|
Revision of bladder neck
|
$15,457.73 |
$15,457.73 |
$15,457.73 |
$3,820.84
|
|
Revision of cervix
|
$33,581.69 |
$33,581.69 |
$33,581.69 |
$3,519.29
|
|
Revision open av fistula without thromb
|
$33,684.29 |
$33,684.29 |
$33,684.29 |
$9,842.40
|
|
Revj/rmvl nea pn w/int nstim
|
$17,254.37 |
$17,254.37 |
$17,254.37 |
$4,807.27
|
|
Rev-rem impl neurostim gen-rec
|
$20,897.92 |
$20,897.92 |
$20,897.92 |
$3,945.00
|
|
Rev/rmv perph nstim eltrd ra
|
$24,560.02 |
$24,560.02 |
$24,560.02 |
$4,108.26
|
|
Rev/rmv prph sac/gstr npg/r
|
$12,822.25 |
$12,822.25 |
$12,822.25 |
$3,958.14
|
|
Rheumatoid factor quantitative
|
$20.15 |
$20.15 |
$20.15 |
$59.80
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$345.07 |
$345.07 |
$345.07 |
$345.07
|
|
Rho d immune globulin inj
|
$166.35 |
$166.35 |
$166.35 |
$232.72
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$580.32 |
$580.32 |
$580.32 |
$300.54
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$6,877.90 |
$6,877.90 |
$6,877.90 |
$1,848.99
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$5,831.80 |
$5,831.80 |
$5,831.80 |
$31.05
|
|
Rmvl icd gen w/rplc icd gen dual lead sys
|
$48,375.00 |
$48,375.00 |
$48,375.00 |
$26,317.20
|
|
Rmvl icd gen w/rplc icd gen mlt lead sys
|
$55,577.53 |
$55,577.53 |
$55,577.53 |
$36,067.20
|
|
Rmvl icd gen w/rplc icd gen sgl lead sys
|
$41,222.63 |
$41,222.63 |
$41,222.63 |
$27,258.51
|
|
Rmvl icd pulse gen only
|
$45,013.70 |
$45,013.70 |
$45,013.70 |
$4,069.52
|
|
Rmvl ndwellg tun pleural cath
|
$2,911.38 |
$2,911.38 |
$2,911.38 |
$1,061.36
|
|
Rmvl ninfct mesh hernia rpr 49623
|
$29,293.47 |
$29,293.47 |
$29,293.47 |
$498.40
|
|
Rmvl perm pm pulse gen
|
$92,445.94 |
$92,445.94 |
$92,445.94 |
$6,820.50
|
|
Rmvl pm gen w/rplc pm gen mlt lead sys
|
$26,506.66 |
$26,506.66 |
$26,506.66 |
$18,635.50
|
|
Rmvl pm gen w/rplc pm gen sgl lead sys
|
$16,182.71 |
$16,182.71 |
$16,182.71 |
$11,241.96
|
|
Rmvl subq card rhythm mntr
|
$35,005.62 |
$35,005.62 |
$35,005.62 |
$2,079.40
|
|
Rmvl tv pm lead sgl
|
$28,589.68 |
$28,589.68 |
$28,589.68 |
$4,028.20
|
|
Romiplostim 125 mcg subcutaneous solution
|
$5,636.81 |
$5,636.81 |
$5,636.81 |
$25.95
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$5,382.75 |
$5,382.75 |
$5,382.75 |
$5,400.67
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$40.27 |
$40.27 |
$40.27 |
$60.40
|
|
Rp loclzj tum 2+area 1+d img
|
$827.45 |
$827.45 |
$827.45 |
$1,283.66
|
|
Rp loclzj tum spect w/ct 1
|
$2,710.50 |
$2,710.50 |
$2,710.50 |
$2,505.00
|
|
Rp loclzj tum spect w/ct 2
|
$3,074.50 |
$3,074.50 |
$3,074.50 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$2,854.80 |
$2,854.80 |
$2,854.80 |
$2,182.05
|
|
Rpl tun-cvad w subq port
|
$12,363.29 |
$12,363.29 |
$12,363.29 |
$4,341.66
|
|
Rpl tun cvc wo subq port
|
$7,162.64 |
$7,162.64 |
$7,162.64 |
$4,115.61
|
|
Rpr aa hrn 1st > 10 rdc
|
$30,378.24 |
$30,378.24 |
$30,378.24 |
$4,000.83
|
|
Rpr aa hrn 1st 3-10 ncr/strn
|
$26,503.48 |
$26,503.48 |
$26,503.48 |
$3,849.30
|
|
Rpr aa hrn 1st 3-10 rdc
|
$27,473.80 |
$27,473.80 |
$27,473.80 |
$4,500.75
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$23,592.91 |
$23,592.91 |
$23,592.91 |
$4,000.83
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$23,244.42 |
$23,244.42 |
$23,244.42 |
$6,397.53
|
|
Rpr aa hrn rcr 3-10 ncr/strn
|
$26,627.89 |
$26,627.89 |
$26,627.89 |
$2,148.00
|
|
Rpr aa hrn rcr 3-10 rdc
|
$19,798.70 |
$19,798.70 |
$19,798.70 |
$4,000.83
|
|
Rpr aa hrn rcr < 3 rdc
|
$30,706.14 |
$30,706.14 |
$30,706.14 |
$3,856.84
|
|
Rsv assay w/optic
|
$59.80 |
$59.80 |
$59.80 |
$64.13
|
|
Rubella antibody igg
|
$40.95 |
$40.95 |
$40.95 |
$73.05
|
|
Rubeola antibody igg
|
$207.35 |
$207.35 |
$207.35 |
$80.00
|
|
Russell viper venom diluted
|
$99.45 |
$99.45 |
$99.45 |
$73.03
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$4,256.80 |
$4,256.80 |
$4,256.80 |
$1,441.80
|
|
Salivary gland function exam
|
$879.45 |
$879.45 |
$879.45 |
$549.70
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,297.40 |
$1,297.40 |
$1,297.40 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$980.20 |
$980.20 |
