|
Replace g-j tube perc
|
$11,115.60 |
$11,115.60 |
$11,115.60 |
$1,568.05
|
|
Reptilase test
|
$117.00 |
$117.00 |
$117.00 |
$72.15
|
|
#resp virpnl dfa-adenovirus
|
$186.00 |
$186.00 |
$186.00 |
$48.10
|
|
Resp virus 6-11 targets
|
$1,667.40 |
$1,667.40 |
$1,667.40 |
$479.20
|
|
Reticulocyte automated
|
$33.00 |
$33.00 |
$33.00 |
$53.00
|
|
Revefenacin inh non-com 1mcg
|
$7.80 |
$7.80 |
$7.80 |
$15.56
|
|
Rheumatoid factor qualitative
|
$33.00 |
$33.00 |
$33.00 |
$57.20
|
|
Rheumatoid factor quantitative
|
$28.80 |
$28.80 |
$28.80 |
$57.50
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$180.80 |
$180.80 |
$180.80 |
$234.12
|
|
Rho(d) immune globulin h, sd
|
$28.80 |
$28.80 |
$28.80 |
$3,228.05
|
|
Rho d immune globulin inj
|
$622.40 |
$622.40 |
$622.40 |
$217.71
|
|
Rib and Chest X-ray (3 views, left side)
|
$141.00 |
$141.00 |
$141.00 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$225.00 |
$225.00 |
$225.00 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$149.40 |
$149.40 |
$149.40 |
$397.60
|
|
Risankizumab-rzaa 60 mg/ml intravenous solution
|
$27.00 |
$27.00 |
$27.00 |
$30,071.50
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$481.60 |
$481.60 |
$481.60 |
$5,004.42
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$7,826.40 |
$7,826.40 |
$7,826.40 |
$5,309.20
|
|
Rmvl fecal impaction/fb spx under anes
|
$3,417.00 |
$3,417.00 |
$3,417.00 |
$2,111.46
|
|
Romiplostim 125 mcg subcutaneous solution
|
$25.20 |
$25.20 |
$25.20 |
$8,935.57
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$7,786.20 |
$7,786.20 |
$7,786.20 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$171.00 |
$171.00 |
$171.00 |
$188.16
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$4,194.00 |
$4,194.00 |
$4,194.00 |
$2,173.60
|
|
Rsv assay w/optic
|
$210.00 |
$210.00 |
$210.00 |
$76.32
|
|
Rubella antibody igg
|
$83.40 |
$83.40 |
$83.40 |
$77.40
|
|
Rubeola antibody igg
|
$58.80 |
$58.80 |
$58.80 |
$80.00
|
|
Russell viper venom diluted
|
$58.80 |
$58.80 |
$58.80 |
$73.03
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$5,043.00 |
$5,043.00 |
$5,043.00 |
$5,174.32
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$108.00 |
$108.00 |
$108.00 |
$314.26
|
|
Sarscov coronavirus ag ia
|
$34.80 |
$34.80 |
$34.80 |
$60.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$640.20 |
$640.20 |
$640.20 |
$497.68
|
|
Scan duplex extremity veins unilateral/limited study
|
$335.40 |
$335.40 |
$335.40 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$655.80 |
$655.80 |
$655.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$670.20 |
$670.20 |
$670.20 |
$597.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$78.00 |
$78.00 |
$78.00 |
$85.15
|
|
Screen cerv/vag thin layer
|
$61.20 |
$61.20 |
$61.20 |
$86.56
|
|
Screening Colonoscopy (average risk)
|
$1,440.00 |
$1,440.00 |
$1,440.00 |
$1,816.36
|
|
Screening Colonoscopy (high risk)
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$2,249.00
|
|
Screening hepatitis b non-obstetric high risk
|
$100.20 |
$100.20 |
$100.20 |
$60.00
|
|
Screening hepatitis c antibody high risk
|
$66.60 |
$66.60 |
$66.60 |
$93.60
|
|
Screening Mammogram
|
$205.20 |
$205.20 |
$205.20 |
$310.20
|
|
Screening prostate cancer PSA
|
$96.00 |
$96.00 |
$96.00 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$5,724.00 |
$5,724.00 |
$5,724.00 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$299.40 |
$299.40 |
$299.40 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$41.40 |
$41.40 |
$41.40 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$91.20 |
$91.20 |
$91.20 |
$96.00
|
|
Semen analysis presence/motility
|
$83.40 |
$83.40 |
$83.40 |
$70.40
|
|
Semen analysis w/count
|
$108.00 |
$108.00 |
$108.00 |
$56.44
|
|
Serpina1 gene
|
$345.60 |
$345.60 |
$345.60 |
$197.00
|
|
Sgmdsc w/band ligation
|
$2,563.80 |
$2,563.80 |
