|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$200.80 |
$200.80 |
$200.80 |
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$296.00 |
$296.00 |
$296.00 |
|
|
Sheath below knee
|
$51.88 |
$51.88 |
$51.88 |
|
|
Sheath gldlight lasr 12fx50cm
|
$7,196.80 |
$7,196.80 |
$7,196.80 |
|
|
Shoe heel sach cushion type
|
$59.27 |
$59.27 |
$85.06 |
|
|
Shoe post-op mens m
|
$138.01 |
$138.01 |
$198.08 |
|
|
Shoe sole wedge outside sole
|
$6.32 |
$6.32 |
$6.32 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$134.40 |
$136.00 |
$172.80 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$160.80 |
$308.80 |
$330.40 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$184.80 |
$264.80 |
$372.00 |
|
|
Shoulder MRI (with and without contrast)
|
$3,189.60 |
$3,566.40 |
$3,686.40 |
|
|
Shoulder MRI (with contrast)
|
$2,353.60 |
$3,084.00 |
$3,301.60 |
|
|
Shoulder MRI (without contrast)
|
$2,228.80 |
$2,516.80 |
$3,229.60 |
|
|
Shoulder X-ray
|
$172.00 |
$240.00 |
$430.40 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$144.80 |
$212.00 |
$385.60 |
|
|
Shrinker prosth above knee
|
$214.41 |
$214.41 |
$294.20 |
|
|
Shrinker prosth below knee
|
$205.57 |
$205.57 |
$294.20 |
|
|
Shunt glaucoma baerveldt 350mm
|
$4,400.00 |
$4,400.00 |
$5,600.00 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$359.20 |
$359.20 |
$533.60 |
|
|
Sialography s&i
|
$462.40 |
$462.40 |
$481.60 |
|
|
Sialolithotomy 42330
|
$3,424.00 |
$3,424.00 |
$3,424.00 |
|
|
Sickling rbc
|
$32.80 |
$32.80 |
$32.80 |
|
|
Sigmoidoscopy and biopsy
|
$1,578.40 |
$1,578.40 |
$2,100.00 |
|
|
Sigmoidoscopy flex decompression 45337
|
$1,964.80 |
$1,964.80 |
$1,964.80 |
|
|
Sigmoidoscopy for bleeding
|
$2,647.20 |
$2,647.20 |
$2,647.20 |
|
|
Sigmoidoscopy/submucosal injection 45335
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
|
|
Sigmoidoscopy w/ablation
|
$2,724.80 |
$2,724.80 |
$2,724.80 |
|
|
Sigmoidoscopy w/fb removal 45332
|
$1,964.80 |
$1,964.80 |
$1,964.80 |
|
|
Sigmoidoscopy w/plcmt stent
|
$5,590.40 |
$5,590.40 |
$5,590.40 |
|
|
Sigmoidoscopy w/resection
|
$2,118.40 |
$2,118.40 |
$2,118.40 |
|
|
Sigmoidoscopy w/tumr remove
|
$2,427.20 |
$2,427.20 |
$2,427.20 |
|
|
Sigmoidoscopy w/ultrasound
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
|
|
Sigmoidoscopy w/us guide bx
|
$3,268.80 |
$3,268.80 |
$3,268.80 |
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$2,426.40 |
$2,426.40 |
$2,426.40 |
|
|
Sig w/tndsc balloon dilation
|
$2,556.80 |
$2,556.80 |
$2,556.80 |
|
|
Sincalide 5 mcg solution for injection
|
$295.20 |
$295.20 |
$329.42 |
|
|
Sinus CT scan (with and without contrast)
|
$2,189.60 |
$2,582.40 |
$2,660.00 |
|
|
Sinus CT scan (with contrast)
|
$1,566.40 |
$1,566.40 |
$2,292.80 |
|
|
Sinus CT scan (without contrast)
|
$1,153.60 |
$1,153.60 |
$2,207.20 |
|
|
Sinus/juglr venogram s&i
|
$1,788.00 |
$1,788.00 |
$2,341.60 |
|
|
Sinus X-ray (complete)
|
$212.00 |
$296.80 |
$479.20 |
|
|
Sinus X-ray (limited)
|
$160.00 |
$263.20 |
$368.00 |
|
|
Sirolimus, oral
|
$15.50 |
$53.42 |
$1,060.00 |
|
|
Skin Biopsy
|
$420.80 |
$420.80 |
$460.80 |
|
|
Skull X-ray (1 to 3 views)
|
$220.80 |
$383.20 |
$396.00 |
|
|
Skull X-ray (complete)
|
$251.20 |
$530.40 |
$545.60 |
|
|
Skyla, 13.5 mg
|
$754.71 |
$754.71 |
$969.82 |
|
|
Sleep Study (Polysomnography)
|
$3,659.20 |
$3,964.80 |
$4,540.80 |
|
|
Sleep study unattended
|
$544.80 |
$544.80 |
$763.20 |
|
|
Sleeve fing rolyan med
