|
Simple cystometrogram 51725
|
$1,217.10 |
$1,217.10 |
$1,217.10 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$106.14 |
$106.14 |
$1,337.85 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$2,304.60 |
$2,304.60 |
$3,588.64 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$2,048.40 |
$2,048.40 |
$3,046.99 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,794.00 |
$1,794.00 |
$2,842.00 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$2,592.00 |
$2,592.00 |
$14,670.66 |
$2,489.25
|
|
Sio flex pelvisacral custom
|
$429.16 |
$429.16 |
$429.16 |
$561.79
|
|
Sio rig pnl pelv/sac pre ots
|
$200.74 |
$200.74 |
$200.74 |
$418.75
|
|
Sipuleucel-t - su
|
$198,700.38 |
$198,700.38 |
$198,700.38 |
$100,990.51
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$704.28 |
$704.28 |
$704.28 |
$14,361.10
|
|
Skeletal muscle relaxant 1/2
|
$191.15 |
$191.15 |
$191.15 |
$83.85
|
|
Skin Biopsy
|
$873.00 |
$873.00 |
$873.00 |
$360.34
|
|
Skin test unlisted antigen ea
|
$62.89 |
$62.89 |
$62.89 |
$48.57
|
|
Sleep study attended
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$7,129.80 |
$7,129.80 |
$9,473.05 |
$3,607.50
|
|
Sleep study unattended
|
$422.40 |
$422.40 |
$1,535.60 |
$580.87
|
|
Sleeve fing rolyan med
|
$210.05 |
$210.05 |
$210.05 |
$203.58
|
|
Sling arm deluxe w/pad xs
|
$64.86 |
$64.86 |
$64.86 |
$30.35
|
|
Sling pelv split sam med
|
$136.64 |
$136.64 |
$287.01 |
$150.00
|
|
Sling suprapubic suburetheral
|
$21,556.44 |
$21,556.44 |
$74,664.38 |
$9,679.96
|
|
Slitting of prepuce
|
$10,209.96 |
$10,209.96 |
$10,209.96 |
$3,365.50
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$194.58 |
$194.58 |
$194.58 |
$129.20
|
|
Slp eval non-spch gen comm dev
|
$431.97 |
$431.97 |
$431.97 |
$285.09
|
|
Slp pure tone screening
|
$55.20 |
$55.20 |
$116.27 |
$60.48
|
|
Slp stdy unatnd w/anal
|
$810.77 |
$810.77 |
$810.77 |
$296.34
|
|
Sm-153 lexidron ther
|
$43,032.62 |
$43,032.62 |
$43,032.62 |
$7,320.12
|
|
Smear fluorescent and/or acid fast stain
|
$70.80 |
$70.80 |
$143.36 |
$64.20
|
|
Smear gram stain
|
$53.64 |
$53.64 |
$75.00 |
$55.25
|
|
Smear nasal eosinophil
|
$54.81 |
$54.81 |
$54.81 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$75.77 |
$75.77 |
$226.20 |
$73.15
|
|
Smear wet mount
|
$45.44 |
$45.44 |
$52.80 |
$67.49
|
|
Smn1 gene full gene sequence
|
$961.43 |
$961.43 |
$961.43 |
$495.69
|
|
Smn1 gen nown famil seq vrnt
|
$961.43 |
$961.43 |
$961.43 |
$276.42
|
|
Smpd1 gene common variants
|
$330.60 |
$330.60 |
$1,664.14 |
$133.84
|
|
Snrpn/ube3a gene
|
$252.60 |
$252.60 |
$1,718.84 |
$231.85
|
|
So airplane w/wo joint cf
|
$1,727.27 |
$1,727.27 |
$1,727.27 |
$1,276.80
|
|
So cap design without jnts cf
|
$1,316.69 |
$1,316.69 |
$1,316.69 |
$606.35
|
|
Socket insert without lock mech
|
$872.72 |
$872.72 |
$872.72 |
$1,192.50
|
|
Sock fracture or equal each
|
$74.51 |
$74.51 |
$80.28 |
$74.51
|
|
Sodium 24 hour urine
|
$39.00 |
$39.00 |
$97.91 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$25.20 |
$25.20 |
$103.80 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$25.20 |
$25.20 |
$61.38 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$25.20 |
$25.20 |
$80.48 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$58.08 |
$58.08 |
$58.08 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$156.48 |
$156.48 |
$330.08 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$697.44 |
$697.44 |
$3,003.98 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$59.38 |
$59.38 |
$61.20 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$8.34 |
$8.34 |
$9.18 |
$177.52
|
|
Soft interface below knee se
|
$130.94 |
$130.94 |
$130.94 |
$179.08
|
|
So neo gsap dna/dna&rna
|
$9,855.00 |
$9,855.00 |
$9,855.00 |
$2,989.55
|
|
So vest canvas/web pre ots
|
$191.42 |
$191.42 |
$191.42 |
