|
Screening Colonoscopy (average risk)
|
$4,549.56 |
$4,549.56 |
$5,032.14 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$4,884.96 |
$4,884.96 |
$6,295.92 |
$1,951.46
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$12.00 |
$12.00 |
$12.00 |
$57.60
|
|
Screening hepatitis b non-obstetric high risk
|
$45.00 |
$45.00 |
$45.00 |
$60.00
|
|
Screening prostate cancer PSA
|
$70.20 |
$70.20 |
$70.20 |
$100.63
|
|
Screen pap by tech w md supv
|
$32.40 |
$32.40 |
$32.40 |
$52.65
|
|
Screw cortex 2.0 x 10mm
|
$428,835.57 |
$428,835.57 |
$428,835.57 |
$29,055.00
|
|
Sedimentation rate erythrocyte automated
|
$38.40 |
$38.40 |
$38.40 |
$42.00
|
|
Semen analysis presence/motility
|
$164.40 |
$164.40 |
$164.40 |
$71.05
|
|
Serpina1 gene
|
$178.80 |
$178.80 |
$178.80 |
$197.00
|
|
Set radiation therapy field
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$762.40
|
|
Set radiation therapy field
|
$1,468.80 |
$1,468.80 |
$1,468.80 |
$1,157.38
|
|
Set radiation therapy field
|
$1,880.40 |
$1,880.40 |
$1,880.40 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$3.00 |
$3.00 |
$3.00 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$31.80 |
$31.80 |
$42.60 |
$21.96
|
|
Sewho cap design without jnts cf
|
$3,617.93 |
$3,617.93 |
$3,617.93 |
$1,685.60
|
|
Sf3b1 gene common variants
|
$280.80 |
$280.80 |
$280.80 |
$248.10
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$221.40 |
$221.40 |
$221.40 |
$235.13
|
|
Sheath below knee
|
$57.78 |
$57.78 |
$57.78 |
$40.88
|
|
Sheath gldlight lasr 12fx50cm
|
$8,725.53 |
$8,725.53 |
$8,725.53 |
$6,570.70
|
|
Sheath laser cavaclear 14f
|
$13,107.98 |
$13,107.98 |
$13,107.98 |
$7,625.52
|
|
Sho arthrs srg bicp tenodsis
|
$33,446.57 |
$33,446.57 |
$33,446.57 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$39,321.24 |
$39,321.24 |
$39,321.24 |
$6,311.00
|
|
Sho arthrs srg lmtd dbrdmt
|
$24,853.73 |
$24,853.73 |
$24,853.73 |
$4,521.67
|
|
Sho arthrs srg rpr slap les
|
$39,321.24 |
$39,321.24 |
$39,321.24 |
$6,311.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$33,446.57 |
$33,446.57 |
$33,446.57 |
$5,148.00
|
|
Shoe clubfoot wedge
|
$177.70 |
$177.70 |
$177.70 |
$111.56
|
|
Shoe dennis browne splint bo
|
$155.02 |
$155.02 |
$155.02 |
$93.52
|
|
Shoe heel new leather standa
|
$145.84 |
$145.84 |
$145.84 |
$88.03
|
|
Shoe heel new rubber standar
|
$123.10 |
$123.10 |
$123.10 |
$63.70
|
|
Shoe heel pad & depress for
|
$223.24 |
$223.24 |
$223.24 |
$149.60
|
|
Shoe heel sach cushion type
|
$378.10 |
$378.10 |
$378.10 |
$228.09
|
|
Shoe heel thomas extend to b
|
$223.24 |
$223.24 |
$223.24 |
$134.68
|
|
Shoe heel thomas with wedge
|
$209.73 |
$209.73 |
$209.73 |
$126.56
|
|
Shoe lift elev heel/sole neo
|
$265.28 |
$265.28 |
$265.28 |
$175.04
|
|
Shoe metatarsal bar between
|
$332.60 |
$332.60 |
$332.60 |
$200.76
|
|
Shoe metatarsal bar wedge ro
|
$145.84 |
$145.84 |
$145.84 |
$69.03
|
|
Shoe outflare wedge
|
$177.70 |
$177.70 |
$177.70 |
$107.24
|
|
Shoe post-op mens m
|
$437.11 |
$437.11 |
$437.11 |
$52.20
|
|
Shoe sole wedge between sole
|
$177.70 |
$177.70 |
$177.70 |
$107.24
|
|
Shoe sole wedge outside sole
|
$127.55 |
$127.55 |
$127.55 |
$77.00
|
|
Shoe wedge sach
|
$305.38 |
$305.38 |
$305.38 |
$171.44
|
|
Sho heel count plast reinfor
|
$574.16 |
$574.16 |
$574.16 |
$346.47
|
|
Sho insert w arch toe filler
|
$1,854.00 |
$1,854.00 |
$1,854.00 |
$1,224.38
|
|
Sho lift taper to metatarsal
|
$186.84 |
$186.84 |
$186.84 |
$111.14
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$48,307.72 |
$48,307.72 |
$48,307.72 |
$7,807.24
|
|
Shoulder X-ray
|
$523.20 |
$523.20 |
$523.20 |
$339.50
|
|
Shrinker prosth above knee
|
$302.56 |
$302.56 |
$302.56 |
$168.89
|
|
Shrinker prosth below knee
|
$291.60 |
$291.60 |
$291.60 |
$105.12
|
|
Shunt glaucoma baerveldt 350mm