|
$148.88 |
$148.88 |
$276.80 |
|
|
Sling pelv split sam med
|
$147.38 |
$147.38 |
$215.23 |
|
|
Sling suprapubic suburetheral
|
$17,960.80 |
$17,960.80 |
$19,593.60 |
|
|
Slitting of prepuce
|
$2,772.00 |
$2,772.00 |
$2,858.40 |
|
|
Slp eval for nonspeech dev ea addl 30 mins
|
$236.80 |
$236.80 |
$236.80 |
|
|
Slp eval non-spch gen comm dev
|
$461.60 |
$461.60 |
$461.60 |
|
|
Slp ther svc non-spch gen
|
$284.80 |
$284.80 |
$284.80 |
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$405.60 |
$741.60 |
$752.00 |
|
|
Small bowel endoscopy
|
$2,467.20 |
$2,467.20 |
$2,467.20 |
|
|
Small bowel endoscopy
|
$2,399.20 |
$2,399.20 |
$2,399.20 |
|
|
Small bowel endoscopy
|
$2,455.20 |
$2,455.20 |
$2,455.20 |
|
|
Small bowel endoscopy
|
$2,545.60 |
$2,545.60 |
$2,545.60 |
|
|
Small bowel endoscopy
|
$2,308.80 |
$2,308.80 |
$2,308.80 |
|
|
Small bowel endoscopy
|
$2,623.20 |
$2,623.20 |
$2,623.20 |
|
|
Small bowel endoscopy
|
$2,396.80 |
$2,396.80 |
$2,396.80 |
|
|
Small bowel endoscopy
|
$5,757.60 |
$5,757.60 |
$5,757.60 |
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$2,677.60 |
$2,677.60 |
$2,677.60 |
|
|
Small bowel endoscopy/biopsy
|
$2,467.20 |
$2,467.20 |
$2,467.20 |
|
|
Small bowel endoscopy/biopsy
|
$2,676.80 |
$2,676.80 |
$2,676.80 |
|
|
Small bowel endoscopy br/wa
|
$2,262.40 |
$2,262.40 |
$2,262.40 |
|
|
Small bowel endoscopy br/wa
|
$2,406.40 |
$2,406.40 |
$2,406.40 |
|
|
Small bowel endoscopy/stent 44370
|
$6,381.60 |
$6,381.60 |
$6,381.60 |
|
|
Smear fluorescent and/or acid fast stain
|
$35.20 |
$35.20 |
$35.20 |
|
|
Smear gram stain
|
$28.80 |
$28.80 |
$28.80 |
|
|
Smear nasal eosinophil
|
$24.00 |
$24.00 |
$24.00 |
|
|
Smear special stain inclusion bodies/parasites
|
$45.60 |
$45.60 |
$45.60 |
|
|
Smear wet mount
|
$27.20 |
$27.20 |
$27.20 |
|
|
So cap design without jnts cf
|
$1,104.80 |
$1,104.80 |
$1,115.56 |
|
|
Socket insert without lock mech
|
$1,629.94 |
$1,629.94 |
$1,629.94 |
|
|
Sock fracture or equal each
|
$18.99 |
$18.99 |
$41.60 |
|
|
Sodium 24 hour urine
|
$56.00 |
$56.00 |
$56.00 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$40.00 |
$60.00 |
$60.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$60.00 |
$60.00 |
$240.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$0.02 |
$48.00 |
$200.00 |
|
|
Sodium chloride 3 % ivpb
|
$1.49 |
$2.40 |
$5.08 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$63.99 |
$63.99 |
$103.57 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$373.91 |
$373.91 |
$373.91 |
|
|
Sodium serum/plasma/whole blood
|
$32.80 |
$32.80 |
$32.80 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$71.86 |
$71.86 |
$142.07 |
|
|
Soft interface below knee se
|
$103.81 |
$103.81 |
$103.81 |
|
|
Somatosensory testing
|
$531.20 |
$531.20 |
$531.20 |
|
|
Sotalol hydrochloride IV
|
$114,699.07 |
$114,699.07 |
$114,699.07 |
|
|
So vest canvas/web pre ots
|
$342.33 |
$342.33 |
$410.80 |
|
|
Special physics consult
|
$492.80 |
$492.80 |
$1,028.80 |
|
|
Special radiation dosimetry
|
$62.40 |
$62.40 |
$709.60 |
|
|
Special radiation treatment
|
$291.20 |
$291.20 |
$3,086.40 |
|
|
Special teletx port plan
|
$276.80 |
$276.80 |
$1,494.40 |
|
|
Specimen fat stain
|
$30.40 |
$30.40 |
$30.40 |
|
|
Speech and Language Evaluation (comprehensive)
|
$468.00 |
$468.00 |
$568.80 |
|
|
Speech audiometry complete
|
$121.60 |
$121.60 |
$121.60 |
|
|
Speech evaluation complex
|
$415.20 |
$415.20 |
$415.20 |
|