|
Scan duplex extremity veins unilateral/limited study
|
$28.50 |
$561.60 |
$1,066.65 |
|
|
Scan duplex lower extremity arteries complete bilateral
|
$24.00 |
$955.50 |
$1,645.15 |
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$24.00 |
$572.00 |
$1,109.55 |
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$33.00 |
$603.20 |
$1,419.60 |
|
|
Scan proc cranial extra
|
$21,903.09 |
$21,903.09 |
$21,903.09 |
|
|
Scan proc spinal
|
$50,222.83 |
$50,222.83 |
$52,747.79 |
|
|
Sclerotherapy fluid collection pq w/img
|
$5,435.28 |
$5,435.28 |
$5,435.28 |
|
|
Scope plantar fasciotomy
|
$8,263.11 |
$8,263.11 |
$8,263.11 |
|
|
Scr c/v cyto,thinlayer,rescr
|
$73.45 |
$76.70 |
$87.10 |
|
|
Screening Colonoscopy (average risk)
|
$601.90 |
$601.90 |
$609.70 |
|
|
Screening Colonoscopy (high risk)
|
$575.90 |
$575.90 |
$593.45 |
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$57.00 |
$57.00 |
$57.00 |
|
|
Screening Mammogram
|
$118.30 |
$197.60 |
$410.15 |
|
|
Screening prostate cancer PSA
|
$46.50 |
$115.70 |
$159.90 |
|
|
Screen/visual acuity/bilat/quant 99173
|
$21.00 |
$21.00 |
$26.65 |
|
|
Sc ther infusion reset pump
|
$354.25 |
$354.25 |
$354.25 |
|
|
Sec art mech thrmbc non-intracranial add-on
|
$50,542.95 |
$50,542.95 |
$50,542.95 |
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$104.65 |
$104.65 |
$158.60 |
|
|
Sedimentation rate erythrocyte automated
|
$41.60 |
$53.30 |
$67.60 |
|
|
Semen analysis presence/motility
|
$16.50 |
$74.75 |
$118.95 |
|
|
Sensorimotor examination
|
$59.80 |
$59.80 |
$59.80 |
|
|
Serpina1 gene
|
$287.30 |
$287.30 |
$287.30 |
|
|
Sertraline (zoloft) - sendout
|
$154.70 |
$215.15 |
$234.65 |
|
|
Set radiation therapy field
|
$26,517.40 |
$26,517.40 |
$29,050.45 |
|
|
Set radiation therapy field
|
$1,458.60 |
$1,458.60 |
$1,458.60 |
|
|
Set radiation therapy field
|
$31,109.00 |
$31,109.00 |
$34,732.10 |
|
|
Sever cranial nerve
|
$27,933.49 |
$27,933.49 |
$27,933.49 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$35.75 |
$168.75 |
$196.95 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$55.90 |
$55.90 |
$198.75 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$58.50 |
$58.50 |
$279.00 |
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$74.10 |
$74.10 |
$74.10 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$29.90 |
$109.85 |
$272.35 |
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$37.70 |
$123.00 |
$174.20 |
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$58.50 |
$58.50 |
$170.95 |
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$26.65 |
$141.70 |
$150.80 |
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$40.30 |
$112.50 |
$165.10 |
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$55.25 |
$185.25 |
$213.85 |
|
|
Sho arthrs srg bicp tenodsis
|
$8,217.11 |
$21,612.66 |
$37,519.97 |
|
|
Sho arthrs srg lmtd dbrdmt
|
$15,755.12 |
$15,755.12 |
$21,581.40 |
|
|
Sho arthrs srg lss&rescj ads
|
$15,295.32 |
$15,295.32 |
$27,354.99 |
|
|
Sho arthrs srg xtnsv dbrdmt
|
$7,242.57 |
$18,804.67 |
$28,643.43 |
|
|
Shoe post-op mens m
|
$55.90 |
$55.90 |
$55.90 |
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$1,077.00 |
$8,472.56 |
$37,052.81 |
|
|
Shoulder MRI (with and without contrast)
|
$2,364.70 |
$2,843.10 |
$5,010.20 |
|
|
Shoulder MRI (with contrast)
|
$2,214.55 |
$2,465.45 |
$5,245.50 |
|
|
Shoulder MRI (without contrast)
|
$81.75 |
$2,274.35 |
$4,387.50 |
|
|
Shoulder X-ray
|
$72.00 |
$374.40 |
$614.25 |
|
|
