|
Salmonella antibody
|
$18.50 |
$18.50 |
$18.50 |
$37.58
|
|
Sarscov2 vac 5mcg/0.5ml im
|
$105.00 |
$105.00 |
$105.00 |
$222.30
|
|
Sarscov coronavirus ag ia
|
$100.00 |
$100.00 |
$100.00 |
$59.25
|
|
Sarscov & inf vir a&b ag ia
|
$126.00 |
$126.00 |
$126.00 |
$104.00
|
|
Sbsq psyc collab care mgmt
|
$95.00 |
$95.00 |
$95.00 |
$109.46
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$567.50 |
$567.50 |
$567.50 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$279.50 |
$279.50 |
$279.50 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$567.50 |
$567.50 |
$567.50 |
$750.20
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$279.50 |
$279.50 |
$279.50 |
$497.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$715.50 |
$715.50 |
$715.50 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$274.00 |
$274.00 |
$274.00 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$567.50 |
$567.50 |
$567.50 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$275.00 |
$275.00 |
$275.00 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$273.50 |
$273.50 |
$273.50 |
$595.35
|
|
Scan proc cranial extra
|
$839.25 |
$839.25 |
$839.25 |
$2,366.00
|
|
Scan proc spinal
|
$5,062.50 |
$5,062.50 |
$5,062.50 |
$2,544.58
|
|
Scope uretscp lithovue dig disp
|
$4,270.00 |
$4,270.00 |
$4,270.00 |
$4,490.64
|
|
Scr c/v cyto,thinlayer,rescr
|
$140.50 |
$140.50 |
$140.50 |
$85.15
|
|
Screen cerv/vag thin layer
|
$50.50 |
$50.50 |
$50.50 |
$84.60
|
|
Screening Colonoscopy (average risk)
|
$544.50 |
$544.50 |
$544.50 |
$1,792.00
|
|
Screening Colonoscopy (high risk)
|
$1,447.50 |
$1,447.50 |
$1,447.50 |
$1,951.46
|
|
Screening HIV antigen/antibody combination assay
|
$91.00 |
$91.00 |
$91.00 |
$42.30
|
|
Screening Mammogram
|
$272.50 |
$272.50 |
$272.50 |
$312.55
|
|
Screening prostate cancer PSA
|
$122.50 |
$122.50 |
$122.50 |
$100.63
|
|
Screen/visual acuity/bilat/quant 99173
|
$23.00 |
$23.00 |
$23.00 |
$28.86
|
|
Screw cortex 2.0 x 10mm
|
$1,387.20 |
$1,387.20 |
$1,387.20 |
$29,055.00
|
|
Sec art mech thrmbc non-intracranial add-on
|
$976.50 |
$976.50 |
$976.50 |
$4,377.50
|
|
Sedimentation rate erythrocyte automated
|
$18.50 |
$18.50 |
$18.50 |
$42.00
|
|
Semen analysis presence/motility
|
$103.00 |
$103.00 |
$103.00 |
$71.05
|
|
Sept9 promoter methylation analysis
|
$531.50 |
$531.50 |
$531.50 |
$316.68
|
|
Serpina1 gene
|
$246.88 |
$246.88 |
$246.88 |
$197.00
|
|
Set radiation therapy field
|
$315.50 |
$315.50 |
$315.50 |
$762.40
|
|
Set radiation therapy field
|
$674.00 |
$674.00 |
$674.00 |
$1,157.38
|
|
Set radiation therapy field
|
$674.00 |
$674.00 |
$674.00 |
$1,636.36
|
|
Sevelamer carbonate 800 mg tablet
|
$1.84 |
$1.84 |
$1.84 |
$7.14
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$356.83 |
$356.83 |
$356.83 |
$284.00
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$265.50 |
$265.50 |
$265.50 |
$235.13
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$612.75 |
$612.75 |
$612.75 |
$235.13
|
|
Sho arthrs srg bicp tenodsis
|
$2,712.00 |
$2,712.00 |
$2,712.00 |
$4,950.40
|
|
Sho arthrs srg capsulorraphy
|
$4,937.00 |
$4,937.00 |
$4,937.00 |
$6,311.00
|
|
Sho arthrs srg lmtd dbrdmt
|
$1,816.67 |
$1,816.67 |
$1,816.67 |
$4,521.67
|
|
Sho arthrs srg lss&rescj ads
|
$2,879.67 |
$2,879.67 |
$2,879.67 |
$3,839.54
|
|
Sho arthrs srg rpr slap les
|
$2,527.50 |
$2,527.50 |
$2,527.50 |
$6,311.00
|
|
Sho arthrs srg xtnsv dbrdmt
|
$5,354.67 |
$5,354.67 |
$5,354.67 |
$5,148.00
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$17,212.00 |
$17,212.00 |
$17,212.00 |
$7,807.24
|
|
Shoulder MRI (with and without contrast)
|
$1,267.50 |
$1,267.50 |
$1,267.50 |
$2,713.80
|
|
Shoulder MRI (with contrast)
|
$1,194.50 |
$1,194.50 |
$1,194.50 |
$2,448.60
|
|
Shoulder MRI (without contrast)
|
$1,244.50 |
$1,244.50 |
$1,244.50 |
$2,065.05
|
|
Shoulder X-ray
|
$176.00 |
$176.00 |
$176.00 |
