|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$84.59 |
$84.59 |
$84.59 |
$180.55
|
|
Routine footcare pt w lops
|
$124.00 |
$124.00 |
$124.00 |
$235.13
|
|
Rpl tun cvc wo subq port
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$4,201.80
|
|
Rpr aa hrn 1st < 3 cm rdc
|
$508.80 |
$508.80 |
$508.80 |
$4,176.15
|
|
Rpr aa hrn 1st < 3 ncr/strn
|
$712.00 |
$712.00 |
$712.00 |
$5,855.00
|
|
Rpr fem hernia init blocked
|
$940.00 |
$940.00 |
$940.00 |
$3,909.56
|
|
Rpr rem hernia init reduce
|
$856.80 |
$856.80 |
$856.80 |
$3,856.84
|
|
Rubella antibody igg
|
$102.40 |
$102.40 |
$102.40 |
$73.10
|
|
Rubeola antibody igg
|
$79.20 |
$79.20 |
$79.20 |
$79.68
|
|
Russell viper venom diluted
|
$125.60 |
$125.60 |
$125.60 |
$70.16
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$3,300.88 |
$3,300.88 |
$3,300.88 |
$6,466.16
|
|
Same day nb discharge 99463
|
$160.00 |
$160.00 |
$160.00 |
$183.07
|
|
Sarscov coronavirus ag ia
|
$73.60 |
$73.60 |
$73.60 |
$60.40
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$192.00 |
$192.00 |
$192.00 |
$259.20
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$99.20 |
$99.20 |
$99.20 |
$133.20
|
|
Sbsq nursing facil care/day new problem 25 min
|
$130.40 |
$130.40 |
$130.40 |
$174.60
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$63.20 |
$63.20 |
$63.20 |
$79.20
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$864.00 |
$864.00 |
$864.00 |
$1,012.55
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$624.80 |
$624.80 |
$624.80 |
$670.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$824.80 |
$824.80 |
$824.80 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$636.80 |
$636.80 |
$636.80 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$376.00 |
$376.00 |
$376.00 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$432.80 |
$432.80 |
$432.80 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$716.80 |
$716.80 |
$716.80 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$747.20 |
$747.20 |
$747.20 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$795.20 |
$795.20 |
$795.20 |
$601.70
|
|
Sclerotherapy fluid collection pq w/img
|
$1,564.00 |
$1,564.00 |
$1,564.00 |
$2,114.45
|
|
Screening Colonoscopy (average risk)
|
$512.80 |
$512.80 |
$512.80 |
$1,278.72
|
|
Screening Colonoscopy (high risk)
|
$512.00 |
$512.00 |
$512.00 |
$1,575.00
|
|
Screening Mammogram
|
$283.20 |
$283.20 |
$283.20 |
$303.55
|
|
Screen/visual acuity/bilat/quant 99173
|
$4.80 |
$4.80 |
$4.80 |
$28.86
|
|
Sedimentation rate erythrocyte automated
|
$48.80 |
$48.80 |
$48.80 |
$44.20
|
|
Self-meas bp pt educaj/train
|
$42.40 |
$42.40 |
$42.40 |
$39.77
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$22.40 |
$22.40 |
$22.40 |
$60.18
|
|
Self-mgmt educ/train 5-8 pt 30min
|
$16.80 |
$16.80 |
$16.80 |
$32.86
|
|
Semen analysis presence/motility
|
$55.20 |
$55.20 |
$55.20 |
$70.85
|
|
Semen analysis w/count
|
$126.40 |
$126.40 |
$126.40 |
$56.44
|
|
Serial casting application 97139app
|
$69.60 |
$69.60 |
$69.60 |
$67.42
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$173.60 |
$173.60 |
$173.60 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$204.00 |
$204.00 |
$204.00 |
$286.89
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$231.20 |
$231.20 |
$231.20 |
$442.61
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$269.60 |
$269.60 |
$269.60 |
$480.35
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$160.00 |
$160.00 |
$160.00 |
$258.40
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$183.20 |
$183.20 |
$183.20 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$209.60 |
$209.60 |
$209.60 |
$275.88
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$217.60 |
$217.60 |
$217.60 |
$442.61
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$152.00 |
$152.00 |
$152.00 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$181.60 |
