|
Segmentectomy 32484
|
$15,583.72 |
$15,583.72 |
$15,583.72 |
$2,915.40
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$104.03 |
$104.03 |
$104.03 |
$96.60
|
|
Semen analysis presence/motility
|
$43.62 |
$43.62 |
$43.62 |
$70.40
|
|
Serpina1 gene
|
$157.96 |
$157.96 |
$157.96 |
$197.00
|
|
Sertraline (zoloft) - sendout
|
$366.41 |
$366.41 |
$366.41 |
$126.43
|
|
Set radiation therapy field
|
$342.80 |
$342.80 |
$342.80 |
$782.61
|
|
Set radiation therapy field
|
$880.61 |
$880.61 |
$880.61 |
$1,159.03
|
|
Set radiation therapy field
|
$880.61 |
$880.61 |
$880.61 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$0.01 |
$0.01 |
$0.01 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$0.40 |
$0.40 |
$0.40 |
$21.42
|
|
Sho insert w arch toe filler
|
$965.64 |
$965.64 |
$965.64 |
$1,224.38
|
|
Shot (Injection into Muscle or Under the Skin)
|
$98.09 |
$98.09 |
$98.09 |
$136.80
|
|
Shoulder AC Joint X-ray (both sides)
|
$201.75 |
$201.75 |
$201.75 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$275.16 |
$275.16 |
$275.16 |
$287.25
|
|
Shoulder MRI (with and without contrast)
|
$1,510.60 |
$1,510.60 |
$1,510.60 |
$2,821.65
|
|
Shoulder MRI (with contrast)
|
$2,278.18 |
$2,278.18 |
$2,278.18 |
$2,483.00
|
|
Shoulder MRI (without contrast)
|
$956.04 |
$956.04 |
$956.04 |
$2,088.20
|
|
Shoulder X-ray
|
$201.75 |
$201.75 |
$201.75 |
$341.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$201.75 |
$201.75 |
$201.75 |
$264.00
|
|
Shrinker prosth below knee
|
$103.41 |
$103.41 |
$103.41 |
$105.12
|
|
Shuntogram nonvascular supervision & interpretation
|
$275.16 |
$275.16 |
$275.16 |
$355.80
|
|
Sickling rbc
|
$19.93 |
$19.93 |
$19.93 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$799.16 |
$799.16 |
$799.16 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$799.16 |
$799.16 |
$799.16 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$499.36 |
$499.36 |
$499.36 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$5,491.15 |
$5,491.15 |
$5,491.15 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$201.75 |
$201.75 |
$201.75 |
$347.10
|
|
Sinus X-ray (limited)
|
$201.75 |
$201.75 |
$201.75 |
$215.75
|
|
Skeletal muscle relaxant 1/2
|
$141.36 |
$141.36 |
$141.36 |
$83.85
|
|
Skin Biopsy
|
$497.06 |
$497.06 |
$497.06 |
$361.20
|
|
Skull X-ray (1 to 3 views)
|
$261.20 |
$261.20 |
$261.20 |
$294.66
|
|
Skull X-ray (complete)
|
$261.20 |
$261.20 |
$261.20 |
$423.15
|
|
Skyla, 13.5 mg
|
$2,136.54 |
$2,136.54 |
$2,136.54 |
$1,643.47
|
|
Sleeve fing rolyan med
|
$413.35 |
$413.35 |
$413.35 |
$203.58
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$336.54 |
$336.54 |
$336.54 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$19.49 |
$19.49 |
$19.49 |
$64.20
|
|
Smear gram stain
|
$15.44 |
$15.44 |
$15.44 |
$55.42
|
|
Smear nasal eosinophil
|
$17.18 |
$17.18 |
$17.18 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$21.70 |
$21.70 |
$21.70 |
$73.15
|
|
Smear wet mount
|
$17.06 |
$17.06 |
$17.06 |
$67.49
|
|
Snrpn/ube3a gene
|
$142.57 |
$142.57 |
$142.57 |
$228.80
|
|
So cap design without jnts cf
|
$1,745.84 |
$1,745.84 |
$1,745.84 |
$606.35
|
|
Socket insert below knee
|
$652.18 |
$652.18 |
$652.18 |
$397.60
|
|
Sock fracture or equal each
|
$76.54 |
$76.54 |
$76.54 |
$74.51
|
|
Sodium 24 hour urine
|
$17.59 |
$17.59 |
$17.59 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$4.57 |
$4.57 |
$4.57 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$3.27 |
$3.27 |
$3.27 |
$37.64
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$3.56 |
$3.56 |
$3.56 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$388.93 |
$388.93 |
$388.93 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$17.41 |
$17.41 |
$17.41 |
$46.26
|
|
Soft interface below knee se
|
$178.91 |
$178.91 |
$178.91 |
$179.08
|
|
