|
Shoe wedge sach
|
$742.49 |
$742.49 |
$742.49 |
$171.44
|
|
Sho heel count plast reinfor
|
$1,396.01 |
$1,396.01 |
$1,396.01 |
$346.47
|
|
Sho insert w arch toe filler
|
$4,507.82 |
$4,507.82 |
$4,507.82 |
$1,224.38
|
|
Sho lift taper to metatarsal
|
$482.21 |
$482.21 |
$482.21 |
$111.14
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$28,535.67 |
$28,535.67 |
$28,535.67 |
$6,311.00
|
|
Shoulder X-ray
|
$427.20 |
$427.20 |
$427.20 |
$340.10
|
|
Shrinker prosth above knee
|
$735.64 |
$735.64 |
$735.64 |
$168.89
|
|
Shrinker prosth below knee
|
$517.48 |
$517.48 |
$517.48 |
$103.41
|
|
Shunt glaucoma baerveldt 350mm
|
$13,010.85 |
$13,010.85 |
$13,010.85 |
$4,636.80
|
|
Shuntogram nonvascular supervision & interpretation
|
$349.20 |
$349.20 |
$349.20 |
$354.60
|
|
Sialography s&i
|
$642.00 |
$642.00 |
$642.00 |
$519.42
|
|
Sickling rbc
|
$55.20 |
$55.20 |
$55.20 |
$56.00
|
|
Sigmoidoscopy w/tumr remove
|
$4,008.18 |
$4,008.18 |
$4,008.18 |
$1,398.60
|
|
Sigmoidoscopy w/ultrasound
|
$10,076.58 |
$10,076.58 |
$10,076.58 |
$1,740.57
|
|
Sincalide 5 mcg solution for injection
|
$1,526.46 |
$1,526.46 |
$1,526.46 |
$309.04
|
|
Sinus CT scan (with and without contrast)
|
$1,900.80 |
$1,900.80 |
$1,900.80 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$1,668.60 |
$1,668.60 |
$1,668.60 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,007.40 |
$1,007.40 |
$1,007.40 |
$1,290.19
|
|
Sinus/juglr venogram s&i
|
$3,290.40 |
$3,290.40 |
$3,290.40 |
$2,565.95
|
|
Sio flex pelvisacral custom
|
$2,328.35 |
$2,328.35 |
$2,328.35 |
$561.79
|
|
Sio rig pnl pelv/sac pre ots
|
$1,541.71 |
$1,541.71 |
$1,541.71 |
$418.75
|
|
Sirolimus, oral
|
$12.18 |
$12.18 |
$12.18 |
$41.25
|
|
Skin Biopsy
|
$15,982.44 |
$15,982.44 |
$15,982.44 |
$360.34
|
|
Skin full graft 20sq cm less 15200
|
$19,063.92 |
$19,063.92 |
$19,063.92 |
$2,371.50
|
|
Sleeve fing rolyan med
|
$1,691.65 |
$1,691.65 |
$1,691.65 |
$204.60
|
|
Sling pelv split sam med
|
$751.09 |
$751.09 |
$751.09 |
$147.38
|
|
Sling suprapubic suburetheral
|
$24,036.00 |
$24,036.00 |
$24,036.00 |
$9,077.08
|
|
Small bowel endoscopy
|
$10,751.82 |
$10,751.82 |
$10,751.82 |
$2,244.82
|
|
Small bowel endoscopy
|
$3,177.84 |
$3,177.84 |
$3,177.84 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$24,538.85 |
$24,538.85 |
$24,538.85 |
$2,234.01
|
|
Smear fluorescent and/or acid fast stain
|
$66.60 |
$66.60 |
$66.60 |
$64.00
|
|
Smear gram stain
|
$42.60 |
$42.60 |
$42.60 |
$53.64
|
|
Smear nasal eosinophil
|
$27.00 |
$27.00 |
$27.00 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$241.80 |
$241.80 |
$241.80 |
$71.20
|
|
Smear wet mount
|
$35.40 |
$35.40 |
$35.40 |
$66.30
|
|
Smpd1 gene common variants
|
$330.60 |
$330.60 |
$330.60 |
$140.00
|
|
Snrpn/ube3a gene
|
$252.60 |
$252.60 |
$252.60 |
$228.80
|
|
So airplane w/wo joint cf
|
$7,643.45 |
$7,643.45 |
$7,643.45 |
$1,276.80
|
|
So cap design without jnts cf
|
$5,826.56 |
$5,826.56 |
$5,826.56 |
$856.10
|
|
Socket insert without lock mech
|
$4,734.87 |
$4,734.87 |
$4,734.87 |
$1,192.50
|
|
Sock fracture or equal each
|
$281.20 |
$281.20 |
$281.20 |
$74.51
|
|
Sodium 24 hour urine
|
$50.40 |
$50.40 |
$50.40 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$75.00 |
$75.00 |
$75.00 |
$48.00
|
|
Sodium chloride 0.9 % IV bolus
|
$120.00 |
$120.00 |
$120.00 |
$43.45
|
|
Sodium chloride 0.9 % IV bolus
|
$63.78 |
$63.78 |
$63.78 |
$36.21
|
|
Sodium chloride 3 % ivpb
|
$180.18 |
$180.18 |
$180.18 |
$37.80
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$372.06 |
$372.06 |
$372.06 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,315.56 |
$1,315.56 |
$1,315.56 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$28.20 |
$28.20 |
$28.20 |
$45.50
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$21.72 |
$21.72 |
$21.72 |
$177.52
|
|
Soft interface below knee se
|
$659.31 |
$659.31 |
$659.31 |
$179.08
|
|
So vest canvas/web pre ots
|
$1,391.56 |
$1,391.56 |
$1,391.56 |
