|
Remove vaginal foreign body 57415
|
$267.00 |
$267.00 |
$267.00 |
$3,762.53
|
|
Renal function panel
|
$184.20 |
$184.20 |
$184.20 |
$113.52
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$394.20 |
$394.20 |
$394.20 |
$1,042.00
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$607.20 |
$607.20 |
$607.20 |
$478.00
|
|
Resuscitation cardiopulmonary
|
$720.00 |
$720.00 |
$720.00 |
$751.33
|
|
Resuscitation delivery/birthing room
|
$702.60 |
$702.60 |
$702.60 |
$774.37
|
|
Reticulocyte automated
|
$31.80 |
$31.80 |
$31.80 |
$51.37
|
|
Rheumatoid factor qualitative
|
$30.60 |
$30.60 |
$30.60 |
$57.07
|
|
Rheumatoid factor quantitative
|
$197.40 |
$197.40 |
$197.40 |
$56.24
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$289.80 |
$289.80 |
$289.80 |
$247.55
|
|
Rho d immune globulin inj
|
$394.20 |
$394.20 |
$394.20 |
$217.71
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$15,661.80 |
$15,661.80 |
$15,661.80 |
$9,301.22
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$1,954.80 |
$1,954.80 |
$1,954.80 |
$1,876.00
|
|
Romiplostim 125 mcg subcutaneous solution
|
$10,461.60 |
$10,461.60 |
$10,461.60 |
$8,950.11
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$271.80 |
$271.80 |
$271.80 |
$188.50
|
|
Rpm tx mgmt 1st 20 min
|
$54.60 |
$54.60 |
$54.60 |
$77.91
|
|
Rpm tx mgmt ea addl 20 min
|
$45.00 |
$45.00 |
$45.00 |
$101.25
|
|
Rubella antibody igg
|
$103.20 |
$103.20 |
$103.20 |
$76.70
|
|
Rubeola antibody igg
|
$103.20 |
$103.20 |
$103.20 |
$80.00
|
|
Russell viper venom diluted
|
$260.40 |
$260.40 |
$260.40 |
$71.82
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$75.60 |
$75.60 |
$75.60 |
$109.85
|
|
Sbsq nursing facil care/day new problem 25 min
|
$96.60 |
$96.60 |
$96.60 |
$144.30
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$53.40 |
$53.40 |
$53.40 |
$67.84
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$975.60 |
$975.60 |
$975.60 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$174.60 |
$174.60 |
$174.60 |
$661.20
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$158.40 |
$158.40 |
$158.40 |
$757.02
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$163.20 |
$163.20 |
$163.20 |
$582.50
|
|
Scan duplex extremity veins unilateral/limited study
|
$721.20 |
$721.20 |
$721.20 |
$721.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$755.40 |
$755.40 |
$755.40 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$603.60 |
$603.60 |
$603.60 |
$650.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$597.60 |
$597.60 |
$597.60 |
$570.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$37.80 |
$37.80 |
$37.80 |
$57.60
|
|
Screening Mammogram
|
$372.60 |
$372.60 |
$372.60 |
$313.35
|
|
Screw cortex 2.0 x 10mm
|
$4,459.39 |
$4,459.39 |
$4,459.39 |
$28,563.75
|
|
Sedimentation rate erythrocyte automated
|
$4.20 |
$4.20 |
$4.20 |
$42.25
|
|
Semen analysis w/count
|
$95.40 |
$95.40 |
$95.40 |
$56.44
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$67.80 |
$67.80 |
$67.80 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$94.20 |
$94.20 |
$94.20 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$94.80 |
$94.80 |
$94.80 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$132.60 |
$132.60 |
$132.60 |
$472.79
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$55.20 |
$55.20 |
$55.20 |
$246.18
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$70.80 |
$70.80 |
$70.80 |
$225.50
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$103.20 |
$103.20 |
$103.20 |
$275.88
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$118.80 |
$118.80 |
$118.80 |
$415.22
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$51.00 |
$51.00 |
$51.00 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$65.40 |
$65.40 |
$65.40 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$108.00 |
$108.00 |
$108.00 |
$289.30
|
|
Shoulder MRI (with and without contrast)
|
$3,022.20 |
$3,022.20 |
