smear fluorescent and/or acid fast stain
|
$43.54 |
$43.54 |
$43.54 |
$64.20
|
|
Smear gram stain
|
$33.19 |
$33.19 |
$33.19 |
$57.85
|
|
Smear nasal eosinophil
|
$26.77 |
$26.77 |
$26.77 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$26.41 |
$26.41 |
$26.41 |
$64.35
|
|
Smear wet mount
|
$28.91 |
$28.91 |
$28.91 |
$68.63
|
|
Snrpn/ube3a gene
|
$195.19 |
$195.19 |
$195.19 |
$228.80
|
|
Sodium 24 hour urine
|
$33.90 |
$33.90 |
$33.90 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$7.10 |
$7.10 |
$7.10 |
$47.56
|
|
Sodium chloride 0.9 % IV bolus
|
$7.10 |
$7.10 |
$7.10 |
$46.38
|
|
Sodium chloride 0.9 % IV bolus
|
$6.22 |
$6.22 |
$6.22 |
$43.30
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$32.07 |
$32.07 |
$32.07 |
$95.40
|
|
Sodium serum/plasma/whole blood
|
$24.63 |
$24.63 |
$24.63 |
$42.70
|
|
Special physics consult
|
$198.41 |
$198.41 |
$198.41 |
$700.74
|
|
Special radiation dosimetry
|
$175.21 |
$175.21 |
$175.21 |
$445.50
|
|
Special radiation treatment
|
$634.10 |
$634.10 |
$634.10 |
$1,934.03
|
|
Special teletx port plan
|
$433.92 |
$433.92 |
$433.92 |
$1,046.65
|
|
Specific gravity body fluid
|
$7.50 |
$7.50 |
$7.50 |
$23.63
|
|
Specimen fat stain
|
$10.35 |
$10.35 |
$10.35 |
$32.76
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$622.68 |
$622.68 |
$622.68 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$436.06 |
$436.06 |
$436.06 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$415.00 |
$415.00 |
$415.00 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$115.98 |
$115.98 |
$115.98 |
$43.60
|
|
Splint rstrc wrst/cmc right med
|
$73.51 |
$73.51 |
$73.51 |
$101.18
|
|
Split blood or products
|
$44.97 |
$44.97 |
$44.97 |
$148.98
|
|
Sputum specimen collection
|
$152.37 |
$152.37 |
$152.37 |
$180.00
|
|
Srs linear based
|
$3,372.10 |
$3,372.10 |
$3,372.10 |
$14,124.25
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,269.60 |
$6,269.60 |
$6,269.60 |
$33,765.14
|
|
Stent bili dbl pgtl 10fx5cm
|
$335.22 |
$335.22 |
$335.22 |
$1,512.00
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,630.74 |
$1,630.74 |
$1,630.74 |
$18,472.24
|
|
Stent iliac/open or perc/uni/init 37221
|
$9,555.70 |
$9,555.70 |
$9,555.70 |
$17,281.80
|
|
St evaluate speech sound production
|
$188.41 |
$188.41 |
$188.41 |
$300.00
|
|
St evaluate speech sound production comprehensive/expressive
|
$154.16 |
$154.16 |
$154.16 |
$393.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$237.30 |
$237.30 |
$237.30 |
$406.40
|
|
St evaluation swallow function
|
$208.75 |
$208.75 |
$208.75 |
$336.60
|
|
Strapping of ankle and/or ft 29540
|
$59.60 |
$59.60 |
$59.60 |
$248.05
|
|
Strapping of elbow or wrist 29260
|
$53.53 |
$53.53 |
$53.53 |
$171.00
|
|
Strapping of hand or finger
|
$51.75 |
$51.75 |
$51.75 |
$194.40
|
|
Strapping of knee
|
$82.08 |
$82.08 |
$82.08 |
$224.80
|
|
Strapping of toes 29550
|
$51.75 |
$51.75 |
$51.75 |
$185.36
|
|
Strep b assay w/optic
|
$42.47 |
$42.47 |
$42.47 |
$32.00
|
|
Stress test pulmonary
|
$49.96 |
$49.96 |
$49.96 |
$327.20
|
|
St treatment speech individual
|
$82.79 |
$82.79 |
$82.79 |
$254.15
|
|
St treatment swallow dysfunction/oral
|
$118.12 |
$118.12 |
$118.12 |
$261.60
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$40.73 |
$40.73 |
$40.73 |
$55.13
|
|
Sugars single quant
|
$41.40 |
$41.40 |
$41.40 |
$52.47
|
|
Sulfonylurea screen qn-sendout
|
$71.02 |
$71.02 |
$71.02 |
$184.60
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$64.96 |
$64.96 |
$64.96 |
$111.46
|
|
Surgical pathology level 1 gross examination only
|
$103.49 |
$103.49 |
$103.49 |
$92.59
|
|
Surgical pathology level 2 gross & microscopic examination
|
$112.41 |
$112.41 |
$112.41 |
$149.76
|
|
Surgical pathology level 3 gross & microscopic examination
|
$129.18 |
$129.18 |
$129.18 |
$192.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$149.88 |
$149.88 |
$149.88 |
$253.75
|
|
Surgical pathology level 5 gross & microscopic examination
|
$319.37 |
$319.37 |
$319.37 |
$494.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$323.65 |
$323.65 |
$323.65 |
$790.00
|
|
Susceptibility agar dilution per agent
|
$89.57 |
$89.57 |
$89.57 |
$40.30
|
|
Susceptibility enzyme detection per enzyme
|
$23.91 |
$23.91 |
$23.91 |
$34.48
|
|
Susceptibility mic per plate
|
$45.32 |
$45.32 |
$45.32 |
$94.38
|
|
Svc venogram s&i
|
$1,153.30 |
$1,153.30 |
$1,153.30 |
$1,908.00
|
|
Synvisc or synvisc-one
|
$53.71 |
$53.71 |
$53.71 |
$1,242.63
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$1.79 |
$1.79 |
$1.79 |
$44.85
|
|
System pacing micra av
|
$4,360.53 |
$4,360.53 |
$4,360.53 |
$23,533.65
|