|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$80,317.00 |
$80,317.00 |
$80,317.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$100,368.00 |
$100,368.00 |
$100,368.00 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$80,317.00 |
$80,317.00 |
$80,317.00 |
$24,844.79
|
|
Rmvl icd pulse gen only
|
$20,990.00 |
$20,990.00 |
$20,990.00 |
$4,069.52
|
|
Rmvl ndwellg tun pleural cath
|
$2,541.00 |
$2,541.00 |
$2,541.00 |
$1,172.40
|
|
Rmvl perm pm pulse gen
|
$12,595.00 |
$12,595.00 |
$12,595.00 |
$6,097.00
|
|
Rmvl phrnc nrv stim pg only
|
$10,317.00 |
$10,317.00 |
$10,317.00 |
$4,551.75
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$24,502.00 |
$24,502.00 |
$24,502.00 |
$15,399.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$27,024.00 |
$27,024.00 |
$27,024.00 |
$10,542.00
|
|
Rmvl pq iabp
|
$229.00 |
$229.00 |
$229.00 |
$1,000.62
|
|
Rmvl pq vad left hrt vein sep session
|
$2,214.00 |
$2,214.00 |
$2,214.00 |
$2,542.65
|
|
Rmvl sq defib electrode
|
$10,552.00 |
$10,552.00 |
$10,552.00 |
$4,189.80
|
|
Rmvl subq card rhythm mntr
|
$2,267.00 |
$2,267.00 |
$2,267.00 |
$1,758.00
|
|
Rmvl tongs/halo anthr indiv
|
$571.00 |
$571.00 |
$571.00 |
$460.68
|
|
Rmvl tv pm lead dual
|
$12,134.00 |
$12,134.00 |
$12,134.00 |
$4,219.88
|
|
Rmvl tv pm lead sgl
|
$5,259.00 |
$5,259.00 |
$5,259.00 |
$4,276.80
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$6,746.00 |
$6,746.00 |
$6,746.00 |
$2,217.76
|
|
Rp loclzj tum spect w/ct 1
|
$5,151.00 |
$5,151.00 |
$5,151.00 |
$2,573.55
|
|
Rp loclzj tum spect w/ct 2
|
$5,842.00 |
$5,842.00 |
$5,842.00 |
$3,186.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$6,746.00 |
$6,746.00 |
$6,746.00 |
$2,175.36
|
|
Rpl tun-cvad w subq port
|
$6,738.00 |
$6,738.00 |
$6,738.00 |
$4,819.80
|
|
Rpl tun cvc wo subq port
|
$4,608.00 |
$4,608.00 |
$4,608.00 |
$3,724.63
|
|
Rpr intst excl anrect fist
|
$8,297.00 |
$8,297.00 |
$8,297.00 |
$3,245.23
|
|
Rsv assay w/optic
|
$37.00 |
$37.00 |
$37.00 |
$75.45
|
|
Rubella antibody igg
|
$114.00 |
$114.00 |
$114.00 |
$77.80
|
|
Rubeola antibody igg
|
$133.00 |
$133.00 |
$133.00 |
$80.00
|
|
Russell viper venom diluted
|
$40.00 |
$40.00 |
$40.00 |
$72.54
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$393.00 |
$393.00 |
$393.00 |
$313.66
|
|
Salmonella antibody
|
$12.24 |
$12.24 |
$12.24 |
$37.58
|
|
Sarscov & inf vir a&b ag ia
|
$269.00 |
$269.00 |
$269.00 |
$104.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,792.00 |
$1,792.00 |
$1,792.00 |
$767.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,366.00 |
$1,366.00 |
$1,366.00 |
$582.50
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,070.00 |
$1,070.00 |
$1,070.00 |
$721.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,031.00 |
$1,031.00 |
$1,031.00 |
$651.60
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$595.35
|
|
Scan proc cranial extra
|
$2,180.00 |
$2,180.00 |
$2,180.00 |
$2,248.40
|
|
Scan proc spinal
|
$2,387.00 |
$2,387.00 |
$2,387.00 |
$2,544.58
|
|
Sclerotherapy fluid collection pq w/img
|
$3,381.00 |
$3,381.00 |
$3,381.00 |
$2,148.60
|
|
Screening Mammogram
|
$609.00 |
$609.00 |
$609.00 |
$310.20
|
|
Screen/visual acuity/bilat/quant 99173
|
$37.00 |
$37.00 |
$37.00 |
$28.86
|
|
Scrotal (Testicle) Ultrasound
|
$1,024.00 |
$1,024.00 |
$1,024.00 |
$612.55
|
|
Sec art mech thrmbc non-intracranial add-on
|
$13,551.00 |
$13,551.00 |
$13,551.00 |
$4,380.00
|
|
Sedimentation rate erythrocyte automated
|
$24.00 |
$24.00 |
$24.00 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$132.00 |
$132.00 |
$132.00 |
$94.25
|
|
Semen analysis w/count
|
$23.00 |
$23.00 |
$23.00 |
$56.44
|
|
Sertraline (zoloft) - sendout
|
$66.00 |
$66.00 |
$66.00 |
$126.43
|
|
Set radiation therapy field
|
$1,033.00 |
$1,033.00 |
$1,033.00 |
$787.50
|
|
Set radiation therapy field
|
$2,255.00 |
$2,255.00 |
$2,255.00 |
$1,183.38
|
|
Set radiation therapy field
|
$2,491.00 |
$2,491.00 |
$2,491.00 |
