|
Repair ventral hern init incar 49561
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$2,098.32
|
|
Repair ventral hern init reduc 49560
|
$1,008.64 |
$1,008.64 |
$1,008.64 |
$1,651.70
|
|
Replace g-j tube perc
|
$620.80 |
$620.80 |
$620.80 |
$1,498.53
|
|
Reremove wrist tendon lesion
|
$748.00 |
$748.00 |
$748.00 |
$1,904.00
|
|
Rerepair ing hernia blocked
|
$1,033.60 |
$1,033.60 |
$1,033.60 |
$5,110.00
|
|
Rerepair ing hernia reduce
|
$874.40 |
$874.40 |
$874.40 |
$4,881.00
|
|
Resuscitation cardiopulmonary
|
$1,000.96 |
$1,000.96 |
$1,000.96 |
$764.40
|
|
Reticulocyte automated
|
$19.20 |
$19.20 |
$19.20 |
$52.57
|
|
Revise arm/leg nerve
|
$752.80 |
$752.80 |
$752.80 |
$3,754.40
|
|
Revise hip joint replacement
|
$2,476.16 |
$2,476.16 |
$2,476.16 |
$6,492.20
|
|
Revise/replace knee joint
|
$2,257.60 |
$2,257.60 |
$2,257.60 |
$5,491.20
|
|
Revise/replace knee joint
|
$2,940.16 |
$2,940.16 |
$2,940.16 |
$7,048.60
|
|
Revision of ankle joint
|
$1,056.80 |
$1,056.80 |
$1,056.80 |
$7,913.97
|
|
Revision of foot tendon
|
$1,074.40 |
$1,074.40 |
$1,074.40 |
$5,886.74
|
|
Revision of ileostomy; simple 44312
|
$574.08 |
$574.08 |
$574.08 |
$4,332.25
|
|
Revision of knee joint
|
$2,073.60 |
$2,073.60 |
$2,073.60 |
$2,073.60
|
|
Revision of unstable kneecap
|
$1,342.08 |
$1,342.08 |
$1,342.08 |
$6,973.47
|
|
Revis reconst shoulder joint
|
$3,224.00 |
$3,224.00 |
$3,224.00 |
$10,029.25
|
|
Revis reconst shoulder joint
|
$3,288.00 |
$3,288.00 |
$3,288.00 |
$7,074.60
|
|
Rf abltj nrv nrvtg si jt
|
$1,926.40 |
$1,926.40 |
$1,926.40 |
$3,138.15
|
|
Rheumatoid factor quantitative
|
$35.20 |
$35.20 |
$35.20 |
$57.00
|
|
Rho(d) immune globulin h, sd
|
$585.43 |
$585.43 |
$585.43 |
$3,709.00
|
|
Rho d immune globulin inj
|
$430.46 |
$430.46 |
$430.46 |
$217.71
|
|
Rhythm ecg with report
|
$28.64 |
$28.64 |
$28.64 |
$28.00
|
|
Rmvl ext fixj sys under anes
|
$755.84 |
$755.84 |
$755.84 |
$2,370.00
|
|
Rmvl fb upr arm/elbow deep
|
$3,982.72 |
$3,982.72 |
$3,982.72 |
$3,638.88
|
|
Rmvl tiss expndr without implant insrtn
|
$565.60 |
$565.60 |
$565.60 |
$3,832.40
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$6,249.34 |
$6,249.34 |
$6,249.34 |
$4,820.04
|
|
Rotavirus antibody
|
$43.71 |
$43.71 |
$43.71 |
$125.01
|
|
Rp loclzj tum 2+area 1+d img
|
$451.58 |
$451.58 |
$451.58 |
$1,310.00
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$777.60 |
$777.60 |
$777.60 |
$6,904.15
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$355.84 |
$355.84 |
$355.84 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$368.00 |
$368.00 |
$368.00 |
$6,904.15
|
|
Rubella antibody igg
|
$53.76 |
$53.76 |
$53.76 |
$77.03
|
|
Rubeola antibody igg
|
$25.60 |
$25.60 |
$25.60 |
$80.00
|
|
Russell viper venom diluted
|
$25.60 |
$25.60 |
$25.60 |
$72.54
|
|
Sarscov coronavirus ag ia
|
$44.80 |
$44.80 |
$44.80 |
$59.25
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$58.40 |
$58.40 |
$58.40 |
$109.85
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$37.60 |
$37.60 |
$37.60 |
$67.84
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$259.20 |
$259.20 |
$259.20 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$270.72 |
$270.72 |
$270.72 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$295.36 |
$295.36 |
$295.36 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$270.72 |
$270.72 |
$270.72 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$212.80 |
$212.80 |
$212.80 |
$595.35
|
|
Screening Colonoscopy (average risk)
|
$134.40 |
$134.40 |
$134.40 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$134.40 |
$134.40 |
$134.40 |
$1,951.46
|
|
Screening Mammogram
|
$126.08 |
$126.08 |
$126.08 |
$312.55
|
|
Screening prostate cancer PSA
|
$38.40 |
$38.40 |
$38.40 |
$100.63
|
|
Sho arthrs srg bicp tenodsis
|
$1,589.12 |
$1,589.12 |
$1,589.12 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$1,744.64 |
$1,744.64 |
$1,744.64 |
$6,311.00
|
|
Sho arthrs srg lmtd dbrdmt
|
