|
Replace aortic valve open transaortic 33365
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace aortic valve w/byp cntrl aprch 33369
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace aortic valve w/byp open aprch 33368
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace aortic valve w/byp prq aprch 33367
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace duod/jej tube perc
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace g/c tube perc
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace g-j tube perc
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace picvad cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Replace tunneled cv cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Reposition pm/icd lead
|
$0.60 |
$0.60 |
$0.60 |
|
|
Reposition vad w/image rt/lt sep session
|
$0.60 |
$0.60 |
$0.60 |
|
|
Repos lv lead pm/icd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Repos sq defib eltrd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Respirator motion mgmt simul
|
$609.00 |
$609.00 |
$609.00 |
|
|
Reteplase injection
|
$2,774.40 |
$2,774.40 |
$2,774.40 |
|
|
Reticulocyte automated
|
$16.20 |
$16.20 |
$16.20 |
|
|
Revise abdomen-venous shunt
|
$0.60 |
$0.60 |
$0.60 |
|
|
Revision of cervix
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
|
|
Revision tips
|
$0.60 |
$0.60 |
$0.60 |
|
|
Revsc opn/prq tib/pero stent
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rheumatoid factor qualitative
|
$12.60 |
$12.60 |
$12.60 |
|
|
Rheumatoid factor quantitative
|
$16.20 |
$16.20 |
$16.20 |
|
|
Rho(d) immune globulin h, sd
|
$1,551.00 |
$1,551.00 |
$1,551.00 |
|
|
Rho d immune globulin inj
|
$96.60 |
$96.60 |
$96.60 |
|
|
Rib and Chest X-ray (3 views, left side)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$160.80 |
$160.80 |
$160.80 |
|
|
Rib X-ray (3 views, both sides)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Right ventric recording
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ring fx reform 11-13x17mm
|
$898.20 |
$898.20 |
$898.20 |
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$5,961.00 |
$5,961.00 |
$5,961.00 |
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$3,977.40 |
$3,977.40 |
$3,977.40 |
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$3,402.00 |
$3,402.00 |
$3,402.00 |
|
|
Rmvl icd by tv extr
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl icd pulse gen only
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl ndwellg tun pleural cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl perm pm pulse gen
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl pq vad left hrt vein sep session
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl sq defib electrode
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl subq card rhythm mntr
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl tv pm lead dual
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rmvl tv pm lead sgl
|
$0.60 |
$0.60 |
$0.60 |
|
|
Romiplostim 125 mcg subcutaneous solution
|
$2,861.40 |
$2,861.40 |
$2,861.40 |
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$5.40 |
$5.40 |
$5.40 |
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rp loclzj tum 2+area 1+d img
|
$238.20 |
$238.20 |
$238.20 |
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rpl tun-cvad w subq port
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rpl tun-cvad w subq pump
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rpl tun cvc wo subq port
|
$0.60 |
$0.60 |
$0.60 |
|
|
Rsv assay w/optic
|
$40.20 |
$40.20 |
$40.20 |
|
|
Rubella antibody igg
|
$24.00 |
$24.00 |
$24.00 |
|
|
Rubeola antibody igg
|
$32.40 |
$32.40 |
$32.40 |
|
|
Russell viper venom diluted
|
$24.00 |
$24.00 |
$24.00 |
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$35.40 |
$35.40 |
$35.40 |
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$768.60 |
$768.60 |
$768.60 |
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$482.40 |
$482.40 |
$482.40 |
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$518.40 |
$518.40 |
$518.40 |
|
|
Scan duplex extremity veins unilateral/limited study
|
$500.40 |
$500.40 |
$500.40 |
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$643.20 |
$643.20 |
$643.20 |
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$518.40 |
$518.40 |
$518.40 |
|
|
Screening Mammogram
|
$500.40 |
$500.40 |
$500.40 |
|
|
Screening prostate cancer PSA
|
$32.40 |
$32.40 |
$32.40 |
|
|
Screw cortex 2.0 x 10mm
|
$15,714.60 |
$15,714.60 |
$15,714.60 |
|
|
Scrotal (Testicle) Ultrasound
|
$178.80 |
$178.80 |
$178.80 |
|
|
Sec art mech thrmbc non-intracranial add-on
|
$0.60 |
$0.60 |
$0.60 |
|
|
Sedimentation rate erythrocyte automated
|
$7.80 |
$7.80 |
$7.80 |
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$57.00 |
$57.00 |
$57.00 |
|
|
Semen analysis presence/motility
|
$12.60 |
$12.60 |
$12.60 |
|
|
Sertraline (zoloft) - sendout
|
$48.60 |
$48.60 |
$48.60 |
|
|
Set radiation therapy field
|
$397.80 |
$397.80 |
$397.80 |
|
|
Set radiation therapy field
|
$627.00 |
$627.00 |
$627.00 |
|
|
Set radiation therapy field
|
$723.60 |
$723.60 |
$723.60 |
|
|
Sheath gldlight lasr 12fx50cm
|
$4,828.80 |
$4,828.80 |
$4,828.80 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$58.20 |
$58.20 |
$58.20 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Shoulder MRI (with and without contrast)
|
$601.20 |
$601.20 |
$601.20 |
|
|
Shoulder MRI (with contrast)
|
$489.00 |
$489.00 |
$489.00 |
|
|
Shoulder MRI (without contrast)
|
$276.60 |
$276.60 |
$276.60 |
|
|
Shoulder X-ray
|
$89.40 |
$89.40 |
$89.40 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$71.40 |
$71.40 |
$71.40 |
|
|
Shunt glaucoma baerveldt 350mm
|
$2,356.20 |
$2,356.20 |
$2,356.20 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$0.60 |
$0.60 |
$0.60 |
|
|
Sialography s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
Sickling rbc
|
$16.20 |
$16.20 |
$16.20 |
|
|
Sinus CT scan (with and without contrast)
|
$119.40 |
$119.40 |
$119.40 |
|
|
Sinus CT scan (with contrast)
|
$92.40 |
$92.40 |
$92.40 |
|
|
Sinus CT scan (without contrast)
|
$80.40 |
$80.40 |
$80.40 |
|
|
Sinus/juglr venogram s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
Sinus X-ray (complete)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Sinus X-ray (limited)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Skull X-ray (1 to 3 views)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Skull X-ray (complete)
|
$142.80 |
$142.80 |
$142.80 |
|
|
Sleep Study (Polysomnography)
|
$694.80 |
$694.80 |
$694.80 |
|