$256.54
|
|
Sp bone agrft morsel add-on
|
$122,928.95 |
$122,928.95 |
$122,928.95 |
$406.40
|
|
Sp bone algrft morsel add-on
|
$145,454.78 |
$145,454.78 |
$145,454.78 |
$498.55
|
|
Special physics consult
|
$1,362.60 |
$1,362.60 |
$1,362.60 |
$709.00
|
|
Special radiation dosimetry
|
$1,085.40 |
$1,085.40 |
$1,085.40 |
$393.25
|
|
Special radiation treatment
|
$3,379.20 |
$3,379.20 |
$3,379.20 |
$1,945.00
|
|
Special teletx port plan
|
$2,064.60 |
$2,064.60 |
$2,064.60 |
$1,056.31
|
|
Specific gravity body fluid
|
$24.00 |
$24.00 |
$24.00 |
$21.60
|
|
Sperm antibody test
|
$108.60 |
$108.60 |
$108.60 |
$57.85
|
|
Spinal bone allograftstructural 20931
|
$72,342.87 |
$72,342.87 |
$72,342.87 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$145,454.78 |
$145,454.78 |
$145,454.78 |
$424.20
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$4,017.69 |
$4,017.69 |
$4,017.69 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$520.76 |
$520.76 |
$520.76 |
$77.51
|
|
Splint finger fold over sm
|
$765.78 |
$765.78 |
$765.78 |
$144.05
|
|
Splint finger frog med
|
$779.30 |
$779.30 |
$779.30 |
$38.08
|
|
Splint rstrc wrst/cmc right med
|
$765.78 |
$765.78 |
$765.78 |
$100.75
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$16,033.86 |
$16,033.86 |
$16,033.86 |
$4,713.66
|
|
Split blood or products
|
$273.60 |
$273.60 |
$273.60 |
$127.80
|
|
Srs linear based
|
$16,255.20 |
$16,255.20 |
$16,255.20 |
$14,124.25
|
|
Staph a dna amp probe
|
$192.00 |
$192.00 |
$192.00 |
$125.00
|
|
Static or dynami afo pre ots
|
$2,415.41 |
$2,415.41 |
$2,415.41 |
$284.60
|
|
Stent axios caut enh 15x10mm electrocaut
|
$36,625.78 |
$36,625.78 |
$36,625.78 |
$32,403.15
|
|
Stent bili dbl pgtl 10fx5cm
|
$29,440.80 |
$29,440.80 |
$29,440.80 |
$2,301.33
|
|
Stent bili rx wallflx 10x80 uncvr
|
$32,557.45 |
$32,557.45 |
$32,557.45 |
$20,300.00
|
|
Stent bronch dumon sil 10x40mm
|
$3,381.57 |
$3,381.57 |
$3,381.57 |
$4,673.50
|
|
Stent iliac/open or perc/uni/init 37221
|
$103,487.11 |
$103,487.11 |
$103,487.11 |
$14,356.50
|
|
Stent placemt retro carotid
|
$19,841.40 |
$19,841.40 |
$19,841.40 |
$5,328.00
|
|
Sterile water/saline, 10 ml
|
$45.00 |
$45.00 |
$45.00 |
$13.32
|
|
Sternal pad
|
$874.09 |
$874.09 |
$874.09 |
$216.89
|
|
Stimulants synthetic
|
$159.60 |
$159.60 |
$159.60 |
$80.08
|
|
Stocking sup grips 4 pre ots
|
$144.60 |
$144.60 |
$144.60 |
$31.58
|
|
Straight knee joint heavy du
|
$1,280.07 |
$1,280.07 |
$1,280.07 |
$317.69
|
|
Strapping of ankle and/or ft 29540
|
$300.00 |
$300.00 |
$300.00 |
$217.70
|
|
Strep b dna amp probe
|
$99.60 |
$99.60 |
$99.60 |
$126.10
|
|
Streptomycin injection
|
$877.50 |
$877.50 |
$877.50 |
$143.00
|
|
Str markers specimen anal
|
$790.20 |
$790.20 |
$790.20 |
$800.30
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$9.48 |
$9.48 |
$9.48 |
$53.40
|
|
Sugars single quant
|
$240.60 |
$240.60 |
$240.60 |
$58.80
|
|
Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution
|
$7,727.16 |
$7,727.16 |
$7,727.16 |
$7,487.55
|
|
Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution
|
$440.16 |
$440.16 |
$440.16 |
$82.43
|
|
Support clav 29.6-40.5in med
|
$2,205.65 |
$2,205.65 |
$2,205.65 |
$94.19
|
|
Surgical pathology level 1 gross examination only
|
$124.20 |
$124.20 |
$124.20 |
$79.20
|
|
Surgical pathology level 2 gross & microscopic examination
|
$186.00 |
$186.00 |
$186.00 |
$143.65
|
|
Surgical pathology level 3 gross & microscopic examination
|
$302.40 |
$302.40 |
$302.40 |
$182.25
|
|
Surgical pathology level 4 gross & microscopic examination
|
$360.00 |
$360.00 |
$360.00 |
$252.60
|
|
Surgical pathology level 5 gross & microscopic examination
|
$597.00 |
$597.00 |
$597.00 |
$480.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$658.20 |
$658.20 |
$658.20 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$101.40 |
$101.40 |
$101.40 |
$43.00
|
|
Susceptibility enzyme detection per enzyme
|
$52.80 |
$52.80 |
$52.80 |
$35.40
|