So neo gsap dna/dna&rna
|
$9,754.50 |
$9,754.50 |
$9,754.50 |
$2,989.55
|
|
So neo gsap dna mcrstl ins
|
$2,438.62 |
$2,438.62 |
$2,438.62 |
$2,296.00
|
|
Special physics consult
|
$286.81 |
$286.81 |
$286.81 |
$725.00
|
|
Special radiation dosimetry
|
$342.80 |
$342.80 |
$342.80 |
$392.50
|
|
Special radiation treatment
|
$1,422.46 |
$1,422.46 |
$1,422.46 |
$2,052.00
|
|
Special teletx port plan
|
$880.61 |
$880.61 |
$880.61 |
$1,095.05
|
|
Specific gravity body fluid
|
$9.62 |
$9.62 |
$9.62 |
$22.00
|
|
Specimen fat stain
|
$17.24 |
$17.24 |
$17.24 |
$35.10
|
|
Speech and Language Evaluation (comprehensive)
|
$726.03 |
$726.03 |
$726.03 |
$385.00
|
|
Speech Therapy Session (one-on-one)
|
$241.41 |
$241.41 |
$241.41 |
$248.30
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,161.14 |
$1,161.14 |
$1,161.14 |
$1,457.50
|
|
Spine X-ray (single view, one level)
|
$201.75 |
$201.75 |
$201.75 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$814.88 |
$814.88 |
$814.88 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$86.65 |
$86.65 |
$86.65 |
$71.44
|
|
Splint finger fold over sm
|
$152.70 |
$152.70 |
$152.70 |
$146.88
|
|
Splint finger frog med
|
$59.55 |
$59.55 |
$59.55 |
$38.08
|
|
Splint fing stax assort 1-7in
|
$2.89 |
$2.89 |
$2.89 |
$5.60
|
|
Splint rstrc wrst/cmc right med
|
$152.70 |
$152.70 |
$152.70 |
$99.04
|
|
Sputum specimen collection
|
$961.42 |
$961.42 |
$961.42 |
$180.00
|
|
St analysis behavior qualitative voice/resonance
|
$345.81 |
$345.81 |
$345.81 |
$297.60
|
|
Staph a dna amp probe
|
$77.79 |
$77.79 |
$77.79 |
$125.00
|
|
St cognitve performance testing healthcare professional each hour
|
$329.97 |
$329.97 |
$329.97 |
$286.00
|
|
Stem cells total count
|
$196.95 |
$196.95 |
$196.95 |
$184.00
|
|
Stent axios caut enh 15x10mm electrocaut
|
$6,505.20 |
$6,505.20 |
$6,505.20 |
$32,403.15
|
|
Stent bili rx wallflx 10x80 uncvr
|
$5,928.00 |
$5,928.00 |
$5,928.00 |
$20,962.50
|
|
Sterile water/saline, 10 ml
|
$0.01 |
$0.01 |
$0.01 |
$13.32
|
|
St evaluate speech sound production
|
$352.99 |
$352.99 |
$352.99 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$288.16 |
$288.16 |
$288.16 |
$400.00
|
|
Stimulants synthetic
|
$138.17 |
$138.17 |
$138.17 |
$80.08
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$812.30 |
$812.30 |
$812.30 |
$1,342.00
|
|
Strep a ag ia
|
$49.27 |
$49.27 |
$49.27 |
$75.40
|
|
Streptomycin injection
|
$33.53 |
$33.53 |
$33.53 |
$138.30
|
|
Stress test pulmonary
|
$255.27 |
$255.27 |
$255.27 |
$324.00
|
|
Stress tte complete
|
$1,151.46 |
$1,151.46 |
$1,151.46 |
$1,894.20
|
|
Sugars single quant
|
$237.30 |
$237.30 |
$237.30 |
$64.28
|
|
Sulfonylurea screen qn-sendout
|
$140.35 |
$140.35 |
$140.35 |
$160.05
|
|
Support clav 29.6-40.5in med
|
$119.57 |
$119.57 |
$119.57 |
$94.08
|
|
Surgical pathology level 1 gross examination only
|
$274.25 |
$274.25 |
$274.25 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$568.17 |
$568.17 |
$568.17 |
$142.20
|
|
Surgical pathology level 3 gross & microscopic examination
|
$662.15 |
$662.15 |
$662.15 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$591.66 |
$591.66 |
$591.66 |
$248.00
|
|
Surgical pathology level 5 gross & microscopic examination
|
$1,085.40 |
$1,085.40 |
$1,085.40 |
$480.60
|
|
Surgical pathology level 6 gross & microscopic examination
|
$1,446.53 |
$1,446.53 |
$1,446.53 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$17.18 |
$17.18 |
$17.18 |
$45.45
|
|
Susceptibility enzyme detection per enzyme
|
$17.18 |
$17.18 |
$17.18 |
$35.75
|
|
Susceptibility mic per plate
|
$31.27 |
$31.27 |
$31.27 |
$105.75
|
|
Svc venogram s&i
|
$2,652.99 |
$2,652.99 |
$2,652.99 |
$1,994.00
|
|
Swallowing Evaluation (Bedside)
|
$266.71 |
$266.71 |
$266.71 |
$316.55
|
|
Swallowing Therapy Session
|
$266.90 |
$266.90 |
$266.90 |
$240.31
|