|
Sterile water/saline, 10 ml
|
$0.01 |
$0.01 |
$5.00 |
|
|
Sterile water/saline, 500 ml
|
$3.20 |
$3.20 |
$3.20 |
|
|
Sternal debridement
|
$339.24 |
$3,342.87 |
$13,045.57 |
|
|
St evaluate speech sound production
|
$121.40 |
$125.92 |
$834.00 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$100.13 |
$104.46 |
$1,408.00 |
|
|
Stimulants synthetic
|
$127.90 |
$136.53 |
$168.04 |
|
|
Stimulation of spinal cord
|
$359.92 |
$2,310.83 |
$2,310.83 |
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$475.51 |
$475.51 |
$3,786.00 |
|
|
Storage/year embryo(s)
|
$202.78 |
$202.78 |
$202.78 |
|
|
Storage/year oocyte(s)
|
$202.78 |
$202.78 |
$202.78 |
|
|
Storage/year reprod tissue
|
$202.78 |
$202.78 |
$202.78 |
|
|
Storage/year sperm/semen
|
$202.78 |
$202.78 |
$202.78 |
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$296.12 |
$296.12 |
$296.12 |
|
|
Strapping of ankle and/or ft 29540
|
$10.78 |
$186.72 |
$813.00 |
|
|
Strapping of chest
|
$11.00 |
$186.72 |
$186.72 |
|
|
Strapping of elbow or wrist 29260
|
$11.66 |
$70.29 |
$616.00 |
|
|
Strapping of hand or finger
|
$12.10 |
$70.29 |
$652.00 |
|
|
Strapping of hip
|
$11.44 |
$152.54 |
$226.00 |
|
|
Strapping of knee
|
$11.22 |
$152.54 |
$609.00 |
|
|
Strapping of toes 29550
|
$70.29 |
$70.29 |
$486.00 |
|
|
Strep a ag ia
|
$16.81 |
$16.81 |
$256.00 |
|
|
Strep a dna dir probe
|
$13.20 |
$20.05 |
$20.05 |
|
|
Strep a dna quant
|
$27.72 |
$41.76 |
$41.76 |
|
|
Strep b assay w/optic
|
$8.36 |
$12.73 |
$312.00 |
|
|
Strep b dna amp probe
|
$23.32 |
$35.09 |
$156.33 |
|
|
Streptokinase antibody
|
$8.36 |
$12.66 |
$12.66 |
|
|
Streptomycin injection
|
$31.10 |
$33.53 |
$143.47 |
|
|
Streptozocin injection
|
$1,132.15 |
$1,132.15 |
$1,132.15 |
|
|
Stress test pulmonary
|
$13.42 |
$152.54 |
$956.00 |
|
|
Stress tte complete
|
$594.00 |
$648.84 |
$5,161.00 |
|
|
Str markers spec anal addl
|
$304.81 |
$304.81 |
$1,961.00 |
|
|
Str markers specimen anal
|
$233.07 |
$233.07 |
$2,374.00 |
|
|
Subdural tap fontanelle/sutur infant init 61000
|
$70.62 |
$819.50 |
$819.50 |
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$236.28 |
$236.28 |
$236.28 |
|
|
Subq njx filling matrl 1cc/<
|
$32.12 |
$235.13 |
$584.21 |
|
|
Subq njx fil matrl 5.1-10cc
|
$62.70 |
$724.37 |
$755.08 |
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$73.70 |
$73.70 |
$73.70 |
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$71.06 |
$71.06 |
$71.06 |
|
|
Subsequent repair of nerve
|
$70.84 |
$70.84 |
$70.84 |
|
|
Subtalar arthro w/deb
|
$415.14 |
$3,839.54 |
$3,839.54 |
|
|
Subtalar arthro w/exc
|
$321.20 |
$8,453.60 |
$8,453.60 |
|
|
Subtalar arthro w/fb rmvl
|
$401.06 |
$3,839.54 |
$3,839.54 |
|
|
Subtalar arthro w/fusion
|
$546.70 |
$15,226.08 |
$15,226.08 |
|
|
Subtemporal cranial dcmprn
|
$900.68 |
$900.68 |
$900.68 |
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$14.92 |
$14.92 |
$63.80 |
|
|
Suction lipectomy head&neck
|
$836.00 |
$4,332.25 |
$4,332.25 |
|
|
Suction lipectomy lwr extrem
|
$880.00 |
$4,332.25 |
$4,332.25 |
|
|
Suction lipectomy trunk
|
$1,449.80 |
$4,332.25 |
$4,332.25 |
|
|
Suction lipectomy upr extrem
|
$1,139.16 |
$2,164.64 |
$2,164.64 |
|
|
Sugars multiple quant
|
$7.48 |
$11.53 |
$11.53 |
|
|
Sugars single quant
|
$11.53 |
$11.53 |
$292.06 |
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$4,436.25 |
$4,436.25 |
$1,967,000.00 |