$964.00 |
$964.00 |
$964.00 |
$4,521.67
|
|
Sho arthrs srg lss&rescj ads
|
$984.96 |
$984.96 |
$984.96 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$1,695.36 |
$1,695.36 |
$1,695.36 |
$6,311.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$1,212.16 |
$1,212.16 |
$1,212.16 |
$5,148.00
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$1,512.32 |
$1,512.32 |
$1,512.32 |
$7,807.24
|
|
Shoulder MRI (with and without contrast)
|
$1,145.92 |
$1,145.92 |
$1,145.92 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$950.08 |
$950.08 |
$950.08 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$876.16 |
$876.16 |
$876.16 |
$2,065.05
|
|
Shoulder X-ray
|
$105.60 |
$105.60 |
$105.60 |
$339.50
|
|
Shuntogram nonvascular supervision & interpretation
|
$229.25 |
$229.25 |
$229.25 |
$349.20
|
|
Sigmoidoscopy and biopsy
|
$188.80 |
$188.80 |
$188.80 |
$1,351.63
|
|
Sinus CT scan (with and without contrast)
|
$692.16 |
$692.16 |
$692.16 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$655.36 |
$655.36 |
$655.36 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$645.12 |
$645.12 |
$645.12 |
$1,292.04
|
|
Skin Biopsy
|
$216.96 |
$216.96 |
$216.96 |
$360.34
|
|
Sleep study attended
|
$1,379.20 |
$1,379.20 |
$1,379.20 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$2,949.76 |
$2,949.76 |
$2,949.76 |
$3,607.50
|
|
Sleep study unattended
|
$480.00 |
$480.00 |
$480.00 |
$580.87
|
|
Smear fluorescent and/or acid fast stain
|
$22.40 |
$22.40 |
$22.40 |
$64.20
|
|
Smear gram stain
|
$22.40 |
$22.40 |
$22.40 |
$55.25
|
|
Smear special stain inclusion bodies/parasites
|
$30.72 |
$30.72 |
$30.72 |
$73.15
|
|
Smear wet mount
|
$19.20 |
$19.20 |
$19.20 |
$67.49
|
|
Sodium 24 hour urine
|
$30.27 |
$30.27 |
$30.27 |
$48.60
|
|
Sodium serum/plasma/whole blood
|
$23.55 |
$23.55 |
$23.55 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$328.70 |
$328.70 |
$328.70 |
$177.52
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$276.96 |
$276.96 |
$276.96 |
$543.26
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$1,032.80 |
$1,032.80 |
$1,032.80 |
$4,619.65
|
|
St analysis behavior qualitative voice/resonance
|
$74.88 |
$74.88 |
$74.88 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$119.68 |
$119.68 |
$119.68 |
$286.00
|
|
St evaluate speech sound production
|
$71.68 |
$71.68 |
$71.68 |
$292.95
|
|
St evaluate speech sound production comprehensive/expressive
|
$148.48 |
$148.48 |
$148.48 |
$377.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$277.25 |
$277.25 |
$277.25 |
$399.60
|
|
St evaluation swallow function
|
$277.25 |
$277.25 |
$277.25 |
$314.40
|
|
Strapping of ankle and/or ft 29540
|
$225.28 |
$225.28 |
$225.28 |
$223.45
|
|
Strapping of chest
|
$225.28 |
$225.28 |
$225.28 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$145.28 |
$145.28 |
$145.28 |
$154.70
|
|
Strapping of hand or finger
|
$89.60 |
$89.60 |
$89.60 |
$174.82
|
|
Strapping of knee
|
$178.56 |
$178.56 |
$178.56 |
$205.20
|
|
Strapping of toes 29550
|
$184.96 |
$184.96 |
$184.96 |
$164.70
|
|
Strep a ag ia
|
$28.80 |
$28.80 |
$28.80 |
$75.40
|
|
Stress test pulmonary
|
$176.00 |
$176.00 |
$176.00 |
$322.85
|
|
St treatment speech individual
|
$107.17 |
$107.17 |
$107.17 |
$248.84
|
|
St treatment swallow dysfunction/oral
|
$277.25 |
$277.25 |
$277.25 |
$240.31
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$97.54 |
$97.54 |
$97.54 |
$114.88
|
|
Surgical pathology level 1 gross examination only
|
$22.40 |
$22.40 |
$22.40 |
$79.50
|
|
Surgical pathology level 2 gross & microscopic examination
|
$55.04 |
$55.04 |
$55.04 |
$141.94
|
|
Surgical pathology level 3 gross & microscopic examination
|
$56.96 |
$56.96 |
$56.96 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$77.44 |
$77.44 |
$77.44 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$172.80 |
$172.80 |
$172.80 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$240.00 |
$240.00 |
$240.00 |
$718.00
|
