|
Revasc lithotr-ather tib/per
|
$27,184.80 |
$27,184.80 |
$27,184.80 |
$19,995.50
|
|
Revasc lithotrip-stent-ather
|
$27,619.20 |
$27,619.20 |
$27,619.20 |
$21,249.26
|
|
Revasc lithotrip tibi/perone
|
$15,886.40 |
$15,886.40 |
$15,886.40 |
$13,925.00
|
|
Revasc lithotr-stent tib/per
|
$27,184.80 |
$27,184.80 |
$27,184.80 |
$20,329.50
|
|
Revasc lith-sten-ath tib/per
|
$27,184.80 |
$27,184.80 |
$27,184.80 |
$19,624.54
|
|
Revision of circulation
|
$1,936.80 |
$1,936.80 |
$1,936.80 |
$2,547.00
|
|
Rheumatoid factor qualitative
|
$108.80 |
$108.80 |
$108.80 |
$57.20
|
|
Rheumatoid factor quantitative
|
$111.20 |
$111.20 |
$111.20 |
$57.50
|
|
Rho(d) immune globulin (rhig) human full dose im
|
$141.60 |
$141.60 |
$141.60 |
$172.80
|
|
Rib and Chest X-ray (3 views, left side)
|
$521.60 |
$521.60 |
$521.60 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$670.40 |
$670.40 |
$670.40 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$645.60 |
$645.60 |
$645.60 |
$397.60
|
|
Right ventric recording
|
$2,487.20 |
$2,487.20 |
$2,487.20 |
$2,345.00
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$1,876.00
|
|
Rmvl icd by tv extr
|
$5,570.40 |
$5,570.40 |
$5,570.40 |
$4,375.80
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$41,453.60 |
$41,453.60 |
$41,453.60 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$33,988.80 |
$33,988.80 |
$33,988.80 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$20,338.40 |
$20,338.40 |
$20,338.40 |
$24,620.00
|
|
Rmvl icd pulse gen only
|
$7,474.40 |
$7,474.40 |
$7,474.40 |
$4,039.56
|
|
Rmvl perm pm pulse gen
|
$7,196.00 |
$7,196.00 |
$7,196.00 |
$6,097.00
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$16,461.60 |
$16,461.60 |
$16,461.60 |
$15,399.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$11,600.00 |
$11,600.00 |
$11,600.00 |
$10,542.00
|
|
Rmvl subq card rhythm mntr
|
$2,638.40 |
$2,638.40 |
$2,638.40 |
$1,734.00
|
|
Rmvl tv pm lead dual
|
$5,476.80 |
$5,476.80 |
$5,476.80 |
$4,203.54
|
|
Rmvl tv pm lead sgl
|
$5,062.40 |
$5,062.40 |
$5,062.40 |
$4,225.20
|
|
Rp loclzj tum 2+area 1+d img
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$4,489.60 |
$4,489.60 |
$4,489.60 |
$2,556.60
|
|
Rp loclzj tum spect w/ct 2
|
$6,735.20 |
$6,735.20 |
$6,735.20 |
$3,176.00
|
|
Rpl tun-cvad w subq port
|
$4,610.40 |
$4,610.40 |
$4,610.40 |
$4,738.00
|
|
Rsv assay w/optic
|
$332.80 |
$332.80 |
$332.80 |
$76.32
|
|
Rtm 1st set-up&pt educaj eqp
|
$313.60 |
$313.60 |
$313.60 |
$177.66
|
|
Rtm dev sply mscskl 16-30 d
|
$90.40 |
$90.40 |
$90.40 |
$90.40
|
|
Rtm dev sply resp sys 16-30d
|
$90.40 |
$90.40 |
$90.40 |
$67.80
|
|
Rubella antibody igg
|
$253.60 |
$253.60 |
$253.60 |
$77.40
|
|
Rubeola antibody igg
|
$158.40 |
$158.40 |
$158.40 |
$80.00
|
|
Russell viper venom diluted
|
$324.00 |
$324.00 |
$324.00 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$3,328.80 |
$3,328.80 |
$3,328.80 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$441.60 |
$441.60 |
$441.60 |
$314.26
|
|
Salivary gland function exam
|
$1,528.00 |
$1,528.00 |
$1,528.00 |
$753.60
|
|
Salivary glnd img serial img
|
$1,576.00 |
$1,576.00 |
$1,576.00 |
$701.73
|
|
Sarscov coronavirus ag ia
|
$78.40 |
$78.40 |
$78.40 |
$60.40
|
|
Sarscov & inf vir a&b ag ia
|
$399.20 |
$399.20 |
$399.20 |
$104.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$2,037.60 |
$2,037.60 |
$2,037.60 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$931.20 |
$931.20 |
$931.20 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,672.00 |
$1,672.00 |
$1,672.00 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$2,663.20 |
$2,663.20 |
$2,663.20 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$2,572.80 |
$2,572.80 |
$2,572.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$2,800.80 |
$2,800.80 |
$2,800.80 |
$597.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$206.40 |
$206.40 |
$206.40 |
$85.15