|
$11,523.67 |
$11,523.67 |
$11,523.67 |
$4,636.80
|
|
Sialidase enzyme assay
|
$61.80 |
$61.80 |
$61.80 |
$54.60
|
|
Sialography s&i
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$499.20
|
|
Sialolithotomy 42330
|
$7,757.88 |
$7,757.88 |
$7,757.88 |
$3,837.72
|
|
Sickling rbc
|
$40.20 |
$40.20 |
$40.20 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$2,898.96 |
$2,898.96 |
$4,816.98 |
$1,351.63
|
|
Sigmoidoscopy/submucosal injection 45335
|
$3,605.82 |
$3,605.82 |
$3,605.82 |
$1,444.83
|
|
Sigmoidoscopy w/tumr remove
|
$4,816.98 |
$4,816.98 |
$5,441.16 |
$1,558.80
|
|
Sigmoidoscopy w/ultrasound
|
$11,060.47 |
$11,060.47 |
$11,060.47 |
$1,740.57
|
|
Sim ang w/prs cath rad emb
|
$17,010.60 |
$17,010.60 |
$17,010.60 |
$18,145.20
|
|
Sincalide 5 mcg solution for injection
|
$704.52 |
$704.52 |
$770.64 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$1,397.40 |
$1,397.40 |
$1,397.40 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,055.40 |
$1,055.40 |
$1,055.40 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$2,132.40 |
$2,132.40 |
$2,132.40 |
$2,489.25
|
|
Sio flex pelvisacral custom
|
$957.62 |
$957.62 |
$957.62 |
$561.79
|
|
Sio rig pnl pelv/sac pre ots
|
$634.08 |
$634.08 |
$634.08 |
$418.75
|
|
Sirolimus, oral
|
$29.28 |
$29.28 |
$39.24 |
$41.25
|
|
Skin Biopsy
|
$267.60 |
$267.60 |
$267.60 |
$360.34
|
|
Skin pedicle flap trunk
|
$17,964.48 |
$17,964.48 |
$17,964.48 |
$2,501.86
|
|
Sleeve fing rolyan med
|
$695.75 |
$695.75 |
$695.75 |
$203.58
|
|
Sling pelv split sam med
|
$308.92 |
$308.92 |
$308.92 |
$150.00
|
|
Sling suprapubic suburetheral
|
$27,018.16 |
$27,018.16 |
$27,018.16 |
$9,679.96
|
|
Small bowel endoscopy
|
$5,115.30 |
$5,115.30 |
$5,115.30 |
$2,638.57
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$5,249.10 |
$5,249.10 |
$5,249.10 |
$2,389.40
|
|
Small bowel endoscopy/biopsy
|
$4,252.20 |
$4,252.20 |
$8,090.28 |
$2,413.20
|
|
Smear fluorescent and/or acid fast stain
|
$6,238.80 |
$6,238.80 |
$6,238.80 |
$64.20
|
|
Smear gram stain
|
$24.00 |
$24.00 |
$24.00 |
$55.25
|
|
Smear nasal eosinophil
|
$25.80 |
$25.80 |
$25.80 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$132.60 |
$132.60 |
$132.60 |
$73.15
|
|
Smear wet mount
|
$39.60 |
$39.60 |
$39.60 |
$67.49
|
|
Smpd1 gene common variants
|
$330.60 |
$330.60 |
$330.60 |
$133.84
|
|
Snrpn/ube3a gene
|
$248.40 |
$248.40 |
$248.40 |
$231.85
|
|
So airplane w/wo joint cf
|
$2,545.34 |
$2,545.34 |
$2,545.34 |
$1,276.80
|
|
So cap design without jnts cf
|
$1,940.30 |
$1,940.30 |
$1,940.30 |
$606.35
|
|
Socket insert without lock mech
|
$1,947.38 |
$1,947.38 |
$1,947.38 |
$1,192.50
|
|
Sock fracture or equal each
|
$351.00 |
$351.00 |
$351.00 |
$74.51
|
|
Sodium 24 hour urine
|
$51.60 |
$51.60 |
$51.60 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$28.20 |
$28.20 |
$33.00 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$25.20 |
$25.20 |
$26.40 |
$46.00
|
|
Sodium chloride 0.9 % IV bolus
|
$25.20 |
$25.20 |
$29.04 |
$37.50
|
|
Sodium chloride 3 % ivpb
|
$63.72 |
$63.72 |
$66.60 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$171.72 |
$171.72 |
$179.40 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$1,216.92 |
$1,216.92 |
$1,216.92 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$29.40 |
$29.40 |
$29.40 |
$45.60
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$10.08 |
$10.08 |
$10.50 |
$177.52
|
|
Soft interface below knee se
|
$271.16 |
$271.16 |
$271.16 |
$179.08
|
|
So neo gsap dna mcrstl ins
|
$2,152.20 |
$2,152.20 |
$2,152.20 |
$2,296.00
|
|
So vest canvas/web pre ots
|
$572.33 |
$572.33 |
$572.33 |
$256.54
|
|
Sp bone algrft morsel add-on
|
$89,790.20 |
$89,790.20 |
$89,790.20 |
$498.55
|
|
Special physics consult
|
$1,155.60 |
$1,155.60 |
$1,155.60 |
$725.00
|
