|
Sedimentation rate erythrocyte automated
|
$38.81 |
$38.81 |
$38.81 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$81.48 |
$81.48 |
$81.48 |
$96.00
|
|
Semen analysis presence/motility
|
$44.35 |
$44.35 |
$44.35 |
$70.40
|
|
Set radiation therapy field
|
$3,912.83 |
$3,912.83 |
$3,912.83 |
$782.61
|
|
Set radiation therapy field
|
$3,912.83 |
$3,912.83 |
$3,912.83 |
$1,159.03
|
|
Set radiation therapy field
|
$3,912.83 |
$3,912.83 |
$3,912.83 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$2.42 |
$2.42 |
$2.42 |
$7.14
|
|
Sewhfo airplane without jnts cf
|
$3,214.06 |
$3,214.06 |
$3,214.06 |
$1,685.60
|
|
Sewhfo airplane w/jnt(s) cf
|
$3,794.67 |
$3,794.67 |
$3,794.67 |
$1,990.80
|
|
Sewhfo cap desgn w/jnt(s) cf
|
$3,602.03 |
$3,602.03 |
$3,602.03 |
$1,890.00
|
|
Sewhfo cap design without jnt cf
|
$3,214.06 |
$3,214.06 |
$3,214.06 |
$1,685.60
|
|
Sewho airplane without jnts cf
|
$3,794.67 |
$3,794.67 |
$3,794.67 |
$1,990.80
|
|
Sewho airplane w/jnt(s) cf
|
$3,794.67 |
$3,794.67 |
$3,794.67 |
$1,990.80
|
|
Sewho cap design without jnts cf
|
$3,214.06 |
$3,214.06 |
$3,214.06 |
$1,685.60
|
|
Sewho cap design w/jnt(s) cf
|
$3,602.03 |
$3,602.03 |
$3,602.03 |
$1,890.00
|
|
Sewho erbs palsey design abd
|
$1,379.90 |
$1,379.90 |
$1,379.90 |
$988.40
|
|
Sheath above knee
|
$44.63 |
$44.63 |
$44.63 |
$30.80
|
|
Sheath below knee
|
$33.94 |
$33.94 |
$33.94 |
$40.88
|
|
Sheath gldlight lasr 12fx50cm
|
$5,302.92 |
$5,302.92 |
$5,302.92 |
$6,570.70
|
|
Sheath upper limb
|
$46.20 |
$46.20 |
$46.20 |
$28.00
|
|
Shlder disart int lock elbow
|
$8,814.12 |
$8,814.12 |
$8,814.12 |
$5,586.00
|
|
Shldr disar prosth tiss shap
|
$8,981.84 |
$8,981.84 |
$8,981.84 |
$5,717.60
|
|
Shoe clubfoot wedge
|
$107.24 |
$107.24 |
$107.24 |
$111.56
|
|
Shoe dennis browne splint bo
|
$93.52 |
$93.52 |
$93.52 |
$93.52
|
|
Shoe heel new leather standa
|
$88.03 |
$88.03 |
$88.03 |
$88.03
|
|
Shoe heel new rubber standar
|
$74.31 |
$74.31 |
$74.31 |
$63.70
|
|
Shoe heel pad & depress for
|
$188.44 |
$188.44 |
$188.44 |
$149.60
|
|
Shoe heel sach cushion type
|
$228.09 |
$228.09 |
$228.09 |
$228.09
|
|
Shoe heel thomas extend to b
|
$134.68 |
$134.68 |
$134.68 |
$134.68
|
|
Shoe heel thomas with wedge
|
$126.56 |
$126.56 |
$126.56 |
$126.56
|
|
Shoe lift elev heel/sole neo
|
$176.01 |
$176.01 |
$176.01 |
$175.04
|
|
Shoe metatarsal bar between
|
$200.76 |
$200.76 |
$200.76 |
$200.76
|
|
Shoe metatarsal bar wedge ro
|
$88.03 |
$88.03 |
$88.03 |
$69.03
|
|
Shoe outflare wedge
|
$107.24 |
$107.24 |
$107.24 |
$107.24
|
|
Shoe post-op mens m
|
$28.67 |
$28.67 |
$28.67 |
$53.20
|
|
Shoe sole wedge between sole
|
$107.24 |
$107.24 |
$107.24 |
$107.24
|
|
Shoe sole wedge outside sole
|
$77.00 |
$77.00 |
$77.00 |
$66.00
|
|
Shoe wedge sach
|
$184.24 |
$184.24 |
$184.24 |
$171.44
|
|
Sho heel count plast reinfor
|
$346.47 |
$346.47 |
$346.47 |
$346.47
|
|
Sho insert w arch toe filler
|
$1,207.02 |
$1,207.02 |
$1,207.02 |
$1,224.38
|
|
Sho lift taper to metatarsal
|
$112.78 |
$112.78 |
$112.78 |
$111.14
|
|
Shot (Injection into Muscle or Under the Skin)
|
$94.30 |
$94.30 |
$94.30 |
$136.20
|
|
Shoulder abduction joint pai
|
$709.07 |
$709.07 |
$709.07 |
$316.40
|
|
Shoulder AC Joint X-ray (both sides)
|
$139.33 |
$139.33 |
$139.33 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$139.33 |
$139.33 |
$139.33 |
$286.89
|
|
Shoulder flexion-abduction j
|
$766.86 |
$766.86 |
$766.86 |
$478.80
|
|
Shoulder lock actuator
|
$1,093.62 |
$1,093.62 |
$1,093.62 |
$574.00
|
|
Shoulder MRI (with and without contrast)
|
$3,234.06 |
$3,234.06 |
$3,234.06 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$3,234.06 |
$3,234.06 |