|
|
Scr c/v cyto,thinlayer,rescr
|
$206.40 |
$206.40 |
$206.40 |
$54.40
|
|
Screening Mammogram
|
$468.80 |
$468.80 |
$468.80 |
$310.20
|
|
Screening prostate cancer PSA
|
$212.80 |
$212.80 |
$212.80 |
$101.60
|
|
Screen pap by tech w md supv
|
$136.80 |
$136.80 |
$136.80 |
$53.46
|
|
Screen/visual acuity/bilat/quant 99173
|
$49.60 |
$49.60 |
$49.60 |
$28.86
|
|
Scrotal (Testicle) Ultrasound
|
$1,265.60 |
$1,265.60 |
$1,265.60 |
$611.91
|
|
Sec art mech thrmbc non-intracranial add-on
|
$5,914.40 |
$5,914.40 |
$5,914.40 |
$4,332.68
|
|
Sedimentation rate erythrocyte automated
|
$102.40 |
$102.40 |
$102.40 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$140.00 |
$140.00 |
$140.00 |
$96.00
|
|
Shot (Injection into Muscle or Under the Skin)
|
$183.20 |
$183.20 |
$183.20 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$548.00 |
$548.00 |
$548.00 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$851.20 |
$851.20 |
$851.20 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$8,665.60 |
$8,665.60 |
$8,665.60 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$6,834.40 |
$6,834.40 |
$6,834.40 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$6,362.40 |
$6,362.40 |
$6,362.40 |
$2,096.84
|
|
Shoulder X-ray
|
$883.20 |
$883.20 |
$883.20 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$651.20 |
$651.20 |
$651.20 |
$263.25
|
|
Sialography s&i
|
$1,427.20 |
$1,427.20 |
$1,427.20 |
$499.20
|
|
Sickling rbc
|
$114.40 |
$114.40 |
$114.40 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$2,131.20 |
$2,131.20 |
$2,131.20 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,823.20 |
$1,823.20 |
$1,823.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,777.60 |
$1,777.60 |
$1,777.60 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$2,537.60 |
$2,537.60 |
$2,537.60 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$645.60 |
$645.60 |
$645.60 |
$346.45
|
|
Sinus X-ray (limited)
|
$503.20 |
$503.20 |
$503.20 |
$215.40
|
|
Skin Biopsy
|
$426.40 |
$426.40 |
$426.40 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$479.20 |
$479.20 |
$479.20 |
$294.45
|
|
Skull X-ray (complete)
|
$736.00 |
$736.00 |
$736.00 |
$417.50
|
|
Sleep study attended
|
$2,531.20 |
$2,531.20 |
$2,531.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$5,018.40 |
$5,018.40 |
$5,018.40 |
$3,734.50
|
|
Sleep study unattended
|
$619.20 |
$619.20 |
$619.20 |
$594.00
|
|
Sleeve fing rolyan med
|
$165.60 |
$165.60 |
$165.60 |
$203.58
|
|
Slp pure tone screening
|
$83.20 |
$83.20 |
$83.20 |
$64.50
|
|
Slp stdy unatnd w/anal
|
$108.80 |
$108.80 |
$108.80 |
$296.34
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$992.80 |
$992.80 |
$992.80 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$108.80 |
$108.80 |
$108.80 |
$64.35
|
|
Smear gram stain
|
$116.80 |
$116.80 |
$116.80 |
$55.55
|
|
Smear nasal eosinophil
|
$132.80 |
$132.80 |
$132.80 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$118.40 |
$118.40 |
$118.40 |
$73.50
|
|
Smear wet mount
|
$108.00 |
$108.00 |
$108.00 |
$67.55
|
|
Snrpn/ube3a gene
|
$2,457.60 |
$2,457.60 |
$2,457.60 |
$230.63
|
|
So cap design without jnts cf
|
$686.40 |
$686.40 |
$686.40 |
$606.35
|
|
Sodium 24 hour urine
|
$108.80 |
$108.80 |
$108.80 |
$48.98
|
|
Sodium serum/plasma/whole blood
|
$84.00 |
$84.00 |
$84.00 |
$46.26
|
|
So neo gsap dna mcrstl ins
|
$11,032.00 |
$11,032.00 |
$11,032.00 |
$2,296.00
|
|
Specific gravity body fluid
|
$60.80 |
$60.80 |
$60.80 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$541.60 |
$541.60 |
$541.60 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$342.40 |
$342.40 |
$342.40 |
$246.87
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$2,192.00 |
$2,192.00 |
$2,192.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$366.40 |
$366.40 |
$366.40 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$388.80 |
$388.80 |
$388.80 |
$388.80
|
