|
Red blood cells leukocytes reduced irradiated each unit
|
$199.15 |
$199.15 |
$199.15 |
$534.15
|
|
Refill maint impl spine pump
|
$231.40 |
$231.40 |
$231.40 |
$366.60
|
|
Refill/maint pump/resvr syst
|
$132.08 |
$132.08 |
$132.08 |
$402.48
|
|
Removal cerumen impacted (both sides)
|
$38.01 |
$38.01 |
$38.01 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$125.73 |
$125.73 |
$125.73 |
$255.97
|
|
Removal foreign body foot subcutaneous right
|
$226.43 |
$226.43 |
$226.43 |
$1,260.80
|
|
Removal of adenoids
|
$194.36 |
$194.36 |
$194.36 |
$3,837.72
|
|
Removal of adenoids
|
$210.18 |
$210.18 |
$210.18 |
$3,837.72
|
|
Removal of adenoids <12yrs 42835
|
$179.90 |
$179.90 |
$179.90 |
$3,837.72
|
|
Removal of foreign body
|
$681.46 |
$681.46 |
$681.46 |
$4,149.00
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$147.36 |
$147.36 |
$147.36 |
$292.50
|
|
Removal sutr and stapl no anes
|
$125.18 |
$125.18 |
$125.18 |
$82.05
|
|
Removal sutr or stapl no anes
|
$93.88 |
$93.88 |
$93.88 |
$93.88
|
|
Remove hip foreign body 27086
|
$283.45 |
$283.45 |
$283.45 |
$2,396.00
|
|
Remove spine eltrd perq aray
|
$1,549.18 |
$1,549.18 |
$1,549.18 |
$3,636.18
|
|
Remove tonsils and adenoids
|
$269.84 |
$269.84 |
$269.84 |
$6,966.64
|
|
Remove tonsils and adenoids
|
$281.60 |
$281.60 |
$281.60 |
$3,837.72
|
|
Remove ventilating tube
|
$84.98 |
$84.98 |
$84.98 |
$3,837.72
|
|
Renal cyst study s&i
|
$338.90 |
$338.90 |
$338.90 |
$751.34
|
|
Renal function panel
|
$95.63 |
$95.63 |
$95.63 |
$114.37
|
|
Repair blood vessel direct hand finger
|
$1,279.31 |
$1,279.31 |
$1,279.31 |
$3,898.50
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$294.31 |
$294.31 |
$294.31 |
$1,055.69
|
|
Repair extns tendon finger without grft ea
|
$667.89 |
$667.89 |
$667.89 |
$2,340.00
|
|
Repair finger/hand tendon
|
$816.13 |
$816.13 |
$816.13 |
$4,350.00
|
|
Repair lac palate<2 cm
|
$207.43 |
$207.43 |
$207.43 |
$780.65
|
|
Repair of nasal septum
|
$601.61 |
$601.61 |
$601.61 |
$4,924.40
|
|
Repair of toe dislocation
|
$455.58 |
$455.58 |
$455.58 |
$3,986.00
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$235.66 |
$235.66 |
$235.66 |
$954.20
|
|
Repair rpr lip full thickness vermilion only
|
$344.80 |
$344.80 |
$344.80 |
$1,244.09
|
|
Resect inferior turbinate
|
$250.41 |
$250.41 |
$250.41 |
$3,837.72
|
|
Resp virus 6-11 targets
|
$449.98 |
$449.98 |
$449.98 |
$479.20
|
|
Resuscitation delivery/birthing room
|
$687.83 |
$687.83 |
$687.83 |
$802.00
|
|
Reticulated platelet assay
|
$65.02 |
$65.02 |
$65.02 |
$75.00
|
|
Reticulocyte direct measurement automated
|
$10.23 |
$10.23 |
$10.23 |
$36.57
|
|
Rev-rem impl neurostim gen-rec
|
$838.10 |
$838.10 |
$838.10 |
$4,534.00
|
|
Rev/rmv perph nstim eltrd ra
|
$295.61 |
$295.61 |
$295.61 |
$4,329.39
|
|
Rev/rmv prph sac/gstr npg/r
|
$261.71 |
$261.71 |
$261.71 |
$4,721.00
|
|
Rheumatoid factor quantitative
|
$42.24 |
$42.24 |
$42.24 |
$57.50
|
|
Rib and Chest X-ray (3 views, left side)
|
$320.23 |
$320.23 |
$320.23 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$402.80 |
$402.80 |
$402.80 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$328.13 |
$328.13 |
$328.13 |
$397.60
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$159.10 |
$159.10 |
$159.10 |
$1,876.00
|
|
Rp loclzj tum 2+area 1+d img
|
$554.42 |
$554.42 |
$554.42 |
$1,310.00
|
|
Rsv assay w/optic
|
$27.48 |
$27.48 |
$27.48 |
$76.32
|
|
Rubella antibody igg
|
$43.01 |
$43.01 |
$43.01 |
$77.40
|
|
Rubeola antibody igg
|
$46.08 |
$46.08 |
$46.08 |
$80.00
|
|
Russell viper venom diluted
|
$36.12 |
$36.12 |
$36.12 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$2,028.22 |
$2,028.22 |
$2,028.22 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$377.67 |
$377.67 |
$377.67 |
$314.26
|
|
Salmonella antibody
|
$56.06 |
$56.06 |
$56.06 |
$37.58
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$148.78 |
$148.78 |
$148.78 |
$213.20