$339.50
|
|
Sialolithotomy 42330
|
$1,244.00 |
$1,244.00 |
$1,244.00 |
$3,837.72
|
|
Sickling rbc
|
$124.00 |
$124.00 |
$124.00 |
$57.92
|
|
Sigmoidoscopy and biopsy
|
$292.50 |
$292.50 |
$292.50 |
$1,351.63
|
|
Sigmoidoscopy for bleeding
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$1,890.00
|
|
Simple cystometrogram 51725
|
$420.00 |
$420.00 |
$420.00 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$280.50 |
$280.50 |
$280.50 |
$307.58
|
|
Sinus CT scan (with and without contrast)
|
$402.00 |
$402.00 |
$402.00 |
$1,790.00
|
|
Sinus CT scan (with contrast)
|
$322.50 |
$322.50 |
$322.50 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$269.50 |
$269.50 |
$269.50 |
$1,292.04
|
|
Sinus/juglr venogram s&i
|
$2,669.50 |
$2,669.50 |
$2,669.50 |
$2,489.25
|
|
Skel musc relaxant 3 or more
|
$5.00 |
$5.00 |
$5.00 |
$16.12
|
|
Skin Biopsy
|
$598.00 |
$598.00 |
$598.00 |
$360.34
|
|
Skin full graft 20sq cm less 15200
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,371.50
|
|
Skyla, 13.5 mg
|
$2,276.00 |
$2,276.00 |
$2,276.00 |
$1,643.47
|
|
Sleep study attended
|
$874.00 |
$874.00 |
$874.00 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$3,598.50 |
$3,598.50 |
$3,598.50 |
$3,607.50
|
|
Sleep study unattended
|
$680.00 |
$680.00 |
$680.00 |
$580.87
|
|
Sling suprapubic suburetheral
|
$1,302.38 |
$1,302.38 |
$1,302.38 |
$9,679.96
|
|
Slp eval non-spch gen comm dev
|
$242.50 |
$242.50 |
$242.50 |
$285.09
|
|
Slp stdy unatnd w/anal
|
$680.00 |
$680.00 |
$680.00 |
$296.34
|
|
Sm-153 lexidron ther
|
$9,432.50 |
$9,432.50 |
$9,432.50 |
$7,320.12
|
|
Small bowel endoscopy
|
$313.50 |
$313.50 |
$313.50 |
$2,463.36
|
|
Small bowel endoscopy
|
$279.00 |
$279.00 |
$279.00 |
$2,244.82
|
|
Small bowel endoscopy
|
$524.00 |
$524.00 |
$524.00 |
$2,638.57
|
|
Small bowel endoscopy/biopsy
|
$607.50 |
$607.50 |
$607.50 |
$2,413.20
|
|
Smear fluorescent and/or acid fast stain
|
$39.00 |
$39.00 |
$39.00 |
$64.20
|
|
Smear gram stain
|
$33.00 |
$33.00 |
$33.00 |
$55.25
|
|
Smear nasal eosinophil
|
$13.50 |
$13.50 |
$13.50 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$119.00 |
$119.00 |
$119.00 |
$73.15
|
|
Smear wet mount
|
$25.00 |
$25.00 |
$25.00 |
$67.49
|
|
Sodium 24 hour urine
|
$10.50 |
$10.50 |
$10.50 |
$48.60
|
|
Sodium chloride 0.9 % intravenous solution
|
$120.00 |
$120.00 |
$120.00 |
$48.11
|
|
Sodium chloride 0.9 % IV bolus
|
$76.50 |
$76.50 |
$76.50 |
$46.00
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$72.09 |
$72.09 |
$72.09 |
$77.77
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$541.00 |
$541.00 |
$541.00 |
$410.40
|
|
Sodium serum/plasma/whole blood
|
$10.50 |
$10.50 |
$10.50 |
$45.60
|
|
Sp bone agrft morsel add-on
|
$2,306.19 |
$2,306.19 |
$2,306.19 |
$406.40
|
|
Sp bone algrft morsel add-on
|
$4,162.38 |
$4,162.38 |
$4,162.38 |
$498.55
|
|
Special physics consult
|
$259.50 |
$259.50 |
$259.50 |
$725.00
|
|
Special radiation dosimetry
|
$252.50 |
$252.50 |
$252.50 |
$392.50
|
|
Special radiation treatment
|
$1,078.50 |
$1,078.50 |
$1,078.50 |
$1,986.00
|
|
Special supplies phys/qhp
|
$384.50 |
$384.50 |
$384.50 |
$60.00
|
|
Specific gravity body fluid
|
$16.00 |
$16.00 |
$16.00 |
$22.00
|
|
Speech audiometry complete
|
$40.00 |
$40.00 |
$40.00 |
$109.20
|
|
Speech recep thresh
|
$40.00 |
$40.00 |
$40.00 |
$82.88
|
|
Spinal bone allograftstructural 20931
|
$3,555.49 |
$3,555.49 |
$3,555.49 |
$266.40
|
|
Spinal bone autograftlocal 20936
|
$3,555.49 |
$3,555.49 |
$3,555.49 |
$424.20
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$681.00 |
$681.00 |
$681.00 |
$1,439.40
|
|
Spirometry bronchodilation responsiveness pre/post bronchodilator administration
|
$315.50 |
$315.50 |
$315.50 |
$543.26
|
|
Splint extn xsm w sof-stretch rolyan
|
$64.50 |
$64.50 |
$64.50 |
$68.25
|
|
Split blood or products
|
$185.00 |
$185.00 |
$185.00 |
$127.48
|