Shrinker prosth above knee
|
$63.70 |
$63.70 |
$63.70 |
|
|
Shrinker prosth below knee
|
$19.50 |
$19.50 |
$19.50 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$248.30 |
$248.30 |
$248.30 |
|
|
Sialography s&i
|
$456.30 |
$456.30 |
$789.75 |
|
|
Sialolithotomy 42330
|
$10,743.69 |
$10,743.69 |
$10,743.69 |
|
|
Sickling rbc
|
$29.25 |
$50.70 |
$78.65 |
|
|
Sigmoidoscopy and biopsy
|
$369.20 |
$2,717.58 |
$6,372.80 |
|
|
Sigmoidoscopy for bleeding
|
$3,233.22 |
$3,233.22 |
$6,712.10 |
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,195.97 |
$3,195.97 |
$6,919.25 |
|
|
Sigmoidoscopy w/ablation
|
$2,849.60 |
$2,849.60 |
$2,849.60 |
|
|
Sigmoidoscopy w/tumr remove
|
$599.30 |
$3,450.85 |
$7,874.75 |
|
|
Sigmoidoscopy w/ultrasound
|
$2,014.92 |
$2,014.92 |
$2,014.92 |
|
|
Signal avg ecg w or without ecg 93278
|
$456.95 |
$456.95 |
$676.65 |
|
|
Sig w/tndsc balloon dilation
|
$5,259.16 |
$5,259.16 |
$7,384.84 |
|
|
Sildenafil citrate, 25 mg
|
$4.87 |
$4.87 |
$182.99 |
|
|
Sincalide 5 mcg solution for injection
|
$394.33 |
$403.42 |
$577.26 |
|
|
Sinus CT scan (with and without contrast)
|
$83.25 |
$1,824.55 |
$2,224.30 |
|
|
Sinus CT scan (with contrast)
|
$1,191.45 |
$1,520.35 |
$1,863.55 |
|
|
Sinus CT scan (without contrast)
|
$66.75 |
$1,246.05 |
$1,717.95 |
|
|
Sinus/juglr venogram s&i
|
$2,601.30 |
$2,601.30 |
$2,601.30 |
|
|
Sirolimus, oral
|
$11.43 |
$11.43 |
$11.43 |
|
|
Skin Biopsy
|
$181.50 |
$404.95 |
$793.00 |
|
|
Skin split graft addl 100sq cm 15101
|
$513.50 |
$513.50 |
$513.50 |
|
|
Skin test unlisted antigen ea
|
$8.25 |
$8.25 |
$8.25 |
|
|
Sleep study attended
|
$1,629.55 |
$1,629.55 |
$1,629.55 |
|
|
Sleep Study (Polysomnography)
|
$265.50 |
$3,161.60 |
$5,074.55 |
|
|
Sleep study unattended
|
$492.70 |
$726.70 |
$960.70 |
|
|
Sling arm deluxe w/pad xs
|
$21.00 |
$21.00 |
$373.10 |
|
|
Sling pelv split sam med
|
$57.20 |
$57.20 |
$57.20 |
|
|
Slitting of prepuce
|
$400.40 |
$7,058.79 |
$12,529.66 |
|
|
Slp stdy unatnd w/anal
|
$554.45 |
$554.45 |
$554.45 |
|
|
Slp ther svc non-spch gen
|
$319.15 |
$319.15 |
$319.15 |
|
|
Sm-153 lexidron ther
|
$14,863.55 |
$14,863.55 |
$14,863.55 |
|
|
Small bowel endoscopy
|
$3,471.12 |
$3,471.12 |
$3,471.12 |
|
|
Small bowel endoscopy
|
$3,393.08 |
$3,393.08 |
$3,393.08 |
|
|
Small bowel endoscopy
|
$6,214.91 |
$6,214.91 |
$6,214.91 |
|
|
Small bowel endoscopy/biopsy
|
$3,908.37 |
$3,908.37 |
$3,908.37 |
|
|
Small bowel endoscopy br/wa
|
$4,307.94 |
$4,307.94 |
$4,307.94 |
|
|
Smear fluorescent and/or acid fast stain
|
$48.75 |
$81.25 |
$90.35 |
|
|
Smear gram stain
|
$17.25 |
$60.45 |
$81.25 |
|
|
Smear nasal eosinophil
|
$18.00 |
$41.60 |
$61.10 |
|
|
Smear special stain inclusion bodies/parasites
|
$71.50 |
$83.20 |
$106.60 |
|
|
Smear wet mount
|
$44.25 |
$65.00 |
$88.40 |
|
|
Snrpn/ube3a gene
|
$264.55 |
$341.25 |
$508.95 |
|
|
Sodium 24 hour urine
|
$15.00 |
$65.65 |
$96.85 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$23.40 |
$68.25 |
$130.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$23.40 |
$68.25 |
$130.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$23.40 |
$68.25 |
$130.00 |
|
|
Sodium chloride 3 % ivpb
|
$23.40 |
$33.80 |
$130.00 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$96.12 |
$103.35 |
$134.35 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$250.50 |
$574.27 |
$802.75 |
|
|
Sodium serum/plasma/whole blood
|
$23.25 |
$50.05 |
$78.65 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$7.15 |
$8.71 |
$9.36 |
|