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$76.56 |
$76.56 |
$76.56 |
$109.85
|
|
Sbsq nursing facil care/day new problem 25 min
|
$101.00 |
$101.00 |
$101.00 |
$144.30
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$48.87 |
$48.87 |
$48.87 |
$67.84
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$438.75 |
$438.75 |
$438.75 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$339.88 |
$339.88 |
$339.88 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$459.22 |
$459.22 |
$459.22 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$761.67 |
$761.67 |
$761.67 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$565.11 |
$565.11 |
$565.11 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$628.88 |
$628.88 |
$628.88 |
$597.35
|
|
Screening Mammogram
|
$267.68 |
$267.68 |
$267.68 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$87,383.66 |
$87,383.66 |
$87,383.66 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$814.81 |
$814.81 |
$814.81 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$5.42 |
$5.42 |
$5.42 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$61.59 |
$61.59 |
$61.59 |
$96.00
|
|
Semen analysis w/count
|
$16.98 |
$16.98 |
$16.98 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$424.51 |
$424.51 |
$424.51 |
$316.68
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$43.84 |
$43.84 |
$43.84 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$159.60 |
$159.60 |
$159.60 |
$284.88
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$37.06 |
$37.06 |
$37.06 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$47.46 |
$47.46 |
$47.46 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$61.02 |
$61.02 |
$61.02 |
$269.50
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$69.16 |
$69.16 |
$69.16 |
$400.65
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$32.54 |
$32.54 |
$32.54 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$49.27 |
$49.27 |
$49.27 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$57.86 |
$57.86 |
$57.86 |
$289.30
|
|
Sheath gldlight lasr 12fx50cm
|
$6,766.86 |
$6,766.86 |
$6,766.86 |
$6,570.70
|
|
Shot (Injection into Muscle or Under the Skin)
|
$100.71 |
$100.71 |
$100.71 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$270.69 |
$270.69 |
$270.69 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$192.42 |
$192.42 |
$192.42 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$1,985.75 |
$1,985.75 |
$1,985.75 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,654.68 |
$1,654.68 |
$1,654.68 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,323.60 |
$1,323.60 |
$1,323.60 |
$2,096.84
|
|
Shoulder X-ray
|
$318.79 |
$318.79 |
$318.79 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$231.20 |
$231.20 |
$231.20 |
$263.25
|
|
Shuntogram nonvascular supervision & interpretation
|
$364.74 |
$364.74 |
$364.74 |
$355.80
|
|
Sickling rbc
|
$33.71 |
$33.71 |
$33.71 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$2,254.61 |
$2,254.61 |
$2,254.61 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,878.84 |
$1,878.84 |
$1,878.84 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,503.07 |
$1,503.07 |
$1,503.07 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$312.33 |
$312.33 |
$312.33 |
$346.45
|
|
Sinus X-ray (limited)
|
$198.89 |
$198.89 |
$198.89 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$94.40 |
$94.40 |
$94.40 |
$83.85
|
|
Skin Biopsy
|
$196.31 |
$196.31 |
$196.31 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$295.10 |
$295.10 |
$295.10 |
$294.45
|
|
Skull X-ray (complete)
|
$338.90 |
$338.90 |
$338.90 |
$417.50
|
|
Slco1b1 gene com variants
|
$386.92 |
$386.92 |
$386.92 |
$241.24
|
|
Sleep study unattended
|
$561.25 |
$561.25 |
$561.25 |
$594.00
|
|
Sling suprapubic suburetheral
|
$11,944.73 |
$11,944.73 |
$11,944.73 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$129.28 |
$129.28 |
$129.28 |
$285.09
|