|
Removal cerumen impacted (both sides)
|
$95.00 |
$95.00 |
$153.00 |
$161.25
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$380.00 |
$380.00 |
$380.00 |
$236.64
|
|
Removal embedded foreign body vestibule mouth smpl
|
$379.00 |
$379.00 |
$379.00 |
$838.33
|
|
Removal foreign body foot subcutaneous right
|
$778.00 |
$778.00 |
$778.00 |
$1,256.00
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$232.00 |
$232.00 |
$232.00 |
$313.53
|
|
Remove shoulder foreign body subq 23330
|
$600.00 |
$600.00 |
$600.00 |
$1,794.93
|
|
Remove vaginal foreign body 57415
|
$657.00 |
$657.00 |
$657.00 |
$3,577.50
|
|
Renal cyst study s&i
|
$34.00 |
$34.00 |
$34.00 |
$599.23
|
|
Renal function panel
|
$48.00 |
$48.00 |
$48.00 |
$95.76
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$1,067.00 |
$1,067.00 |
$1,067.00 |
$1,156.00
|
|
Reptilase test
|
$56.00 |
$56.00 |
$105.00 |
$65.72
|
|
#resp virpnl dfa-adenovirus
|
$66.00 |
$66.00 |
$66.00 |
$62.40
|
|
#resp virpnl dfa-parainfluenza
|
$66.00 |
$66.00 |
$66.00 |
$44.40
|
|
Resuscitation cardiopulmonary
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$895.44
|
|
Resuscitation delivery/birthing room
|
$887.00 |
$887.00 |
$887.00 |
$726.60
|
|
Reticulated platelet assay
|
$71.00 |
$71.00 |
$71.00 |
$68.69
|
|
Reticulocyte automated
|
$34.00 |
$34.00 |
$80.00 |
$54.27
|
|
Reticulocyte direct measurement automated
|
$31.00 |
$31.00 |
$31.00 |
$32.50
|
|
Revision open av fistula without thromb
|
$643.00 |
$643.00 |
$643.00 |
$9,842.40
|
|
Rheumatoid factor qualitative
|
$100.00 |
$100.00 |
$100.00 |
$54.60
|
|
Rheumatoid factor quantitative
|
$31.00 |
$31.00 |
$47.00 |
$59.80
|
|
Rmvl foreign body upper arm/elbow subcutaneous
|
$510.00 |
$510.00 |
$510.00 |
$1,897.50
|
|
Rsv assay w/optic
|
$66.00 |
$66.00 |
$152.00 |
$64.13
|
|
Rubella antibody igg
|
$65.00 |
$65.00 |
$122.00 |
$73.05
|
|
Rubeola antibody igg
|
$45.00 |
$45.00 |
$122.00 |
$80.00
|
|
Russell viper venom diluted
|
$58.00 |
$58.00 |
$96.00 |
$73.03
|
|
Salmonella antibody
|
$34.00 |
$34.00 |
$34.00 |
$37.58
|
|
Sarscov coronavirus ag ia
|
$74.00 |
$74.00 |
$110.00 |
$65.00
|
|
Sarscov & inf vir a&b ag ia
|
$193.00 |
$193.00 |
$193.00 |
$104.00
|
|
Sbsq nurs facil care/day unstabl/new prob 35 min 99310
|
$156.00 |
$156.00 |
$332.00 |
$259.20
|
|
Sbsq nursing facil care/day minor complj 15 min
|
$123.00 |
$123.00 |
$174.00 |
$133.20
|
|
Sbsq nursing facil care/day new problem 25 min
|
$152.00 |
$152.00 |
$207.00 |
$187.65
|
|
Sbsq nursing facility care/day e/m stable 10 min
|
$99.00 |
$99.00 |
$116.00 |
$79.20
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$1,487.00 |
$1,487.00 |
$1,487.00 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$878.00 |
$878.00 |
$878.00 |
$662.40
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$788.40
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$866.00 |
$866.00 |
$866.00 |
$586.30
|
|
Scan duplex extremity veins unilateral/limited study
|
$963.00 |
$963.00 |
$963.00 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$958.00 |
$958.00 |
$958.00 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$638.00 |
$638.00 |
$638.00 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$570.00 |
$570.00 |
$570.00 |
$527.80
|
|
Screening prostate cancer PSA
|
$156.00 |
$156.00 |
$156.00 |
$96.00
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$278.00 |
$278.00 |
$278.00 |
$194.35
|
|
Sedimentation rate erythrocyte automated
|
$19.00 |
$19.00 |
$37.00 |
$37.80
|
|
Set radiation therapy field
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$709.00
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$112.00 |
$112.00 |
$112.00 |
$258.40
|
|
Shoulder MRI (with and without contrast)
|
$4,162.00 |
$4,162.00 |
$4,162.00 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$3,495.00 |
$3,495.00 |
$3,495.00 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$5,574.00 |
$5,574.00 |
$5,574.00 |