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$0.22 |
$0.22 |
$0.32 |
|
|
Sulfonylurea screen qn-sendout
|
$123.45 |
$140.35 |
$408.00 |
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$37.73 |
$39.34 |
$41.00 |
|
|
Sup of prep of antigen # of vials 95144
|
$1.98 |
$54.60 |
$54.60 |
|
|
Supply of digital device
|
$152.50 |
$152.50 |
$152.50 |
|
|
Supp non-insulin inf cath/wk
|
$17.40 |
$17.40 |
$17.40 |
|
|
Support clav 29.6-40.5in med
|
$119.57 |
$119.57 |
$147.17 |
|
|
Supprelin la implant
|
$45,350.22 |
$45,350.22 |
$170,685.80 |
|
|
Suprv interfacilty transport
|
$47.52 |
$47.52 |
$47.52 |
|
|
Suprv interfac trnsport addl
|
$40.92 |
$40.92 |
$40.92 |
|
|
Surg dx exam anorectal
|
$65.56 |
$3,245.23 |
$7,499.82 |
|
|
Surg ect salp-oophorectomy 59120
|
$504.68 |
$504.68 |
$504.68 |
|
|
Surg ect without salp-oophorectomy 59121
|
$505.12 |
$505.12 |
$505.12 |
|
|
Surgery for urethra pouch
|
$263.78 |
$4,081.37 |
$4,081.37 |
|
|
Surgery of pancreatic cyst
|
$710.60 |
$710.60 |
$710.60 |
|
|
Surgery to stop leg growth
|
$415.14 |
$8,453.60 |
$8,453.60 |
|
|
Surgery to stop leg growth
|
$458.70 |
$8,453.60 |
$8,453.60 |
|
|
Surgery to stop leg growth
|
$572.00 |
$8,453.60 |
$8,453.60 |
|
|
Surgery to stop leg growth
|
$420.86 |
$8,453.60 |
$8,453.60 |
|
|
Surgical exposure prostate 55860
|
$539.88 |
$6,015.75 |
$6,015.75 |
|
|
Surgical opening esophagus
|
$808.94 |
$808.94 |
$808.94 |
|
|
Surgical opening esophagus
|
$655.16 |
$655.16 |
$655.16 |
|
|
Surgical opening of stomach
|
$589.82 |
$1,109.47 |
$1,109.47 |
|
|
Surgical opening of stomach 43500
|
$488.62 |
$488.62 |
$488.62 |
|
|
Surgical opening of throat
|
$460.68 |
$1,752.89 |
$1,752.89 |
|
|
Surgical pathology level 1 gross examination only
|
$28.98 |
$35.40 |
$292.00 |
|
|
Surgical pathology level 2 gross & microscopic examination
|
$35.40 |
$46.45 |
$568.17 |
|
|
Surgical pathology level 3 gross & microscopic examination
|
$63.23 |
$66.00 |
$840.00 |
|
|
Surgical pathology level 4 gross & microscopic examination
|
$63.23 |
$108.60 |
$591.66 |
|
|
Surgical pathology level 5 gross & microscopic examination
|
$139.21 |
$425.68 |
$1,085.40 |
|
|
Surgical pathology level 6 gross & microscopic examination
|
$442.16 |
$966.69 |
$1,911.78 |
|
|
Surgical repair stomach bleedin ulcer 43501
|
$832.48 |
$832.48 |
$832.48 |
|
|
Surgical repair stomach gastric lac 43502
|
$943.58 |
$943.58 |
$943.58 |
|
|
Surgical revision intestine
|
$666.60 |
$666.60 |
$666.60 |
|
|
Surgigraft, 1 sq cm
|
$127.14 |
$127.14 |
$127.14 |
|
|
Surg tx anal fistula 2nd stage 46285
|
$264.00 |
$3,245.23 |
$3,245.23 |
|
|
Susceptibility agar dilution per agent
|
$4.75 |
$4.75 |
$133.00 |
|
|
Susceptibility enzyme detection per enzyme
|
$4.75 |
$10.04 |
$125.00 |
|
|
Susceptibility mic per plate
|
$8.65 |
$21.00 |
$264.00 |
|
|
Suscept studies macrobroth dilution ea
|
$4.40 |
$6.64 |
$335.00 |
|
|
Suspend bowel w/prosthesis
|
$614.90 |
$614.90 |
$614.90 |
|
|
Suspension of testis
|
$184.58 |
$4,081.37 |
$4,081.37 |
|
|
Suspension of uterus
|
$503.58 |
$503.58 |
$503.58 |
|
|
Suspension of uterus 58400
|
$284.68 |
$284.68 |
$284.68 |
|
|
Sutr lg intestine 1/mult perf without colostomy 44604
|
$650.32 |
$650.32 |
$650.32 |
|
|
Suture bile duct injury 47900
|
$852.28 |
$852.28 |
$852.28 |
|
|
Svc venogram s&i
|
$1,838.28 |
$1,838.28 |
$5,786.00 |
|
|
Swallowing Evaluation (Bedside)
|
$43.78 |
$77.92 |
$1,247.00 |
|
