|
Smear wet mount
|
$24.00 |
$43.20 |
$165.00 |
|
|
Smn1 gene full gene sequence
|
$207.92 |
$207.92 |
$235.04 |
|
|
Smn1 gen nown famil seq vrnt
|
$127.88 |
$127.88 |
$144.56 |
|
|
Smpd1 gene common variants
|
$32.66 |
$1,189.20 |
$1,260.60 |
|
|
Snrpn/ube3a gene
|
$143.56 |
$143.56 |
$681.00 |
|
|
Sodium 24 hour urine
|
$10.50 |
$33.88 |
$508.20 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$7.20 |
$43.40 |
$120.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$3.22 |
$38.40 |
$268.80 |
|
|
Sodium chloride 0.9 % IV bolus
|
$8.40 |
$52.20 |
$121.60 |
|
|
Sodium chloride 3 % ivpb
|
$0.60 |
$22.80 |
$90.80 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$3.60 |
$61.20 |
$539.40 |
|
|
Sodium hyaluronate 20 mg/2 ml syringe
|
$197.40 |
$1,648.80 |
$2,860.80 |
|
|
Sodium serum/plasma/whole blood
|
$10.50 |
$32.40 |
$215.40 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$316.80 |
$1,007.60 |
$1,007.60 |
|
|
Solid skin barrier
|
$7.80 |
$7.80 |
$7.80 |
|
|
Solid skin barrier 6x6
|
$17.40 |
$17.40 |
$17.40 |
|
|
Somatosensory testing
|
$17.25 |
$583.80 |
$1,094.46 |
|
|
Somatropin injection
|
$1,512.00 |
$2,111.40 |
$2,557.80 |
|
|
So neo gsap dna/dna&rna
|
$4,153.80 |
$8,406.40 |
$8,747.20 |
|
|
Spacer bag/reservoir
|
$153.60 |
$189.60 |
$587.20 |
|
|
Sp bone agrft morsel add-on
|
$107.64 |
$121.68 |
$2,306.19 |
|
|
Sp bone agrft struct add-on
|
$117.76 |
$133.12 |
$249.60 |
|
|
Sp bone algrft morsel add-on
|
$56.12 |
$63.44 |
$4,162.38 |
|
|
Special casting material
|
$193.80 |
$193.80 |
$286.20 |
|
|
Special physics consult
|
$259.50 |
$833.40 |
$1,786.40 |
|
|
Special radiation dosimetry
|
$29.90 |
$739.80 |
$1,407.20 |
|
|
Special radiation treatment
|
$1,078.50 |
$2,055.00 |
$4,554.00 |
|
|
Special supplies phys/qhp
|
$4.14 |
$55.20 |
$648.60 |
|
|
Special teletx port plan
|
$32.43 |
$1,035.60 |
$2,329.60 |
|
|
Specific gravity body fluid
|
$12.00 |
$22.33 |
$209.40 |
|
|
Specimen fat stain
|
$4.14 |
$4.68 |
$357.00 |
|
|
Speech and Language Evaluation (comprehensive)
|
$225.00 |
$404.40 |
$865.20 |
|
|
Speech audiometry complete
|
$40.00 |
$122.40 |
$207.00 |
|
|
Speech evaluation complex
|
$26.91 |
$547.80 |
$1,349.40 |
|
|
Speech recep thresh
|
$40.00 |
$97.20 |
$99.20 |
|
|
Speech Therapy Session (one-on-one)
|
$69.60 |
$253.20 |
$536.40 |
|
|
Sperm antibody test
|
$8.32 |
$73.80 |
$291.60 |
|
|
Sperm evaluation test
|
$13.34 |
$13.34 |
$15.08 |
|
|
Sperm identification
|
$83.95 |
$83.95 |
$94.90 |
|
|
Sperm isolation complex
|
$39.56 |
$39.56 |
$44.72 |
|
|
Sperm isolation simple
|
$25.30 |
$25.30 |
$28.60 |
|
|
Sperm washing 58323
|
$7.82 |
$7.82 |
$8.84 |
|
|
Sphenoid sinus surgery
|
$439.76 |
$497.12 |
$1,141.80 |
|
|
Sphincteroplasty inc/prolapse adult 46750
|
$483.00 |
$483.00 |
$546.00 |
|
|
Spinal bone allograftstructural 20931
|
$71.30 |
$80.60 |
$3,555.49 |
|
|
Spinal bone autograftlocal 20936
|
$59.80 |
$67.60 |
$3,555.49 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$126.00 |
$1,439.40 |
$2,461.20 |
|
|
Spine X-ray (single view, one level)
|
$88.00 |
$269.60 |
$686.40 |
|
|
Spirmtry w/brnchdil inf-2 yr
|
$88.32 |
$88.32 |
$99.84 |
|
|
Spirometry up to 2 yrs old
|
$54.28 |
$54.28 |
$61.36 |
|
|
Spleen imaging
|
$10.58 |
$1,228.80 |
$1,228.80 |
|
|
Splenectomy total open 38100
|
$743.13 |
$743.13 |
$840.06 |
