|
Rubella antibody igg
|
$157.60 |
$157.60 |
$157.60 |
$77.50
|
|
Rubeola antibody igg
|
$265.60 |
$265.60 |
$265.60 |
$80.00
|
|
Russell viper venom diluted
|
$751.20 |
$751.20 |
$751.20 |
$73.03
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$67.20 |
$67.20 |
$67.20 |
$5,174.32
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$480.80 |
$480.80 |
$480.80 |
$314.79
|
|
Salivary glnd img serial img
|
$1,960.80 |
$1,960.80 |
$1,960.80 |
$701.73
|
|
Sarscov coronavirus ag ia
|
$46.40 |
$46.40 |
$46.40 |
$60.40
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,002.40 |
$1,002.40 |
$1,002.40 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$1,192.80 |
$1,192.80 |
$1,192.80 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$595.35
|
|
Scr c/v cyto,thinlayer,rescr
|
$104.00 |
$104.00 |
$104.00 |
$85.15
|
|
Screen cerv/vag thin layer
|
$81.60 |
$81.60 |
$81.60 |
$86.56
|
|
Screening Colonoscopy (high risk)
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$2,000.00
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$292.00 |
$292.00 |
$292.00 |
$57.60
|
|
Screening hepatitis b non-obstetric high risk
|
$172.00 |
$172.00 |
$172.00 |
$60.00
|
|
Screening hepatitis c antibody high risk
|
$251.20 |
$251.20 |
$251.20 |
$93.60
|
|
Screening Mammogram
|
$273.60 |
$273.60 |
$273.60 |
$310.20
|
|
Screening prostate cancer PSA
|
$120.00 |
$120.00 |
$120.00 |
$101.60
|
|
Screw cortex 2.0 x 10mm
|
$9,627.20 |
$9,627.20 |
$9,627.20 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$781.60 |
$781.60 |
$781.60 |
$608.90
|
|
Sedimentation rate erythrocyte automated
|
$69.60 |
$69.60 |
$69.60 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$157.60 |
$157.60 |
$157.60 |
$96.60
|
|
Semen analysis presence/motility
|
$143.20 |
$143.20 |
$143.20 |
$70.40
|
|
Semen analysis w/count
|
$213.60 |
$213.60 |
$213.60 |
$56.44
|
|
Serpina1 gene
|
$351.20 |
$351.20 |
$351.20 |
$197.00
|
|
Sgmdsc w/band ligation
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$2,288.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.5cm/<
|
$83.40 |
$83.40 |
$83.40 |
$284.00
|
|
Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$284.88
|
|
Shave sgl skin lsn s/n/h/f/g 0.5cm/<
|
$494.40 |
$494.40 |
$494.40 |
$235.13
|
|
Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm
|
$494.40 |
$494.40 |
$494.40 |
$223.00
|
|
Shave sgl skin lsn t/a/l 0.5cm/<
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$311.40
|
|
Shave sgl skin lsn t/a/l 0.6-1.0cm
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$234.00
|
|
Shave sgl skin lsn t/a/l 1.1-2.0cm
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$286.89
|
|
Shoe post-op mens m
|
$75.60 |
$75.60 |
$75.60 |
$53.20
|
|
Shot (Injection into Muscle or Under the Skin)
|
$147.00 |
$147.00 |
$147.00 |
$136.80
|
|
Shoulder AC Joint X-ray (both sides)
|
$480.80 |
$480.80 |
$480.80 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$368.00 |
$368.00 |
$368.00 |
$287.25
|
|
Shoulder MRI (with and without contrast)
|
$4,850.40 |
$4,850.40 |
$4,850.40 |
$2,821.65
|
|
Shoulder MRI (with contrast)
|
$3,689.60 |
$3,689.60 |
$3,689.60 |
$2,483.00
|
|
Shoulder MRI (without contrast)
|
$3,040.00 |
$3,040.00 |
$3,040.00 |
$2,088.20
|
|
Shoulder X-ray
|
$372.00 |
$372.00 |
$372.00 |
$341.40
|
|
Shoulder X-ray (single view, both shoulders)
|
$704.80 |
$704.80 |
$704.80 |
$264.00
|
|
Shunt glaucoma baerveldt 350mm
|
$6,739.20 |
$6,739.20 |
$6,739.20 |
$4,538.82
|
|
Sialography s&i
|
$1,552.00 |
$1,552.00 |
$1,552.00 |
$499.20
|
|
Sickling rbc
|
$98.40 |
$98.40 |
$98.40 |
$59.40
|
|
Sigmoidoscopy and biopsy
|
$3,816.80 |
$3,816.80 |
$3,816.80 |
$1,446.90
|
|
Sigmoidoscopy flex decompression 45337
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$1,078.88
|
|
Sigmoidoscopy for bleeding
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$1,993.08
