|
Sacroiliac Joint X-ray (3 or more views)
|
$192.60 |
$192.60 |
$192.60 |
$314.79
|
|
Sargramostim injection
|
$477.00 |
$477.00 |
$477.00 |
$552.52
|
|
Scan duplex extremity veins unilateral/limited study
|
$397.80 |
$397.80 |
$397.80 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$509.40 |
$509.40 |
$509.40 |
$660.00
|
|
Scan proc cranial extra
|
$220.80 |
$220.80 |
$220.80 |
$2,248.40
|
|
Scope plantar fasciotomy
|
$706.80 |
$706.80 |
$706.80 |
$3,839.54
|
|
Screening Colonoscopy (average risk)
|
$633.00 |
$633.00 |
$633.00 |
$1,800.00
|
|
Screening Colonoscopy (high risk)
|
$718.20 |
$718.20 |
$718.20 |
$2,000.00
|
|
Screening Mammogram
|
$381.00 |
$381.00 |
$381.00 |
$310.20
|
|
Screening prostate cancer PSA
|
$129.60 |
$129.60 |
$129.60 |
$101.60
|
|
Screen/visual acuity/bilat/quant 99173
|
$33.00 |
$33.00 |
$33.00 |
$28.86
|
|
Screw cortex 2.0 x 10mm
|
$5,530.20 |
$5,530.20 |
$5,530.20 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$249.00 |
$249.00 |
$249.00 |
$608.90
|
|
Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time
|
$11.40 |
$11.40 |
$11.40 |
$223.89
|
|
Sedimentation rate erythrocyte automated
|
$27.00 |
$27.00 |
$27.00 |
$42.00
|
|
Self-adher band w>=3" <5"/yd
|
$11.40 |
$11.40 |
$11.40 |
$2.07
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$81.00 |
$81.00 |
$81.00 |
$96.60
|
|
Semen analysis presence/motility
|
$114.60 |
$114.60 |
$114.60 |
$70.40
|
|
Sequestrectomy olecrn proces
|
$1,044.60 |
$1,044.60 |
$1,044.60 |
$7,807.24
|
|
Sgmdsc w/band ligation
|
$181.80 |
$181.80 |
$181.80 |
$2,288.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$369.60 |
$369.60 |
$369.60 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$117.00 |
$117.00 |
$117.00 |
$284.88
|
|
Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm
|
$97.80 |
$97.80 |
$97.80 |
$436.64
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$56.40 |
$56.40 |
$56.40 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g >2cm
|
$118.80 |
$118.80 |
$118.80 |
$400.40
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$52.80 |
$52.80 |
$52.80 |
$311.40
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$102.60 |
$102.60 |
$102.60 |
$234.00
|
|
Sho arthrs srg bicp tenodsis
|
$1,636.80 |
$1,636.80 |
$1,636.80 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$2,060.40 |
$2,060.40 |
$2,060.40 |
$7,166.67
|
|
Sho arthrs srg lmtd dbrdmt
|
$1,133.40 |
$1,133.40 |
$1,133.40 |
$4,807.00
|
|
Sho arthrs srg lss&rescj ads
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$3,839.54
|
|
Sho arthrs srg prtl synvct
|
$851.40 |
$851.40 |
$851.40 |
$5,886.74
|
|
Sho arthrs srg rmvl loose/fb
|
$1,157.40 |
$1,157.40 |
$1,157.40 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$2,005.20 |
$2,005.20 |
$2,005.20 |
$6,740.20
|
|
Sho arthrs srg xtnsv dbrdmt
|
$1,236.60 |
$1,236.60 |
$1,236.60 |
$5,148.00
|
|
Shoe post-op mens m
|
$186.60 |
$186.60 |
$186.60 |
$53.20
|
|
Shot (Injection into Muscle or Under the Skin)
|
$141.00 |
$141.00 |
$141.00 |
$136.80
|
|
Shoulder AC Joint X-ray (both sides)
|
$192.00 |
$192.00 |
$192.00 |
$270.20
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$2,174.40 |
$2,174.40 |
$2,174.40 |
$7,907.11
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$142.80 |
$142.80 |
$142.80 |
$287.25
|
|
Shoulder MRI (with and without contrast)
|
$1,855.20 |
$1,855.20 |
$1,855.20 |
$2,821.65
|
|
Shoulder MRI (with contrast)
|
$1,384.20 |
$1,384.20 |
$1,384.20 |
$2,483.00
|
|
Shoulder MRI (without contrast)
|
$966.00 |
$966.00 |
$966.00 |
$2,088.20
|
|
Shoulder prosthesis removal
|
$1,563.60 |
$1,563.60 |
$1,563.60 |
$4,832.80
|
|
Shoulder X-ray
|
$144.60 |
$144.60 |
$144.60 |
$341.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$142.20 |
$142.20 |
$142.20 |
$264.00
|
|
Shuntogram nonvascular supervision & interpretation
|
$257.40 |
