|
Screening Colonoscopy (high risk)
|
$2,370.55 |
$2,370.55 |
$2,370.55 |
$2,000.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$33.15 |
$33.15 |
$33.15 |
$57.60
|
|
Screening Mammogram
|
$593.45 |
$593.45 |
$593.45 |
$310.20
|
|
Screening prostate cancer PSA
|
$49.40 |
$49.40 |
$49.40 |
$101.60
|
|
Screen pap by tech w md supv
|
$81.90 |
$81.90 |
$81.90 |
$53.46
|
|
Screen/visual acuity/bilat/quant 99173
|
$117.00 |
$117.00 |
$117.00 |
$28.86
|
|
Scrotal (Testicle) Ultrasound
|
$643.50 |
$643.50 |
$643.50 |
$612.55
|
|
Sec abd wall suture evisceration/dehsn 49900
|
$3,226.60 |
$3,226.60 |
$3,226.60 |
$2,005.60
|
|
Sec art mech thrmbc non-intracranial add-on
|
$4,570.15 |
$4,570.15 |
$4,570.15 |
$4,380.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$455.65 |
$455.65 |
$455.65 |
$223.89
|
|
Sedimentation rate erythrocyte automated
|
$12.35 |
$12.35 |
$12.35 |
$42.00
|
|
Segmentectomy 32484
|
$6,598.80 |
$6,598.80 |
$6,598.80 |
$2,915.40
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$178.10 |
$178.10 |
$178.10 |
$94.25
|
|
Self-meas bp 2 readg bid 30d
|
$46.80 |
$46.80 |
$46.80 |
$11.30
|
|
Self-meas bp pt educaj/train
|
$143.65 |
$143.65 |
$143.65 |
$29.55
|
|
Self-mgmt educ/train 2-4 pt 30min
|
$61.75 |
$61.75 |
$61.75 |
$51.98
|
|
Self-mgmt educ/train 5-8 pt 30min
|
$54.60 |
$54.60 |
$54.60 |
$33.04
|
|
Semen analysis
|
$29.25 |
$29.25 |
$29.25 |
$13.60
|
|
Semen analysis presence/motility
|
$124.15 |
$124.15 |
$124.15 |
$70.40
|
|
Serial tonometry
|
$174.20 |
$174.20 |
$174.20 |
$131.02
|
|
Serpina1 gene
|
$195.65 |
$195.65 |
$195.65 |
$195.65
|
|
Set radiation therapy field
|
$795.60 |
$795.60 |
$795.60 |
$787.50
|
|
Set radiation therapy field
|
$1,641.90 |
$1,641.90 |
$1,641.90 |
$1,183.38
|
|
Set radiation therapy field
|
$2,087.80 |
$2,087.80 |
$2,087.80 |
$1,641.90
|
|
Sf3b1 gene common variants
|
$866.45 |
$866.45 |
$866.45 |
$248.10
|
|
Sgmdsc w/band ligation
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$387.40 |
$387.40 |
$387.40 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$387.40 |
$387.40 |
$387.40 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$779.35 |
$779.35 |
$779.35 |
$442.22
|
|
Shave sgl skin lsn f/e/e/n/l/m >2cm
|
$779.35 |
$779.35 |
$779.35 |
$472.79
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$387.40 |
$387.40 |
$387.40 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$387.40 |
$387.40 |
$387.40 |
$223.00
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$387.40 |
$387.40 |
$387.40 |
$269.50
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$779.35 |
$779.35 |
$779.35 |
$400.40
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$779.35 |
$779.35 |
$779.35 |
$314.00
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$387.40 |
$387.40 |
$387.40 |
$235.13
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$387.40 |
$387.40 |
$387.40 |
$289.30
|
|
Sho arthrs dx +- synovial bx
|
$1,567.80 |
$1,567.80 |
$1,567.80 |
$3,839.54
|
|
Sho arthrs srg bicp tenodsis
|
$3,763.50 |
$3,763.50 |
$3,763.50 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$3,936.40 |
$3,936.40 |
$3,936.40 |
$7,166.67
|
|
Sho arthrs srg compl synvct
|
$2,051.40 |
$2,051.40 |
$2,051.40 |
$4,399.11
|
|
Sho arthrs srg lmtd dbrdmt
|
$2,010.45 |
$2,010.45 |
$2,010.45 |
$4,807.00
|
|
Sho arthrs srg lss&rescj ads
|
$2,025.40 |
$2,025.40 |
$2,025.40 |
$3,839.54
|
|
Sho arthrs srg prtl synvct
|
$1,874.60 |
$1,874.60 |
$1,874.60 |
$5,886.74
|
|
Sho arthrs srg rmvl loose/fb
|
$2,025.40 |
$2,025.40 |
$2,025.40 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$3,814.20 |
$3,814.20 |
$3,814.20 |
$6,740.20
|
|
Sho arthrs srg xtnsv dbrdmt
|
$2,282.15 |
$2,282.15 |
$2,282.15 |
$5,148.00
|
|
Shoe heel pad & depress for
|
$25.35 |
$25.35 |
$25.35 |
$149.60
|
|