$1,938.28
|
|
Shoulder X-ray
|
$66.00 |
$66.00 |
$742.00 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$486.00 |
$486.00 |
$486.00 |
$342.54
|
|
Sialography s&i
|
$105.00 |
$105.00 |
$696.00 |
$403.70
|
|
Sickling rbc
|
$116.00 |
$116.00 |
$116.00 |
$53.40
|
|
Sinus CT scan (with and without contrast)
|
$3,537.00 |
$3,537.00 |
$3,537.00 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$2,838.00 |
$2,838.00 |
$2,838.00 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$2,003.00 |
$2,003.00 |
$2,003.00 |
$1,151.00
|
|
Sinus/juglr venogram s&i
|
$2,967.00 |
$2,967.00 |
$2,967.00 |
$2,052.67
|
|
Sleep Study (Polysomnography)
|
$5,820.00 |
$5,820.00 |
$5,820.00 |
$4,043.20
|
|
Smear fluorescent and/or acid fast stain
|
$88.00 |
$88.00 |
$88.00 |
$50.70
|
|
Smear gram stain
|
$43.00 |
$43.00 |
$102.00 |
$48.00
|
|
Smear nasal eosinophil
|
$76.00 |
$76.00 |
$76.00 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$26.00 |
$26.00 |
$122.00 |
$60.00
|
|
Smear wet mount
|
$45.00 |
$45.00 |
$103.00 |
$56.13
|
|
Snrpn/ube3a gene
|
$586.00 |
$586.00 |
$586.00 |
$228.80
|
|
Sodium 24 hour urine
|
$71.00 |
$71.00 |
$71.00 |
$47.25
|
|
Sodium chloride 0.9 % intravenous solution
|
$65.00 |
$65.00 |
$65.00 |
$46.35
|
|
Sodium chloride 0.9 % IV bolus
|
$65.00 |
$65.00 |
$65.00 |
$42.25
|
|
Sodium serum/plasma/whole blood
|
$34.00 |
$34.00 |
$63.00 |
$42.43
|
|
Specific gravity body fluid
|
$38.00 |
$38.00 |
$38.00 |
$21.55
|
|
Specimen fat stain
|
$24.00 |
$24.00 |
$24.00 |
$40.00
|
|
Speech evaluation complex
|
$468.00 |
$468.00 |
$468.00 |
$409.97
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$601.00 |
$601.00 |
$601.00 |
$526.80
|
|
Split blood or products
|
$160.00 |
$160.00 |
$160.00 |
$143.64
|
|
St analysis behavior qualitative voice/resonance
|
$662.00 |
$662.00 |
$662.00 |
$295.10
|
|
St cognitve performance testing healthcare professional each hour
|
$361.00 |
$361.00 |
$361.00 |
$313.96
|
|
St evaluate speech sound production
|
$662.00 |
$662.00 |
$662.00 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$673.00 |
$673.00 |
$673.00 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$739.00 |
$739.00 |
$739.00 |
$336.00
|
|
St evaluation swallow function
|
$673.00 |
$673.00 |
$673.00 |
$323.72
|
|
Strep a ag ia
|
$53.00 |
$53.00 |
$149.00 |
$75.40
|
|
Stress test pulmonary
|
$408.00 |
$408.00 |
$408.00 |
$330.63
|
|
Stress tte complete
|
$2,571.00 |
$2,571.00 |
$2,571.00 |
$1,989.60
|
|
Str markers specimen anal
|
$1,297.00 |
$1,297.00 |
$1,297.00 |
$978.25
|
|
St treatment speech individual
|
$502.00 |
$502.00 |
$502.00 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$524.00 |
$524.00 |
$524.00 |
$221.00
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$82.50 |
$82.50 |
$82.50 |
$52.49
|
|
Surgical pathology level 1 gross examination only
|
$141.00 |
$141.00 |
$141.00 |
$81.00
|
|
Surgical pathology level 2 gross & microscopic examination
|
$222.00 |
$222.00 |
$222.00 |
$138.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$313.00 |
$313.00 |
$313.00 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$469.00 |
$469.00 |
$469.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$647.00 |
$647.00 |
$647.00 |
$489.00
|
|
Surgical pathology level 6 gross & microscopic examination
|
$666.00 |
$666.00 |
$666.00 |
$720.75
|
|
Susceptibility agar dilution per agent
|
$44.00 |
$44.00 |
$44.00 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$22.00 |
$22.00 |
$50.00 |
$31.85
|
|
Susceptibility mic per plate
|
$39.00 |
$39.00 |
$62.00 |
$89.70
|
|
Svc venogram s&i
|
$1,828.00 |
$1,828.00 |
$1,828.00 |
$1,908.00
|
|
Sweat collection by iontophoresis
|
$194.00 |
$194.00 |
$194.00 |
$100.20
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$39.00 |
$39.00 |
$76.00 |
$45.70
|
|
T3 (triiodothyronine) free
|
$80.00 |
$80.00 |
$93.00 |
$91.20
|
|
T3 (triiodothyronine) total
|
$67.00 |
$67.00 |
$79.00 |
$88.00
|