$1,641.90
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$705.00 |
$705.00 |
$705.00 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$724.00 |
$724.00 |
$724.00 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$1,322.00 |
$1,322.00 |
$1,322.00 |
$442.22
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$738.00 |
$738.00 |
$738.00 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$705.00 |
$705.00 |
$705.00 |
$225.50
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$724.00 |
$724.00 |
$724.00 |
$270.50
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$724.00 |
$724.00 |
$724.00 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$705.00 |
$705.00 |
$705.00 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$724.00 |
$724.00 |
$724.00 |
$289.30
|
|
Shot (Injection into Muscle or Under the Skin)
|
$204.00 |
$204.00 |
$204.00 |
$135.85
|
|
Shoulder AC Joint X-ray (both sides)
|
$428.00 |
$428.00 |
$428.00 |
$268.80
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$393.00 |
$393.00 |
$393.00 |
$288.75
|
|
Shoulder MRI (with and without contrast)
|
$5,536.00 |
$5,536.00 |
$5,536.00 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$3,832.00 |
$3,832.00 |
$3,832.00 |
$2,449.85
|
|
Shoulder MRI (without contrast)
|
$3,636.00 |
$3,636.00 |
$3,636.00 |
$2,060.00
|
|
Shoulder X-ray
|
$390.00 |
$390.00 |
$390.00 |
$340.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$359.00 |
$359.00 |
$359.00 |
$260.40
|
|
Shuntogram nonvascular supervision & interpretation
|
$583.00 |
$583.00 |
$583.00 |
$359.55
|
|
Sialography s&i
|
$805.00 |
$805.00 |
$805.00 |
$512.40
|
|
Sialolithotomy 42330
|
$9,553.00 |
$9,553.00 |
$9,553.00 |
$3,864.00
|
|
Sickling rbc
|
$47.00 |
$47.00 |
$47.00 |
$56.99
|
|
Sigmoidoscopy and biopsy
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$1,550.40
|
|
Simple cystometrogram 51725
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$614.00
|
|
Sinus CT scan (with and without contrast)
|
$3,161.00 |
$3,161.00 |
$3,161.00 |
$1,788.60
|
|
Sinus CT scan (with contrast)
|
$2,930.00 |
$2,930.00 |
$2,930.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$2,342.00 |
$2,342.00 |
$2,342.00 |
$1,283.87
|
|
Sinus/juglr venogram s&i
|
$9,334.00 |
$9,334.00 |
$9,334.00 |
$2,537.60
|
|
Sinus X-ray (complete)
|
$444.00 |
$444.00 |
$444.00 |
$345.24
|
|
Sinus X-ray (limited)
|
$342.00 |
$342.00 |
$342.00 |
$214.50
|
|
Skin Biopsy
|
$803.00 |
$803.00 |
$803.00 |
$362.40
|
|
Skull X-ray (1 to 3 views)
|
$393.00 |
$393.00 |
$393.00 |
$297.00
|
|
Skull X-ray (complete)
|
$650.00 |
$650.00 |
$650.00 |
$417.50
|
|
Sleep Study (Polysomnography)
|
$4,804.00 |
$4,804.00 |
$4,804.00 |
$3,721.41
|
|
Sleep study unattended
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$594.00
|
|
Sleeve fing rolyan med
|
$789.00 |
$789.00 |
$789.00 |
$204.60
|
|
Slp pure tone screening
|
$97.00 |
$97.00 |
$97.00 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$629.00 |
$629.00 |
$629.00 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$40.00 |
$40.00 |
$40.00 |
$64.00
|
|
Smear gram stain
|
$32.00 |
$32.00 |
$32.00 |
$54.03
|
|
Smear nasal eosinophil
|
$12.00 |
$12.00 |
$12.00 |
$45.50
|
|
Smear special stain inclusion bodies/parasites
|
$36.00 |
$36.00 |
$36.00 |
$71.81
|
|
Smear wet mount
|
$87.00 |
$87.00 |
$87.00 |
$66.30
|
|
Snrpn/ube3a gene
|
$260.00 |
$260.00 |
$260.00 |
$228.80
|
|
Sodium 24 hour urine
|
$42.00 |
$42.00 |
$42.00 |
$48.75
|
|
Sodium serum/plasma/whole blood
|
$20.00 |
$20.00 |
$20.00 |
$45.60
|
|
Special physics consult
|
$1,169.00 |
$1,169.00 |
$1,169.00 |
$725.00
|
|
Special radiation dosimetry
|
$988.00 |
$988.00 |
$988.00 |
$392.73
|
|
Special radiation treatment
|
$4,321.00 |
$4,321.00 |
$4,321.00 |
$2,045.50
|
|
Special teletx port plan
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$1,086.99
|
|
Speech and Language Evaluation (comprehensive)
|
$949.00 |
$949.00 |
$949.00 |
$380.00
|
