|
Sigmoidoscopy/submucosal injection 45335
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
$1,820.00
|
|
Sigmoidoscopy w/ablation
|
$2,724.80 |
$2,724.80 |
$2,724.80 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$1,964.80 |
$1,964.80 |
$1,964.80 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$5,590.40 |
$5,590.40 |
$5,590.40 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$2,118.40 |
$2,118.40 |
$2,118.40 |
$3,035.44
|
|
Sigmoidoscopy w/tumr remove
|
$2,427.20 |
$2,427.20 |
$2,427.20 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$3,268.80 |
$3,268.80 |
$3,268.80 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$2,426.40 |
$2,426.40 |
$2,426.40 |
$1,976.25
|
|
Sig w/tndsc balloon dilation
|
$2,556.80 |
$2,556.80 |
$2,556.80 |
$2,288.00
|
|
Sincalide 5 mcg solution for injection
|
$329.42 |
$329.42 |
$329.42 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,660.00 |
$2,660.00 |
$2,660.00 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$2,292.80 |
$2,292.80 |
$2,292.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$2,207.20 |
$2,207.20 |
$2,207.20 |
$1,289.00
|
|
Sinus/juglr venogram s&i
|
$2,341.60 |
$2,341.60 |
$2,341.60 |
$2,517.48
|
|
Sinus X-ray (complete)
|
$479.20 |
$479.20 |
$479.20 |
$346.45
|
|
Sinus X-ray (limited)
|
$368.00 |
$368.00 |
$368.00 |
$215.40
|
|
Sirolimus, oral
|
$53.42 |
$53.42 |
$53.42 |
$41.70
|
|
Skin Biopsy
|
$460.80 |
$460.80 |
$460.80 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$396.00 |
$396.00 |
$396.00 |
$294.45
|
|
Skull X-ray (complete)
|
$530.40 |
$530.40 |
$530.40 |
$417.50
|
|
Skyla, 13.5 mg
|
$969.82 |
$969.82 |
$969.82 |
$1,643.47
|
|
Sleep Study (Polysomnography)
|
$4,540.80 |
$4,540.80 |
$4,540.80 |
$3,734.50
|
|
Sleeve fing rolyan med
|
$148.88 |
$148.88 |
$148.88 |
$203.58
|
|
Sling pelv split sam med
|
$147.38 |
$147.38 |
$147.38 |
$150.00
|
|
Sling suprapubic suburetheral
|
$19,593.60 |
$19,593.60 |
$19,593.60 |
$9,679.96
|
|
Slitting of prepuce
|
$2,858.40 |
$2,858.40 |
$2,858.40 |
$3,376.23
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$741.60 |
$741.60 |
$741.60 |
$557.70
|
|
Small bowel endoscopy
|
$2,467.20 |
$2,467.20 |
$2,467.20 |
$2,596.41
|
|
Small bowel endoscopy
|
$2,399.20 |
$2,399.20 |
$2,399.20 |
$2,399.20
|
|
Small bowel endoscopy
|
$2,455.20 |
$2,455.20 |
$2,455.20 |
$2,951.65
|
|
Small bowel endoscopy
|
$2,545.60 |
$2,545.60 |
$2,545.60 |
$2,590.33
|
|
Small bowel endoscopy
|
$2,308.80 |
$2,308.80 |
$2,308.80 |
$2,740.80
|
|
Small bowel endoscopy
|
$2,623.20 |
$2,623.20 |
$2,623.20 |
$3,486.34
|
|
Small bowel endoscopy
|
$2,396.80 |
$2,396.80 |
$2,396.80 |
$2,088.00
|
|
Small bowel endoscopy
|
$5,757.60 |
$5,757.60 |
$5,757.60 |
$2,956.20
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$2,677.60 |
$2,677.60 |
$2,677.60 |
$2,638.57
|
|
Small bowel endoscopy/biopsy
|
$2,467.20 |
$2,467.20 |
$2,467.20 |
$2,490.15
|
|
Small bowel endoscopy/biopsy
|
$2,676.80 |
$2,676.80 |
$2,676.80 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$2,262.40 |
$2,262.40 |
$2,262.40 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$2,406.40 |
$2,406.40 |
$2,406.40 |
$2,406.40
|
|
Small bowel endoscopy/stent 44370
|
$6,381.60 |
$6,381.60 |
$6,381.60 |
$4,992.00
|
|
So cap design without jnts cf
|
$1,115.56 |
$1,115.56 |
$1,115.56 |
$606.35
|
|
Socket insert without lock mech
|
$1,629.94 |
$1,629.94 |
$1,629.94 |
$1,192.50
|
|
Sock fracture or equal each
|
$18.99 |
$18.99 |
$18.99 |
$74.51
|
|
Sodium chloride 0.9 % IV bolus
|
$0.02 |
$0.02 |
$0.02 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$1.49 |
$1.49 |
$1.49 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$103.57 |
$103.57 |
$103.57 |
$80.14
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$142.07 |
$142.07 |
$142.07 |
$177.52
|
|
Soft interface below knee se
|
$103.81 |
$103.81 |
$103.81 |
$179.08
|
|
Sotalol hydrochloride IV
