|
Smpd1 gene common variants
|
$210.60 |
$210.60 |
$210.60 |
$133.84
|
|
Snrpn/ube3a gene
|
$228.80 |
$228.80 |
$228.80 |
$230.63
|
|
Sock fracture or equal each
|
$123.50 |
$123.50 |
$123.50 |
$74.51
|
|
Sock wool above knee
|
$68.90 |
$68.90 |
$68.90 |
$51.18
|
|
Sodium 24 hour urine
|
$22.75 |
$22.75 |
$22.75 |
$48.68
|
|
Sodium chloride 0.9 % intravenous solution
|
$3.25 |
$3.25 |
$3.25 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$14.95 |
$14.95 |
$14.95 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$2.93 |
$2.93 |
$2.93 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$0.60 |
$0.60 |
$0.60 |
$39.60
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$14.88 |
$14.88 |
$14.88 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,184.54 |
$1,184.54 |
$1,184.54 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$21.45 |
$21.45 |
$21.45 |
$46.00
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$4.68 |
$4.68 |
$4.68 |
$177.52
|
|
Soft interface below knee se
|
$242.45 |
$242.45 |
$242.45 |
$179.08
|
|
Somatropin injection
|
$2,770.40 |
$2,770.40 |
$2,770.40 |
$2,111.40
|
|
Sotalol hydrochloride IV
|
$771.26 |
$771.26 |
$771.26 |
$5,761.57
|
|
So vest canvas/web pre ots
|
$150.80 |
$150.80 |
$150.80 |
$256.54
|
|
Spacer bag/reservoir
|
$31.20 |
$31.20 |
$31.20 |
$26.00
|
|
Sp bone agrft morsel add-on
|
$725.40 |
$725.40 |
$725.40 |
$406.40
|
|
Sp bone agrft struct add-on
|
$785.20 |
$785.20 |
$785.20 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$498.55 |
$498.55 |
$498.55 |
$498.55
|
|
Special casting material
|
$47.45 |
$47.45 |
$47.45 |
$47.45
|
|
Special physics consult
|
$735.15 |
$735.15 |
$735.15 |
$725.00
|
|
Special radiation dosimetry
|
$844.35 |
$844.35 |
$844.35 |
$392.73
|
|
Special radiation treatment
|
$3,174.60 |
$3,174.60 |
$3,174.60 |
$2,052.00
|
|
Special supplies phys/qhp
|
$31.85 |
$31.85 |
$31.85 |
$60.00
|
|
Special teletx port plan
|
$1,913.60 |
$1,913.60 |
$1,913.60 |
$1,100.00
|
|
Specific gravity body fluid
|
$14.95 |
$14.95 |
$14.95 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$998.40 |
$998.40 |
$998.40 |
$385.00
|
|
Speech audiometry complete
|
$154.70 |
$154.70 |
$154.70 |
$109.20
|
|
Speech recep thresh
|
$154.70 |
$154.70 |
$154.70 |
$82.88
|
|
Speech Therapy Session (one-on-one)
|
$338.00 |
$338.00 |
$338.00 |
$248.84
|
|
Sperm antibody test
|
$136.50 |
$136.50 |
$136.50 |
$57.85
|
|
Sperm evaluation test
|
$87.75 |
$87.75 |
$87.75 |
$27.03
|
|
Sperm isolation complex
|
$325.00 |
$325.00 |
$325.00 |
$176.28
|
|
Sperm isolation simple
|
$174.20 |
$174.20 |
$174.20 |
$126.05
|
|
Sperm washing 58323
|
$59.80 |
$59.80 |
$59.80 |
$238.06
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$3,159.00 |
$3,159.00 |
$3,159.00 |
$3,245.23
|
|
Spinal bone allograftstructural 20931
|
$470.60 |
$470.60 |
$470.60 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$707.85 |
$707.85 |
$707.85 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$3,105.70 |
$3,105.70 |
$3,105.70 |
$1,474.00
|
|
Spine X-ray (single view, one level)
|
$436.80 |
$436.80 |
$436.80 |
$251.40
|
|
Spirometry up to 2 yrs old
|
$455.00 |
$455.00 |
$455.00 |
$242.25
|
|
Splenectomy total open 38100
|
$5,083.00 |
$5,083.00 |
$5,083.00 |
$2,166.00
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$471.90 |
$471.90 |
$471.90 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$68.25 |
$68.25 |
$68.25 |
$68.25
|
|
Splint finger 4 prong foam sm
|
$20.80 |
$20.80 |
$20.80 |
$34.00
|
|
Splint finger frog med
|
$40.95 |
$40.95 |
$40.95 |
$38.08
|
|
Splint fing stax assort 1-7in
|
$5.85 |
$5.85 |
$5.85 |
$5.60
|
|
Splint rstrc wrst/cmc right med
|
$68.25 |
$68.25 |
$68.25 |
$100.00
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$7,138.95 |
$7,138.95 |
$7,138.95 |
$4,687.20
|
|
Split blood or products
|
$768.30 |
$768.30 |
$768.30 |
$129.50