$2,563.80 |
$2,288.00
|
|
Shot (Injection into Muscle or Under the Skin)
|
$84.60 |
$84.60 |
$84.60 |
$136.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$100.20 |
$100.20 |
$100.20 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$2,563.20 |
$2,563.20 |
$2,563.20 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$2,096.84
|
|
Shoulder X-ray
|
$127.80 |
$127.80 |
$127.80 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$100.20 |
$100.20 |
$100.20 |
$263.25
|
|
Sickling rbc
|
$19.20 |
$19.20 |
$19.20 |
$59.40
|
|
Sigmoidoscopy and biopsy
|
$3,302.40 |
$3,302.40 |
$3,302.40 |
$1,446.90
|
|
Sigmoidoscopy flex decompression 45337
|
$3,232.80 |
$3,232.80 |
$3,232.80 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$3,850.20 |
$3,850.20 |
$3,850.20 |
$1,993.08
|
|
Sigmoidoscopy/submucosal injection 45335
|
$4,209.00 |
$4,209.00 |
$4,209.00 |
$1,820.00
|
|
Sigmoidoscopy w/ablation
|
$1,296.60 |
$1,296.60 |
$1,296.60 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$3,232.80 |
$3,232.80 |
$3,232.80 |
$1,395.28
|
|
Sigmoidoscopy w/tumr remove
|
$3,209.40 |
$3,209.40 |
$3,209.40 |
$1,645.43
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,232.80 |
$3,232.80 |
$3,232.80 |
$1,976.25
|
|
Sig w/tndsc balloon dilation
|
$3,466.80 |
$3,466.80 |
$3,466.80 |
$2,288.00
|
|
Sincalide 5 mcg solution for injection
|
$384.80 |
$384.80 |
$384.80 |
$309.14
|
|
Sinus CT scan (with contrast)
|
$847.80 |
$847.80 |
$847.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$741.00 |
$741.00 |
$741.00 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$133.20 |
$133.20 |
$133.20 |
$346.45
|
|
Sinus X-ray (limited)
|
$156.60 |
$156.60 |
$156.60 |
$215.40
|
|
Skin Biopsy
|
$381.60 |
$381.60 |
$381.60 |
$360.34
|
|
Skull X-ray (1 to 3 views)
|
$125.40 |
$125.40 |
$125.40 |
$294.45
|
|
Skull X-ray (complete)
|
$149.40 |
$149.40 |
$149.40 |
$417.50
|
|
Sleep Study (Polysomnography)
|
$3,163.20 |
$3,163.20 |
$3,163.20 |
$3,734.50
|
|
Sling arm deluxe w/pad xs
|
$30.00 |
$30.00 |
$30.00 |
$30.35
|
|
Sling suprapubic suburetheral
|
$3,422.40 |
$3,422.40 |
$3,422.40 |
$9,679.96
|
|
Slitting of prepuce
|
$5,239.20 |
$5,239.20 |
$5,239.20 |
$3,376.23
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$225.00 |
$225.00 |
$225.00 |
$557.70
|
|
Smear fluorescent and/or acid fast stain
|
$30.00 |
$30.00 |
$30.00 |
$64.35
|
|
Smear gram stain
|
$30.00 |
$30.00 |
$30.00 |
$55.55
|
|
Smear nasal eosinophil
|
$57.60 |
$57.60 |
$57.60 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$49.80 |
$49.80 |
$49.80 |
$73.50
|
|
Smear wet mount
|
$41.40 |
$41.40 |
$41.40 |
$67.55
|
|
Sodium 24 hour urine
|
$33.00 |
$33.00 |
$33.00 |
$48.98
|
|
Sodium chloride 0.9 % intravenous solution
|
$55.40 |
$55.40 |
$55.40 |
$49.07
|
|
Sodium chloride 0.9 % IV bolus
|
$38.40 |
$38.40 |
$38.40 |
$45.62
|
|
Sodium chloride 0.9 % IV bolus
|
$38.60 |
$38.60 |
$38.60 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$32.40 |
$32.40 |
$32.40 |
$40.61
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$45.40 |
$45.40 |
$45.40 |
$80.14
|
|
Sodium serum/plasma/whole blood
|
$33.00 |
$33.00 |
$33.00 |
$46.26
|
|
Speech and Language Evaluation (comprehensive)
|
$820.20 |
$820.20 |
$820.20 |
$384.80
|
|
Speech evaluation complex
|
$891.00 |
$891.00 |
$891.00 |
$527.06
|
|
Speech Therapy Session (one-on-one)
|
$536.40 |
$536.40 |
$536.40 |
$246.87
|
|
Spine X-ray (single view, one level)
|
$100.20 |
$100.20 |
$100.20 |
$251.00
|
|
Splint rstrc wrst/cmc right med
|
$128.40 |
$128.40 |
$128.40 |
$99.04
|
|
Stent bili dbl pgtl 10fx5cm
|
$808.20 |
$808.20 |
$808.20 |
$2,704.27
|
|
Stent bili rx wallflx 10x80 uncvr
|
$1,921.20 |
$1,921.20 |
$1,921.20 |
$20,962.50
|
|
Sterile water/saline, 10 ml
|
$4.20 |
$4.20 |
$4.20 |
$13.32
|
|
St evaluate speech sound production
|
$820.20 |
$820.20 |
$820.20 |
$292.95
|