|
$114,699.07 |
$114,699.07 |
$114,699.07 |
$5,761.57
|
|
So vest canvas/web pre ots
|
$410.80 |
$410.80 |
$410.80 |
$256.54
|
|
Special physics consult
|
$1,028.80 |
$1,028.80 |
$1,028.80 |
$725.00
|
|
Special radiation dosimetry
|
$709.60 |
$709.60 |
$709.60 |
$392.50
|
|
Special radiation treatment
|
$3,086.40 |
$3,086.40 |
$3,086.40 |
$2,052.00
|
|
Special teletx port plan
|
$1,494.40 |
$1,494.40 |
$1,494.40 |
$1,095.05
|
|
Speech and Language Evaluation (comprehensive)
|
$500.00 |
$500.00 |
$500.00 |
$384.80
|
|
Speech audiometry complete
|
$121.60 |
$121.60 |
$121.60 |
$109.20
|
|
Speech recep thresh
|
$78.40 |
$78.40 |
$78.40 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$283.20 |
$283.20 |
$283.20 |
$246.87
|
|
Sperm isolation complex
|
$260.00 |
$260.00 |
$260.00 |
$176.28
|
|
Sperm isolation simple
|
$200.00 |
$200.00 |
$200.00 |
$126.05
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,884.00 |
$1,884.00 |
$1,884.00 |
$1,439.40
|
|
Spine X-ray (single view, one level)
|
$414.40 |
$414.40 |
$414.40 |
$251.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$449.96 |
$449.96 |
$449.96 |
$388.80
|
|
Splint extn xsm w sof-stretch rolyan
|
$61.35 |
$61.35 |
$61.35 |
$71.44
|
|
Splint finger fold over sm
|
$34.80 |
$34.80 |
$34.80 |
$146.88
|
|
Splint finger frog med
|
$4.98 |
$4.98 |
$4.98 |
$38.08
|
|
Splint func pos polyflex ii med
|
$316.73 |
$316.73 |
$316.73 |
$61.64
|
|
Splint rstrc wrst/cmc right med
|
$209.60 |
$209.60 |
$209.60 |
$99.04
|
|
Srs linear based
|
$12,160.00 |
$12,160.00 |
$12,160.00 |
$14,124.25
|
|
St analysis behavior qualitative voice/resonance
|
$444.00 |
$444.00 |
$444.00 |
$297.60
|
|
St cognitve performance testing healthcare professional each hour
|
$340.80 |
$340.80 |
$340.80 |
$286.00
|
|
Stem cells total count
|
$205.60 |
$205.60 |
$205.60 |
$194.25
|
|
Stent axios caut enh 15x10mm electrocaut
|
$35,903.99 |
$35,903.99 |
$35,903.99 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$10,389.60 |
$10,389.60 |
$10,389.60 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$29,942.84 |
$29,942.84 |
$29,942.84 |
$20,962.50
|
|
Stent placemt retro carotid
|
$8,537.60 |
$8,537.60 |
$8,537.60 |
$5,328.00
|
|
St evaluate speech sound production
|
$388.80 |
$388.80 |
$388.80 |
$292.95
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$479.20 |
$479.20 |
$479.20 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
$1,345.40
|
|
Strapping of ankle and/or ft 29540
|
$224.80 |
$224.80 |
$224.80 |
$223.45
|
|
Strapping of chest
|
$212.00 |
$212.00 |
$212.00 |
$195.33
|
|
Strapping of elbow or wrist 29260
|
$194.40 |
$194.40 |
$194.40 |
$157.46
|
|
Strapping of hand or finger
|
$189.60 |
$189.60 |
$189.60 |
$177.45
|
|
Strapping of hip
|
$187.20 |
$187.20 |
$187.20 |
$164.70
|
|
Strapping of knee
|
$207.20 |
$207.20 |
$207.20 |
$205.20
|
|
Strapping of toes 29550
|
$194.40 |
$194.40 |
$194.40 |
$164.70
|
|
Streptomycin injection
|
$35.41 |
$35.41 |
$35.41 |
$138.30
|
|
Stress test pulmonary
|
$357.60 |
$357.60 |
$357.60 |
$324.00
|
|
Stress tte complete
|
$2,543.20 |
$2,543.20 |
$2,543.20 |
$1,900.96
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$25,358.48 |
$25,358.48 |
$25,358.48 |
$7,487.55
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$119.96 |
$119.96 |
$119.96 |
$82.46
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$578.09 |
$578.09 |
$578.09 |
$129.89
|
|
Support clav 29.6-40.5in med
|
$225.12 |
$225.12 |
$225.12 |
$94.08
|
|
Supprelin la implant
|
$72,648.14 |
$72,648.14 |
$72,648.14 |
$80,935.72
|
|
Surg dx exam anorectal
|
$3,645.60 |
$3,645.60 |
$3,645.60 |
$3,480.50
|
|
Surgical pathology level 1 gross examination only
|
$30.40 |
$30.40 |
$30.40 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$66.40 |
$66.40 |
$66.40 |
$143.55
|
|
Surgical pathology level 3 gross & microscopic examination
|
$80.00 |
$80.00 |
$80.00 |
$184.21
|
