|
Screening Colonoscopy (average risk)
|
$2,442.70 |
$2,442.70 |
$2,442.70 |
$1,278.72
|
|
Screening Colonoscopy (high risk)
|
$2,442.70 |
$2,442.70 |
$2,442.70 |
$1,575.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$141.05 |
$141.05 |
$141.05 |
$57.60
|
|
Screening Mammogram
|
$171.60 |
$171.60 |
$171.60 |
$303.55
|
|
Screening prostate cancer PSA
|
$53.95 |
$53.95 |
$53.95 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$11,541.37 |
$11,541.37 |
$11,541.37 |
$28,750.65
|
|
Sec art mech thrmbc non-intracranial add-on
|
$7,474.35 |
$7,474.35 |
$7,474.35 |
$4,565.60
|
|
Sedimentation rate erythrocyte automated
|
$38.35 |
$38.35 |
$38.35 |
$44.20
|
|
Semen analysis w/count
|
$274.30 |
$274.30 |
$274.30 |
$56.44
|
|
Serpina1 gene
|
$174.85 |
$174.85 |
$174.85 |
$191.73
|
|
Sertraline (zoloft) - sendout
|
$217.75 |
$217.75 |
$217.75 |
$173.16
|
|
Set radiation therapy field
|
$1,582.75 |
$1,582.75 |
$1,582.75 |
$731.50
|
|
Set radiation therapy field
|
$2,827.50 |
$2,827.50 |
$2,827.50 |
$1,102.40
|
|
Set radiation therapy field
|
$4,680.65 |
$4,680.65 |
$4,680.65 |
$1,636.36
|
|
Sgmdsc w/band ligation
|
$2,685.80 |
$2,685.80 |
$2,685.80 |
$1,645.43
|
|
Shave sgl skin lsn s/n/h/f/g 1.1-2cm
|
$313.95 |
$313.95 |
$313.95 |
$275.88
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$142.35 |
$142.35 |
$142.35 |
$311.25
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$284.70 |
$284.70 |
$284.70 |
$235.13
|
|
Shoe post-op mens m
|
$51.25 |
$51.25 |
$51.25 |
$41.56
|
|
Shoulder MRI (with and without contrast)
|
$5,696.60 |
$5,696.60 |
$5,696.60 |
$2,705.30
|
|
Shoulder MRI (with contrast)
|
$5,179.20 |
$5,179.20 |
$5,179.20 |
$2,449.80
|
|
Shoulder MRI (without contrast)
|
$4,708.60 |
$4,708.60 |
$4,708.60 |
$2,051.28
|
|
Shoulder X-ray
|
$690.30 |
$690.30 |
$690.30 |
$367.02
|
|
Shuntogram nonvascular supervision & interpretation
|
$1,009.45 |
$1,009.45 |
$1,009.45 |
$345.00
|
|
Sialography s&i
|
$684.45 |
$684.45 |
$684.45 |
$462.40
|
|
Sickling rbc
|
$120.25 |
$120.25 |
$120.25 |
$53.55
|
|
Sigmoidoscopy and biopsy
|
$2,727.40 |
$2,727.40 |
$2,727.40 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$2,890.55 |
$2,890.55 |
$2,890.55 |
$1,073.68
|
|
Sigmoidoscopy for bleeding
|
$3,014.05 |
$3,014.05 |
$3,014.05 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$1,374.60
|
|
Sigmoidoscopy w/ablation
|
$3,314.35 |
$3,314.35 |
$3,314.35 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$2,899.00 |
$2,899.00 |
$2,899.00 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$3,314.35 |
$3,314.35 |
$3,314.35 |
$4,379.25
|
|
Sigmoidoscopy w/resection
|
$3,314.35 |
$3,314.35 |
$3,314.35 |
$3,245.23
|
|
Sigmoidoscopy w/tumr remove
|
$2,973.75 |
$2,973.75 |
$2,973.75 |
$1,395.28
|
|
Sigmoidoscopy w/ultrasound
|
$2,737.80 |
$2,737.80 |
$2,737.80 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$3,314.35 |
$3,314.35 |
$3,314.35 |
$2,314.50
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,129.75 |
$3,129.75 |
$3,129.75 |
$1,664.40
|
|
Signal avg ecg w or without ecg 93278
|
$579.15 |
$579.15 |
$579.15 |
$309.52
|
|
Sig w/tndsc balloon dilation
|
$2,973.75 |
$2,973.75 |
$2,973.75 |
$1,813.80
|
|
Sincalide 5 mcg solution for injection
|
$229.84 |
$229.84 |
$229.84 |
$355.41
|
|
Sinus CT scan (with and without contrast)
|
$1,916.85 |
$1,916.85 |
$1,916.85 |
$1,815.00
|
|
Sinus CT scan (with contrast)
|
$1,738.75 |
$1,738.75 |
$1,738.75 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$1,502.15 |
$1,502.15 |
$1,502.15 |
$1,279.50
|
|
Sinus/juglr venogram s&i
|
$4,828.20 |
$4,828.20 |
$4,828.20 |
$2,489.25
|
|
Sirolimus, oral
|
$16.67 |
$16.67 |
$16.67 |
$40.61
|
|
Sirolimus-protein bound 100 mg intravenous suspension
|
$0.42 |
$0.42 |
$0.42 |
$114.21
|
|
Skin Biopsy
|
$188.50 |
$188.50 |
$188.50 |
$382.80
|
|
Sleep Study (Polysomnography)
|
$3,593.20 |
$3,593.20 |
$3,593.20 |
$3,936.80