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$520.00 |
$520.00 |
$520.00 |
$1,612.78
|
|
Spontaneous nystagmus study
|
$681.20 |
$681.20 |
$681.20 |
$130.65
|
|
Sprchoroidal spc njx rx agt
|
$991.90 |
$991.90 |
$991.90 |
$454.19
|
|
Srs cranial lesion complex
|
$5,161.00 |
$5,161.00 |
$5,161.00 |
$3,244.00
|
|
Srs cranial lesion simple
|
$3,621.80 |
$3,621.80 |
$3,621.80 |
$3,145.05
|
|
Srs cran les complex addl
|
$1,250.60 |
$1,250.60 |
$1,250.60 |
$711.20
|
|
Srs cran les simple addl
|
$904.80 |
$904.80 |
$904.80 |
$719.20
|
|
Srs linear based
|
$34,285.55 |
$34,285.55 |
$34,285.55 |
$14,124.25
|
|
Srs multisource
|
$34,285.55 |
$34,285.55 |
$34,285.55 |
$35,192.81
|
|
Srs spinal lesion
|
$4,461.60 |
$4,461.60 |
$4,461.60 |
$2,631.20
|
|
Srs spinal lesion addl
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$591.20
|
|
St analysis behavior qualitative voice/resonance
|
$499.20 |
$499.20 |
$499.20 |
$297.68
|
|
Staph a dna amp probe
|
$157.30 |
$157.30 |
$157.30 |
$125.00
|
|
Static or dynami afo pre ots
|
$664.95 |
$664.95 |
$664.95 |
$291.20
|
|
St cognitve performance testing healthcare professional each hour
|
$442.00 |
$442.00 |
$442.00 |
$286.00
|
|
Stenger test speech
|
$93.60 |
$93.60 |
$93.60 |
$404.25
|
|
Stent axios caut enh 15x10mm electrocaut
|
$12,916.15 |
$12,916.15 |
$12,916.15 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$395.85 |
$395.85 |
$395.85 |
$2,649.79
|
|
Stent bili rx wallflx 10x80 uncvr
|
$32,740.50 |
$32,740.50 |
$32,740.50 |
$20,962.50
|
|
Stent placemt retro carotid
|
$5,298.80 |
$5,298.80 |
$5,298.80 |
$5,328.00
|
|
Stereotactic bx aspir/exc burr intracranial les 61750
|
$5,155.80 |
$5,155.80 |
$5,155.80 |
$3,308.00
|
|
Sternal debridement
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$1,318.40
|
|
St evaluate speech sound production
|
$499.20 |
$499.20 |
$499.20 |
$293.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$538.85 |
$538.85 |
$538.85 |
$400.00
|
|
Stomach Emptying Scan (Nuclear Medicine)
|
$2,028.65 |
$2,028.65 |
$2,028.65 |
$1,345.40
|
|
Storage/year embryo(s)
|
$455.00 |
$455.00 |
$455.00 |
$236.00
|
|
Storage/year oocyte(s)
|
$325.00 |
$325.00 |
$325.00 |
$236.00
|
|
Stot/tot hysterectomy after cesaren delivery 59525
|
$2,723.50 |
$2,723.50 |
$2,723.50 |
$2,723.50
|
|
Strapping of ankle and/or ft 29540
|
$471.90 |
$471.90 |
$471.90 |
$223.45
|
|
Strapping of elbow or wrist 29260
|
$177.45 |
$177.45 |
$177.45 |
$157.46
|
|
Strapping of hand or finger
|
$177.45 |
$177.45 |
$177.45 |
$177.45
|
|
Strapping of knee
|
$385.45 |
$385.45 |
$385.45 |
$205.20
|
|
Strep a ag ia
|
$75.40 |
$75.40 |
$75.40 |
$75.40
|
|
Strep b dna amp probe
|
$157.30 |
$157.30 |
$157.30 |
$124.15
|
|
Streptomycin injection
|
$175.50 |
$175.50 |
$175.50 |
$138.30
|
|
Stress test pulmonary
|
$510.25 |
$510.25 |
$510.25 |
$324.00
|
|
Stress tte complete
|
$2,049.45 |
$2,049.45 |
$2,049.45 |
$1,900.96
|
|
Str markers specimen anal
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$751.50
|
|
Subq i/p critical care pr day age 28 days/less than 99469
|
$2,285.40 |
$2,285.40 |
$2,285.40 |
$717.60
|
|
Subq njx filling matrl 1cc/<
|
$218.40 |
$218.40 |
$218.40 |
$235.13
|
|
Subq njx fil matrl 5.1-10cc
|
$439.40 |
$439.40 |
$439.40 |
$988.00
|
|
Subsequent intensive care infant 1500-2500 grams 99479
|
$715.00 |
$715.00 |
$715.00 |
$224.80
|
|
Subsequent intensive care infant 2501-5000 grams 99480
|
$686.40 |
$686.40 |
$686.40 |
$216.00
|
|
Subtalar arthro w/deb
|
$2,509.00 |
$2,509.00 |
$2,509.00 |
$3,839.54
|
|
Subtemporal cranial dcmprn
|
$5,228.60 |
$5,228.60 |
$5,228.60 |
$2,208.33
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$4.54 |
$4.54 |
$4.54 |
$54.80
|
|
Suction lipectomy head&neck
|
$1,596.40 |
$1,596.40 |
$1,596.40 |
$4,332.25
|
|
Suction lipectomy lwr extrem
|
$3,016.00 |
$3,016.00 |
$3,016.00 |
$5,661.00
|