$3,022.20 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$3,022.20 |
$3,022.20 |
$3,022.20 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$2,851.80 |
$2,851.80 |
$2,851.80 |
$2,088.20
|
|
Shoulder X-ray
|
$461.40 |
$461.40 |
$461.40 |
$340.10
|
|
Sickling rbc
|
$78.00 |
$78.00 |
$78.00 |
$56.00
|
|
Sincalide 5 mcg solution for injection
|
$545.40 |
$545.40 |
$545.40 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$1,861.80 |
$1,861.80 |
$1,861.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,473.60 |
$1,473.60 |
$1,473.60 |
$1,292.04
|
|
Skin Biopsy
|
$204.00 |
$204.00 |
$204.00 |
$360.34
|
|
Sleep study attended
|
$2,586.60 |
$2,586.60 |
$2,586.60 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$3,183.60 |
$3,183.60 |
$3,183.60 |
$3,598.50
|
|
Sling suprapubic suburetheral
|
$3,590.89 |
$3,590.89 |
$3,590.89 |
$9,077.08
|
|
Slp stdy unatnd w/anal
|
$494.40 |
$494.40 |
$494.40 |
$296.34
|
|
Smear fluorescent and/or acid fast stain
|
$177.00 |
$177.00 |
$177.00 |
$64.00
|
|
Smear gram stain
|
$12.00 |
$12.00 |
$12.00 |
$54.03
|
|
Smear special stain inclusion bodies/parasites
|
$112.80 |
$112.80 |
$112.80 |
$71.40
|
|
Sodium 24 hour urine
|
$92.40 |
$92.40 |
$92.40 |
$48.60
|
|
Sodium chloride 0.9 % IV bolus
|
$18.60 |
$18.60 |
$18.60 |
$43.45
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$117.60 |
$117.60 |
$117.60 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$78.00 |
$78.00 |
$78.00 |
$45.50
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$529.80 |
$529.80 |
$529.80 |
$543.26
|
|
Stent bili dbl pgtl 10fx5cm
|
$340.51 |
$340.51 |
$340.51 |
$2,301.33
|
|
St evaluate speech sound production
|
$324.60 |
$324.60 |
$324.60 |
$289.20
|
|
St evaluate speech sound production comprehensive/expressive
|
$324.60 |
$324.60 |
$324.60 |
$376.23
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$553.80 |
$553.80 |
$553.80 |
$370.50
|
|
St evaluation swallow function
|
$424.20 |
$424.20 |
$424.20 |
$309.60
|
|
Strep b dna amp probe
|
$63.00 |
$63.00 |
$63.00 |
$126.10
|
|
Stress test pulmonary
|
$424.80 |
$424.80 |
$424.80 |
$322.85
|
|
St treatment speech individual
|
$199.20 |
$199.20 |
$199.20 |
$249.00
|
|
St treatment swallow dysfunction/oral
|
$165.60 |
$165.60 |
$165.60 |
$243.99
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$64.80 |
$64.80 |
$64.80 |
$54.55
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$247.20 |
$247.20 |
$247.20 |
$122.16
|
|
Surgical pathology level 1 gross examination only
|
$186.60 |
$186.60 |
$186.60 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$331.80 |
$331.80 |
$331.80 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$107.40 |
$107.40 |
$107.40 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$84.60 |
$84.60 |
$84.60 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$980.40 |
$980.40 |
$980.40 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$3,936.60 |
$3,936.60 |
$3,936.60 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$58.80 |
$58.80 |
$58.80 |
$43.20
|
|
Susceptibility mic per plate
|
$185.40 |
$185.40 |
$185.40 |
$104.58
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$33.60 |
$33.60 |
$33.60 |
$40.00
|
|
T3 (triiodothyronine) free
|
$307.80 |
$307.80 |
$307.80 |
$99.00
|
|
T3 (triiodothyronine) total
|
$175.20 |
$175.20 |
$175.20 |
$93.52
|
|
T4 (thyroxine) free
|
$163.80 |
$163.80 |
$163.80 |
$84.15
|
|
T4 (thyroxine) total
|
$189.00 |
$189.00 |
$189.00 |
$67.10
|
|
Tacrolimus 1 mg capsule, immediate-release
|
$9.60 |
$9.60 |
$9.60 |
$9.93
|
|
Tacrolimus therapeutic drug level
|
$111.60 |
$111.60 |
$111.60 |
$120.60
|
|
Talymed
|
$318.50 |
$318.50 |
$318.50 |
$3,411.49
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$132.60 |
$132.60 |
$132.60 |
$175.92
|
|
Tc-99m depreotide
|
$2,739.60 |
$2,739.60 |
$2,739.60 |
$1,486.80
|
|
Tc-99m labeled rbc
|
$22.80 |
$22.80 |
$22.80 |
$302.40
|
|
Tc-99m maa
|
$118.80 |
$118.80 |
$118.80 |
$288.75
|