$3,234.06 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$2,310.06 |
$2,310.06 |
$2,310.06 |
$2,096.84
|
|
Shoulder universal joint
|
$831.77 |
$831.77 |
$831.77 |
$509.60
|
|
Shoulder X-ray
|
$208.99 |
$208.99 |
$208.99 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$208.99 |
$208.99 |
$208.99 |
$263.25
|
|
Shrinker prosth above knee
|
$143.58 |
$143.58 |
$143.58 |
$168.89
|
|
Shrinker prosth below knee
|
$100.97 |
$100.97 |
$100.97 |
$105.12
|
|
Shrinker upper limb
|
$132.66 |
$132.66 |
$132.66 |
$109.50
|
|
Shunt glaucoma baerveldt 350mm
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$4,538.82
|
|
Sialography s&i
|
$821.74 |
$821.74 |
$821.74 |
$499.20
|
|
Sialolithotomy 42330
|
$1,075.03 |
$1,075.03 |
$1,075.03 |
$3,837.72
|
|
Sickling rbc
|
$165.82 |
$165.82 |
$165.82 |
$59.40
|
|
Sincalide 5 mcg solution for injection
|
$279.06 |
$279.06 |
$279.06 |
$309.14
|
|
Single pivot hinge pair
|
$505.74 |
$505.74 |
$505.74 |
$280.00
|
|
Sinus CT scan (with and without contrast)
|
$1,824.98 |
$1,824.98 |
$1,824.98 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,368.81 |
$1,368.81 |
$1,368.81 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,824.98 |
$1,824.98 |
$1,824.98 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$139.33 |
$139.33 |
$139.33 |
$346.45
|
|
Sinus X-ray (limited)
|
$139.33 |
$139.33 |
$139.33 |
$215.40
|
|
Sio flex pelvisacral custom
|
$561.79 |
$561.79 |
$561.79 |
$561.79
|
|
Sirolimus, oral
|
$16.04 |
$16.04 |
$16.04 |
$41.70
|
|
Skin Biopsy
|
$224.78 |
$224.78 |
$224.78 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$209.05 |
$209.05 |
$209.05 |
$294.45
|
|
Skull X-ray (complete)
|
$139.33 |
$139.33 |
$139.33 |
$417.50
|
|
Sleep study attended
|
$1,675.69 |
$1,675.69 |
$1,675.69 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$3,084.09 |
$3,084.09 |
$3,084.09 |
$3,734.50
|
|
Sleep study unattended
|
$978.88 |
$978.88 |
$978.88 |
$594.00
|
|
Sleeve fing rolyan med
|
$419.83 |
$419.83 |
$419.83 |
$203.58
|
|
Sling pelv split sam med
|
$51.02 |
$51.02 |
$51.02 |
$150.00
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$146.61 |
$146.61 |
$146.61 |
$139.44
|
|
Slp eval non-spch gen comm dev
|
$240.35 |
$240.35 |
$240.35 |
$285.09
|
|
Slp stdy unatnd w/anal
|
$1,065.34 |
$1,065.34 |
$1,065.34 |
$296.34
|
|
Slp ther svc non-spch gen
|
$240.35 |
$240.35 |
$240.35 |
$188.50
|
|
Sm-153 lexidron ther
|
$12,166.17 |
$12,166.17 |
$12,166.17 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$417.98 |
$417.98 |
$417.98 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$34.78 |
$34.78 |
$34.78 |
$64.35
|
|
Smear gram stain
|
$29.12 |
$29.12 |
$29.12 |
$55.55
|
|
Smear nasal eosinophil
|
$58.74 |
$58.74 |
$58.74 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$147.95 |
$147.95 |
$147.95 |
$73.50
|
|
Smear wet mount
|
$83.16 |
$83.16 |
$83.16 |
$67.55
|
|
Smpd1 gene common variants
|
$173.49 |
$173.49 |
$173.49 |
$133.84
|
|
So cap design without jnts cf
|
$1,723.68 |
$1,723.68 |
$1,723.68 |
$606.35
|
|
Socket insert above knee
|
$955.98 |
$955.98 |
$955.98 |
$425.60
|
|
Socket insert below knee
|
$596.12 |
$596.12 |
$596.12 |
$397.60
|
|
Socket insert knee articulat
|
$905.69 |
$905.69 |
$905.69 |
$557.20
|
|
Socket insert symes
|
$825.72 |
$825.72 |
$825.72 |
$459.20
|
|
Socket insert without lock mech
|
$1,379.39 |
$1,379.39 |
$1,379.39 |
$1,192.50
|
|
Socket insert w lock mech
|
$1,655.30 |
$1,655.30 |
$1,655.30 |
$1,418.83
|
|
Sock fracture or equal each
|
$80.75 |
$80.75 |
$80.75 |
$74.51
|
|
Sock wool above knee
|
$51.18 |
$51.18 |
$51.18 |
$51.18
|
|
Sodium 24 hour urine
|
$33.21 |
$33.21 |
$33.21 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$31.16 |
$31.16 |
$31.16 |
$49.07
|