|
Removal sutr/staple req anes
|
$79.45 |
$79.45 |
$79.45 |
$2,431.38
|
|
Renal function panel
|
$319.40 |
$319.40 |
$319.40 |
$114.37
|
|
Repair blood vessel dir lower extr
|
$742.05 |
$742.05 |
$742.05 |
$1,731.55
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$348.15 |
$348.15 |
$348.15 |
$1,055.69
|
|
Repair dental ellis ii fx
|
$275.90 |
$275.90 |
$275.90 |
$442.48
|
|
Repair extns tendon finger without grft ea
|
$468.00 |
$468.00 |
$468.00 |
$2,340.00
|
|
Repair lac palate<2 cm
|
$413.15 |
$413.15 |
$413.15 |
$780.65
|
|
Repair lip full thkns =<one-half vert height
|
$563.15 |
$563.15 |
$563.15 |
$1,308.00
|
|
Repair lip full thkns >one-half vert height/cmplx
|
$1,054.10 |
$1,054.10 |
$1,054.10 |
$1,928.07
|
|
Repair palate
|
$607.05 |
$607.05 |
$607.05 |
$7,000.36
|
|
Repair rpr lip full thickness vermilion only
|
$518.45 |
$518.45 |
$518.45 |
$1,244.09
|
|
Repair tendon extensor foot 1/2 each tendon
|
$616.80 |
$616.80 |
$616.80 |
$3,839.54
|
|
Repair tendon/muscle forearm/wrist prime sngl ea
|
$1,083.60 |
$1,083.60 |
$1,083.60 |
$4,499.12
|
|
Repair vagina/perineum
|
$12,321.65 |
$12,321.65 |
$12,321.65 |
$4,096.68
|
|
Replace g-j tube perc
|
$172.15 |
$172.15 |
$172.15 |
$1,568.05
|
|
Reptilase test
|
$167.65 |
$167.65 |
$167.65 |
$72.15
|
|
Reticulocyte automated
|
$95.80 |
$95.80 |
$95.80 |
$53.00
|
|
Rheumatoid factor quantitative
|
$95.80 |
$95.80 |
$95.80 |
$57.50
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$766.82 |
$766.82 |
$766.82 |
$234.12
|
|
Rib and Chest X-ray (3 views, left side)
|
$725.30 |
$725.30 |
$725.30 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$911.55 |
$911.55 |
$911.55 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$586.90 |
$586.90 |
$586.90 |
$397.60
|
|
Ring fx reform 11-13x17mm
|
$199.00 |
$199.00 |
$199.00 |
$1,509.75
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$1,582.75 |
$1,582.75 |
$1,582.75 |
$2,429.37
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$879.02 |
$879.02 |
$879.02 |
$6,287.16
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$879.02 |
$879.02 |
$879.02 |
$5,309.20
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$136.35 |
$136.35 |
$136.35 |
$1,876.00
|
|
Romiplostim 125 mcg subcutaneous solution
|
$6,752.04 |
$6,752.04 |
$6,752.04 |
$8,935.57
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$137.42 |
$137.42 |
$137.42 |
$188.16
|
|
Rp loclzj tum spect w/ct 1
|
$1,363.40 |
$1,363.40 |
$1,363.40 |
$2,556.60
|
|
Rubella antibody igg
|
$139.55 |
$139.55 |
$139.55 |
$77.40
|
|
Rubeola antibody igg
|
$119.75 |
$119.75 |
$119.75 |
$80.00
|
|
Russell viper venom diluted
|
$167.65 |
$167.65 |
$167.65 |
$73.03
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$638.80 |
$638.80 |
$638.80 |
$314.26
|
|
Scan duplex extremity veins unilateral/limited study
|
$982.80 |
$982.80 |
$982.80 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$419.20 |
$419.20 |
$419.20 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$509.40 |
$509.40 |
$509.40 |
$597.35
|
|
Screening hepatitis b non-obstetric high risk
|
$702.70 |
$702.70 |
$702.70 |
$60.00
|
|
Screening Mammogram
|
$259.55 |
$259.55 |
$259.55 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$3,418.85 |
$3,418.85 |
$3,418.85 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$803.80 |
$803.80 |
$803.80 |
$611.91
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$18.70 |
$18.70 |
$18.70 |
$225.04
|
|
Sedimentation rate erythrocyte automated
|
$101.15 |
$101.15 |
$101.15 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$188.00 |
$188.00 |
$188.00 |
$96.00
|
|
Semen analysis presence/motility
|
$122.45 |
$122.45 |
$122.45 |
$70.40
|
|
Serial casting application 97139app
|
$219.40 |
$219.40 |
$219.40 |
$78.39
|
|
Serial tonometry
|
$76.25 |
$76.25 |
$76.25 |
$131.02
|
|
Shot (Injection into Muscle or Under the Skin)
|
$278.20 |
$278.20 |
$278.20 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$714.60 |