|
|
Sleep study unattended
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$595.50
|
|
Sleeve fing rolyan med
|
$401.32 |
$401.32 |
$401.32 |
$167.31
|
|
Sling arm deluxe w/pad xs
|
$18.64 |
$18.64 |
$18.64 |
$25.55
|
|
Sling pelv split sam med
|
$86.52 |
$86.52 |
$86.52 |
$132.60
|
|
Sling suprapubic suburetheral
|
$4,499.24 |
$4,499.24 |
$4,499.24 |
$10,439.00
|
|
Slp pure tone screening
|
$67.60 |
$67.60 |
$67.60 |
$67.60
|
|
Small bowel endoscopy
|
$2,466.10 |
$2,466.10 |
$2,466.10 |
$2,466.10
|
|
Small bowel endoscopy
|
$2,554.50 |
$2,554.50 |
$2,554.50 |
$2,244.82
|
|
Small bowel endoscopy
|
$2,951.65 |
$2,951.65 |
$2,951.65 |
$2,638.57
|
|
Small bowel endoscopy
|
$2,518.10 |
$2,518.10 |
$2,518.10 |
$2,244.82
|
|
Small bowel endoscopy
|
$2,961.40 |
$2,961.40 |
$2,961.40 |
$2,638.57
|
|
Small bowel endoscopy
|
$3,265.60 |
$3,265.60 |
$3,265.60 |
$2,734.20
|
|
Small bowel endoscopy
|
$2,815.15 |
$2,815.15 |
$2,815.15 |
$1,294.80
|
|
Small bowel endoscopy
|
$2,956.20 |
$2,956.20 |
$2,956.20 |
$2,244.82
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$2,984.80 |
$2,984.80 |
$2,984.80 |
$2,244.82
|
|
Small bowel endoscopy 44365
|
$2,481.70 |
$2,481.70 |
$2,481.70 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$2,490.15 |
$2,490.15 |
$2,490.15 |
$2,442.70
|
|
Small bowel endoscopy/biopsy
|
$3,109.60 |
$3,109.60 |
$3,109.60 |
$2,244.82
|
|
Small bowel endoscopy br/wa
|
$2,681.25 |
$2,681.25 |
$2,681.25 |
$1,261.31
|
|
Small bowel endoscopy br/wa
|
$2,956.20 |
$2,956.20 |
$2,956.20 |
$2,381.60
|
|
Small bowel endoscopy/stent 44370
|
$4,980.30 |
$4,980.30 |
$4,980.30 |
$6,104.15
|
|
Smear fluorescent and/or acid fast stain
|
$108.55 |
$108.55 |
$108.55 |
$64.20
|
|
Smear gram stain
|
$81.90 |
$81.90 |
$81.90 |
$57.85
|
|
Smear nasal eosinophil
|
$155.35 |
$155.35 |
$155.35 |
$49.50
|
|
Smear special stain inclusion bodies/parasites
|
$417.95 |
$417.95 |
$417.95 |
$64.35
|
|
Smear wet mount
|
$192.40 |
$192.40 |
$192.40 |
$68.63
|
|
Smn1 gene full gene sequence
|
$1,309.10 |
$1,309.10 |
$1,309.10 |
$495.69
|
|
Smpd1 gene common variants
|
$770.25 |
$770.25 |
$770.25 |
$140.00
|
|
Snrpn/ube3a gene
|
$678.60 |
$678.60 |
$678.60 |
$228.80
|
|
Sodium 24 hour urine
|
$74.10 |
$74.10 |
$74.10 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$51.80 |
$51.80 |
$51.80 |
$47.56
|
|
Sodium chloride 0.9 % IV bolus
|
$46.38 |
$46.38 |
$46.38 |
$46.38
|
|
Sodium chloride 0.9 % IV bolus
|
$46.12 |
$46.12 |
$46.12 |
$43.30
|
|
Sodium chloride 3 % ivpb
|
$45.01 |
$45.01 |
$45.01 |
$46.85
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$47.58 |
$47.58 |
$47.58 |
$95.40
|
|
Sodium serum/plasma/whole blood
|
$9.75 |
$9.75 |
$9.75 |
$42.70
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$345.74 |
$345.74 |
$345.74 |
$163.50
|
|
So gsap cl fr cpy nmbr&mcrst
|
$7,020.00 |
$7,020.00 |
$7,020.00 |
$1,345.31
|
|
So neo gsap dna/dna&rna
|
$9,360.00 |
$9,360.00 |
$9,360.00 |
$2,989.55
|
|
So neo gsap dna mcrstl ins
|
$7,410.00 |
$7,410.00 |
$7,410.00 |
$2,332.88
|
|
Special physics consult
|
$3,096.60 |
$3,096.60 |
$3,096.60 |
$700.74
|
|
Special radiation dosimetry
|
$1,058.20 |
$1,058.20 |
$1,058.20 |
$445.50
|
|
Special radiation treatment
|
$4,132.70 |
$4,132.70 |
$4,132.70 |
$1,934.03
|
|
Special teletx port plan
|
$7,567.30 |
$7,567.30 |
$7,567.30 |
$1,046.65
|
|
Specimen fat stain
|
$35.10 |
$35.10 |
$35.10 |
$32.76
|
|
Sperm antibody test
|
$279.50 |
$279.50 |
$279.50 |
$56.44
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$1,674.40 |
$1,674.40 |
$1,674.40 |
$1,502.08
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$632.45 |
$632.45 |
$632.45 |
$559.96
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$952.38 |
$952.38 |
$952.38 |
$392.09
|
|
Splint extn xsm w sof-stretch rolyan
|
$28.62 |
$28.62 |
$28.62 |
$43.60
|
|
Splint finger fold over sm
|
$30.62 |
$30.62 |
$30.62 |
$106.50
|