$181.60 |
$181.60 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$205.60 |
$205.60 |
$205.60 |
$302.55
|
|
Sho arthrs srg bicp tenodsis
|
$1,350.40 |
$1,350.40 |
$1,350.40 |
$5,419.00
|
|
Sho arthrs srg capsulorraphy
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$5,419.00
|
|
Sho arthrs srg lmtd dbrdmt
|
$800.00 |
$800.00 |
$800.00 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$1,521.60 |
$1,521.60 |
$1,521.60 |
$5,419.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$875.20 |
$875.20 |
$875.20 |
$3,839.54
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$1,573.60 |
$1,573.60 |
$1,573.60 |
$6,839.00
|
|
Shoulder MRI (with and without contrast)
|
$3,167.20 |
$3,167.20 |
$3,167.20 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$2,511.20 |
$2,511.20 |
$2,511.20 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$1,850.40 |
$1,850.40 |
$1,850.40 |
$2,051.28
|
|
Shoulder X-ray
|
$239.20 |
$239.20 |
$239.20 |
$367.02
|
|
Sialolithotomy 42330
|
$346.40 |
$346.40 |
$346.40 |
$3,837.72
|
|
Sickling rbc
|
$21.60 |
$21.60 |
$21.60 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$439.20 |
$439.20 |
$439.20 |
$1,351.63
|
|
Sigmoidoscopy for bleeding
|
$762.40 |
$762.40 |
$762.40 |
$1,993.08
|
|
Sigmoidoscopy w/fb removal 45332
|
$155.20 |
$155.20 |
$155.20 |
$1,395.28
|
|
Sigmoidoscopy w/tumr remove
|
$176.80 |
$176.80 |
$176.80 |
$1,395.28
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$504.80 |
$504.80 |
$504.80 |
$1,664.40
|
|
Sig w/tndsc balloon dilation
|
$710.40 |
$710.40 |
$710.40 |
$1,813.80
|
|
Simple cystometrogram 51725
|
$308.80 |
$308.80 |
$308.80 |
$589.45
|
|
Sinus CT scan (with and without contrast)
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$799.20 |
$799.20 |
$799.20 |
$1,279.50
|
|
Skin Biopsy
|
$152.00 |
$152.00 |
$152.00 |
$382.80
|
|
Skin split graft addl 100sq cm 15101
|
$280.80 |
$280.80 |
$280.80 |
$460.00
|
|
Skin test unlisted antigen ea
|
$80.00 |
$80.00 |
$80.00 |
$39.77
|
|
Skyla, 13.5 mg
|
$839.20 |
$839.20 |
$839.20 |
$2,343.60
|
|
Sleep study attended
|
$1,223.20 |
$1,223.20 |
$1,223.20 |
$1,237.08
|
|
Sleep Study (Polysomnography)
|
$1,616.80 |
$1,616.80 |
$1,616.80 |
$3,936.80
|
|
Sleep study unattended
|
$358.40 |
$358.40 |
$358.40 |
$595.50
|
|
Sleeve fing rolyan med
|
$164.80 |
$164.80 |
$164.80 |
$167.31
|
|
Slitting of prepuce
|
$291.20 |
$291.20 |
$291.20 |
$2,983.40
|
|
Slp eval non-spch gen comm dev
|
$90.40 |
$90.40 |
$90.40 |
$285.09
|
|
Slp pure tone screening
|
$19.20 |
$19.20 |
$19.20 |
$67.60
|
|
Small bowel endoscopy br/wa
|
$1,371.20 |
$1,371.20 |
$1,371.20 |
$2,381.60
|
|
Smear fluorescent and/or acid fast stain
|
$81.60 |
$81.60 |
$81.60 |
$64.20
|
|
Smear gram stain
|
$66.40 |
$66.40 |
$66.40 |
$57.85
|
|
Smear nasal eosinophil
|
$83.20 |
$83.20 |
$83.20 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$109.60 |
$109.60 |
$109.60 |
$64.35
|
|
Smear wet mount
|
$69.60 |
$69.60 |
$69.60 |
$68.63
|
|
Sodium 24 hour urine
|
$102.40 |
$102.40 |
$102.40 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$70.84 |
$70.84 |
$70.84 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$77.92 |
$77.92 |
$77.92 |
$51.51
|
|
Sodium chloride 0.9 % IV bolus
|
$67.30 |
$67.30 |
$67.30 |
$46.35
|
|
Sodium chloride 3 % ivpb
|
$42.50 |
$42.50 |
$42.50 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$179.44 |
$179.44 |
$179.44 |
$104.00
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$182.40 |
$182.40 |
$182.40 |
$651.32
|
|
Sodium serum/plasma/whole blood
|
$35.20 |
$35.20 |
$35.20 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$74.58 |
$74.58 |
$74.58 |
$223.86
|
|
Specific gravity body fluid
|
$35.20 |
$35.20 |
$35.20 |
$23.63
|
|
Specimen fat stain
|
$68.00 |
$68.00 |
$68.00 |
$32.76
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,038.40 |
$1,038.40 |
$1,038.40 |
$1,502.08
|