$257.40 |
$257.40 |
$355.80
|
|
Sialidase enzyme assay
|
$60.00 |
$60.00 |
$60.00 |
$54.99
|
|
Sialolithotomy 42330
|
$1,941.60 |
$1,941.60 |
$1,941.60 |
$3,837.72
|
|
Sickling rbc
|
$37.80 |
$37.80 |
$37.80 |
$59.40
|
|
Sigmoidoscopy and biopsy
|
$210.60 |
$210.60 |
$210.60 |
$1,446.90
|
|
Sigmoidoscopy for bleeding
|
$459.00 |
$459.00 |
$459.00 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$180.60 |
$180.60 |
$180.60 |
$1,650.75
|
|
Sigmoidoscopy w/ablation
|
$420.00 |
$420.00 |
$420.00 |
$2,604.00
|
|
Sigmoidoscopy w/tumr remove
|
$396.60 |
$396.60 |
$396.60 |
$1,645.43
|
|
Sig w/tndsc balloon dilation
|
$264.60 |
$264.60 |
$264.60 |
$2,288.00
|
|
Sincalide 5 mcg solution for injection
|
$422.40 |
$422.40 |
$422.40 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$1,477.80 |
$1,477.80 |
$1,477.80 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,144.80 |
$1,144.80 |
$1,144.80 |
$1,289.00
|
|
Sinusotomy sphenoid w/wo bx 31050
|
$878.40 |
$878.40 |
$878.40 |
$6,465.11
|
|
Sinus X-ray (complete)
|
$177.60 |
$177.60 |
$177.60 |
$347.10
|
|
Sinus X-ray (limited)
|
$96.00 |
$96.00 |
$96.00 |
$215.75
|
|
Skin Biopsy
|
$357.60 |
$357.60 |
$357.60 |
$361.20
|
|
Skin split graft addl 100sq cm 15101
|
$238.80 |
$238.80 |
$238.80 |
$1,793.40
|
|
Skull X-ray (1 to 3 views)
|
$180.60 |
$180.60 |
$180.60 |
$294.66
|
|
Skull X-ray (complete)
|
$190.20 |
$190.20 |
$190.20 |
$423.15
|
|
Sleeve fing rolyan med
|
$127.20 |
$127.20 |
$127.20 |
$203.58
|
|
Sling arm deluxe w/pad xs
|
$37.80 |
$37.80 |
$37.80 |
$30.35
|
|
Sling suprapubic suburetheral
|
$2,908.80 |
$2,908.80 |
$2,908.80 |
$9,679.96
|
|
Slitting of prepuce
|
$1,693.20 |
$1,693.20 |
$1,693.20 |
$3,376.23
|
|
Slp pure tone screening
|
$39.60 |
$39.60 |
$39.60 |
$64.50
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$305.40 |
$305.40 |
$305.40 |
$557.70
|
|
Small bowel endoscopy
|
$438.60 |
$438.60 |
$438.60 |
$2,596.41
|
|
Small bowel endoscopy
|
$617.40 |
$617.40 |
$617.40 |
$2,244.82
|
|
Small bowel endoscopy
|
$723.00 |
$723.00 |
$723.00 |
$2,638.57
|
|
Small bowel endoscopy
|
$739.20 |
$739.20 |
$739.20 |
$2,518.10
|
|
Small bowel endoscopy
|
$157.80 |
$157.80 |
$157.80 |
$2,088.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$581.40 |
$581.40 |
$581.40 |
$2,590.33
|
|
Small bowel endoscopy 44365
|
$550.20 |
$550.20 |
$550.20 |
$2,244.82
|
|
Small bowel endoscopy/biopsy
|
$483.00 |
$483.00 |
$483.00 |
$2,490.15
|
|
Small bowel endoscopy br/wa
|
$125.40 |
$125.40 |
$125.40 |
$1,924.00
|
|
Smear gram stain
|
$33.00 |
$33.00 |
$33.00 |
$55.42
|
|
Smear nasal eosinophil
|
$36.60 |
$36.60 |
$36.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$44.40 |
$44.40 |
$44.40 |
$73.15
|
|
Smear wet mount
|
$44.40 |
$44.40 |
$44.40 |
$67.49
|
|
Sodium 24 hour urine
|
$37.80 |
$37.80 |
$37.80 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$7.20 |
$7.20 |
$7.20 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$10.80 |
$10.80 |
$10.80 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$9.60 |
$9.60 |
$9.60 |
$37.64
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$39.60 |
$39.60 |
$39.60 |
$80.73
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$197.40 |
$197.40 |
$197.40 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$37.80 |
$37.80 |
$37.80 |
$46.26
|
|
Sp bone agrft morsel add-on
|
$231.60 |
$231.60 |
$231.60 |
$406.40
|
|
Sp bone agrft struct add-on
|
$249.60 |
$249.60 |
$249.60 |
$442.40
|
|
Sp bone algrft morsel add-on
|
$190.20 |
$190.20 |
$190.20 |
$498.55
|
|
Special supplies phys/qhp
|
$319.80 |
$319.80 |
$319.80 |
$60.00
|
|
Specific gravity body fluid
|
$12.00 |
$12.00 |
$12.00 |
$22.00
|
|
Speech and Language Evaluation (comprehensive)
|
$444.00 |
$444.00 |
$444.00 |
$385.00
|
|
Speech Therapy Session (one-on-one)
|
$180.60 |
$180.60 |
$180.60 |
$248.30
|
