|
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
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$185.92 |
$185.92 |
$185.92 |
$455.01
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$879.79 |
$879.79 |
$879.79 |
$2,429.37
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$1,197.30 |
$1,197.30 |
$1,197.30 |
$9,301.22
|
|
Rmvl fecal impaction/fb spx under anes
|
$3,881.60 |
$3,881.60 |
$3,881.60 |
$2,111.46
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$2,655.20 |
$2,655.20 |
$2,655.20 |
$1,876.00
|
|
Rmvl icd by tv extr
|
$4,732.00 |
$4,732.00 |
$4,732.00 |
$4,375.80
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$36,624.00 |
$36,624.00 |
$36,624.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$46,516.00 |
$46,516.00 |
$46,516.00 |
$33,467.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$36,420.00 |
$36,420.00 |
$36,420.00 |
$24,620.00
|
|
Rmvl icd pulse gen only
|
$6,119.20 |
$6,119.20 |
$6,119.20 |
$4,039.56
|
|
Rmvl ndwellg tun pleural cath
|
$1,831.20 |
$1,831.20 |
$1,831.20 |
$1,172.40
|
|
Rmvl perm pm pulse gen
|
$6,702.40 |
$6,702.40 |
$6,702.40 |
$6,097.00
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$23,538.40 |
$23,538.40 |
$23,538.40 |
$15,399.00
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$16,092.00 |
$16,092.00 |
$16,092.00 |
$10,542.00
|
|
Rmvl pq iabp
|
$3,126.40 |
$3,126.40 |
$3,126.40 |
$969.10
|
|
Rmvl pq vad left hrt vein sep session
|
$3,754.40 |
$3,754.40 |
$3,754.40 |
$2,553.60
|
|
Rmvl subq card rhythm mntr
|
$2,768.00 |
$2,768.00 |
$2,768.00 |
$1,734.00
|
|
Rmvl tv pm lead dual
|
$3,630.40 |
$3,630.40 |
$3,630.40 |
$4,203.54
|
|
Rmvl tv pm lead sgl
|
$3,777.60 |
$3,777.60 |
$3,777.60 |
$4,225.20
|
|
Rmv prosth mat/mesh/abd wall/infec 11008
|
$3,851.20 |
$3,851.20 |
$3,851.20 |
$538.85
|
|
Romiplostim 125 mcg subcutaneous solution
|
$3,797.16 |
$3,797.16 |
$3,797.16 |
$8,935.57
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$2,651.02 |
$2,651.02 |
$2,651.02 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$82.40 |
$82.40 |
$82.40 |
$188.16
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$3,292.00 |
$3,292.00 |
$3,292.00 |
$2,203.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$2,173.60
|
|
Rpl tun-cvad w subq port
|
$5,940.80 |
$5,940.80 |
$5,940.80 |
$4,738.00
|
|
Rpl tun cvc wo subq port
|
$5,582.40 |
$5,582.40 |
$5,582.40 |
$3,724.63
|
|
Rpr blood ves w/vein graft/up ext 35236
|
$10,267.20 |
$10,267.20 |
$10,267.20 |
$5,988.54
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$116.00 |
$116.00 |
$116.00 |
$314.26
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,022.40 |
$1,022.40 |
$1,022.40 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$567.20 |
$567.20 |
$567.20 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$632.00 |
$632.00 |
$632.00 |
$583.00
|
|
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
|
|
Sclerotherapy fluid collection pq w/img
|
$2,643.20 |
$2,643.20 |
$2,643.20 |
$2,144.48
|
|
Scope uretscp lithovue dig disp
|
$3,180.00 |
$3,180.00 |
$3,180.00 |
$4,246.72
|
|
Screening Mammogram
|
$487.20 |
$487.20 |
$487.20 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$51,041.60 |
$51,041.60 |
$51,041.60 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$614.40 |
$614.40 |
$614.40 |
$611.91
|
|
Sec art mech thrmbc non-intracranial add-on
|
$7,875.20 |
$7,875.20 |
$7,875.20 |
