|
Puncture arterial withdrawal blood for diagnosis
|
$114.40 |
$114.40 |
$114.40 |
$129.36
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$620.80 |
$620.80 |
$620.80 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$1,302.40 |
$1,302.40 |
$1,302.40 |
$1,060.47
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$527.63 |
$527.63 |
$527.63 |
$4,017.00
|
|
Racepinephrine hcl soln nebu 2.25% (base equivalent)
|
$11.99 |
$11.99 |
$11.99 |
$6.48
|
|
Range of motion measurements
|
$70.40 |
$70.40 |
$70.40 |
$64.50
|
|
Rbc irradiated each unit
|
$512.80 |
$512.80 |
$512.80 |
$550.40
|
|
Red blood cells leukocytes reduced each unit
|
$484.00 |
$484.00 |
$484.00 |
$444.60
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$586.40 |
$586.40 |
$586.40 |
$534.15
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$286.33 |
$286.33 |
$286.33 |
$357.91
|
|
Rem/biv cast full arm/leg
|
$407.20 |
$407.20 |
$407.20 |
$324.00
|
|
Remdesivir 100 mg intravenous powder for solution
|
$644.00 |
$644.00 |
$644.00 |
$1,555.39
|
|
Removal cerumen impacted (both sides)
|
$192.00 |
$192.00 |
$192.00 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$336.80 |
$336.80 |
$336.80 |
$255.97
|
|
Removal foreign body foot cmplx
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$2,659.20
|
|
Removal foreign body foot subcutaneous right
|
$1,662.40 |
$1,662.40 |
$1,662.40 |
$1,260.80
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$1,055.69
|
|
Repair lip full thkns =<one-half vert height
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$1,308.00
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$1,304.00 |
$1,304.00 |
$1,304.00 |
$954.20
|
|
Rib and Chest X-ray (3 views, left side)
|
$503.20 |
$503.20 |
$503.20 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$641.60 |
$641.60 |
$641.60 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$604.80 |
$604.80 |
$604.80 |
$397.60
|
|
Rmvl subq card rhythm mntr
|
$2,768.00 |
$2,768.00 |
$2,768.00 |
$1,734.00
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$48.46 |
$48.46 |
$48.46 |
$188.16
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$116.00 |
$116.00 |
$116.00 |
$314.26
|
|
Scan duplex extremity veins unilateral/limited study
|
$878.40 |
$878.40 |
$878.40 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$676.80 |
$676.80 |
$676.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$508.00 |
$508.00 |
$508.00 |
$597.35
|
|
Screening Mammogram
|
$487.20 |
$487.20 |
$487.20 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$1,057.92 |
$1,057.92 |
$1,057.92 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$614.40 |
$614.40 |
$614.40 |
$611.91
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$132.80 |
$132.80 |
$132.80 |
$96.00
|
|
Semen analysis presence/motility
|
$56.00 |
$56.00 |
$56.00 |
$70.40
|
|
Serial casting application 97139app
|
$98.40 |
$98.40 |
$98.40 |
$78.39
|
|
Shot (Injection into Muscle or Under the Skin)
|
$144.00 |
$144.00 |
$144.00 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$452.80 |
$452.80 |
$452.80 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$404.00 |
$404.00 |
$404.00 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$3,881.60 |
$3,881.60 |
$3,881.60 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$3,234.40 |
$3,234.40 |
$3,234.40 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$3,040.80 |
$3,040.80 |
$3,040.80 |
$2,096.84
|
|
Shoulder X-ray
|
$530.40 |
$530.40 |
$530.40 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$303.20 |
$303.20 |
$303.20 |
$263.25
|
|
Sinus CT scan (with contrast)
|
$2,211.20 |
$2,211.20 |
$2,211.20 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$473.60 |
$473.60 |
$473.60 |
$346.45
|
|
Sinus X-ray (limited)
|
$332.80 |
$332.80 |
$332.80 |
$215.40
|
|
Skull X-ray (1 to 3 views)
|
$410.40 |
$410.40 |
$410.40 |
$294.45
|
|
Skull X-ray (complete)
|
$771.20 |
$771.20 |
$771.20 |
$417.50
|
|
Sleeve fing rolyan med
