|
Shoe post-op mens m
|
$137.50 |
$214.00 |
$689.70 |
|
|
Shoe sole wedge between sole
|
$280.39 |
$280.39 |
$280.39 |
|
|
Shoe sole wedge outside sole
|
$201.27 |
$201.27 |
$201.27 |
|
|
Shoe wedge sach
|
$481.85 |
$481.85 |
$481.85 |
|
|
Sho heel count plast reinfor
|
$365.50 |
$365.50 |
$905.95 |
|
|
Sho insert w arch toe filler
|
$2,925.40 |
$2,925.40 |
$2,925.40 |
|
|
Sho lift taper to metatarsal
|
$294.82 |
$294.82 |
$294.82 |
|
|
Shorten radius or ulna
|
$28,846.21 |
$28,846.21 |
$28,846.21 |
|
|
Shot (Injection into Muscle or Under the Skin)
|
$21.00 |
$117.50 |
$436.00 |
|
|
Shoulder AC Joint X-ray (both sides)
|
$121.00 |
$293.50 |
$1,192.00 |
|
|
Shoulder Arthroscopy (Rotator Cuff Repair)
|
$22,860.17 |
$22,860.17 |
$34,575.13 |
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$147.00 |
$322.20 |
$563.00 |
|
|
Shoulder MRI (with and without contrast)
|
$1,598.00 |
$2,324.00 |
$4,409.00 |
|
|
Shoulder MRI (with contrast)
|
$928.00 |
$1,370.50 |
$4,705.50 |
|
|
Shoulder MRI (without contrast)
|
$809.00 |
$2,015.00 |
$4,319.50 |
|
|
Shoulder X-ray
|
$170.00 |
$308.50 |
$1,188.00 |
|
|
Shoulder X-ray (single view, both shoulders)
|
$126.50 |
$171.00 |
$535.50 |
|
|
Shrinker prosth above knee
|
$115.00 |
$181.50 |
$477.40 |
|
|
Shrinker prosth below knee
|
$96.00 |
$335.82 |
$1,025.00 |
|
|
Shrinker upper limb
|
$133.00 |
$133.00 |
$133.00 |
|
|
Shunt glaucoma baerveldt 350mm
|
$5,041.00 |
$5,332.00 |
$18,183.00 |
|
|
Shuntogram nonvascular supervision & interpretation
|
$255.00 |
$424.00 |
$766.50 |
|
|
Sialidase enzyme assay
|
$31.00 |
$54.00 |
$54.00 |
|
|
Sialography s&i
|
$164.00 |
$525.50 |
$1,587.00 |
|
|
Sialolithotomy 42330
|
$1,969.50 |
$2,723.50 |
$10,371.75 |
|
|
Sickling rbc
|
$58.50 |
$121.50 |
$237.50 |
|
|
Sigmoidoscopy and biopsy
|
$7,092.60 |
$7,092.60 |
$7,229.42 |
|
|
Sigmoidoscopy/submucosal injection 45335
|
$7,092.60 |
$7,092.60 |
$7,117.33 |
|
|
Sigmoidoscopy w/fb removal 45332
|
$6,157.05 |
$6,157.05 |
$6,157.05 |
|
|
Sigmoidoscopy w/tumr remove
|
$7,549.60 |
$7,549.60 |
$12,311.73 |
|
|
Sigmoidoscopy w/ultrasound
|
$6,522.85 |
$6,522.85 |
$6,522.85 |
|
|
Signal avg ecg w or without ecg 93278
|
$80.50 |
$149.50 |
$483.50 |
|
|
Simple cystometrogram 51725
|
$463.00 |
$640.00 |
$640.00 |
|
|
Sincalide 5 mcg solution for injection
|
$1,080.00 |
$1,080.00 |
$1,213.31 |
|
|
Sinus CT scan (with and without contrast)
|
$1,029.50 |
$1,456.50 |
$7,703.00 |
|
|
Sinus CT scan (with contrast)
|
$822.00 |
$1,357.80 |
$7,115.00 |
|
|
Sinus CT scan (without contrast)
|
$742.50 |
$1,268.40 |
$6,498.00 |
|
|
Sinus/juglr venogram s&i
|
$933.00 |
$1,613.50 |
$2,416.50 |
|
|
Sinus X-ray (complete)
|
$182.50 |
$489.00 |
$1,380.00 |
|
|
Sinus X-ray (limited)
|
$84.00 |
$217.00 |
$1,055.00 |
|
|
Sio flex pelvisacral custom
|
$1,511.01 |
$1,511.01 |
$1,511.01 |
|
|
Sio rig pnl pelv/sac pre ots
|
$1,000.51 |
$1,000.51 |
$1,000.51 |
|
|
Sipuleucel-t - su
|
$187,807.50 |
$187,807.50 |
$187,807.50 |
|
|
Sirolimus, oral
|
$19.17 |
$19.17 |
$19.17 |
|
|
Skin Biopsy
|
$200.50 |
$277.00 |
$324.00 |
|
|
Skin full graft add-on 15241
|
$286.50 |
$389.00 |
$389.00 |
|
|
Skin split graft addl 100sq cm 15101
|
$1,246.00 |
$1,723.00 |
$1,723.00 |
|
|
Skull X-ray (1 to 3 views)
|
$110.00 |
$324.60 |
$1,229.00 |
|
|
Skull X-ray (complete)
|
$165.50 |
$496.50 |
$1,506.00 |
|
|
Skyla, 13.5 mg
|
$3,884.00 |
$3,884.00 |
$3,884.00 |
|
|