|
|
Sigmoidoscopy w/ablation
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$1,395.28
|
|
Sigmoidoscopy w/plcmt stent
|
$7,896.80 |
$7,896.80 |
$7,896.80 |
$3,692.00
|
|
Sigmoidoscopy w/tumr remove
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$1,645.43
|
|
Sigmoidoscopy w/ultrasound
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$1,740.57
|
|
Sigmoidoscopy w/us guide bx
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$2,288.00
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$3,816.80 |
$3,816.80 |
$3,816.80 |
$1,976.25
|
|
Signal avg ecg w or without ecg 93278
|
$536.00 |
$536.00 |
$536.00 |
$280.00
|
|
Sig w/tndsc balloon dilation
|
$3,933.60 |
$3,933.60 |
$3,933.60 |
$2,288.00
|
|
Simple cystometrogram 51725
|
$4,291.20 |
$4,291.20 |
$4,291.20 |
$589.45
|
|
Sincalide 5 mcg solution for injection
|
$516.00 |
$516.00 |
$516.00 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$3,280.80 |
$3,280.80 |
$3,280.80 |
$1,796.50
|
|
Sinus CT scan (with contrast)
|
$2,612.80 |
$2,612.80 |
$2,612.80 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,924.00 |
$1,924.00 |
$1,924.00 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$542.40 |
$542.40 |
$542.40 |
$347.10
|
|
Sinus X-ray (limited)
|
$385.60 |
$385.60 |
$385.60 |
$215.75
|
|
Sirolimus, oral
|
$180.00 |
$180.00 |
$180.00 |
$41.70
|
|
Skin Biopsy
|
$362.40 |
$362.40 |
$362.40 |
$361.20
|
|
Skull X-ray (1 to 3 views)
|
$440.00 |
$440.00 |
$440.00 |
$294.66
|
|
Skull X-ray (complete)
|
$532.80 |
$532.80 |
$532.80 |
$423.15
|
|
Skyla, 13.5 mg
|
$2,325.00 |
$2,325.00 |
$2,325.00 |
$1,643.47
|
|
Sleep study attended
|
$6,004.00 |
$6,004.00 |
$6,004.00 |
$1,329.00
|
|
Sleep Study (Polysomnography)
|
$6,611.20 |
$6,611.20 |
$6,611.20 |
$3,734.50
|
|
Sleep study unattended
|
$653.60 |
$653.60 |
$653.60 |
$594.00
|
|
Sling arm deluxe w/pad xs
|
$244.00 |
$244.00 |
$244.00 |
$30.35
|
|
Sling suprapubic suburetheral
|
$4,885.60 |
$4,885.60 |
$4,885.60 |
$9,679.96
|
|
Slitting of prepuce
|
$4,708.80 |
$4,708.80 |
$4,708.80 |
$3,376.23
|
|
Slp eval non-spch gen comm dev
|
$375.20 |
$375.20 |
$375.20 |
$285.09
|
|
Slp pure tone screening
|
$22.80 |
$22.80 |
$22.80 |
$64.50
|
|
Sm-153 lexidron ther
|
$15,008.80 |
$15,008.80 |
$15,008.80 |
$7,320.12
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$809.60 |
$809.60 |
$809.60 |
$557.70
|
|
Small bowel endoscopy
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,596.41
|
|
Small bowel endoscopy
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,244.82
|
|
Small bowel endoscopy
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,638.57
|
|
Small bowel endoscopy
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,518.10
|
|
Small bowel endoscopy
|
$4,264.00 |
$4,264.00 |
$4,264.00 |
$2,088.00
|
|
Small bowel endoscopy >2nd w/remove 44363
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,590.33
|
|
Small bowel endoscopy br/wa
|
$4,264.00 |
$4,264.00 |
$4,264.00 |
$1,924.00
|
|
Small bowel endoscopy br/wa
|
$4,128.80 |
$4,128.80 |
$4,128.80 |
$2,406.40
|
|
Small bowel endoscopy/stent 44370
|
$7,896.80 |
$7,896.80 |
$7,896.80 |
$4,992.00
|
|
Smear fluorescent and/or acid fast stain
|
$111.20 |
$111.20 |
$111.20 |
$64.20
|
|
Smear gram stain
|
$111.20 |
$111.20 |
$111.20 |
$55.42
|
|
Smear nasal eosinophil
|
$122.40 |
$122.40 |
$122.40 |
$46.20
|
|
Smear special stain inclusion bodies/parasites
|
$235.20 |
$235.20 |
$235.20 |
$73.15
|
|
Smear wet mount
|
$135.20 |
$135.20 |
$135.20 |
$67.49
|
|
Sodium 24 hour urine
|
$74.20 |
$74.20 |
$74.20 |
$48.75
|
|
Sodium chloride 0.9 % intravenous solution
|
$26.00 |
$26.00 |
$26.00 |
$48.58
|
|
Sodium chloride 0.9 % IV bolus
|
$22.20 |
$22.20 |
$22.20 |
$45.56
|
|
Sodium chloride 0.9 % IV bolus
|
$32.40 |
$32.40 |
$32.40 |
$37.64
|
|
Sodium chloride 3 % ivpb
|
$26.40 |
$26.40 |
$26.40 |
$39.60
|
