|
Sho arthrs srg rmvl loose/fb
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,740.20
|
|
Sho arthrs srg xtnsv dbrdmt
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$5,148.00
|
|
Shoe clubfoot wedge
|
$84.12 |
$84.12 |
$84.12 |
$111.56
|
|
Shoe dennis browne splint bo
|
$73.36 |
$73.36 |
$73.36 |
$93.52
|
|
Shoe heel new leather standa
|
$69.03 |
$69.03 |
$69.03 |
$88.03
|
|
Shoe heel new rubber standar
|
$58.26 |
$58.26 |
$58.26 |
$63.70
|
|
Shoe heel pad & depress for
|
$105.67 |
$105.67 |
$105.67 |
$149.60
|
|
Shoe heel sach cushion type
|
$178.97 |
$178.97 |
$178.97 |
$228.09
|
|
Shoe heel thomas extend to b
|
$105.67 |
$105.67 |
$105.67 |
$134.68
|
|
Shoe heel thomas with wedge
|
$99.28 |
$99.28 |
$99.28 |
$126.56
|
|
Shoe lift elev heel/sole neo
|
$138.07 |
$138.07 |
$138.07 |
$175.04
|
|
Shoe metatarsal bar between
|
$157.44 |
$157.44 |
$157.44 |
$200.76
|
|
Shoe metatarsal bar wedge ro
|
$69.03 |
$69.03 |
$69.03 |
$69.03
|
|
Shoe outflare wedge
|
$84.12 |
$84.12 |
$84.12 |
$107.24
|
|
Shoe sole wedge between sole
|
$84.12 |
$84.12 |
$84.12 |
$107.24
|
|
Shoe sole wedge outside sole
|
$60.39 |
$60.39 |
$60.39 |
$66.00
|
|
Shoe wedge sach
|
$144.54 |
$144.54 |
$144.54 |
$171.44
|
|
Sho heel count plast reinfor
|
$271.78 |
$271.78 |
$271.78 |
$346.47
|
|
Sho insert w arch toe filler
|
$973.88 |
$973.88 |
$973.88 |
$1,224.38
|
|
Sho lift taper to metatarsal
|
$88.46 |
$88.46 |
$88.46 |
$111.14
|
|
Shortening of hand tendon
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Shortening of thigh bone
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,413.38
|
|
Shorten radius or ulna
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,609.96
|
|
Shorten radius & ulna
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,907.11
|
|
Shot (Injection into Muscle or Under the Skin)
|
$99.00 |
$99.00 |
$99.00 |
$135.85
|
|
Shoulder abduction joint pai
|
$572.12 |
$572.12 |
$572.12 |
$316.40
|
|
Shoulder AC Joint X-ray (both sides)
|
$119.66 |
$119.66 |
$119.66 |
$268.80
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,907.11
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$143.75 |
$143.75 |
$143.75 |
$288.75
|
|
Shoulder flexion-abduction j
|
$618.72 |
$618.72 |
$618.72 |
$478.80
|
|
Shoulder harness
|
$346.52 |
$346.52 |
$346.52 |
$280.00
|
|
Shoulder lock actuator
|
$882.36 |
$882.36 |
$882.36 |
$574.00
|
|
Shoulder MRI (with and without contrast)
|
$479.72 |
$479.72 |
$479.72 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$1,077.92 |
$1,077.92 |
$1,077.92 |
$2,449.85
|
|
Shoulder MRI (without contrast)
|
$328.08 |
$328.08 |
$328.08 |
$2,060.00
|
|
Shoulder prosthesis removal
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$3,870.38
|
|
Shoulder prosthesis removal
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$4,832.80
|
|
Shoulder universal joint
|
$671.08 |
$671.08 |
$671.08 |
$509.60
|
|
Shoulder X-ray
|
$119.66 |
$119.66 |
$119.66 |
$340.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$119.66 |
$119.66 |
$119.66 |
$260.40
|
|
Shrinker prosth above knee
|
$112.59 |
$112.59 |
$112.59 |
$168.89
|
|
Shrinker prosth below knee
|
$79.21 |
$79.21 |
$79.21 |
$109.00
|
|
Shrinker upper limb
|
$104.07 |
$104.07 |
$104.07 |
$109.50
|
|
Shunt as-aort to pulm art
|
$1,900.89 |
$1,900.89 |
$1,900.89 |
$1,900.89
|
|
Shunt central w/prostc graft
|
$1,900.89 |
$1,900.89 |
$1,900.89 |
$1,900.89
|
|
Shunt desc aorta to pulm art
|
$1,833.73 |
$1,833.73 |
$1,833.73 |
$1,833.73
|
|
Shuntogram nonvascular supervision & interpretation
|
$143.75 |
$143.75 |
$143.75 |
$359.55