Shoe post-op mens m
|
$99.45 |
$99.45 |
$99.45 |
$53.20
|
|
Shorten radius or ulna
|
$2,782.00 |
$2,782.00 |
$2,782.00 |
$6,609.96
|
|
Shot (Injection into Muscle or Under the Skin)
|
$319.15 |
$319.15 |
$319.15 |
$135.85
|
|
Shoulder AC Joint X-ray (both sides)
|
$446.55 |
$446.55 |
$446.55 |
$268.80
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$4,053.40 |
$4,053.40 |
$4,053.40 |
$7,907.11
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$525.85 |
$525.85 |
$525.85 |
$288.75
|
|
Shoulder MRI (with and without contrast)
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$2,739.30
|
|
Shoulder MRI (with contrast)
|
$3,543.15 |
$3,543.15 |
$3,543.15 |
$2,449.85
|
|
Shoulder MRI (without contrast)
|
$1,084.20 |
$1,084.20 |
$1,084.20 |
$2,060.00
|
|
Shoulder prosthesis removal
|
$4,030.00 |
$4,030.00 |
$4,030.00 |
$3,870.38
|
|
Shoulder prosthesis removal
|
$4,940.00 |
$4,940.00 |
$4,940.00 |
$4,832.80
|
|
Shoulder X-ray
|
$446.55 |
$446.55 |
$446.55 |
$340.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$438.10 |
$438.10 |
$438.10 |
$260.40
|
|
Shuntogram nonvascular supervision & interpretation
|
$477.10 |
$477.10 |
$477.10 |
$359.55
|
|
Sialidase enzyme assay
|
$54.60 |
$54.60 |
$54.60 |
$54.99
|
|
Sialolithotomy 42330
|
$587.60 |
$587.60 |
$587.60 |
$3,864.00
|
|
Sickling rbc
|
$24.70 |
$24.70 |
$24.70 |
$56.99
|
|
Sigmoidoscopy and biopsy
|
$326.30 |
$326.30 |
$326.30 |
$1,459.20
|
|
Sigmoidoscopy flex decompression 45337
|
$600.60 |
$600.60 |
$600.60 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$2,726.10 |
$2,726.10 |
$2,726.10 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$503.10 |
$503.10 |
$503.10 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$17,798.95 |
$17,798.95 |
$17,798.95 |
$3,692.00
|
|
Sigmoidoscopy w/resection
|
$1,006.85 |
$1,006.85 |
$1,006.85 |
$2,997.10
|
|
Sigmoidoscopy w/tumr remove
|
$586.30 |
$586.30 |
$586.30 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$606.45 |
$606.45 |
$606.45 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$2,726.10 |
$2,726.10 |
$2,726.10 |
$1,976.25
|
|
Sig w/tndsc balloon dilation
|
$357.50 |
$357.50 |
$357.50 |
$2,288.00
|
|
Sim ang w/prs cath rad emb
|
$20,094.75 |
$20,094.75 |
$20,094.75 |
$18,145.20
|
|
Simple cystometrogram 51725
|
$727.35 |
$727.35 |
$727.35 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$305.29 |
$305.29 |
$305.29 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$798.20 |
$798.20 |
$798.20 |
$1,788.60
|
|
Sinus CT scan (with contrast)
|
$798.20 |
$798.20 |
$798.20 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$720.20 |
$720.20 |
$720.20 |
$1,283.87
|
|
Sinus/juglr venogram s&i
|
$14,413.10 |
$14,413.10 |
$14,413.10 |
$2,537.60
|
|
Sinus X-ray (complete)
|
$458.25 |
$458.25 |
$458.25 |
$345.24
|
|
Sinus X-ray (limited)
|
$439.40 |
$439.40 |
$439.40 |
$214.50
|
|
Sipuleucel-t - su
|
$585.96 |
$585.96 |
$585.96 |
$100,990.51
|
|
Sirolimus, oral
|
$56.88 |
$56.88 |
$56.88 |
$41.70
|
|
Skel musc relaxant 3 or more
|
$49.40 |
$49.40 |
$49.40 |
$16.12
|
|
Skin Biopsy
|
$387.40 |
$387.40 |
$387.40 |
$362.40
|
|
Skin full graft 20sq cm less 15200
|
$2,379.00 |
$2,379.00 |
$2,379.00 |
$2,379.00
|
|
Skin full graft add-on 15241
|
$531.70 |
$531.70 |
$531.70 |
$560.01
|
|
Skin split graft addl 100sq cm 15101
|
$447.20 |
$447.20 |
$447.20 |
$1,793.40
|
|
Skull base/brainstem surgery
|
$9,505.60 |
$9,505.60 |
$9,505.60 |
$3,770.91
|
|
Skull X-ray (1 to 3 views)
|
$528.45 |
$528.45 |
$528.45 |
$295.10
|
|
Skull X-ray (complete)
|
$549.90 |
$549.90 |
$549.90 |
$417.50
|
|
Skyla, 13.5 mg
|
$1,577.76 |
$1,577.76 |
$1,577.76 |
$1,643.47
|
|
Sleep study attended
|
$2,745.60 |
$2,745.60 |
$2,745.60 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$5,278.00 |
$5,278.00 |
$5,278.00 |
$3,721.41
|