$256.54
|
|
Sp bone algrft morsel add-on
|
$44,174.87 |
$44,174.87 |
$44,174.87 |
$498.55
|
|
Special physics consult
|
$266.40 |
$266.40 |
$3,125.87 |
$725.00
|
|
Special radiation dosimetry
|
$1,682.12 |
$1,682.12 |
$1,682.12 |
$392.50
|
|
Special radiation treatment
|
$6,807.38 |
$6,807.38 |
$6,807.38 |
$1,986.00
|
|
Special teletx port plan
|
$4,807.98 |
$4,807.98 |
$4,807.98 |
$1,086.99
|
|
Specific gravity body fluid
|
$16.80 |
$16.80 |
$115.36 |
$22.00
|
|
Specimen fat stain
|
$53.64 |
$53.64 |
$53.64 |
$35.10
|
|
Speech evaluation complex
|
$504.84 |
$504.84 |
$504.84 |
$527.06
|
|
Sperm antibody test
|
$108.60 |
$108.60 |
$124.73 |
$57.85
|
|
Spinal bone autograftlocal 20936
|
$43,878.08 |
$43,878.08 |
$43,878.08 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,191.80 |
$2,191.80 |
$2,191.80 |
$1,439.40
|
|
Spirmtry w/brnchdil inf-2 yr
|
$570.00 |
$570.00 |
$570.00 |
$368.50
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$399.60 |
$399.60 |
$1,115.87 |
$543.26
|
|
Spleen imaging
|
$2,472.19 |
$2,472.19 |
$2,472.19 |
$679.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$740.53 |
$740.53 |
$740.53 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$157.81 |
$157.81 |
$290.60 |
$68.25
|
|
Splint finger fold over sm
|
$137.56 |
$137.56 |
$232.49 |
$146.88
|
|
Splint finger frog med
|
$65.88 |
$65.88 |
$138.40 |
$38.08
|
|
Splint func pos polyflex ii med
|
$612.53 |
$612.53 |
$612.53 |
$58.65
|
|
Splint rstrc wrst/cmc right med
|
$137.56 |
$137.56 |
$226.47 |
$99.04
|
|
Split blood or products
|
$164.33 |
$164.33 |
$164.33 |
$127.48
|
|
Sputum specimen collection
|
$273.60 |
$273.60 |
$273.60 |
$180.00
|
|
Srs linear based
|
$88,309.99 |
$88,309.99 |
$88,309.99 |
$13,585.00
|
|
St analysis behavior qualitative voice/resonance
|
$205.80 |
$205.80 |
$824.80 |
$297.60
|
|
Staph a dna amp probe
|
$61.20 |
$61.20 |
$438.14 |
$125.00
|
|
Static or dynami afo pre ots
|
$445.20 |
$445.20 |
$445.20 |
$284.60
|
|
St cognitve performance testing healthcare professional each hour
|
$247.80 |
$247.80 |
$874.97 |
$286.00
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$74,262.25 |
$74,262.25 |
$74,262.25 |
$21,626.50
|
|
Stent axios caut enh 15x10mm electrocaut
|
$57,189.89 |
$57,189.89 |
$255,127.50 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$5,278.50 |
$5,278.50 |
$45,970.80 |
$2,520.08
|
|
Stent bili rx wallflx 10x80 uncvr
|
$49,933.80 |
$49,933.80 |
$140,182.88 |
$20,962.50
|
|
Stent bronch dumon sil 10x40mm
|
$5,373.83 |
$5,373.83 |
$5,373.83 |
$4,939.20
|
|
Stent iliac/open or perc/uni/init 37221
|
$40,877.38 |
$40,877.38 |
$40,877.38 |
$14,356.50
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$40,568.96 |
$40,568.96 |
$40,568.96 |
$9,008.54
|
|
Sterile water/saline, 10 ml
|
$25.20 |
$25.20 |
$25.20 |
$13.32
|
|
Sternal pad
|
$222.16 |
$222.16 |
$222.16 |
$216.89
|
|
St evaluate speech sound production
|
$475.20 |
$475.20 |
$824.80 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$410.40 |
$410.40 |
$824.80 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$566.40 |
$566.40 |
$949.61 |
$399.60
|
|
St evaluation swallow function
|
$676.80 |
$676.80 |
$745.25 |
$314.40
|
|
Stocking sup grips 4 pre ots
|
$41.29 |
$41.29 |
$41.29 |
$31.58
|
|
Straight knee joint heavy du
|
$184.49 |
$184.49 |
$184.49 |
$317.69
|
|
Strapping of ankle and/or ft 29540
|
$316.20 |
$316.20 |
$379.36 |
$223.45
|
|
Strapping of chest
|
$562.92 |
$562.92 |
$562.92 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$78.60 |
$78.60 |
$379.36 |
$154.70
|
|
Strapping of hand or finger
|
$78.60 |
$78.60 |
$103.49 |
$174.82
|
|
Strapping of knee
|
$379.36 |
$379.36 |
$592.80 |
$205.20
|
|
Strep a ag ia
|
$36.00 |
$36.00 |
$143.36 |
$75.40
|
|
Strep a dna dir probe
|
$195.83 |
$195.83 |
$195.83 |
$96.72
|