$980.20 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,064.70 |
$1,064.70 |
$1,064.70 |
$788.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$773.50 |
$773.50 |
$773.50 |
$507.18
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$378.95 |
$378.95 |
$378.95 |
$586.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$475.15 |
$475.15 |
$475.15 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,645.15 |
$1,645.15 |
$1,645.15 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,109.55 |
$1,109.55 |
$1,109.55 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$527.80
|
|
Scan proc spinal
|
$52,747.79 |
$52,747.79 |
$52,747.79 |
$975.00
|
|
Screening Mammogram
|
$303.55 |
$303.55 |
$303.55 |
$287.12
|
|
Sedimentation rate erythrocyte automated
|
$67.60 |
$67.60 |
$67.60 |
$37.80
|
|
Semen analysis presence/motility
|
$38.35 |
$38.35 |
$38.35 |
$79.92
|
|
Serpina1 gene
|
$287.30 |
$287.30 |
$287.30 |
$195.65
|
|
Set radiation therapy field
|
$26,517.40 |
$26,517.40 |
$26,517.40 |
$709.00
|
|
Set radiation therapy field
|
$31,109.00 |
$31,109.00 |
$31,109.00 |
$1,601.60
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$35.75 |
$35.75 |
$35.75 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$55.90 |
$55.90 |
$55.90 |
$286.89
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$58.50 |
$58.50 |
$58.50 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$74.10 |
$74.10 |
$74.10 |
$513.33
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$29.90 |
$29.90 |
$29.90 |
$258.40
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$37.70 |
$37.70 |
$37.70 |
$231.75
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$58.50 |
$58.50 |
$58.50 |
$259.58
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$26.65 |
$26.65 |
$26.65 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$40.30 |
$40.30 |
$40.30 |
$231.52
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$55.25 |
$55.25 |
$55.25 |
$304.50
|
|
Sho arthrs srg bicp tenodsis
|
$37,519.97 |
$37,519.97 |
$37,519.97 |
$4,523.20
|
|
Sho arthrs srg lmtd dbrdmt
|
$21,581.40 |
$21,581.40 |
$21,581.40 |
$3,594.44
|
|
Sho arthrs srg lss&rescj ads
|
$27,354.99 |
$27,354.99 |
$27,354.99 |
$3,594.44
|
|
Sho arthrs srg xtnsv dbrdmt
|
$28,643.43 |
$28,643.43 |
$28,643.43 |
$3,705.22
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$37,052.81 |
$37,052.81 |
$37,052.81 |
$5,272.00
|
|
Shoulder MRI (with and without contrast)
|
$4,757.35 |
$4,757.35 |
$4,757.35 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$3,753.75 |
$3,753.75 |
$3,753.75 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$3,753.75 |
$3,753.75 |
$3,753.75 |
$1,938.28
|
|
Shoulder X-ray
|
$613.60 |
$613.60 |
$613.60 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$248.30 |
$248.30 |
$248.30 |
$342.54
|
|
Sialography s&i
|
$456.30 |
$456.30 |
$456.30 |
$403.70
|
|
Sickling rbc
|
$78.65 |
$78.65 |
$78.65 |
$53.40
|
|
Sigmoidoscopy and biopsy
|
$6,372.80 |
$6,372.80 |
$6,372.80 |
$1,351.63
|
|
Sigmoidoscopy for bleeding
|
$6,712.10 |
$6,712.10 |
$6,712.10 |
$1,594.50
|
|
Sigmoidoscopy/submucosal injection 45335
|
$6,919.25 |
$6,919.25 |
$6,919.25 |
$1,278.72
|
|
Sigmoidoscopy w/tumr remove
|
$7,874.75 |
$7,874.75 |
$7,874.75 |
$1,350.83
|
|
Signal avg ecg w or without ecg 93278
|
$456.95 |
$456.95 |
$456.95 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$7,384.84 |
$7,384.84 |
$7,384.84 |
$1,364.66
|
|
Sildenafil citrate, 25 mg
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Sincalide 5 mcg solution for injection
|
$403.42 |
$403.42 |
$403.42 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,117.70 |
$2,117.70 |
$2,117.70 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$1,763.45 |
$1,763.45 |
$1,763.45 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$1,246.05 |
$1,246.05 |
$1,246.05 |
$1,151.00
|
|
Skin Biopsy
|
$793.00 |
$793.00 |
$793.00 |
$362.40
|
|
Sleep Study (Polysomnography)
|
$5,074.55 |
$5,074.55 |
$5,074.55 |
$4,043.20
|
|
Sleep study unattended
|
$492.70 |
$492.70 |
$492.70 |
$631.55
|
|
Slitting of prepuce
|
$12,529.66 |
$12,529.66 |
$12,529.66 |
$3,176.92
|