|
Repair lip full thkns >one-half vert height/cmplx
|
$402.96 |
$402.96 |
$402.96 |
$1,928.07
|
|
Repair of digit nerve hand/foot 1 nerve
|
$791.04 |
$791.04 |
$791.04 |
$3,505.32
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$227.28 |
$227.28 |
$227.28 |
$1,006.50
|
|
Repair rpr lip full thickness vermilion only
|
$341.52 |
$341.52 |
$341.52 |
$1,224.63
|
|
Repair throat wound
|
$684.00 |
$684.00 |
$684.00 |
$1,915.20
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$63.84 |
$63.84 |
$63.84 |
$478.00
|
|
Replace duod/jej tube perc
|
$277.44 |
$277.44 |
$277.44 |
$1,354.54
|
|
Replace g/c tube perc
|
$278.16 |
$278.16 |
$278.16 |
$1,341.50
|
|
Reptilase test
|
$7.44 |
$7.44 |
$7.44 |
$72.00
|
|
#resp virpnl dfa-adenovirus
|
$10.56 |
$10.56 |
$10.56 |
$45.80
|
|
Resuscitation cardiopulmonary
|
$364.08 |
$364.08 |
$364.08 |
$764.40
|
|
Reticulocyte automated
|
$56.64 |
$56.64 |
$56.64 |
$52.57
|
|
Revision of cervix
|
$1,915.92 |
$1,915.92 |
$1,915.92 |
$3,721.00
|
|
Revision of cervix
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$3,854.76
|
|
Rheumatoid factor qualitative
|
$32.40 |
$32.40 |
$32.40 |
$57.20
|
|
Rheumatoid factor quantitative
|
$71.04 |
$71.04 |
$71.04 |
$57.00
|
|
Rho d immune globulin inj
|
$130.56 |
$130.56 |
$130.56 |
$217.71
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$1,531.28 |
$1,531.28 |
$1,531.28 |
$2,429.37
|
|
Rmvl fb upr arm/elbow deep
|
$1,779.84 |
$1,779.84 |
$1,779.84 |
$3,638.88
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$479.76 |
$479.76 |
$479.76 |
$1,822.05
|
|
Rmvl subq card rhythm mntr
|
$486.96 |
$486.96 |
$486.96 |
$1,734.00
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$2,098.13 |
$2,098.13 |
$2,098.13 |
$6,333.33
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$306.72 |
$306.72 |
$306.72 |
$188.50
|
|
Rpl non-tun cvc wo sbq prt/pmp
|
$599.28 |
$599.28 |
$599.28 |
$2,173.60
|
|
Rp loclzj tum spect w/ct 1
|
$1,107.12 |
$1,107.12 |
$1,107.12 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$975.84 |
$975.84 |
$975.84 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$473.04 |
$473.04 |
$473.04 |
$2,173.60
|
|
Rsv assay w/optic
|
$179.52 |
$179.52 |
$179.52 |
$79.38
|
|
Rubella antibody igg
|
$66.24 |
$66.24 |
$66.24 |
$77.03
|
|
Rubeola antibody igg
|
$37.92 |
$37.92 |
$37.92 |
$80.00
|
|
Russell viper venom diluted
|
$49.92 |
$49.92 |
$49.92 |
$72.54
|
|
Rx metab gen seq alys pnl 6
|
$127.44 |
$127.44 |
$127.44 |
$1,008.79
|
|
Salmonella antibody
|
$56.16 |
$56.16 |
$56.16 |
$37.58
|
|
Sarscov coronavirus ag ia
|
$44.64 |
$44.64 |
$44.64 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$120.24 |
$120.24 |
$120.24 |
$104.00
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$379.44 |
$379.44 |
$379.44 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$158.64 |
$158.64 |
$158.64 |
$662.00
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$245.52 |
$245.52 |
$245.52 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$170.16 |
$170.16 |
$170.16 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$273.60 |
$273.60 |
$273.60 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$409.44 |
$409.44 |
$409.44 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$238.08 |
$238.08 |
$238.08 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$176.40 |
$176.40 |
$176.40 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$36.00 |
$36.00 |
$36.00 |
$85.15
|
|
Screening Mammogram
|
$130.56 |
$130.56 |
$130.56 |
$312.55
|
|
Screening prostate cancer PSA
|
$76.32 |
$76.32 |
$76.32 |
$100.63
|
|
Screw cortex 2.0 x 10mm
|
$218.88 |
$218.88 |
$218.88 |
$29,055.00
|
|
Sedimentation rate erythrocyte automated
|
$39.12 |
$39.12 |
$39.12 |
$42.00
|
|