Sleep study attended
|
$907.00 |
$1,254.50 |
$5,916.00 |
|
|
Sleep Study (Polysomnography)
|
$1,901.00 |
$2,628.50 |
$4,699.00 |
|
|
Sleep study unattended
|
$680.00 |
$985.00 |
$1,615.00 |
|
|
Sleeve fing rolyan med
|
$127.00 |
$133.00 |
$1,097.81 |
|
|
Sling pelv split sam med
|
$176.50 |
$176.50 |
$487.43 |
|
|
Sling suprapubic suburetheral
|
$11,481.50 |
$15,295.50 |
$42,631.49 |
|
|
Slitting of prepuce
|
$1,751.00 |
$2,421.00 |
$11,286.71 |
|
|
Slp eval non-spch gen comm dev
|
$494.00 |
$494.00 |
$494.00 |
|
|
Slp pure tone screening
|
$22.00 |
$51.00 |
$316.00 |
|
|
Slp ther svc non-spch gen
|
$91.00 |
$123.00 |
$475.50 |
|
|
Sm-153 lexidron ther
|
$20,875.00 |
$20,875.00 |
$20,875.00 |
|
|
Small Bowel Barium X-ray (Follow-Through)
|
$304.50 |
$550.20 |
$2,106.00 |
|
|
Small bowel endoscopy
|
$2,466.75 |
$2,466.75 |
$2,466.75 |
|
|
Small bowel endoscopy br/wa
|
$8,133.02 |
$8,133.02 |
$8,133.02 |
|
|
Smear fluorescent and/or acid fast stain
|
$78.60 |
$145.00 |
$164.00 |
|
|
Smear gram stain
|
$37.00 |
$77.50 |
$235.50 |
|
|
Smear nasal eosinophil
|
$65.40 |
$156.00 |
$156.00 |
|
|
Smear special stain inclusion bodies/parasites
|
$36.00 |
$178.00 |
$402.50 |
|
|
Smear wet mount
|
$67.80 |
$135.50 |
$147.50 |
|
|
So airplane w/wo joint cf
|
$1,361.50 |
$2,350.00 |
$6,081.52 |
|
|
So cap design without jnts cf
|
$1,778.50 |
$1,778.50 |
$4,635.91 |
|
|
Socket insert without lock mech
|
$1,092.50 |
$1,092.50 |
$3,072.74 |
|
|
Socket insert w lock mech
|
$881.50 |
$1,654.00 |
$1,968.50 |
|
|
Sock fracture or equal each
|
$171.92 |
$171.92 |
$171.92 |
|
|
Sodium 24 hour urine
|
$21.00 |
$58.20 |
$139.00 |
|
|
Sodium chloride 0.9 % intravenous solution
|
$105.00 |
$121.55 |
$306.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$105.00 |
$121.55 |
$306.00 |
|
|
Sodium chloride 0.9 % IV bolus
|
$106.95 |
$106.95 |
$124.20 |
|
|
Sodium chloride 3 % ivpb
|
$127.97 |
$143.22 |
$397.00 |
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$264.26 |
$295.74 |
$355.00 |
|
|
Sodium serum/plasma/whole blood
|
$26.00 |
$45.60 |
$107.00 |
|
|
Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution
|
$45.00 |
$45.00 |
$45.00 |
|
|
Soft interface below knee se
|
$132.00 |
$205.00 |
$427.87 |
|
|
Solid skin barrier
|
$21.00 |
$21.00 |
$21.00 |
|
|
So neo gsap dna/dna&rna
|
$4,484.40 |
$4,484.40 |
$4,484.40 |
|
|
So vest canvas/web pre ots
|
$903.07 |
$903.07 |
$903.07 |
|
|
Sp bone algrft morsel add-on
|
$57,906.53 |
$57,906.53 |
$57,906.53 |
|
|
Special physics consult
|
$1,007.50 |
$1,470.00 |
$1,783.00 |
|
|
Special radiation dosimetry
|
$345.00 |
$446.00 |
$649.50 |
|
|
Special radiation treatment
|
$270.00 |
$2,058.00 |
$3,035.50 |
|
|
Special teletx port plan
|
$852.00 |
$1,100.00 |
$1,661.00 |
|
|
Specific gravity body fluid
|
$139.00 |
$139.00 |
$139.00 |
|
|
Specimen fat stain
|
$41.50 |
$51.00 |
$69.60 |
|
|
Speech and Language Evaluation (comprehensive)
|
$145.00 |
$252.50 |
$373.50 |
|
|
Speech audiometry complete
|
$82.50 |
$82.50 |
$82.50 |
|
|
Speech recep thresh
|
$66.50 |
$66.50 |
$66.50 |
|
|
Speech Therapy Session (one-on-one)
|
$153.50 |
$202.50 |
$267.50 |
|
|
Spinal bone allograftstructural 20931
|
$47,489.02 |
$47,489.02 |
$47,489.02 |
|
|
Spinal bone autograftlocal 20936
|
$101,759.35 |
$101,759.35 |
$101,759.35 |
|
|
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance
|
$691.50 |
$855.50 |
$3,135.00 |
|