|
Scan duplex extremity veins unilateral/limited study
|
$500.20 |
$553.88 |
$697.84 |
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$407.89 |
$411.64 |
$574.29 |
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$454.06 |
$463.92 |
$647.22 |
|
|
Sclerotherapy fluid collection pq w/img
|
$1,239.84 |
$1,239.84 |
$1,372.90 |
|
|
Scope uretscp lithovue dig disp
|
$2,981.93 |
$2,981.93 |
$3,301.95 |
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$24.60 |
$24.60 |
$24.60 |
|
|
Screening Mammogram
|
$198.44 |
$219.74 |
$276.85 |
|
|
Screw cortex 2.0 x 10mm
|
$1,891.89 |
$19,706.86 |
$75,557.30 |
|
|
Scrotal (Testicle) Ultrasound
|
$613.54 |
$728.57 |
$1,016.45 |
|
|
Sec art mech thrmbc non-intracranial add-on
|
$2,060.46 |
$2,060.46 |
$2,281.58 |
|
|
Sedimentation rate erythrocyte automated
|
$4.34 |
$127.72 |
$178.18 |
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$25.01 |
$27.70 |
$52.90 |
|
|
Semen analysis presence/motility
|
$28.01 |
$28.01 |
$28.01 |
|
|
Semen analysis w/count
|
$19.68 |
$19.68 |
$19.68 |
|
|
Sept9 promoter methylation analysis
|
$279.94 |
$279.94 |
$279.94 |
|
|
Serpina1 gene
|
$42.85 |
$47.45 |
$168.16 |
|
|
Sertraline (zoloft) - sendout
|
$24.58 |
$24.58 |
$24.58 |
|
|
Set radiation therapy field
|
$182.04 |
$182.04 |
$253.97 |
|
|
Set radiation therapy field
|
$256.25 |
$256.25 |
$357.50 |
|
|
Sevelamer carbonate pdr 20mg
|
$19.89 |
$19.89 |
$22.02 |
|
|
Sewho airplane without jnts cf
|
$1,356.08 |
$1,501.61 |
$1,891.89 |
|
|
Sf3b1 gene common variants
|
$196.80 |
$217.92 |
$274.56 |
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$76.26 |
$76.26 |
$76.26 |
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$76.26 |
$76.26 |
$76.26 |
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$152.32 |
$152.32 |
$152.32 |
|
|
Sheath gldlight lasr 12fx50cm
|
$2,981.93 |
$3,301.95 |
$6,711.28 |
|
|
Shoe lift elev heel/sole neo
|
$213.82 |
$236.77 |
$298.30 |
|
|
Shoe post-op mens m
|
$213.82 |
$236.77 |
$298.30 |
|
|
Sho insert w arch toe filler
|
$890.52 |
$986.09 |
$1,242.39 |
|
|
Sho lift taper to metatarsal
|
$93.28 |
$103.29 |
$130.13 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$49.61 |
$73.19 |
$102.11 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$152.76 |
$185.53 |
$258.83 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$148.47 |
$502.66 |
$701.28 |
|
|
Shoulder MRI (with and without contrast)
|
$1,399.07 |
$3,362.78 |
$4,510.41 |
|
|
Shoulder MRI (with contrast)
|
$1,166.15 |
$2,964.85 |
$3,917.55 |
|
|
Shoulder MRI (without contrast)
|
$932.72 |
$2,695.55 |
$2,984.83 |
|
|
Shoulder X-ray
|
$245.49 |
$509.22 |
$710.43 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$106.13 |
$387.04 |
$539.97 |
|
|
Shrinker prosth above knee
|
$142.89 |
$158.22 |
$199.35 |
|
|
Shrinker prosth below knee
|
$142.89 |
$158.22 |
$199.35 |
|
|
Shrinker upper limb
|
$93.28 |
$103.29 |
$130.13 |
|
|
Shunt glaucoma baerveldt 350mm
|
$1,158.25 |
$1,158.25 |
$1,282.55 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$224.58 |
$224.58 |
$224.58 |
|
|
Sialography s&i
|
$336.41 |
$336.41 |
$469.33 |
|
|
Sickling rbc
|
$11.69 |
$12.94 |
$43.86 |
|
|
Sincalide 5 mcg solution for injection
|
$92.25 |
$92.25 |
$102.15 |
|
|
Sinus CT scan (with and without contrast)
|
$755.58 |
$2,111.50 |
$2,945.80 |
|
|
Sinus CT scan (with contrast)
|
$629.58 |
$1,917.57 |
$2,675.25 |
|
|