$714.60 |
$714.60 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$352.65 |
$352.65 |
$352.65 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$3,301.70 |
$3,301.70 |
$3,301.70 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$2,446.60 |
$2,446.60 |
$2,446.60 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$2,139.80 |
$2,139.80 |
$2,139.80 |
$2,096.84
|
|
Shoulder X-ray
|
$421.90 |
$421.90 |
$421.90 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$244.85 |
$244.85 |
$244.85 |
$263.25
|
|
Shunt glaucoma baerveldt 350mm
|
$2,800.00 |
$2,800.00 |
$2,800.00 |
$4,538.82
|
|
Shuntogram nonvascular supervision & interpretation
|
$444.50 |
$444.50 |
$444.50 |
$355.80
|
|
Sickling rbc
|
$139.70 |
$139.70 |
$139.70 |
$59.40
|
|
Sincalide 5 mcg solution for injection
|
$559.95 |
$559.95 |
$559.95 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,647.60 |
$1,647.60 |
$1,647.60 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,267.40 |
$1,267.40 |
$1,267.40 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,140.65 |
$1,140.65 |
$1,140.65 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$543.00 |
$543.00 |
$543.00 |
$346.45
|
|
Sinus X-ray (limited)
|
$175.65 |
$175.65 |
$175.65 |
$215.40
|
|
Skin Biopsy
|
$260.75 |
$260.75 |
$260.75 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$300.75 |
$300.75 |
$300.75 |
$294.45
|
|
Skull X-ray (complete)
|
$481.75 |
$481.75 |
$481.75 |
$417.50
|
|
Sling suprapubic suburetheral
|
$1,066.05 |
$1,066.05 |
$1,066.05 |
$9,679.96
|
|
Slp pure tone screening
|
$141.65 |
$141.65 |
$141.65 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$801.10 |
$801.10 |
$801.10 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$79.85 |
$79.85 |
$79.85 |
$64.35
|
|
Smear gram stain
|
$81.15 |
$81.15 |
$81.15 |
$55.55
|
|
Smear nasal eosinophil
|
$82.50 |
$82.50 |
$82.50 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$113.05 |
$113.05 |
$113.05 |
$73.50
|
|
Smear wet mount
|
$26.50 |
$26.50 |
$26.50 |
$67.55
|
|
Smpd1 gene common variants
|
$110.15 |
$110.15 |
$110.15 |
$133.84
|
|
Sodium 24 hour urine
|
$117.10 |
$117.10 |
$117.10 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$12.92 |
$12.92 |
$12.92 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$5.00 |
$5.00 |
$5.00 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$12.92 |
$12.92 |
$12.92 |
$37.64
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$62.37 |
$62.37 |
$62.37 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$95.80 |
$95.80 |
$95.80 |
$46.26
|
|
Specific gravity body fluid
|
$46.60 |
$46.60 |
$46.60 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$475.25 |
$475.25 |
$475.25 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$455.60 |
$455.60 |
$455.60 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,592.70 |
$1,592.70 |
$1,592.70 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$238.20 |
$238.20 |
$238.20 |
$251.00
|
|
Splint finger fold over sm
|
$155.75 |
$155.75 |
$155.75 |
$146.88
|
|
Split blood or products
|
$235.50 |
$235.50 |
$235.50 |
$127.80
|
|
St analysis behavior qualitative voice/resonance
|
$475.25 |
$475.25 |
$475.25 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$265.00 |
$265.00 |
$265.00 |
$286.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$108.37 |
$108.37 |
$108.37 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$20,962.50
|
|
St evaluate speech sound production
|
$475.25 |
$475.25 |
$475.25 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$545.70 |
$545.70 |
$545.70 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$2,043.10 |
$2,043.10 |
$2,043.10 |
$1,345.40
|
|
Strep a ag ia
|
$150.40 |
$150.40 |
$150.40 |
$75.40
|
|
Stress test pulmonary
|
$592.35 |
$592.35 |
$592.35 |
$324.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$56.67 |
$56.67 |
$56.67 |
$54.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$4,064.40 |
$4,064.40 |
$4,064.40 |
$7,487.55
|