|
|
Splice spleen/kidney veins
|
$1,494.31 |
$1,494.31 |
$1,689.22 |
|
|
Splicing of ureters
|
$742.44 |
$742.44 |
$839.28 |
|
|
Splint dorsal bloc wh med perf 3.2mm lf polyflex ii
|
$147.20 |
$552.80 |
$4,211.40 |
|
|
Splint extn xsm w sof-stretch rolyan
|
$64.50 |
$108.00 |
$478.80 |
|
|
Splint finger 4 prong foam sm
|
$2.40 |
$222.60 |
$4,609.20 |
|
|
Splint finger frog med
|
$79.20 |
$79.20 |
$79.20 |
|
|
Splint fing stax assort 1-7in
|
$10.20 |
$15.00 |
$24.80 |
|
|
Splint func pos polyflex ii med
|
$13.60 |
$116.40 |
$1,043.40 |
|
|
Splint rstrc wrst/cmc right med
|
$49.80 |
$128.40 |
$346.20 |
|
|
Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 %
|
$445.74 |
$1,369.20 |
$5,983.20 |
|
|
Split blood or products
|
$71.40 |
$284.40 |
$1,128.05 |
|
|
Splt agrft f/s/n/h/f/g/m ea
|
$83.95 |
$2,538.00 |
$2,538.00 |
|
|
Sprchoroidal spc njx rx agt
|
$415.50 |
$415.50 |
$415.50 |
|
|
Sputum specimen collection
|
$65.40 |
$1,087.80 |
$1,087.80 |
|
|
Sr-89 stront chlor ther / mci
|
$2,293.20 |
$5,445.60 |
$5,445.60 |
|
|
Srs cranial lesion complex
|
$901.60 |
$901.60 |
$1,019.20 |
|
|
Srs cranial lesion simple
|
$667.46 |
$754.52 |
$11,250.60 |
|
|
Srs cran les complex addl
|
$195.04 |
$195.04 |
$220.48 |
|
|
Srs cran les simple addl
|
$141.45 |
$141.45 |
$159.90 |
|
|
Srs linear based
|
$2,193.60 |
$12,437.40 |
$19,575.60 |
|
|
Srs multisource
|
$30,975.00 |
$30,975.00 |
$33,912.60 |
|
|
Srs spinal lesion
|
$737.15 |
$737.15 |
$833.30 |
|
|
Srs spinal lesion addl
|
$162.61 |
$162.61 |
$183.82 |
|
|
St analysis behavior qualitative voice/resonance
|
$216.00 |
$383.20 |
$508.80 |
|
|
Staph a dna amp probe
|
$24.38 |
$143.20 |
$175.20 |
|
|
St cognitve performance testing healthcare professional each hour
|
$270.40 |
$444.00 |
$982.20 |
|
|
Stem cells total count
|
$53.82 |
$60.84 |
$1,216.20 |
|
|
Stenger test pure tone
|
$89.60 |
$89.60 |
$89.60 |
|
|
Stent/athrectomy/fem/pop/unilat 37227
|
$15,054.60 |
$52,541.72 |
$108,697.20 |
|
|
Stent axios caut enh 15x10mm electrocaut
|
$1,053.75 |
$12,508.65 |
$58,726.80 |
|
|
Stent bili dbl pgtl 10fx5cm
|
$75.60 |
$564.00 |
$3,092.40 |
|
|
Stent bili rx wallflx 10x80 uncvr
|
$971.75 |
$6,966.60 |
$46,683.00 |
|
|
Stent bronch dumon sil 10x40mm
|
$5,596.20 |
$10,323.00 |
$22,262.40 |
|
|
Stent iliac/open or perc/uni/init 37221
|
$6,580.00 |
$17,448.00 |
$35,121.00 |
|
|
Stent iliac/open/perc/ea ad/ipsila 37223
|
$3,688.80 |
$10,869.00 |
$24,887.17 |
|
|
Stent placemt retro carotid
|
$685.40 |
$685.40 |
$774.80 |
|
|
Stent/tib/peroneal/unilat/initial 37230
|
$24,161.40 |
$31,604.40 |
$52,541.72 |
|
|
Stereoscopic x-ray guidance
|
$13.34 |
$15.08 |
$48.60 |
|
|
Stereotactic bx aspir/exc burr intracranial les 61750
|
$921.15 |
$921.15 |
$1,041.30 |
|
|
Stereotactic radiation trmt
|
$277.15 |
$277.15 |
$313.30 |
|
|
Sterile gauze <= 16 sq in
|
$0.60 |
$1.20 |
$12.00 |
|
|
Sterile needle
|
$8.40 |
$367.80 |
$6,580.20 |
|
|
Sterile water/saline, 10 ml
|
$2.80 |
$35.55 |
$53.00 |
|
|
Sterile water/saline, 500 ml
|
$3.60 |
$25.20 |
$70.80 |
|
|
Sternal debridement
|
$354.66 |
$354.66 |
$400.92 |
|
|
St evaluate speech sound production
|
$205.80 |
$380.00 |
$820.20 |
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$235.50 |
$429.60 |
$827.40 |
|
|
Stimulation of spinal cord
|
$376.28 |
$376.28 |
$425.36 |
|