Sinus CT scan (without contrast)
|
$503.58 |
$1,584.65 |
$2,210.78 |
|
|
Sinus/juglr venogram s&i
|
$585.48 |
$585.48 |
$648.32 |
|
|
Sinus X-ray (complete)
|
$170.98 |
$226.94 |
$316.61 |
|
|
Sinus X-ray (limited)
|
$181.63 |
$183.85 |
$253.40 |
|
|
Sirolimus, oral
|
$15.79 |
$15.79 |
$17.48 |
|
|
Skeletal muscle relaxant 1/2
|
$74.23 |
$74.23 |
$74.23 |
|
|
Skin Biopsy
|
$161.54 |
$161.54 |
$178.88 |
|
|
Skull X-ray (1 to 3 views)
|
$157.58 |
$322.88 |
$450.45 |
|
|
Skull X-ray (complete)
|
$231.02 |
$406.93 |
$567.71 |
|
|
Slco1b1 gene com variants
|
$255.15 |
$255.15 |
$255.15 |
|
|
Sleep Study (Polysomnography)
|
$3,416.71 |
$3,416.71 |
$3,416.71 |
|
|
Sleep study unattended
|
$631.55 |
$631.55 |
$631.55 |
|
|
Sling pelv split sam med
|
$142.89 |
$158.22 |
$199.35 |
|
|
Sling suprapubic suburetheral
|
$6,553.44 |
$7,256.74 |
$10,328.15 |
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$74.21 |
$74.21 |
$103.54 |
|
|
Slp eval non-spch gen comm dev
|
$135.22 |
$155.39 |
$216.79 |
|
|
Slp ther svc non-spch gen
|
$65.34 |
$107.42 |
$149.87 |
|
|
Sm-153 lexidron ther
|
$4,149.56 |
$4,149.56 |
$5,228.08 |
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$212.79 |
$391.96 |
$546.84 |
|
|
Smear fluorescent and/or acid fast stain
|
$23.17 |
$25.66 |
$36.11 |
|
|
Smear gram stain
|
$68.89 |
$93.07 |
$129.85 |
|
|
Smear special stain inclusion bodies/parasites
|
$9.56 |
$47.77 |
$66.64 |
|
|
Smear wet mount
|
$28.14 |
$64.37 |
$89.81 |
|
|
Snrpn/ube3a gene
|
$230.63 |
$255.38 |
$321.75 |
|
|
So airplane w/wo joint cf
|
$93.28 |
$93.28 |
$103.29 |
|
|
Sock fracture or equal each
|
$54.94 |
$60.84 |
$76.65 |
|
|
Sodium 24 hour urine
|
$34.70 |
$56.17 |
$78.37 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$11.07 |
$12.26 |
$15.45 |
|
|
Sodium chloride 0.9 % IV bolus
|
$11.07 |
$12.26 |
$15.45 |
|
|
Sodium chloride 0.9 % IV bolus
|
$11.07 |
$12.26 |
$15.45 |
|
|
Sodium chloride 3 % ivpb
|
$1.43 |
$11.07 |
$12.26 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$49.20 |
$81.59 |
$90.35 |
|
|
Sodium serum/plasma/whole blood
|
$14.94 |
$39.16 |
$54.63 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$98.61 |
$98.61 |
$109.19 |
|
|
Soft interface below knee se
|
$163.80 |
$181.38 |
$228.52 |
|
|
Somatosensory testing
|
$121.36 |
$134.39 |
$169.32 |
|
|
Somatropin injection
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
So vest canvas/web pre ots
|
$213.82 |
$236.77 |
$298.30 |
|
|
Special pump services
|
$451.21 |
$451.21 |
$499.63 |
|
|
Special radiation dosimetry
|
$101.89 |
$101.89 |
$142.15 |
|
|
Special radiation treatment
|
$268.35 |
$297.15 |
$374.38 |
|
|
Specific gravity body fluid
|
$11.69 |
$12.94 |
$16.31 |
|
|
Speech and Language Evaluation (comprehensive)
|
$200.56 |
$206.44 |
$288.01 |
|
|
Speech evaluation complex
|
$423.98 |
$423.98 |
$423.98 |
|
|
Speech Therapy Session (one-on-one)
|
$77.70 |
$86.04 |
$108.40 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$305.88 |
$453.05 |
$632.06 |
|
|
Spine X-ray (single view, one level)
|
$159.19 |
$268.35 |
$374.38 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$614.59 |
$680.55 |
$857.43 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$34.65 |
$38.37 |
$48.34 |
|
|
Splint func pos polyflex ii med
|
$108.65 |
$120.31 |
$151.58 |
|
|
Splint rstrc wrst/cmc right med
|
$41.41 |
$45.86 |
$57.78 |
|
|
Sputum specimen collection
|
$276.30 |
$276.30 |
$276.30 |
|