|
|
Shunt subclavian to pulm art
|
$1,805.33 |
$1,805.33 |
$1,805.33 |
$29,988.00
|
|
Shunt supr v/c p-art 1 lung
|
$1,903.39 |
$1,903.39 |
$1,903.39 |
$1,903.39
|
|
Shunt supr v/c p-art bth lng
|
$2,029.39 |
$2,029.39 |
$2,029.39 |
$2,029.39
|
|
Sialidase enzyme assay
|
$16.86 |
$16.86 |
$16.86 |
$54.99
|
|
Sialography s&i
|
$328.08 |
$328.08 |
$328.08 |
$512.40
|
|
Sialolithotomy 42330
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,864.00
|
|
Sickling rbc
|
$7.60 |
$7.60 |
$7.60 |
$56.99
|
|
Sigmoidoscopy and biopsy
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,550.40
|
|
Sigmoidoscopy flex decompression 45337
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$8,347.72 |
$8,347.72 |
$8,347.72 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$3,816.64 |
$3,816.64 |
$3,816.64 |
$2,997.10
|
|
Sigmoidoscopy w/tumr remove
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$1,278.72 |
$1,278.72 |
$1,278.72 |
$1,976.25
|
|
Signal avg ecg w or without ecg 93278
|
$81.12 |
$81.12 |
$81.12 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$1,645.43 |
$1,645.43 |
$1,645.43 |
$2,288.00
|
|
Silicon gel insert w/wo lock
|
$1,086.79 |
$1,086.79 |
$1,086.79 |
$840.00
|
|
Sim ang w/prs cath rad emb
|
$15,873.70 |
$15,873.70 |
$15,873.70 |
$17,010.60
|
|
Simple cystometrogram 51725
|
$343.55 |
$343.55 |
$343.55 |
$614.00
|
|
Sincalide 5 mcg solution for injection
|
$151.98 |
$151.98 |
$151.98 |
$309.14
|
|
Single energy x-ray study
|
$143.75 |
$143.75 |
$143.75 |
$125.84
|
|
Single pivot hinge pair
|
$396.72 |
$396.72 |
$396.72 |
$280.00
|
|
Single transfer toe-hand
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,413.38
|
|
Sinus CT scan (with and without contrast)
|
$241.18 |
$241.18 |
$241.18 |
$1,788.60
|
|
Sinus CT scan (with contrast)
|
$241.18 |
$241.18 |
$241.18 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$143.75 |
$143.75 |
$143.75 |
$1,283.87
|
|
Sinus/juglr venogram s&i
|
$4,341.66 |
$4,341.66 |
$4,341.66 |
$2,537.60
|
|
Sinusotomy maxillary sinus 31020
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$2,616.15
|
|
Sinusotomy sinus remove polyps 31032
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,465.11
|
|
Sinusotomy sphenoid w/wo bx 31050
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,465.11
|
|
Sinus X-ray (complete)
|
$119.66 |
$119.66 |
$119.66 |
$345.24
|
|
Sinus X-ray (limited)
|
$119.66 |
$119.66 |
$119.66 |
$214.50
|
|
Sio flex pelvisacral custom
|
$453.30 |
$453.30 |
$453.30 |
$561.79
|
|
Sio rig pnl pelv/sac pre ots
|
$160.65 |
$160.65 |
$160.65 |
$418.75
|
|
Sipuleucel-t - su
|
$75,077.67 |
$75,077.67 |
$75,077.67 |
$100,990.51
|
|
Sirolimus, oral
|
$1.34 |
$1.34 |
$1.34 |
$41.70
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$120.21 |
$120.21 |
$120.21 |
$14,361.10
|
|
Six volt bat otto bock/eq ea
|
$449.55 |
$449.55 |
$449.55 |
$274.40
|
|
Skin and muscle repair face
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
$4,332.25
|
|
Skin barrier with flange
|
$12.34 |
$12.34 |
$12.34 |
$1.65
|
|
Skin Biopsy
|
$558.97 |
$558.97 |
$558.97 |
$362.40
|
|
Skin full graft 20sq cm less 15200
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
$2,379.00
|
|
Skin full graft add-on 15241
|
$131.76 |
$131.76 |
$131.76 |
$560.01
|
|
Skin pedicle flap arms/legs
|
$4,872.75 |
$4,872.75 |
$4,872.75 |
$4,332.25
|
|
Skin pedicle flap trunk
|
$2,837.09 |
$2,837.09 |
$2,837.09 |
$2,501.86
|
|
Skin split graft addl 100sq cm 15101
|
$149.22 |
$149.22 |
$149.22 |
$1,793.40
|
|
Skin test unlisted antigen ea
|
$39.77 |
$39.77 |
$39.77 |
$48.57
|