|
$318.24 |
$318.24 |
$318.24 |
$203.58
|
|
Slp eval non-spch gen comm dev
|
$385.60 |
$385.60 |
$385.60 |
$285.09
|
|
Slp ther svc non-spch gen
|
$284.00 |
$284.00 |
$284.00 |
$188.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$14.00 |
$14.00 |
$14.00 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$48.00 |
$48.00 |
$48.00 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$18.76 |
$18.76 |
$18.76 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$11.80 |
$11.80 |
$11.80 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$78.04 |
$78.04 |
$78.04 |
$80.14
|
|
Speech and Language Evaluation (comprehensive)
|
$471.20 |
$471.20 |
$471.20 |
$384.80
|
|
Speech Therapy Session (one-on-one)
|
$306.40 |
$306.40 |
$306.40 |
$246.87
|
|
Spine X-ray (single view, one level)
|
$267.20 |
$267.20 |
$267.20 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$781.04 |
$781.04 |
$781.04 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$100.93 |
$100.93 |
$100.93 |
$71.44
|
|
St analysis behavior qualitative voice/resonance
|
$376.00 |
$376.00 |
$376.00 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$309.60 |
$309.60 |
$309.60 |
$286.00
|
|
Sterile water/saline, 10 ml
|
$11.37 |
$11.37 |
$11.37 |
$13.32
|
|
Sterile water/saline, 500 ml
|
$14.00 |
$14.00 |
$14.00 |
$28.11
|
|
St evaluate speech sound production
|
$354.40 |
$354.40 |
$354.40 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$342.40 |
$342.40 |
$342.40 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$191.20 |
$191.20 |
$191.20 |
$223.45
|
|
Strapping of chest
|
$182.40 |
$182.40 |
$182.40 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$114.40 |
$114.40 |
$114.40 |
$157.46
|
|
Strapping of hand or finger
|
$152.00 |
$152.00 |
$152.00 |
$177.45
|
|
Strapping of hip
|
$199.20 |
$199.20 |
$199.20 |
$164.70
|
|
Strapping of knee
|
$134.40 |
$134.40 |
$134.40 |
$205.20
|
|
Strapping of toes 29550
|
$176.00 |
$176.00 |
$176.00 |
$164.70
|
|
Stress test pulmonary
|
$264.80 |
$264.80 |
$264.80 |
$324.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$68.29 |
$68.29 |
$68.29 |
$54.80
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$51.37 |
$51.37 |
$51.37 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$57.55 |
$57.55 |
$57.55 |
$129.89
|
|
Surgical pathology level 1 gross examination only
|
$120.80 |
$120.80 |
$120.80 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$150.40 |
$150.40 |
$150.40 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$172.00 |
$172.00 |
$172.00 |
$184.21
|
|
Surgical pathology level 4 gross & microscopic examination
|
$176.00 |
$176.00 |
$176.00 |
$250.20
|
|
Surgical pathology level 5 gross & microscopic examination
|
$558.40 |
$558.40 |
$558.40 |
$480.60
|
|
Swallowing Evaluation (Bedside)
|
$340.80 |
$340.80 |
$340.80 |
$316.80
|
|
Swallowing Therapy Session
|
$287.20 |
$287.20 |
$287.20 |
$232.56
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$404.80 |
$404.80 |
$404.80 |
$289.20
|
|
Tc-99m maa
|
$936.80 |
$936.80 |
$936.80 |
$312.06
|
|
Tc-99m mebrofenin
|
$178.40 |
$178.40 |
$178.40 |
$157.65
|
|
Tc-99m medronate
|
$133.60 |
$133.60 |
$133.60 |
$111.01
|
|
Tc-99m pentetate dtpa
|
$388.80 |
$388.80 |
$388.80 |
$222.60
|
|
Tc-99m pentetate dtpa aerosol
|
$388.80 |
$388.80 |
$388.80 |
$191.50
|
|
Tc-99m pertechnetate per mci
|
$108.00 |
$108.00 |
$108.00 |
$18.67
|
|
Tc-99m sestamibi p study dose
|
$352.00 |
$352.00 |
$352.00 |
$287.20
|
|
Tc-99m sulfur colloid
|
$308.00 |
$308.00 |
$308.00 |
$245.70
|
|
Tc-99m tetrofosmin p study dose
|
$120.00 |
$120.00 |
$120.00 |
$193.28
|
|
Telehealth original site facility fee
|
$84.00 |
$84.00 |
$84.00 |
$51.00
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$5,856.08 |
$5,856.08 |
$5,856.08 |
$14,951.87
|
|
Terbutaline 1 mg/ml subcutaneous solution
|
$49.57 |
$49.57 |
$49.57 |
$39.33
|
|
Test stress cardiovascular tracing only
|
$1,175.20 |
$1,175.20 |
$1,175.20 |
$953.40
|