$4,332.68
|
|
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
|
|
Semen analysis w/count
|
$56.00 |
$56.00 |
$56.00 |
$56.44
|
|
Serial casting application 97139app
|
$98.40 |
$98.40 |
$98.40 |
$78.39
|
|
Serial tonometry
|
$136.00 |
$136.00 |
$136.00 |
$131.02
|
|
Set radiation therapy field
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
$782.61
|
|
Set radiation therapy field
|
$1,747.20 |
$1,747.20 |
$1,747.20 |
$1,159.03
|
|
Set radiation therapy field
|
$2,710.40 |
$2,710.40 |
$2,710.40 |
$1,636.36
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$196.80 |
$196.80 |
$196.80 |
$235.13
|
|
Shoe heel sach cushion type
|
$62.76 |
$62.76 |
$62.76 |
$228.09
|
|
Shoe post-op mens m
|
$146.13 |
$146.13 |
$146.13 |
$53.20
|
|
Shoe sole wedge outside sole
|
$28.44 |
$28.44 |
$28.44 |
$66.00
|
|
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
|
|
Shrinker prosth above knee
|
$227.02 |
$227.02 |
$227.02 |
$168.89
|
|
Shrinker prosth below knee
|
$217.66 |
$217.66 |
$217.66 |
$105.12
|
|
Shunt glaucoma baerveldt 350mm
|
$4,695.68 |
$4,695.68 |
$4,695.68 |
$4,538.82
|
|
Sialolithotomy 42330
|
$3,776.80 |
$3,776.80 |
$3,776.80 |
$3,837.72
|
|
Sincalide 5 mcg solution for injection
|
$424.00 |
$424.00 |
$424.00 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,536.00 |
$2,536.00 |
$2,536.00 |
$1,796.30
|
|
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/juglr venogram s&i
|
$3,350.40 |
$3,350.40 |
$3,350.40 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$473.60 |
$473.60 |
$473.60 |
$346.45
|
|
Sinus X-ray (limited)
|
$332.80 |
$332.80 |
$332.80 |
$215.40
|
|
Sirolimus, oral
|
$7.20 |
$7.20 |
$7.20 |
$41.70
|
|
Skin Biopsy
|
$444.00 |
$444.00 |
$444.00 |
$360.34
|
|
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
|
|
Skyla, 13.5 mg
|
$780.88 |
$780.88 |
$780.88 |
$1,643.47
|
|
Sleep Study (Polysomnography)
|
$4,428.80 |
$4,428.80 |
$4,428.80 |
$3,734.50
|
|
Sleep study unattended
|
$708.00 |
$708.00 |
$708.00 |
$594.00
|
|
Sleeve fing rolyan med
|
$318.24 |
$318.24 |
$318.24 |
$203.58
|
|
Sling pelv split sam med
|
$227.88 |
$227.88 |
$227.88 |
$150.00
|
|
Sling suprapubic suburetheral
|
$18,777.20 |
$18,777.20 |
$18,777.20 |
$9,679.96
|
|
Slitting of prepuce
|
$4,891.20 |
$4,891.20 |
$4,891.20 |
$3,376.23
|
|
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
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$760.80 |
$760.80 |
$760.80 |
$557.70
|
|
Sock fracture or equal each
|
$61.03 |
$61.03 |
$61.03 |
$74.51
|
|
Sodium chloride 0.9 % intravenous solution
|
$27.00 |
$27.00 |
$27.00 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$15.60 |
$15.60 |
$15.60 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$18.00 |
$18.00 |
$18.00 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$11.64 |
$11.64 |
$11.64 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$51.24 |
$51.24 |
$51.24 |
$80.14
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$295.48 |
$295.48 |
$295.48 |
$410.40
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$65.78 |
$65.78 |
$65.78 |
$177.52
|
|
Sotalol hydrochloride IV
|
$3,667.00 |
$3,667.00 |
$3,667.00 |
$5,761.57
|
|
So vest canvas/web pre ots
|
$365.16 |
$365.16 |
$365.16 |
$256.54
|
|
Special physics consult
|
$1,028.80 |
$1,028.80 |
$1,028.80 |
$725.00
|
|
Special radiation dosimetry
|
$709.60 |
$709.60 |
$709.60 |
$392.50
|