Semen analysis presence/motility
|
$31.44 |
$31.44 |
$31.44 |
$71.05
|
|
Serpina1 gene
|
$25.44 |
$25.44 |
$25.44 |
$197.00
|
|
Sevelamer carbonate 800 mg tablet
|
$1.29 |
$1.29 |
$1.29 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$2.62 |
$2.62 |
$2.62 |
$21.96
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$90.24 |
$90.24 |
$90.24 |
$284.88
|
|
Shoulder MRI (with and without contrast)
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$1,030.08 |
$1,030.08 |
$1,030.08 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$2,065.05
|
|
Shoulder X-ray
|
$137.28 |
$137.28 |
$137.28 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$78.48 |
$78.48 |
$78.48 |
$349.20
|
|
Sickling rbc
|
$32.40 |
$32.40 |
$32.40 |
$57.92
|
|
Sincalide 5 mcg solution for injection
|
$138.21 |
$138.21 |
$138.21 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$1,092.48 |
$1,092.48 |
$1,092.48 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$962.40 |
$962.40 |
$962.40 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$902.88 |
$902.88 |
$902.88 |
$1,292.04
|
|
Sirolimus, oral
|
$292.14 |
$292.14 |
$292.14 |
$41.25
|
|
Skel musc relaxant 3 or more
|
$89.04 |
$89.04 |
$89.04 |
$16.12
|
|
Skin Biopsy
|
$179.52 |
$179.52 |
$179.52 |
$360.34
|
|
Sleep study attended
|
$522.00 |
$522.00 |
$522.00 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$1,282.80 |
$1,282.80 |
$1,282.80 |
$3,607.50
|
|
Sleep study unattended
|
$116.64 |
$116.64 |
$116.64 |
$580.87
|
|
Slitting of prepuce
|
$604.80 |
$604.80 |
$604.80 |
$3,365.50
|
|
Smear fluorescent and/or acid fast stain
|
$32.40 |
$32.40 |
$32.40 |
$64.20
|
|
Smear gram stain
|
$52.32 |
$52.32 |
$52.32 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$37.92 |
$37.92 |
$37.92 |
$73.15
|
|
Smear wet mount
|
$22.56 |
$22.56 |
$22.56 |
$67.49
|
|
Sodium 24 hour urine
|
$41.28 |
$41.28 |
$41.28 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$143.52 |
$143.52 |
$143.52 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$132.48 |
$132.48 |
$132.48 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$49.68 |
$49.68 |
$49.68 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$9.90 |
$9.90 |
$9.90 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.47 |
$14.47 |
$14.47 |
$77.77
|
|
Sodium serum/plasma/whole blood
|
$38.88 |
$38.88 |
$38.88 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$178.20 |
$178.20 |
$178.20 |
$177.52
|
|
Specific gravity body fluid
|
$2.16 |
$2.16 |
$2.16 |
$22.00
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$504.00 |
$504.00 |
$504.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$208.56 |
$208.56 |
$208.56 |
$543.26
|
|
Split blood or products
|
$49.92 |
$49.92 |
$49.92 |
$127.48
|
|
St analysis behavior qualitative voice/resonance
|
$72.00 |
$72.00 |
$72.00 |
$297.60
|
|
Staph a dna amp probe
|
$37.92 |
$37.92 |
$37.92 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$85.44 |
$85.44 |
$85.44 |
$286.00
|
|
Stent bili dbl pgtl 10fx5cm
|
$103.92 |
$103.92 |
$103.92 |
$2,520.08
|
|
St evaluate speech sound production
|
$70.08 |
$70.08 |
$70.08 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$144.24 |
$144.24 |
$144.24 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$192.00 |
$192.00 |
$192.00 |
$399.60
|
|
St evaluation swallow function
|
$135.36 |
$135.36 |
$135.36 |
$314.40
|
|
Stimulants synthetic
|
$18.24 |
$18.24 |
$18.24 |
$80.08
|
|
Strapping of ankle and/or ft 29540
|
$44.88 |
$44.88 |
$44.88 |
$223.45
|
|
Strapping of chest
|
$52.08 |
$52.08 |
$52.08 |
$195.33
|
|
Strapping of hand or finger
|
$35.28 |
$35.28 |
$35.28 |
$174.82
|
|
Strapping of knee
|
$67.68 |
$67.68 |
$67.68 |
$205.20
|
|
Strapping of toes 29550
|
$35.28 |
$35.28 |
$35.28 |
$164.70
|
